Posner-Schlossman Syndrome (PSS), Glaucomatocyclitic Crisis (GCC), treatment attack, slit lamp

👁 What is Posner-Schlossman Syndrome (PSS)?

• First described in 1948 by Posner & Schlossman
• Also called Glaucomatocyclitic Crisis (GCC)
• Characterized by recurrent, unilateral episodes of elevated IOP with mild anterior uveitis
• Affects young to middle-aged males (20–50 years)

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🔍 Clinical Features

PhaseFindings

Acute attack

• Elevated IOP (40–60 mmHg)
• Mild ocular inflammation
• Keratic precipitates (KPs)
• Corneal epithelial edema
• Blurred vision, dull eye pain
  | Interattack phase |
• IOP normal
• No signs of inflammation
• Visual function preserved

➡️ May go undiagnosed for years due to subtle symptoms

 

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📉 IOP & Corneal Changes

IOP LevelEffect

40 mmHg	Corneal epithelial edema
55 mmHg	Stromal edema + Descemet folds
≥60 mmHg	Ocular discomfort, dull pain

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⚠ Risk of Glaucoma

Risk FactorsOutcome

Frequent/prolonged attacks	Optic disc cupping
High peak IOP	Visual field loss
Early-onset PSS	Faster progression
➡️ Up to 25–45% develop Primary Open-Angle Glaucoma (POAG)

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💊 Treatment Overview

PhaseManagement

Acute phase

• IOP-lowering drops
• Topical steroids
  | Glaucoma progression |
• Consider early trabeculectomy

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✅ Summary

• PSS = recurring mild uveitis + high IOP
• Often resolves spontaneously, but repeated attacks damage optic nerve
• Requires careful monitoring for glaucoma
• Early treatment can preserve vision