Question
A 25-year-old man presents with a painless red eye. His intraocular pressure (IOP) is measured at 60 mmHg. What is the most likely diagnosis?
| A. |
Chronic papilledema
|
| B. |
Acute angle closure glaucoma
|
| C. |
Glaucomatocyclitic crisis
|
| D. |
Acute anterior uveitis
|
Show Answer
|
Correct Answer » C
Explanation
|
|
- Young adult with painless red eye
- Markedly elevated intraocular pressure (IOP = 60 mmHg)
- Minimal symptoms despite very high IOP is characteristic
- Posner–Schlossman syndrome presents with:
- Mild unilateral anterior uveitis
- Recurrent attacks
- Open-angle glaucoma with very high IOP
- Mild redness with little or no pain
Reasons to Rule Out Other Options
A. Chronic papilledema
- Papilledema is optic disc swelling due to raised intracranial pressure
- Does not usually cause:
- Red eye
- Markedly raised IOP
- Acute ocular presentation
- Hence unlikely
B. Acute angle-closure glaucoma
- Typically presents with:
- Severe painful red eye
- Headache
- Nausea/vomiting
- Halos around lights
- Although IOP can be very high, the eye is usually extremely painful
- Painless presentation rules it out
D. Acute anterior uveitis
- Usually presents with:
- Pain
- Photophobia
- Ciliary congestion
- Small constricted pupil
- IOP is usually low or mildly elevated initially
- IOP of 60 mmHg with painless eye is atypical
