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Open Access Highly Accessed Case report

Spontaneous malignant glaucoma in a patient with patent peripheral iridotomy

Mallika Premsenthil1, Mohamad Aziz Salowi2, Chong Min Siew2, Intan ak Gudom2 and Tan Kah1*

Author Affiliations

1 Department of Ophthalmology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Lot 77, Seksyen 22, Kuching Town Land District, Jalan Tun Ahmad Zaidi Adruce, 93150 Kuching, Sarawak, Malaysia

2 Department of Ophthalmology, Sarawak General Hospital, 93150 Kuching, Sarawak, Malaysia

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BMC Ophthalmology 2012, 12:64  doi:10.1186/1471-2415-12-64

Published: 14 December 2012



To report a case of spontaneous malignant glaucoma in an Asian female. To propose the term “positive vitreous pressure glaucoma” to reflect the pathophysiology, treatment and prognosis of the condition.

Case presentation

A 56-year old Chinese female was diagnosed of primary angle closure glaucoma and had bilateral laser peripheral iridotomy one year ago. She presented with spontaneous onset of malignant glaucoma involving the left eye. The condition was treated successfully; the final best corrected visual acuity was 0.67 (decimal notation).


This case highlights that acute angle closure attack can occur in an eye with patent peripheral iridotomy. Early recognition and treatment is essential for good visual prognosis.