Answer
The correct answer is (A) Glaucoma, because the presence of khaki-colored “ghost cells” in the anterior chamber signifies a risk for ghost cell glaucoma, a form of secondary open-angle glaucoma that results from degenerated red blood cells obstructing aqueous outflow through the trabecular meshwork. These ghost cells, which arise 1-3 weeks after a vitreous or anterior chamber hemorrhage, have lost their hemoglobin and become rigid, spherical remnants incapable of deforming sufficiently to exit through the trabecular meshwork. They migrate into the anterior chamber through a disrupted anterior hyaloid face, which can occur after ocular surgery such as cataract extraction, trauma, or spontaneous disruption, and their accumulation impedes normal aqueous drainage, leading to elevated intraocular pressure (IOP). Clinically, patients present with IOP spikes, a quiet eye, and a tan-colored anterior chamber cell reaction out of proportion to flare. Corneal decompensation (B) is not directly caused by ghost cells but may occur secondarily only if IOP remains severely elevated for a prolonged period; cystoid macular edema (C) is a common postoperative complication due to inflammatory mediators affecting the macula, unrelated to red cell degeneration or trabecular obstruction; and IOL dislocation (D) results from zonular weakness or capsular instability rather than from the presence of ghost cells. Thus, in a patient one week after cataract surgery with resolving hyphema and ghost cells visible in the anterior chamber, the major concern is obstruction of aqueous outflow by these degenerated erythrocytes—leading to secondary open-angle (ghost cell) glaucoma.
