Purpose To report acute angle-closure glaucoma associated with Atropine eye ointment for cycloplegic refraction in a PHPV(persistent hyperplastic primary vitreous) patient.

Methods  Review of clinical, photographic, and ultrasound data of a 3-year-old PHPV patient who underwent the onset of acute angle-closure glaucoma induced by Atropine eye ointment.

Results Intra-ocular pressure was controlled after trabeculectomy and cataract extraction.

Conclusions Special attention should be paid to such special case as PHPV before prescribing Atropine to avoid drug-induced angle-closure glaucoma. Surgerical treatment could be effective when medication seemed useless in lowing the intraocular pressure.