Malignant glaucoma, though the name implicates something neoplastic, but its acute or insidious onset and ominous presentation can be a nightmare for the ophthalmologist. As posterior capsular rent (PCR) is a commonly encountered complication even in experienced hand it can lead to malignant glaucoma in about 1.2-4% cases. Intraoperative clinical suspicion and serial postoperative evaluation can diagnose and monitor the ailment. Exchanging the aqueous and vitreous though the rent and jeopardisation of the anterior chamber physiology are the basic mechanism to set up the clinical entity. Several other postulations and evidence based studies came into play which helped us to better understand and search the ideal therapeutic approach that can potentiate the optimum visual outcome. The age old notion of refractory to medical therapy (Von Greafe’s nomenclature) has been challenged by application of proper medical therapy as well as surgical intervention. These ushered a new era of malignant glaucoma management by incisional and laser techniques. This review article enlightens evidence based concepts and newer therapeutic approaches.
