Pigmentary glaucoma

Pearls Manager: Andrew Tatham

Pigmentary glaucoma represents 1 to 1.5% of all glaucoma cases. It is more common in Caucasian myopic men and is typically diagnosed at the age of 30 to 50 years. The risk of developing pigmentary glaucoma from pigment dispersion syndrome is 25 to 50%.

Signs of pigment dispersion include backward bowing of the peripheral iris, mid-peripheral iris transilluminations, Krukenberg spindle and dense pigmentation of the trabecular meshwork with pigment at or anterior to Schwalbe’s line. Large intraocular pressure fluctuations are common.

EGS Guidelines, 4th edition, Page 92

Niyadurupola N, Broadway DC. Pigment dispersion syndrome and pigmentary glaucoma – a major review. Clin Experiment Ophthalmol, 2008;36(9):868-82.