Question 1

What causes pigment to be released from the iris?

Accepted Answer

It is thought that the anatomy of the eye in short-sighted people leads to contact between the iris and the lens and its supporting structures. This can cause chafing or rubbing during normal activities such as focusing to read. Vigorous exercise may also increase pigment release in some patients. If you have pigment dispersion syndrome and are concerned about exercise, please discuss this with your doctor before starting or stopping any exercise programme.

Question 2

How is pigmentary glaucoma diagnosed?

Accepted Answer

Typically patients have no symptoms early in the disease. When it advances, a patient may notice difficulty with side vision, and rarely episodes of haloes or blurry vision. Your ophthalmologist will carry out a thorough examination of your eyes, including the drainage angle. Patients with pigment dispersion often have more pigment than usual in the drainage angle, pigment on the inner lining of the cornea, and thinning of the iris where chafing occurs. Imaging of the optic nerve and formal visual field testing are also commonly needed.

Question 3

What medical treatments are available?

Accepted Answer

Medical treatment of pigmentary glaucoma is similar to treatment for primary open-angle glaucoma. Your doctor will advise on the best approach for you, which may involve eye drops, laser treatment or sometimes surgery.

Question 4

What laser treatments are available?

Accepted Answer

A laser procedure can make a small hole in the iris to change the eye's anatomy so there is less iris chafing and therefore less pigment dispersion. A different laser, laser trabeculoplasty, can also be used to improve drainage and lower pressure, and can be very effective in pigmentary glaucoma because of the extra pigment in the drainage angle. For more aggressive cases, surgical options such as trabeculectomy or tube shunt surgery may be considered.

Question 5

What is the outlook with pigmentary glaucoma?

Accepted Answer

Because pigmentary glaucoma can have no symptoms and typically occurs at a younger age, it is often underdiagnosed. However, if identified early and treated appropriately, patients usually do well and blindness from this form of glaucoma is relatively rare. In some cases the pigment dispersion may even regress over time, and sometimes eye pressures return to normal. As with all types of glaucoma, regular follow-up examinations are critical to preserving sight.

What medical treatments are available?

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