Spontaneous malignant glaucoma in a longstanding hypotonous eye

A 38-year-old man with longstanding low intraocular pressure (IOP) in his right aphakic eye presented with severe pain and high IOP (35 mm Hg). On examination, visual acuity was light perception. The central and peripheral portions of the iris were directly opposed to the posterior corneal surface and synechial closure of the pupil margin. B-scan ultrasonography showed posterior vitreous detachment. The patient was treated with topical cycloplegics, a topical beta-blocker, and a systemic hyperosmotic agent. After 1 week, the anterior chamber was deep centrally, with peripheral synechiae between the iris and the cornea. The IOP of the right eye was 4 mm Hg. This case is an unusual spontaneous malignant glaucoma occurring in a longstanding hypotonous eye.