Posner-Schlossman Syndrome

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Disease

  • = Iridocyclitic crisis
  • Acute, unilateral, recurring episodes of increased intraocular pressure with mild anterior uveitis
  • Cause unclear, presumed acute trabeculitis
  • Primarily affects young adults; more common in males than females

Findings

  • Elevated intraocular pressure (usually around 40-50mmHg)
  • +/- Corneal edema
  • Anterior chamber cells; fine, white, central corneal precipitates
  • Open anteiror chamber angle
  • Normal IOP and no signs of uveitis between attacks

Treatment

  • IOP reduction: Local therapy + Diamox intravenously or orally, +/- Mannitol intravenously, depending on IOP
  • Steroid therapy: e.g., Pred Forte initially 4 times daily (up to hourly) for 1 week, then gradually reduce
    • For frequent recurrences, consider Pred forte once daily or every other day for months to years

Sources

  • EyeWiki Glaucomatocyclitic Crisis (Posner-Schlossman Syndrome)
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)