Search
glaucomatocyclitic crisis (Posner-Schlossman Syndrome)
Epidemiology:
- adults 20-50 years
Pathology:
- self-limited recurrent episodes of markedly elevated intraocular pressure with mild idiopathic anterior chamber inflammation
Clinical manifestations:
- recurrent, unilateral red eye with very mild discomfort, or possibly no discomfort at all
- visual acuity will be mildly reduced (often chief complaint)
- cornea will be mildly edematous
- anterior chamber will be remarkably clear
- often, the only signs of anterior chamber inflammation will be a rare cell or two in the chamber or, more commonly, a few keratic precipitates on the endothelium
- increased intraocular pressure with open angles
- intraocular pressure can range from 30-70mm Hg, but the patient will not be in acute distress
- elevation of intraocular pressure out of proportion to the severity of the uveitis [3]
- duration of attack vary from a few hours to several weeks
- normal optic disc
- normal intraocular pressure between episodes
- both eyes may be involved at different times, but rarely simultaneously
Special laboratory:
- ophthalmoscopy
Management:
- lower intraocular pressure
a) ophthalmic agents
1] timolol
2] dorzolamide
3] apraclonidine
b) oral carbonic anydrase inhibitor
- control of inflammation
- prednisolone acetate ophthalmic 1% QID
- oral NSAIDs
- surgery
- indications
- signs of optic nerve damage
- visual field changes
- prognosis
- most patients treated for attacks recover without long-term sequelae
- patients with repeated attacks may have optic nerve damage or visual field deficits
- duration & magnitude of elevated intraocular pressure rather than the frequency of attacks is implicated
Related
glaucoma
General
complication
open-angle glaucoma (OAG)
uveitis
syndrome
References
- Handbook of Ocular Disease Management
UVEITIC GLAUCOMA & GLAUCOMATOCYCLITIC CRISIS
http://cms.revoptom.com/handbook/sect4b.htm
- Glaucomatocyclitic Crisis (Posner-Schlossman Syndrome)
http://eyewiki.aao.org/Glaucomatocyclitic_Crisis_(Posner-Schlossman_Syndrome)
- Oakman JH and Roy H
Medscape: Posner-Schlossman Syndrome
http://emedicine.medscape.com/article/1205949-overview
- EyeWiki
Hung C and Giaconi JA
Glaucomatocyclitic Crisis (Posner-Schlossman Syndrome)
http://eyewiki.aao.org/Glaucomatocyclitic_Crisis_%28Posner-Schlossman_Syndrome%29