Cholesterol Crystals in Aqueous Humor of the Eye with Phacolytic Glaucoma

ABSTRACT

Iridescent cholesterol crystals in the anterior chamber are unusual finding. Although the clinical picture of phacolytic glaucoma is well recognized, the nature of the iridescent or hyperrefringent crystals is not well understood. A 70 years old womon presented with the acute onset of monocular pain and redness. The examination revealed a high intraocular pressure (42 mmHg), conjunctival hyperemia, and diffuse corneal edema. The heavy flare and pseudohypopyon were seen in the anterior chamber associated with iridescent or hyperrefringent particles. The anterior chamber aspirate obtained at operation was subsequently examined by wet field microscopy. Wet field microscopy showed that macrophages identified histologically in the aspirate corresponded to regular round cells about two to three times the size of an leukocyte. And, notched rectangular platelike crystals were typical morphologically of cholesterol, varied in size, and contacted each other. We found cholesterol crystals in aqueous humor of the eye with phacolytic glaucoma.