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   Table of Contents      
ARTICLES
Year : 1972  |  Volume : 20  |  Issue : 1  |  Page : 25-27

Glaucomatocyclitic crisis (Posner--Schlossman syndrome) case report


M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad, India

Correspondence Address:
S K Narang
M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad
India
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Source of Support: None, Conflict of Interest: None


PMID: 4677507

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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 2019 Aug 24];20:25-7. Available from: http://www.ijo.in/text.asp?1972/20/1/25/34672


  Introduction Top


This syndrome was first descri­bed by Posner & Sciilossman [1] 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 [1] reported a case in winch surgery was necessary after the patient had 3-4 attacks.

In their first report Posner and Scnlossman [4] found Joniasco pically open angles in four of twelve patients and failed to com­ment on the angle appearance of the remaining eight. Levatin [2] reported one bilateral case and stated that the angles were gonio­scopically open. Sokolic[5] des­cribed bilateral angle anomalies in a male aged 42 who had suffered from glaucomatocylitic attacks in his right eye. Hart and Weatherill [2] 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 Top


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 Top


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 Top


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 Top


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 Top


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 Top


No abnormality detected.


  Treatment Top


The case was diagnosed as glaucomatocyclitic crisis R. E. and following treatment prescribed:

  1. Tab. Prednisolon 5 mg Q.I.D.
  2. Tab Diamox (250 mg) 1 t. d. s.
  3. Betnesol N. eye drope t.d.s.


He was asked to report after 3 days. Patient did not take diamox tablets.


  Progress Top


After 3 days.

Tension RE : 15.9 mm Hg. Schiots

Vision - BE : 6/6

Fields - Normal

Fundi - Normal

No corneal oedema seen.


  Discussion Top


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 [2] 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 [5] 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 Top


A case of Posner-Schlossman Syndrome is described in which no angle anomaly was detected.

 
  References Top

1.
Chandler, P. A. and Grant W. M.: Lectures on glaucoma Lea & Febiger Philadephia (1965).  Back to cited text no. 1
    
2.
Hart C. T. and Weatherill J. R. Gonio­scopy and tonography in Glancomato cyclitic crisis. Brit. J. O. 52, 682-687 (1968).  Back to cited text no. 2
    
3.
Levatin P : Glaucomato-cyclitic crisis. J. O. 41, 1056-1060 (1956). (1956).  Back to cited text no. 3
    
4.
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).  Back to cited text no. 4
    
5.
Sokolic, P.: Acta. Ophthal (Kbh) 44; 607 (1966) cited by Hart and Weatherill, in 2.  Back to cited text no. 5
    




 

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  In this article
Introduction
Case Report
Past History
On Examination
Biomicroscopy
Gonioscopy
General Examination
Treatment
Progress
Discussion
Summary
References

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