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Published on: February 15, 2022
Spontaneous malignant glaucoma in a longstanding hypotonous eye.
Sang Woo Park1, Jae Kyoun Ahn, Hwan Heo
1Department of Ophthalmology, Chonnam National University Medical School and Hospital. 8 Hakdong, Donggu, Gwangju 501-757, South Korea. exo70@naver.com
Summary
This case report details unusual malignant glaucoma in a patient with a history of low intraocular pressure (IOP). The condition caused severe pain and vision loss, highlighting a rare complication in aphakic eyes.
Area of Science:
- Ophthalmology
- Medical Case Reports
Background:
- Malignant glaucoma is a rare, severe form of angle-closure glaucoma.
- It typically occurs postoperatively or in predisposed individuals, often associated with hyperopic eyes.
Purpose of the Study:
- To report a unique case of spontaneous malignant glaucoma.
- To describe its occurrence in a longstanding hypotonous aphakic eye.
Main Methods:
- Clinical examination including visual acuity and intraocular pressure (IOP) measurement.
- Anterior segment imaging (implied by description of iris-corneal opposition).
- B-scan ultrasonography to assess posterior segment structures.
- Pharmacological management with topical cycloplegics, beta-blockers, and systemic hyperosmotic agents.
Main Results:
- A 38-year-old male presented with acute severe ocular pain and markedly elevated IOP (35 mm Hg) in his right aphakic eye.
- Examination revealed iris opposing the cornea and synechial closure.
- Initial treatment led to a significant decrease in IOP (4 mm Hg) but persistent peripheral synechiae.
Conclusions:
- Malignant glaucoma can occur spontaneously in eyes with a history of hypotony.
- This presentation is highly unusual, challenging typical understanding of malignant glaucoma pathogenesis.
- Careful IOP management is crucial in complex ocular conditions.
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