A 30-year-old man presents with his third episode over two years of unilateral blurred vision and mild ocular ache. Each episode shows markedly raised intraocular pressure around 42 mmHg, fine stellate keratic precipitates, only trace anterior chamber cells, and a mid-dilated unreactive pupil. Between episodes the eye and pressure are normal. The diagnosis is:
- A Acute angle-closure glaucoma
- B Fuchs heterochromic iridocyclitis
- C Posner-Schlossman syndrome ✓
- D HLA-B27 associated acute anterior uveitis
Correct answer: C. Posner-Schlossman syndrome
Explanation
Posner-Schlossman syndrome (glaucomatocyclitic crisis) features recurrent unilateral attacks of markedly elevated IOP with only mild anterior chamber inflammation and stellate KPs, due to trabeculitis. Complete resolution between attacks distinguishes it from Fuchs heterochromic iridocyclitis, which is chronic with diffuse iris stromal atrophy. Angle closure shows a shallow chamber and no KPs, and HLA-B27 uveitis produces heavy cell and flare with hypopyon or fibrin rather than dominant pressure rise.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.