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September 1962

Mydriatic-Cycloplegic Treatment in Malignant Glaucoma

Author Affiliations

From the Massachusetts Eye and Ear Infirmary, Howe Laboratory of Ophthalmology, and Harvard Medical School.

Arch Ophthalmol. 1962;68(3):353-359. doi:10.1001/archopht.1962.00960030357010

The term malignant glaucoma refers to a condition in which, after operation for angleclosure glaucoma, the anterior chamber becomes extremely shallow or flat, and the tension abnormally high. This condition was first described by von Graefe almost a hundred years ago.1 The mechanism of malignant glaucoma has not yet been satisfactorily explained.

Malignant glaucoma apparently occurs only in association with angle-closure glaucoma, either acute or subacute, typically in eyes having very shallow anterior chambers before operation.2 Although malignant glaucoma occurs in a very small percentage of patients having surgery for angle-closure glaucoma, if it develops in one eye, it almost invariably develops in the second eye if operation is performed on the second eye when the tension is elevated. Malignant glaucoma may occur even if by the use of acetazolamide and urea the tension is brought to normal but the angle remains closed. On the other hand, if