Glaucomatocyclitic crisis in a Nigerian child: a case report

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.