Ghost Cell Glaucoma

Abstract

Ghost cell glaucoma was first described in 1976 by Campbell and coworkers as a transient secondary open angle glaucoma in which the trabecular meshwork is obstructed by degenerated red blood cells called “ghost cells.” Ghost cells may develop in any remaining red blood cells 7-10 days following vitreous hemorrhage from any etiology. The erythrocytes become spherical, less pliable, and partially lose their intracellular hemoglobin, causing them to appear tan-colored. The denaturized hemoglobin left in the cytoplasm binds to the internal surface of the cell membrane forming granules (Heinz bodies). Ghost cells, once formed, may remain for months in the vitreous cavity after hemorrhage. These vitreous ghost cells can gain access to the anterior chamber through a disrupted anterior hyaloid face, or an open posterior capsule from previous surgery, after traumatic injury or spontaneously. Ghost cells are less pliable than fresh cells; thus, once in the anterior chamber, they may obstruct the trabecular meshwork and markedly increase intraocular pressure.