Thirty-one cases of epidemic dropsy with raised intraocular pressure were studied. Glaucoma was bilateral in all, with open angles and no signs of anterior segment inflammation. The outflow facility was unimpaired (C value, 0.24 +/- 0.09 microL/min/mm Hg). Aqueous bioassays revealed significantly elevated prostaglandin E2 level (23.33 +/- 4.32 ng/mL) and histamine activity (13.0 +/- 2.76 ng/mL) in all samples from patients with epidemic dropsy glaucoma as compared with negligible levels in control samples from patients with open angle glaucoma. Aqueous biochemical analysis revealed increased total protein level (1.03 +/- 0.10 g/L) with a normal globulin pattern as compared with controls (0.26 +/- 0.08 g/L). On histopathologic and histochemical testing, a normal trabecular meshwork was found in 11 of the 12 trabeculectomy specimens. It is concluded that dropsy glaucoma is hypersecretory in nature; prostaglandin and histamine release may have significant roles in its pathogenesis.