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Silicone oil has been an important adjunct for internal tamponade in the treatment of complicated retinal detachment for the past 4 decades. A known complication of its use has been the development of secondary glaucoma. This article reviews the current body of literature documenting the different pathogeneses, predisposing factors and management of silicone oil induced pressure elevation and optic neuropathy. Categorization is clarified for the different types of secondary glaucomas due to silicone oil. Four different mechanisms have been proposed for the pathogenesis of glaucoma that require different therapeutic strategies: (1) overfill with total anterior chamber fill leads to an open-angle glaucoma due to mechanical obstruction of outflow, (2) pupillary block with silicone oil incites angle closure glaucoma, (3) denaturation of silicone oil into microdroplets may sweep into the trabecular meshwork with the development of secondary open angle glaucoma, or (4) finally, inflammation or exacerbation of pre-existing glaucoma. Understanding the risk factors and the pathogenesis of secondary glaucoma when using silicone oil helps guide the timely and appropriate course of treatment. [ABSTRACT FROM AUTHOR]