Phacomorphic glaucoma is caused by closure of the anterior chamber angle by a large intumescent cataract. A pupillary block mechanism may play a role. The initial treatment includes topical antiglaucoma medication(s), although a systemic CAI and hyperosmotic agent may be necessary as well (see 9.4, ACUTE ANGLE CLOSURE GLAUCOMA). Can be mistaken for pupillary ACG; however, the anterior chamber may be more uniformly shallow than in a purely pupillary block mechanism where iris bombé is prominent. A laser iridectomy may be effective in relieving any part of pupillary block, although this may only be a temporizing measure. Cataract extraction is the definitive treatment.