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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Posner-Schlossman syndrome, also called glaucomato-cyclitic crisis, is an ocular disease characterized by monocular rises in intraocular pressure and cyclitis. The cause of the disease remains unknown. However it could be asked whether this syndrome is not the clinical expression of immunologic reactions of the anaphylactoid type, in connection with a viral infection, in genetically predisposed patients. The treatment of the crisis consists of the administration of inhibitors of carbonic anhydrase as well as local application of betablockers and corticosteroids drops. There is actually no treatment preventing recurrences.
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PMID:[The Posner-Schlossman syndrome]. 248 28

A series of patients is presented showing the widely variable clinical behaviour of different groups of patients who share the common features of cyclitic glaucoma. These cyclitic glaucomas may be classified: 1. Glaucomatocyclitic crises: unilateral or bilateral. This condition presents acutely, almost always in males with a strong tendency to spontaneous resolution but a liability to subsequent recurrence. Some cases are slow to resolve and may recur frequently. 2. Heterochromic cyclitis: glaucoma infrequently complicates heterochromic cyclitis and then with only a mild rise in intraocular pressure (IOP). 3. Chronic cyclitis: unilateral or bilateral. This is more common in females often presenting with a high rise in IOP which may be difficult to control medically. An insidious form of chronic cyclitis occurs in middle-aged, blue-eyed females, often with sarcoid, and is likely to progress to profound visual loss if unrecognised.
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PMID:Cyclitic glaucoma. 275 30

In Posner-Schlossman syndrome a repeated crisis of intraocular pressure (IOP) elevation to 25-45 mmHg continues for 3-10 days. During the relapses glaucomatous damage often occurs. The IOP and its variation during the crisis are similar to those in glaucoma simplex. Therefore, the syndrome can be considered as a natural model for investigations into glaucoma simplex. By analyzing five cases of Posner-Schlossman syndrome in which the glaucomatous lesions ranged from the earliest to advanced stages, the development and progression of glaucomatous damage of the optic nerve at varying chronically elevated IOP levels became evident. The earliest evident fundus change is a nerve fiber layer defect (NFLD) in the Bjerrum tangent, and not the enlargement of the physiologic excavation. The latter does not develop before stage IV. The slit-like NFLD shows a decrease in sensitivity of 0.2-0.4 log ND unit, which is thus easily overlooked. As the disease progresses the NFLD becomes more pronounced, its width increases and it becomes wedge-shaped. Due to a considerable loss of nerve fibers at the wedge-shaped defect, a small notch which develops in the direction of NFLD is not observed until stage IV. Goldmann perimetry demonstrated a certain abnormality at stages IV-V; in addition to the wedge-shaped NFLD, diffuse thinning of the NFLD begins around the optic disk and develops into a large, concentric excavation. For identification of the most delicate NFLDs, stereo fundus photography in color with 8-fold magnification, on 6 x 6 film is recommended.
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PMID:[Early fundus changes caused by repeated small crises in the Posner-Schlossman syndrome: a model for glaucoma simplex]. 707 89

The intraocular pressure (IOP) of glaucomatocyclitic crisis with the attack fell 50.3%, from 37.8 +/- 8.2 mmHg to 18.8 +/- 4.8 mmHg, 4 hours after instillation of 1% apraclonidine. Glaucomatocyclitic crisis showed a more significant hypotensive response to 1% apraclonidine than primary open-angle glaucoma (24.8%, from 43. 1 +/- 8.1 mmHg to 32.4 +/- 7.5 mmHg after 4 hours). The intraocular pressure decrease percentage was similar regardless of the initial level of intraocular pressure. Clinically significant changes in mean systolic and diastolic blood pressures, were not observed, however, a mild decrease in the pulse rate was noted. And the local mydriatic effect on the pupillary diameter was significant. Apraclonidine, 1% might be newly indicated to control the IOP rise of glaucomatocyclitic crisis. Further studies on the possible mechanism of the prostaglandin mediated hypotensive effect of 1% apraclonidine are suggested.
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PMID:Effect of apraclonidine hydrochloride on the attack of Posner-Schlossman syndrome. 790 42

