Differential Diagnosis - Pacific University
Differential Diagnosis - Pacific University
Differential Diagnosis - Pacific University
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
*<br />
Is Posner Schlossman Syndrome<br />
Benign<br />
• CASE PP: 37 yo AM<br />
1 st exam in 09/2007: Pt at that time reports recurrent uveitic<br />
attacks OD x 5-6x/year and reports he felt he was having an attack at<br />
that time: discomfort and slight blurred vision OD.<br />
VA 20/20- OD, OS<br />
IOP 22 OD, 14 OS mmHg<br />
C/D ratio 0.5 H/V OD, 0.4 H/V OS<br />
Assessment: Recurrent non-granulomatous anterior uveitis OD<br />
Plan: Scopolamine bid, Cosopt bid, Pred Forte q2hr OD, RTC 3<br />
weeks for follow up<br />
Date<br />
Acute<br />
Attack<br />
vs<br />
Follow<br />
Up<br />
Visual Acuity<br />
OD, OS<br />
9/29/2007 AA 20/20‐ OD,<br />
OS<br />
IOP<br />
OD, OS<br />
Present<br />
ocular meds<br />
Plan<br />
22, 14 None PF q2hr,<br />
scop bid,<br />
cosopt bid<br />
OD. RTC 3<br />
days<br />
10/1/07 FU 20/25 OD, OS 12, 12 PF q2hr, scop<br />
bid, cosopt<br />
bid OD<br />
10/5/2007 FU 20/25 OD<br />
20/20 OS<br />
10, 14 PF qid, Scop<br />
bid, Cosopt<br />
bid OD<br />
PF qid,<br />
continue<br />
Scop/coso<br />
pt bid OD<br />
RTC 4<br />
days<br />
Taper PF,<br />
d/c<br />
Cosopt<br />
and scop<br />
OD<br />
RTC 3<br />
weeks<br />
Additional<br />
Recurrent<br />
NG<br />
Anterior<br />
Uveitis<br />
“”<br />
“”<br />
Date AA vs FU Visual<br />
Acuity<br />
OD, OS<br />
1/30/12 AA 20/15,<br />
20/20<br />
2/10/12 FU 20/15,<br />
20/20<br />
3/5/12 FU with<br />
AA:<br />
symptoms<br />
presented<br />
yesterday<br />
20/15,<br />
20/20<br />
3/19/12 FU 20/20 OD,<br />
OS<br />
IOP<br />
OD, OS<br />
Present ocular meds<br />
27, 11 Self initiated PF 1day<br />
ago OD<br />
Plan<br />
PF qid and Brimonidine<br />
bid OD, RTC 10 days<br />
8, 11 PF qid, Brim bid OD Taper PF, continue<br />
Brim bid OD<br />
RTC 3 weeks for<br />
DFE/OCT<br />
32, 12 None Begin PF qid x 2 weeks,<br />
Brim bid OD. RTC 2<br />
weeks.<br />
7, 14 PF qid and Brim qd<br />
OD<br />
Taper PF slowly,<br />
continue brimonidine<br />
bid OD. Begin trial IBU<br />
200mg po tid. F/U in 1<br />
mo.<br />
03/05/12<br />
RNFL thickness OCT<br />
Impression:<br />
Good symmetry in a triple<br />
hump pattern OD, OS.<br />
No glaucomatous RNFL<br />
thinning OD, OS.<br />
Is Posner Schlossman Syndrome<br />
Benign<br />
• Case 2: NH 67 yo AAM<br />
– 2007: OS red with 8/10 pain, photophobia, and cloudy vision. Pt<br />
reports several occurrences over past few years. Last occurrence<br />
3-4 mos ago and reports it usually resolves in 1 week.<br />
• VA 20/20 OD, 20/30- OS<br />
• Pupils: (+)APD OS<br />
• SLE: +KP’s and 1+ cells OS<br />
• IOP 16 OD/48 OS mmHg<br />
• C/D 0.4 OD, 0.6 OS<br />
• Assessment: Trabeculitis OS<br />
• Plan: Alphagan tid OS, Levobunolol bid OS, Dorzolamide bid OS, IOP check<br />
1 day<br />
Date VA IOP Current ocular meds Plan<br />
4/27/07 20/20, 20/25‐ 16, 36 Brim tid, levo bid, dorz bid, PF<br />
qid<br />
5/2/07 20/20, 20/25 16, 15 Brim tid, levo bid, dorz bid, PF<br />
taper<br />
CPM, RTC 5<br />
days<br />
Taper PF, RTC 2<br />
weeks for<br />
CEE/IOP check<br />
6/5/07 20/20, 20/25 18, 18 Self D/C all meds Start Cosopt tx<br />
bid OS, RTC 6<br />
mos for<br />
HVF/OCT/IOP<br />
12/6/07 20/20, 20/25 18, 22 Cosopt bid OS<br />
RTC 6 weeks<br />
for IOP check.<br />
***FDT at this date showed<br />
nasal step and early inferior<br />
arcuate defect OS. C/D 0.4<br />
OD, 0.6 OS<br />
LOST TO FOLLOW UP<br />
4/10/09 20/20, 20/30‐ 19,54 D/C cosopt bid OS<br />
C/D : 0.45 OD, 0.95 OS<br />
***OCT today<br />
Cosopt bid,<br />
Brim bid, PF qid<br />
OS<br />
Coursebook Page 43 of 139<br />
3
Change language