A 25-year-old young adult presented with painless red eye with 10P of 60 mmHg. What is the most likely diagnosis?
Ans. c. Glaucomatocyclitic crisis The most likely diagnosis in a 25-year-old young adult with painless red eye with 10P of 60 mmHg is glaucomatocyclitic crisis. `Unilateral attacks of mild non-granulomatous anterior uveitis with elevations in 10P are the hallmark of Posner Schlossman syndrome (PSS). Acute attacks of glaucomatocyclitic crisis last from a few hours to several weeks and may be recurrent. Between episodes, lOP and aqueous outflow facility return to normal.' Posner Schlossman syndrome Unilateral attacks of mild non-granulomatous anterior uveitis with elevations in lOP are the hallmark of Posner Schlossman syndrome (PSS). It is also called as glaucomatocyclitic crisis. Acute attacks of glaucomatocyclitic crisis last from a few hours to several weeks and may be recurrent Between episodes, lop and aqueous outflow facility return to normal. Clinical Features: Episodic unilateral mild anterior uveitis, photophobia, reduced vision and colored rings around lights (from secondary corneal edema)Q. Symptoms of an acute attack of PSS may include unilateral blurred vision and pain. Clinical exam reveals mild anterior chamber reaction and small to medium sized non- granulomatous keratic precipitatesQ There may also be associated corneal edema, which resolves with lowering of the 10P. Intraocular pressure elevation is usually as high as 40-60 mmHg, which is due to blockage of the trabecular meshwork with mononuclear cellsQ Treatment: The aim of treatment is to address the anterior segment inflammation and lower 10PQ. Topical steroids and ocular hypotensive medications are sufficient to control these attacks but not to prevent Without intervention, these attacks usually resolve.
Chronic papilledema
Acute angle closure glaucoma
Glaucomatocyclitic crisis
Acute anterior uveitis