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What Is the Uveitis-Glaucoma-Hyphema (UGH) Syndrome?

Uveitis-Glaucoma-Hyphema (UGH) syndrome is a complication in which an intraocular lens mechanically irritates the iris or nearby tissues. This chafing can trigger recurrent inflammation (uveitis), elevated intraocular pressure (glaucoma or pressure spikes), and bleeding in the anterior chamber (microhyphema or hyphema). It most often occurs after cataract surgery when an intraocular lens is malpositioned or unstable, but it can happen with various lens types. Prompt diagnosis helps prevent optic nerve damage and corneal complications from repeated pressure elevation.

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What Is the Uveitis-Glaucoma-Hyphema (UGH) Syndrome?

Uveitis-Glaucoma-Hyphema (UGH) syndrome is a complication in which an intraocular lens mechanically irritates the iris or nearby tissues. This chafing can trigger recurrent inflammation (uveitis), elevated intraocular pressure (glaucoma or pressure spikes), and bleeding in the anterior chamber (microhyphema or hyphema). It most often occurs after cataract surgery when an intraocular lens is malpositioned or unstable, but it can happen with various lens types. Prompt diagnosis helps prevent optic nerve damage and corneal complications from repeated pressure elevation.

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Why it happens

The core problem is mechanical rubbing from an intraocular lens or its haptics against the iris, ciliary body, or angle structures. This can occur with anterior chamber lenses, sulcus placement issues, decentered lenses, or broken components. Repeated irritation releases pigment and blood and drives inflammation. Over time, the pressure spikes can damage the optic nerve if not controlled.

Common symptoms and signs

Symptoms may be intermittent and often recur in episodes. People may notice vision changes related to blood, inflammation, or pressure elevation. Signs are identified on slit-lamp exam and pressure checks.

  • Blurred vision or transient haze
  • Eye pain, redness, or light sensitivity
  • Floaters or seeing a reddish tinge from blood
  • Elevated intraocular pressure and pigment dispersion

How it is diagnosed

Diagnosis is based on history of intraocular lens surgery plus exam findings of inflammation, bleeding, and pressure elevation. Clinicians evaluate lens position, look for iris transillumination defects, and check for microhyphema. Gonioscopy can identify angle findings and blood, and ultrasound biomicroscopy can help locate lens chafing when the view is limited. The goal is to confirm a mechanical source and rule out other causes of recurrent uveitis or hyphema.

Treatment

Initial treatment often includes topical anti-inflammatory drops and pressure-lowering medications, along with management of hyphema precautions when present. However, definitive treatment usually requires correcting the mechanical problem by repositioning, exchanging, or removing the intraocular lens or offending component. Addressing the source reduces recurrence and protects the optic nerve. Follow-up is important to monitor pressure, inflammation control, and any secondary glaucoma damage.

FAQs on UGH syndrome

Can UGH syndrome happen years after cataract surgery?

Yes. It can occur soon after surgery or later if the intraocular lens shifts, becomes unstable, or its components begin to rub surrounding tissues. New symptoms after a long stable period still warrant evaluation.

Is UGH syndrome an emergency?

It can be urgent, especially with high intraocular pressure, significant hyphema, or severe inflammation. Repeated pressure spikes can threaten the optic nerve. Seek prompt care for pain, sudden blur, or visible blood in the eye.

How is it treated definitively?

Definitive treatment usually involves eliminating lens chafing by repositioning or exchanging the intraocular lens. Medications can control inflammation and pressure temporarily, but recurrence is common if the mechanical cause remains. Your surgeon will recommend the safest approach for your anatomy.

Can UGH syndrome cause glaucoma?

Yes. Pressure spikes and pigment or blood blocking the drainage system can lead to secondary glaucoma. Controlling pressure and addressing the lens source helps reduce long-term risk.

References

Uveitis-Glaucoma-Hyphaema Syndrome. EyeWiki (American Academy of Ophthalmology). https://eyewiki.aao.org/Uveitis-Glaucoma-Hyphaema_Syndrome. Date Accessed: February 19, 2026.

Etiology and Management of Uveitis-Glaucoma-Hyphema Syndrome: A Comprehensive Review. Luo B, et al. https://pmc.ncbi.nlm.nih.gov/articles/PMC12311461/. Date Accessed: February 19, 2026.

Uveitis-Glaucoma-Hyphema Syndrome Caused by Soemmering Ring Cataract in the Absence of an Intraocular Lens. Dubois J, et al. https://pmc.ncbi.nlm.nih.gov/articles/PMC10715750/. Date Accessed: February 19, 2026.

Uveitis-Glaucoma-Hyphema Syndrome After Ahmed Glaucoma Valve Implantation: A Case Report. PubMed. https://pubmed.ncbi.nlm.nih.gov/39063945/. Date Accessed: February 19, 2026.

Uveitis Glaucoma Hyphema (UGH) Syndrome. University of Iowa EyeRounds. https://www.eyerounds.org/cases/257-UGH-syndrome.pdf. Date Accessed: February 19, 2026.