What is Posner-Schlossman syndrome (PSS) (glaucomatocyclitic crisis)?

Updated: May 18, 2020
  • Author: Leonard K Seibold, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Posner-Schlossman syndrome, also known as glaucomatocyclitic crisis, is an ocular condition with self-limited recurrent episodes of markedly elevated intraocular pressure (IOP) and nongranulomatous anterior chamber inflammation. It is most often classified as secondary inflammatory glaucoma.

In 1948, Posner and Schlossman first recognized glaucomatocyclitic crisis and described the features of this syndrome. [1] For this reason, the entity is often termed Posner-Schlossman syndrome (PSS). Their original paper identified key features of the condition, including recurrent episodes of mild cyclitis and uniocular involvement. Attack duration varies from a few hours to several weeks. Glaucomatocyclitic crisis is characterized by a slight decrease in vision, elevated IOP, and open anterior chamber angles, with normal visual fields and optic nerve appearance. In addition, IOP and outflow facility are normal between episodes. [2]

Since this original description, other cases attributed to glaucomatocyclitic crisis have been found to deviate from these criteria. [3]

Additional features that are now recognized are as follows:

  • Almost exclusively, this condition affects individuals aged 20-50 years.
  • Both eyes may be involved at different times but very rarely simultaneously. [4, 5]
  • The rise of IOP is out of proportion to the severity of the uveitis, and this rise in IOP precedes the identifiable inflammatory reaction, at times by several days.
  • Current literature supports cytomegalovirus (CMV) infection as the likely inflammatory precursor to the anterior uveitis and elevated IOP. [6]

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