Malignant Glaucoma



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Malignant glaucoma has also other names like aqueous misdirection and ciliary block glaucoma.

It is characteristic by:

1- High intraocular pressure.

2- Shallow anterior chamber.

3- No pupillary block.

4- Misdirection of aqueous humor to the posterior segment and vitreous instead of going to the anterior chamber and accumulation of aqueous in the vitreous behind the lens.

This accumulation will push the lens forward causing shallow anterior chamber.

5- It usually occurs after surgery like cataract surgery or glaucoma surgery.

The mechanism behind aqueous misdirection is anterior rotation of ciliary process and misdirection of aqueous humor to the vitreous instead to the anterior chamber.

Treatments

1- atropine so the ciliary muscles and process relaxed.

2- Anti-glaucoma eye drops to decrease aqueous humor production.

3- Hyperosmotic oral medications to decrease the volume of vitreous.

4- In case it occur in aphakic or pseudophakic eyes, treatment is with YAG laser to the anterior vitreous face and to create a hole back on the posterior capsule.

5- In some cases vitrectomy surgery will be indicated.





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