Glaucomatocyclitic crisis

Glaucomatocyclitic Crisis (GCC), also known as Posner-Schlossman Syndrome, is a rare ocular condition characterized by recurrent episodes of mild anterior uveitis and elevated intraocular pressure (IOP). This condition predominantly affects adults and is notable for its unilateral presentation, though bilateral cases have been reported. The etiology of GCC remains largely unknown, but it is believed to involve a combination of genetic, immunologic, and environmental factors.

Symptoms and Diagnosis

The hallmark symptoms of a Glaucomatocyclitic Crisis include sudden onset of blurred vision, mild eye pain, and the appearance of halos around lights. These symptoms are attributed to the elevated IOP. Unlike other forms of glaucoma, GCC episodes are typically self-limiting, lasting from a few hours to several weeks before spontaneously resolving.

Diagnosis of GCC is primarily clinical, based on the characteristic presentation and exclusion of other causes of uveitis and ocular hypertension. Comprehensive eye examinations, including measurement of IOP, gonioscopy, and dilated fundus examination, are essential. Advanced imaging techniques, such as optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM), may be utilized to assess the anterior chamber angle and exclude secondary causes of angle closure.

Treatment

The treatment of Glaucomatocyclitic Crisis focuses on managing the elevated IOP and controlling the inflammatory component of the disease. Topical corticosteroids are used to reduce inflammation, while anti-glaucoma medications, such as topical beta-blockers, alpha agonists, or carbonic anhydrase inhibitors, are employed to lower IOP. In cases where medical therapy is insufficient, surgical interventions, including laser therapy or trabeculectomy, may be considered.

Prognosis

The prognosis for individuals with GCC is generally good, as the condition is self-limiting and responds well to treatment. However, recurrent episodes can lead to trabecular meshwork damage, resulting in chronic glaucoma. Regular monitoring and management of IOP are crucial to prevent long-term visual impairment.

Epidemiology

Glaucomatocyclitic Crisis is a rare condition, with a higher prevalence reported in Asian populations. It affects adults, with no clear gender predilection. The exact incidence and prevalence of GCC are difficult to determine due to its episodic nature and the potential for misdiagnosis.

Pathophysiology

The pathophysiology of Glaucomatocyclitic Crisis is not fully understood. It is hypothesized that an immune-mediated response may trigger inflammation in the trabecular meshwork, leading to increased resistance to aqueous humor outflow and subsequent IOP elevation. Viral infections, particularly with herpes simplex virus, have been suggested as a potential trigger for the immune response in some cases.