|Year : 1972 | Volume
| Issue : 1 | Page : 25-27
Glaucomatocyclitic crisis (Posner--Schlossman syndrome) case report
SK Narang, SJ Shah
M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad, India
S K Narang
M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Narang S K, Shah S J. Glaucomatocyclitic crisis (Posner--Schlossman syndrome) case report. Indian J Ophthalmol 1972;20:25-7
|How to cite this URL:|
Narang S K, Shah S J. Glaucomatocyclitic crisis (Posner--Schlossman syndrome) case report. Indian J Ophthalmol [serial online] 1972 [cited 2020 Feb 17];20:25-7. Available from: http://www.ijo.in/text.asp?1972/20/1/25/34672
| Introduction|| |
This syndrome was first described by Posner & Sciilossman  it is seen most commonly between the age group of 20-50 years. Typically, the onset is acute consisting of slight ocular discomfort, blurred vision and seeing coloured naloes arouna nights, cnaracteristically affecting only one eye. Examination reveals epithelial oedema and tension usually between 40 and 70 mm. hg. Schiotz. A few K.P.s are seen. The treatment is cortisone locally and the patient becomes alright within 3-4 nays without any diminution of vision and field defects. Surgery is rarely needed. Chandler and Grant  reported a case in winch surgery was necessary after the patient had 3-4 attacks.
In their first report Posner and Scnlossman  found Joniasco pically open angles in four of twelve patients and failed to comment on the angle appearance of the remaining eight. Levatin  reported one bilateral case and stated that the angles were gonioscopically open. Sokolic described bilateral angle anomalies in a male aged 42 who had suffered from glaucomatocylitic attacks in his right eye. Hart and Weatherill  reported 7 cases of this syndrome and found angle anomalies in all, just like those seen in developmental, glaucoma. They concluded that the rise of tension is due to some microscopic changes in the trabecular-meshwork alongwith the macroscopic changes in the angle.
| Case Report|| |
B. B. a Hindoo male 4,3 years of age visited Snetn M & J Institute of Ophthalmology, Ahmedabad on 25.9.1970 with the complaints of detective vision and moderate pain in the right eye for the last 2 days. The pain was not accompanied by vomiting. The onset was sudden. Patient took some analgesic tablets but was not relieved.
| Past History|| |
Patient had a similar attack of pain and diminution of vision in the right eye 6 months back. He was diagnosed as a case of glaucoma by some general practitioner. He became alright with medical treatment in 3-4 days time. He was referred to our out-door for investigations of glaucoma on 6-3-1970.
At that time tension was within normal limits provocative tests were negative. No other abnomality could be detected. K.P.'s were absent.
The patient was advised to report if there should be similar attack again.
FAMILY HISTORY AND PERSONAL : of no significance.
| On Examination|| |
RE : VISION 6/12 J2
Lids were normal. No conjunctival or ciliary congestion Thin corneal haze was noted. Pupil was semidilated and sluggishly reacting to light. Anterior chamber was of normal depth. Tension 42.6mm Hg. Schiotz.
Fundus was normal.
LE : VISION 6/6 and no other abnormality was detected.
Tension 18.9 mm. Hg. Schiotz.
| Biomicroscopy|| |
RE: Corneal epithelial oedema +, 5-6 fresh K. P.'s more in the central part. One KP in the centre was a large one like mutton-fat and rest were small surrounding. It.
A patch of iris atrophy at 6 O'clock position.
No aqueous flare and no posterior synechiae.
LE : Nothing abnormal was detected.
| Gonioscopy|| |
RE : The iris was flat and the angle wide open all round with broad ciliary band and distinct scleral spur. No K. P.; no pigment and no abnormal vessels. No indication of injury or synechiae seen.
LE : Angle was wide and open all around, with no other abnormality.
| General Examination|| |
No abnormality detected.
| Treatment|| |
The case was diagnosed as glaucomatocyclitic crisis R. E. and following treatment prescribed:
- Tab. Prednisolon 5 mg Q.I.D.
- Tab Diamox (250 mg) 1 t. d. s.
- Betnesol N. eye drope t.d.s.
He was asked to report after 3 days. Patient did not take diamox tablets.
| Progress|| |
After 3 days.
Tension RE : 15.9 mm Hg. Schiots
Vision - BE : 6/6
Fields - Normal
Fundi - Normal
No corneal oedema seen.
| Discussion|| |
The patient described in the present report has shown normal angle and definite Keratic-precipitates in the affected eye. It is in contrast to the findings of Hart & Weatherill  who two thought that the inflammatory reaction was secondary to the onset of glaucoma the cause of which was in the trabecular-meshwork of developmental nature. Levatin  found normal open angle just like one described by us.
We are of the opinion that rise of tension should not give rise to such an inflammatory reaction as to have keratic precipitates. Moreover if it is a developmental anomaly, then the rise of tension should be a constant feature and riot intermittent The basic process is probably the inflammation of the ciliary body and trabecularmeshwork which may be minimal and rise of tension is secondary to it. The etiological factor for this inflammation still remains unknown.
| Summary|| |
A case of Posner-Schlossman Syndrome is described in which no angle anomaly was detected.
| References|| |
Chandler, P. A. and Grant W. M.: Lectures on glaucoma Lea & Febiger Philadephia (1965).
Hart C. T. and Weatherill J. R. Gonioscopy and tonography in Glancomato cyclitic crisis. Brit. J. O. 52, 682-687 (1968).
Levatin P : Glaucomato-cyclitic crisis. J. O. 41, 1056-1060 (1956). (1956).
Posner, A, S. and Schlossman A: A Syndrome of unilateral recurrent attacks of glancoma with Cyclitic Symptoms. A.M. A. Arch Ophth. 39, 517 (1948).
Sokolic, P.: Acta. Ophthal (Kbh) 44; 607 (1966) cited by Hart and Weatherill, in 2.