Point-of-care monitoring of perioperative intraocular pressure using portable tonometry in a patient with Posner-Schlossman syndrome: a case report

Abstract

A 56-year-old man with a rotator cuff injury, scheduled for arthroscopic reconstruction surgery, had a history of recurrent symptoms of eyeball pain and blurred vision for several years. After close examination, he was diagnosed with Posner-Schlossman syndrome. Three weeks before the scheduled surgery, his intraocular pressure (IOP) increased (> 30 mmHg) and he became extremely anxious about the surgery. We monitored his IOP intraoperatively and successfully completed general anesthesia without any sequelae. As Posner-Schlossman syndrome can present with severe complications that may lead to postoperative visual loss, intraoperative monitoring of intraocular monitoring and careful anesthetic management are crucial to protect vision.

Keywords: Anesthesia; Intraocular pressure; Monitoring; Posner-Schlossman syndrome; Tonometry.

Fig. 1

Bedside measurement of intraocular pressure in the anesthetized patient using a portable tonometer. The transducer is gently tapped on the patient's cornea perpendicularly and pressure measured ten times. The device averages these readings and displays intraocular pressure on the screen.

Fig. 2

Serial monitoring of perioperative intraocular pressure and ocular perfusion pressure by portable tonometry. IOP: intraocular pressure, OPP: ocular perfusion pressure.