Glaucomatocyclitic Crisis in a Nigerian Child: A Case Report

T. Sarimiye, S. Adebusoye
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Abstract

Background: Glaucomatocyclitic crisis is a condition that elicits significant elevated intraocular pressure (IOP) with minimal non-granulomatous anterior uveitis. It is usually unilateral, occasionally recurrent, and easily treatable in most cases. It is seen mainly in young adults but is rarely reported in children. This is to report an uncommon case of glaucomatous cyclitic crisis (Posner-Schlossman syndrome) in a Nigerian child. Case report: A 15-year-old boy presented with pain, haloes around light, photophobia, and decreased vision in the left eye over the course of the day. He has a similar history from 5 years ago, with a brief resolution on steroid eye drops. Ocular examination in the left eye revealed minimal non-granulomatous anterior uveitis with significantly elevated intraocular pressure. He was treated with topical steroid and ocular hypotensive and his IOP was 14 mmHg at 14 hours, down from 44 mmHg at the start. The anterior chamber was quiet by the fourth day of treatment. The clinical picture in this child was consistent with Posner-Schlossman syndrome. Following resolution of the inflammation and discontinuation of all medications, the patient is being followed up as a glaucoma suspect because of the subtle disc finding and the slight risk of glaucoma development later. Conclusion: Although glaucomatocyclitic crisis is uncommon in children, it should be considered in the differential diagnosis of uveitis and glaucoma in paediatric patients.
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尼日利亚儿童青光眼周期危象1例报告
背景:青光眼周期危象是一种引起眼压(IOP)显著升高并伴有轻度非肉芽肿性前葡萄膜炎的疾病。它通常是单侧的,偶尔复发,在大多数情况下很容易治疗。它主要见于年轻人,但在儿童中很少报道。本文报告一例少见的尼日利亚儿童青光眼周期性危象(Posner-Schlossman综合征)。病例报告:一名15岁的男孩,表现为疼痛,光晕,畏光,左眼视力下降,持续一天。他五年前也有类似的病史,曾短暂服用类固醇眼药水。左眼眼部检查发现轻度非肉芽肿性前葡萄膜炎,眼压明显升高。患者接受局部类固醇和眼部降压药治疗,14小时时IOP为14 mmHg,低于开始时的44 mmHg。在治疗的第四天,前房是安静的。该患儿的临床表现符合Posner-Schlossman综合征。在炎症消退并停止所有药物治疗后,患者被作为疑似青光眼进行随访,因为发现了细微的椎间盘,并且以后青光眼发展的风险很小。结论:虽然青光眼周期危象在儿童中并不常见,但在鉴别诊断葡萄膜炎和青光眼时应加以考虑。
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