Malignant glaucoma.

MALIGNANT glaucoma is a condition in which a rise in intra-ocular pressure is associated with complete or almost complete loss of the anterior chamber of the eye. It usually develops after surgical treatment for glaucoma has been carried out and in eyes with a narrow angle. It is usually found that, if it occurs in one eye, a rise in tension in the other eye follows a similar course. It is uncommon, but it has long been recognized and was first described by von Graefe (1869). Interest in this form of glaucoma has been stimulated by the observations of Chandler (1950), who postulated that extraction of the lens was the treatment which offered the best chance of restoration of vision, and further suggested that, with the onset of raised tension in the second eye, the lens of that eye should be extracted immediately. Removal of the lens had, of course, been practised intermittently for this condition since the 19th century. Malignant glaucoma is associated with an anterior movement of the iris-lens diaphragm, and is said to occur more usually in eyes with a shallow anterior chamber and in which the tension has been elevated at the time of operation. It occurs, not infrequently, in patients of a fairly young age group. This communication describes a patient who developed malignant glaucoma first in one eye and then in the other, and who recovered vision and normal tension in both eyes without extraction of the lenses.