Posner-Schlossman syndrome

Posner-Schlossman Syndrome

Posner-Schlossman Syndrome, also known as Glaucomatocyclitic Crisis, is a rare ocular condition characterized by recurrent episodes of elevated intraocular pressure (IOP) and mild anterior uveitis. It was first described by Dr. Allen Posner and Dr. David Schlossman in 1948. The syndrome primarily affects young to middle-aged adults and is typically unilateral, meaning it affects only one eye.

Clinical Presentation

Patients with Posner-Schlossman Syndrome often present with sudden onset of blurred vision, mild eye discomfort, and halos around lights. The episodes are usually self-limiting, lasting from a few hours to several weeks. During an attack, the intraocular pressure can rise significantly, sometimes exceeding 40 mmHg, while the anterior chamber shows mild inflammation with a few cells and flare.

Pathophysiology

The exact cause of Posner-Schlossman Syndrome is not well understood. It is believed to be related to an inflammatory process that affects the trabecular meshwork, leading to impaired aqueous humor outflow and elevated IOP. Some studies suggest a possible viral etiology, with herpes simplex virus and cytomegalovirus being implicated in some cases.

Diagnosis

Diagnosis of Posner-Schlossman Syndrome is primarily clinical, based on the characteristic symptoms and findings during an ocular examination. Key diagnostic features include:

• Elevated intraocular pressure during an attack
• Mild anterior chamber inflammation
• Open angles on gonioscopy
• Absence of posterior synechiae

Differential diagnosis includes other causes of uveitis and secondary glaucoma, such as Fuchs' heterochromic iridocyclitis and herpetic uveitis.

Treatment

The management of Posner-Schlossman Syndrome focuses on controlling intraocular pressure and inflammation. Treatment options include:

• Topical beta-blockers or carbonic anhydrase inhibitors to lower IOP
• Topical corticosteroids to reduce inflammation
• Antiviral medications if a viral cause is suspected

Long-term prognosis is generally good, but repeated episodes can lead to glaucomatous optic nerve damage if not adequately managed.

Also see

• Glaucoma
• Uveitis
• Fuchs' heterochromic iridocyclitis
• Herpetic uveitis

External

• Age-Related Macular Degeneration

• Amblyopia (Lazy Eye)

• Anophthalmia and Microphthalmia

• Astigmatism

B

• Behçet's Disease* Bietti's Crystalline Dystrophy

• Blepharitis* Blepharospasm

C

• Cataracts

• Coloboma

• Color Blindness

• Corneal Conditions

D

• Diabetic Retinopathy

• Dry Eye

F

• Floaters

G

• Glaucoma

I

• Idiopathic Intracranial Hypertension

L

• Low Vision

M

• Macular Edema

• Macular Hole

• Macular Pucker

P

• Pink Eye

R

• Rare Diseases

• Refractive Errors

• Retinal Detachment

• Retinitis Pigmentosa

• Retinoblastoma

• Retinopathy of Prematurity

S

• Stargardt Disease

U

• Usher Syndrome

• Uveitis

V

• Vitreous Detachment