A 40-year-old man has three discrete attacks over two years of blurred vision, halos around lights, and mild discomfort in the left eye. During attacks, intraocular pressure is 45 mm Hg with mild corneal epithelial edema, only a few fine keratic precipitates, minimal anterior chamber cells, and a deep chamber. Between attacks, examination and pressure are normal. The most likely diagnosis is:

• A Posner-Schlossman syndrome ✓
• B Fuchs heterochromic iridocyclitis
• C Acute angle-closure glaucoma
• D Pigment dispersion syndrome

Explanation

Posner-Schlossman syndrome, or glaucomatocyclitic crisis, consists of recurrent self-limited attacks of markedly elevated intraocular pressure with only mild anterior chamber inflammation, a few small keratic precipitates, and corneal edema, in an eye with an open deep chamber, returning completely to normal between attacks. Acute angle closure would show a shallow chamber and no keratic precipitates, while pigment dispersion shows a Krukenberg spindle, midperipheral iris transillumination defects, and heavily pigmented trabecular meshwork.

Reference: Khurana's Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.