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Clinical history
Blind eye with elevated intraocular pressure
Diagnosis
Phacomorphic glaucoma. Note the large, globoid lens with mature cataractous changes including eosinophilic, “Morgagnian” globules, which is pushing the iris forward and markedly shallowing the anterior chamber. There are focal peripheral anterior synechiae, but the angle remains partially open. There is also atopic atrophy (the optic nerve is hypercellular with thickened pial septae). Bullous keratopathy and calcium deposition (band keratopathy) are also present. Also note the changes consistent with prior retinal detachment and repair (extensive, multifocal chorioretinal scarring with gliosis and disorganization of the retina and a scleral encircling band).
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