Is Posner Schlossman syndrome benign?

PURPOSE: To determine the clinical course of patients with Posner Schlossman syndrome (PSS).

DESIGN: Retrospective noncomparative case series.

PARTICIPANTS: Fifty-three eyes of 50 patients.

METHODS: The case notes of all patients with PSS seen at the Uveitis Clinic of Singapore National Eye Centre were reviewed for evidence of glaucoma damage and risk factors.

MAIN OUTCOME MEASURES: Visual field and optic disc changes consistent with glaucoma.

RESULTS: There were 28 men and 22 women, and their mean age at onset was 35 years. Fourteen eyes (26.4%) were diagnosed to have developed glaucoma as a result of repeated attacks of PSS. Patients with 10 years or more of PSS have a 2.8 times higher risk (95% confidence interval 1.19-6.52) of developing glaucoma compared with patients with less than 10 years duration of the disease. Nine eyes (17%) underwent glaucoma filtering surgery with antimetabolites. Their postoperative follow-up ranged from 15 to 50 months (mean, 37 months). Four eyes continued to have episodes of iritis after surgery, and one of these eyes had elevated intraocular pressure during the event.

CONCLUSIONS: A significant number of patients with PSS have glaucoma develop over time, and they need to have their optic disc appearance and visual fields carefully monitored.