Posner-Schlossman Syndrome: A case Report

Arif Adenwala

Glaucomatocyclitic crisis is a condition with self-limited recurrent episodes of markedly elevated intraocular pressure (IOP) with mild idiopathic anterior chamber inflammation. It is most often classified as secondary inflammatory glaucoma. Glaucomatocyclitic crisis is caused by an idiopathic inflammatory process of the trabecular meshwork, causing a decrease in aqueous outflow.

Aim: To describe as case of Glaucomatocyclitic crisis or Posner Schlossman Syndrome

A Case Report: A 60 yearl old Male patient presented with decrease vision, mild heaviness and coloutred haloes. Past history of both eyes Phacoemulsification done 2 years back. Post operative visual rehabilitation was good. He is known case of POAG on treatment
Ocular examination: Left Eye was normal, Right eye shows few cells in AC with mild flare. Lens was well placed. IOP was 35 mmHg in right eye. BCVA was 0.7 in right eye. Fundus shows significant glaucomatous changes. Visual field also had significant field defects. OCT shows reduction in retinal nerve fiber thickness.

Patient was started with local prednisolone eye drops with local anti glaucoma medications to reduce the inflammation and IOP. His visual acuity and IOP improved after the medications. He was normal in between the attacks.

He developed 3-4 regular attacks with few months and so was subjected to Trabeculectomy after taking second opinion. His IOP got stabilised and now the frequency of attacks had reduced. He is also not using any local steroid eye drops.

Conclusion: Glaucomatocyclitic crisis is condition with recurrent episodes of elevated IOP with idiopathic anterior chamber inflammation.

It was first described in 1948 by Posner and Schlossman
It is idiopathic with other possible causes like viral infection like CMV or HSV infection or autonomic defect
Local Anti Inflammatory and Anti glaucoma medications are drug of choice. Surgery is indicated if the IOP is not under control and if there is increase recurrence rate of attacks. Trabeculectomy is the procedure of choice.