What is the pathophysiology of glaucoma caused by intraocular tumors?

Updated: Jun 25, 2020
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

There are a number of different mechanisms by which ocular tumors can cause glaucoma: (1) direct invasion, (2) pigment dispersion, (3) melanophagic, (4) hemolytic, (5) uveitic, (6) secondary angle closure, (7) iris neovascularization, (8) choroidal detachment, (9) suprachoroidal hemorrhage, and (10) anterior displacement of lens-iris diaphragm.

Mechanisms of elevated intraocular pressure in intraocular malignant melanoma, which is the most common intraocular tumor causing secondary glaucoma, include the following:

Melanoma arising within the iris

  • Direct growth of the tumor into the angle

  • Tumor seeding into the angle

  • Pigment release into the anterior chamber and into the angle

Melanoma arising within the ciliary body

  • Pigment dispersion

  • Direct invasion

Melanoma arising within the choroid

  • Neovascularization of the angle

  • Anterior displacement of lens-iris diaphragm with angle closure

  • Hemorrhage with volume effect or angle closure

  • Spontaneous necrosis causing uveitis and secondary glaucoma

  • Tumor seeding into the chamber angle

  • Pigment release into the aqueous, the surface of the iris, and the chamber angle


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