Clinical profile and management of Posner Schlossman syndrome

Objectives: The present study was to evaluate the clinical profile and management of Posner Schlossman syndrome in tertiary care center of North Bihar. Methods: The diagnosis of PSS was made on the basis of the presence of mainly unilateral recurrent mild non‑granulomatous iritis with cells in the anterior chamber, with/without fine KPs, elevated IOP, open angles on gonioscopy, without posterior synechiae or posterior uveitis, with the attack lasting few days to weeks. Other causes of uveitis were ruled out by certain investigations: tuberculin skin test, chest X‑ray, venereal disease research laboratory test (VDRL), fluorescent treponemal antibody absorption test (FTA‑ABS), IgG for toxoplasmosis, and serum angiotensin‑converting enzyme (ACE) test. Results: Out of the 30 patients with PSS, 16(53.33%) were affected in the right eye and 9(30%) were affected in the left eye. In 5(16.67%) patients, the affliction was bilateral in nature. Out of 36 eyes. cataract was seen in 3(8.33%) eyes and glaucoma in 10(27.78%) eyes. 22(61.11%) eyes had mild or no visual impairment (visual acuity better than 20/70), 4(11.11%) eyes had moderate visual impairment (<20/70 to 20/200). 1(2.78%) eye had severe visual impairment (<20/200 to 20/400). 2(5.55%) eyes had blindness (>20/400 to 20/1200). 1(2.78%) eye had blindness (>20/1200 to PL). 1(2.78%) eye had blindness (NPL). And the visual acuity was undetermined or unspecified in 5(13.89%) eyes. The mean logMAR at presentation was 0.43 ± 0.65. Conclusions: PSS is more common in young to middle aged population. It is predominantly unilateral involvement. Common comorbidities are glaucoma. High potency steroids are mostly used for the treatment of PSS. Mild or no visual impairment are seen in most of the Posner Schlossman syndrome patients.