Glaucoma
Posner-Schlossman Syndrome
Also known as: Posner-Schlossman syndrome, PSS, glaucomatocyclitic crisis, glaucomato-cyclitic crisis, recurrent unilateral elevated IOP, trabeculitis IOP, recurrent IOP spikes uveitis, glaucoma uveitis attack
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
A recurrent condition of unilateral attacks of markedly elevated intraocular pressure (30–60 mmHg) associated with mild anterior uveitis (trabeculitis). Also known as glaucomatocyclitic crisis. Between attacks the eye is normal. The elevated IOP is disproportionate to the minimal inflammation. Must be distinguished from primary angle closure glaucoma and herpetic uveitis.
Recognition
Symptoms: what patients report
- Recurrent episodes of mild unilateral eye ache or discomfort.
- Slightly blurred vision during the attack (from corneal oedema at very high IOP).
- Mild photophobia.
- Coloured haloes around lights if corneal oedema is present.
- Symptoms are typically mild and may not match the severity of IOP elevation.
- Between attacks: completely asymptomatic.
- Attacks last hours to weeks.
Signs: what the examination shows
- Markedly elevated IOP: typically 30–60 mmHg during an acute attack — disproportionate to the mild clinical signs.
- Minimal anterior chamber reaction: fine keratic precipitates, mild AC cells.
- Open angle on gonioscopy — NOT angle closure.
- Corneal oedema: fine epithelial oedema if IOP is very high.
- No posterior synechiae.
- Normal disc and normal angles between attacks.
- Recurrent unilateral attacks — usually the same eye each time.
What OptoGuide™ covers for posner-schlossman syndrome
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Glaucomatocyclitic Crisis (Posner-Schlossman Syndrome) — EyeWiki
- In vivo Confocal Microscopy of Posner-Schlossman Syndrome: Comparison with herpes simplex keratitis, HLA-B27 anterior uveitis and acute attack of primary angle closure. Hong Y, Wang M, Wu L. Scientific Reports. 2017;7(1)
- Posner-Schlossman Syndrome. Megaw R, Agarwal PK. Survey of Ophthalmology. 2017 May - Jun;62(3):277-285.
- Cytomegalovirus Anterior Uveitis: Clinical Manifestations, Diagnosis, Treatment, and Immunological Mechanisms. Zhang J, Kamoi K, Zong Y, Yang M, Ohno-Matsui K. Viruses. 2023;15(1):185.
- Centre for Eye Health — Chair-side Reference: Secondary Glaucomas
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.