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Advanced Technical IVT

Aqueous misdirection

Abnormal flow of aqueous humor posteriorly into the vitreous cavity, causing anterior lens displacement and angle closure.

Full Definition

Aqueous misdirection, also known as ciliolenticular block or malignant glaucoma, is a rare but serious complication where aqueous humor flows abnormally into the vitreous cavity rather than through normal anterior pathways. This misdirection causes anterior rotation of the ciliary body, forward movement of the lens-iris diaphragm, and secondary angle closure with elevated intraocular pressure. The condition can occur after any intraocular surgery but is most common following filtration surgery in eyes with shallow anterior chambers. Treatment may require intensive medical therapy, laser procedures, or surgical intervention to restore normal aqueous flow patterns.

Usage

Usage note: 'Malignant glaucoma' is a misnomer as the condition is not malignant, but the term remains in common clinical use.

In Context

  • "Post-operative aqueous misdirection was suspected when IOP remained elevated despite patent iridotomy." — Complication assessment
  • "The patient developed malignant glaucoma requiring urgent vitrectomy to restore aqueous flow." — Emergency management

Also known as

malignant glaucoma ciliolenticular block

Don't confuse with

pupillary block choroidal effusion

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