Non-Arteritic Anterior Ischemic Optic Neuropathy Secondary to Posner Schlossman Syndrome in a 26-Year-Old Female

Non-arteritic anterior ischemic optic neuropathy (NAION) is a condition that leads to ischemia and subsequent infarction of the optic nerve due to a disruption in blood supply. While the exact pathogenesis is largely controversial, NAION is presumed to result from a hypoperfusion to the short posterior ciliary arteries that supply the optic nerve head. Posner-Schlossman syndrome (PSS), otherwise known as glaucomatocyclitic crisis, is a benign disease marked by acute, unilateral, recurrent attacks of elevated intraocular pressure (IOP) accompanied by mild anterior chamber inflammation. Instances of IOP elevation may lead to decreased perfusion of the optic nerve head based on the principle that eye perfusion is inversely related to IOP and directly proportional to the mean arterial pressure. When pressure in the eye is elevated, it compromises blood flow, putting those with a small cupto- disc ratio at a higher likelihood of developing ischemia, swelling, and infarction. The purpose of this study is to describe a case of a 26-year-old patient with no cardiovascular risk factors and a small cup-to-disc ratio who presented to our clinic with NAION secondary to a high IOP.