Aqueous misdirection digital illustration

Aqueous misdirection Save

ICD-10 code: H40.83

Chapter: Diseases of the eye and adnexia

Aqueous Misdirection: Causes, Symptoms, and Treatment

Aqueous misdirection, also known as malignant glaucoma, is a rare complication of intraocular surgery or laser procedures. It occurs when the aqueous humor, the fluid that fills the anterior chamber of the eye, is redirected to the posterior chamber, causing an increase in intraocular pressure and a shallowing of the anterior chamber.

While the exact cause of aqueous misdirection is unknown, it is believed to be a result of a shift in the intraocular pressure gradient, causing the aqueous humor to flow in the wrong direction. Certain risk factors, such as age, a history of glaucoma, and the use of certain medications, may increase the likelihood of developing the condition.

Symptoms of Aqueous Misdirection

The symptoms of aqueous misdirection can vary depending on the severity of the condition. Some common symptoms include:

  1. Blurred vision
  2. Eye pain or discomfort
  3. Increased intraocular pressure
  4. Shallow anterior chamber
  5. Redness of the eye

If you experience any of these symptoms after intraocular surgery or laser procedures, it is important to contact your ophthalmologist immediately. Early detection and treatment can help prevent permanent damage to your vision.

Treatment of Aqueous Misdirection

Treatment for aqueous misdirection typically involves a combination of medications and surgical procedures. Medications, such as pilocarpine, can help to constrict the pupil and increase the outflow of aqueous humor. In more severe cases, surgical procedures, such as vitrectomy or trabeculectomy, may be necessary to relieve the pressure and restore normal fluid flow.

It is important to note that early intervention is key in the treatment of aqueous misdirection. Delayed treatment can lead to permanent damage to the optic nerve and irreversible vision loss.


While aqueous misdirection is a rare complication of intraocular surgery or laser procedures, it is important to be aware of the symptoms and seek prompt treatment if they occur. By working closely with your ophthalmologist, you can help to ensure the best possible outcome for your vision.