Posner-Schlossman syndrome (glaucomatocyclitic crisis) is a condition of unknown etiology. Patients present with blurred vision, show minimal anterior chamber activity, and raised intraocular pressure (IOP). Corneal edema may cause colored halos. The condition tends to be recurrent, usually responding to a topical steroid and ocular hypotensives. The eyes appear normal between attacks. We present a patient who had bilateral Posner-Schlossman syndrome and underwent filtering surgery to control raised intraocular pressure in both eyes. During the follow up of more than 4 years, the control of IOP was good and he had no further attacks.
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PMID:Trabeculectomy in the management of Posner-Schlossman syndrome. 1213 94

A 41-year-old woman with acute OD pain and decreased visual acuity presented with anterior uveitis, an intraocular pressure of 56 mm Hg, an open angle, ipsilateral nerve fiber bundle visual field defects, and optic nerve edema. With control of intraocular pressure and uveitis, visual acuity improved to 20/25, visual field defects persisted, and optic disc pallor developed. She has remained stable over 23 months of follow-up. This case represents a concurrence of glaucomatocyclitic crisis (Posner-Schlossman syndrome, PSS) and nonarteritic ischemic optic neuropathy (NAION). Although this combination occurs rarely, patients with PSS and other risk factors for NAION, including an optic disc that lacks a physiologic cup, should be protected against NAION by prophylactic treatment with ocular antihypertensive medications.
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PMID:Posner-Schlossman syndrome and nonarteritic anterior ischemic optic neuropathy. 1466 6

Glaucomatocyclitic crisis is caused by an idiopathic inflammatory process of the trabecular meshwork, causing a decrease in aqueous outflow. This decrease causes the cyclitis-associated ocular hypertension. There is rarely any pain or other findings typically associated with glaucoma. Thus, the diagnosis is easily missed. Patients may present with nonspecific symptoms such as blurry vision or periorbital discomfort. Examination typically reveals a noninjected, slightly mydriatic eye. Slit-lamp examination may reveal fewer-than-expected inflammatory cells in the anterior chamber, with only occasional small nonpigmented keratic precipitates on the corneal epithelium. The intraocular pressure is typically increased (30 to 70 mm Hg), despite an open angle. Therapy is aimed at controlling the increased intraocular pressure with the use of topical imidazolines, beta-blockers, and carbonic anhydrase inhibitors. Complications related to prolonged and recurrent attacks of increased intraocular pressure may result in damage to the optic nerve head and visual field compromise.
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PMID:A case of glaucomatocyclitic crisis in the emergency department. 1643 Dec 28

Studies have shown that pressure phosphene tonometry (PPT) may be applied to glaucoma patients. It has the potential for patients to self-monitor the intraocular pressure (IOP) at home. We describe the successful use of this approach in a patient with Posner-Schlossman syndrome. In the first part of the study, we investigated whether our patient could use PPT accurately and reliably. In the second part of the study, our patient performed daily home self-tonometry, and was educated to seek ophthalmic assessment if his self-measured IOP was >or=21 mmHg. The outcome measurements included IOP and the number of unscheduled attendances for ophthalmic assessment. The use of PPT reduced his number of unscheduled hospital visits from 0.82 to 0.47 visits per month. PPT can be applied with accuracy, reliability and safety in patients with Posner-Schlossman syndrome, with potential benefits in reducing unnecessary ophthalmic attendances by nearly 50%.
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PMID:Pressure phosphene self-tonometry in a patient with Posner-Schlossman syndrome. 1692 96

Posner-Schlossman syndrome is a rare eye condition involving mild anterior chamber inflammation and extreme intermittent intraocular pressure elevations. Symptoms are mild and not incapacitating, but aviators need proper diagnosis and treatment to ensure that visual acuity and visual fields are not affected.
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PMID:Posner-Schlossman syndrome and medical certification. 1704 59

Posner-Schlossman syndrome (PSS) or glaucomatocyclitic crisis is a rare, typically unilateral recurrent inflammatory ocular hypertensive disease in which diagnosis can be challenging. An acute elevation of intraocular pressure is accompanied by or followed within a few days by a mild, often symptomless uveal inflammation. The mild nature of the uveitis at presentation of the first attack may go undetected. Medical treatment is indicated to prevent pressure-related optic nerve damage and to reduce inflammation. This report details a patient with Posner-Schlossman syndrome whose unilateral pressure elevation was initially treated as acute angle-closure glaucoma. He subsequently had several episodes of increased pressure over a two-year period. Diagnostic difficulties in this case are discussed.
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PMID:Posner-Schlossman syndrome (glaucomatocyclitic crisis). 1717 67


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