Pigmentary glaucoma

Question 1

What is the aetiology of pigmentary glaucoma?

Answer 1

Develops secondary to Pigment Dispersion Syndrome (PDS)

Question 2

What is the pathophysiology of pigmentary glaucoma?

Answer 2

Pigment granules break off from the iris from the iris pigment epithelium.

These granules clog up the trabecular meshwork via the aqueous humour currents elevating the IOP

Question 3

What are the signs of pigmentary glaucoma

Answer 3

• Fluctuated IOP
• Krukenberg spindle
• Deep AC and flare
• Radial transillumination
• Visible pigment ( within iris furrows, on anterior surface of lens,
  -open angle

Question 4

What are the symptoms a px would describe with pigmentary glaucoma?

Answer 4

• Previous trauma, surgery or eye disease
• Halo’s when looking at light
• Blurred Vision

Question 5

key facts about pigmentary glaucoma?

Answer 5

Difficult to predict
* Presentation is usually 3rd-4th decades
* Males more at risk of OAG development than females
* IOP can be very unstable (higher levels and wider fluctuations

Question 6

what is the referral of pigmentary glaucoma?

Answer 6

Pigment dispersion syndrome with normal IOP, no evidence of optic neuropathy, normal visual fields: monitor 12 monthly
* IOP raised: refer in accordance with level
* Evidence of glaucomatous optic neuropathy: routine referral

Question 7

what is the management for pigment dispersion syndrome?

Answer 7

Medical treatment for IOP
* Laser trabeculoplasty
* Laser iridotomy
* Trabeculectomy