A 68-year-old woman undergoes uncomplicated phacoemulsification for cataract. On day one postoperatively, the anterior chamber is flat with an intraocular pressure of 52 mmHg and a myopic shift. The posterior segment is unremarkable. Which of the following is the most likely diagnosis?
- A Pupillary block glaucoma
- B Steroid-induced glaucoma
- C Malignant glaucoma (aqueous misdirection) ✓
- D Neovascular glaucoma
Correct answer: C. Malignant glaucoma (aqueous misdirection)
Explanation
Malignant glaucoma presents with a flat anterior chamber, myopic shift from anterior displacement of the lens-iris diaphragm, and elevated IOP after intraocular surgery. It results from posterior misdirection of aqueous into the vitreous. Pupillary block would show iris bombe and is ruled out by a patent iridotomy. Steroid-induced glaucoma occurs weeks later. Neovascular glaucoma shows iris neovascularization.
Reference: Shields' Textbook of Glaucoma, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.