Pigmentary Glaucoma

Pigmentary dispersion syndrome is a condition in which increased amounts of pigment circulate within the front portion of the eye. This often results in having pigment layered on the back of the cornea, thinning of the iris creating characteristic ‘Transillumination Defects,’ and clogging of the ocular drainage system with pigment. A pathognomonic finding is deposition of pigment behind the crystalline lens, the so-called Scheie’s Line. This dispersed pigment can block the drainage channel enough to cause an increase in intraocular pressure (IOP). If the pigment is cleared by the eye’s drainage system without damage to the drainage channels, then the eye pressure does not stay elevated. However, should the trabecular meshwork be damaged by the body’s reaction to the pigment, the pressure will rise and glaucoma can result.

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In cases of pigmentary glaucoma, the IOP often is very high, reaching levels above 40 mm Hg. Pigmentary dispersion leads to pigmentary glaucoma in 20% to 50% of patients. It is more common in males and often appears in people under 50 years of age.

Treatment is the same as for other forms of open-angle glaucoma, including medications, laser therapy, or surgery. With adequate treatment, the prognosis for pigmentary glaucoma is good.

© 2020, 2015, 2009 Dr. Robert Schertzer Inc. based on 2007 The American Academy of Ophthalmology

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This post was written by Rob Schertzer