60 yrs/f , c/o pain in eye since today morning. H /o redness since yesterday. VA is less than 6/60. Lt headache is present. pupils is sluggishly reacting to light. Dx & Rx.



This pt has mild cilliary congestion . Cornea is slightly hazy , & pupil is small ( not dilated ) with sluggish reaction to light . So apperantly it looks like a case of acute iridocyclitis & I had suspected iridocyclitis. But when I examined on slit lamp , there was corneal edema with small bullae scattered all over cornea & shallow AC. Iop was 54.7 mm hg. But surprisingly pupil was not dilated & was small with presence of sluggish reaction to light. So this is a case of acute angle Clo sure glaucoma.

Dr Harshad ! Thanx for updating ! As per your latest description and adding further findings my impression is as follows : Posner schlossman syndrome ( PSS ) ( Glaucomatocyclitic crisis ) . Pls do gonioscopy : the angle will help in coming to further confirmation about this case as in PSS the angle is open . This is a really nice case !

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There is circumciliary congestion pupilis sluggish mildly diated patient having pain their is slight exudate in AC I see one or two k pl cornea is hazy in pupillary area it looks like a case of kerato uveitis must have used cyclogyl If tension is increased must be secondary glacoma

Superonasal bulbar conjunctiva is showing avascular zone look like alkali burn IOP may be raised due to associated trabeculitis, pupil is slightly vertically oval & ciliary congestion is present indicating anterior uveitis in second & third picture it shows some cataract also

Could be either AAU or ON

Do u mean optic neuritis by " ON " ?

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This case needs more information as photo is not enough to come to conclusion . Only guess work and generating differential diagnodis may not be plausible . please give more information if possible so that discussion becomes more enjoying and fruitful . If u r not offended and dont mind then please share following additional information about the case . 1. IOP 2. RAPD : present or absent 3.AC depth & Ac cells & flare 4. Angle status : gonioscopy 5. Fundus finding if possible

Dear sir , this is a little bit interesting case & that's why I have deliberately withheld the findings u have asked for . I am going to furnish you the findings in next reply , but can u make out more likely possibility just by looking at the photos & complaints & the details already given ?

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Nice case sir

Thank u mam.

Acute anterior uveitis

Could be lntumescent lens causing glaucoma. Antr chamber is shallow. Iv mannitol. Diamox tablet Record IOP Take the case for lens extraction.

With addition of information , My impression is : Posner Schlossman syndrome ( PSS ) (Glaucomatocyclitic crisis )

Lt eye: glaucoma:closed angle

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