A 44-year-old patient presents with acute, unilateral ocular pain, a cloudy cornea, a mature cataract, a milky substance in the anterior chamber, and an intraocular pressure of 45 mm Hg. He gives a vague history of ocular trauma to the eye. Which of the following is true?
he is at a high-risk for cataract surgery.
he should be treated conservatively until the intraocular pressure normalizes, perhaps in a week.
one suspects a traumatic ruptured lens capsule.
he should have cataract surgery on an urgent basis.
Answer. D. he should have cataract surgery on an urgent basis.
Explanation: The signs and symptoms are highly suggestive of phacolytic glaucoma. Keratic precipitates are rare in this condition. Cataract surgery, using routine phacoemulsification and in-the-bag IOL on an urgent basis is the best course of therapy.