A 29-year-old man has recurrent attacks of blurred vision with coloured halos lasting a few days. During an attack the intraocular pressure is 46 mmHg, gonioscopy shows widely open angles, and there are only 1+ anterior chamber cells with a few small keratic precipitates. Between attacks the eye is completely normal. What is the diagnosis?
- A Acute congestive angle-closure glaucoma
- B Posner-Schlossman syndrome ✓
- C Fuchs heterochromic iridocyclitis
- D Glaucomatocyclitic crisis secondary to herpes zoster
Correct answer: B. Posner-Schlossman syndrome
Explanation
Posner-Schlossman syndrome, or glaucomatocyclitic crisis, features recurrent unilateral spikes of very high intraocular pressure with disproportionately mild anterior chamber inflammation, open angles, and complete resolution between attacks. Acute angle closure is excluded by the open angles and the paucity of symptoms such as severe pain and a mid-dilated fixed pupil. Fuchs heterochromic iridocyclitis is chronic and persistent, not episodic, and usually lowers pressure.
Reference: Khurana, Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.