This retrospective observational consecutive case series assessed the incidence and risk factors associated with developing glaucoma after paediatric cataract surgery with primary intraocular lens (IOL) implantation. They reviewed 136 children (199 eyes) who underwent paediatric cataract surgery before the age of one and had a minimum of one year of follow-up at a single tertiary centre between January 2003 and December 2012. They found that glaucoma developed in 31 eyes (16%) of 21 children with five and 10-year incidence rates of 12% and 28% respectively. They described a bimodal incidence rate with the first peak occuring at 2.5 months and the second peak at 5.7 years. Risk factors for developing glaucoma included younger age for initial surgery, shorter axial length, longer follow-up, use of trypan blue, reintervention and bilateral surgery. Although there have been several studies looking at development of glaucoma post paediatric cataract surgery, this appears to be the first study to find a relationship between the use of trypan blue and glaucoma. Further studies are required to assess the extent of the risk of using trypan blue in these children.