What is Pigmentary Glaucoma?

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  • Written By: Steve R.
  • Edited By: Kristen Osborne
  • Last Modified Date: 26 September 2019
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Pigmentary glaucoma is a rare form of glaucoma that occurs when the pigment layer of the eye rubs against the lens, forcing the pigment to move into the aqueous humor. This leads to fluid buildup, which puts pressure on the optic nerve, and can lead to blindness if it is not detected and treated in its early stages. Once pigmentary glaucoma sets in, the disease develops quickly. Treatment often includes eyedrops, medications, and surgical procedures.

Some individuals with pigmentary glaucoma don't experience any symptoms. Some people, however, may complain of blurred vision and seeing colored halos surrounding lights after rigorous exercise. Other symptoms are in line with those experienced by glaucoma patients, including a decrease in peripheral vision and extreme eye pain. In addition, the eyes may appear red and water excessively.

Another symptom of pigmentary glaucoma includes Krukenberg's Spindle. Krukenberg Spindle's is a thin, vertical band of pigments that accumulate on the cornea. This buildup is caused by pieces of pigment from the back of the iris. Transillumination defect of the iris is another indication of the eye condition. This defect of the iris results in a pigment loss on the iris, and the pigment is improperly scattered throughout the eye.


Caucasian men are prone to pigmentary glaucoma than women, and men also usually need more radical medical attention treatment, including surgical procedures, to treat the disease. In addition, the disease often affects people who are nearsighted, and generally strikes people in their 20s, 30s, and 40s. Those who participate in hearty exercise, such as running and playing basketball, also may be susceptible to this form of glaucoma, as rigorous exercise produces more pigment to be discharged from the iris, preventing eye drainage.

Prescribed eyedrops used in treating pigmentary glaucoma have minimal side effects and are easy to use. Other medication, called miotics, may also be used in treatment. Miotics cause the pupils to become smaller, which helps to reduce the amount of pigment that is released. Miotics do, however, often have side effects, such as causing blurred vision.

In some instances, laser treatment may be used in treatment. Argo laser trabeculoplasty involves using a laser to increase the fluid flow into the eye, which helps to lower eye pressure. While this treatment works initially, often times patients will report a feeling of pressure on their eye years down the road.

Another treatment option is trabeculectomy. This outpatient procedure that takes less than 60 minutes helps to drain the aqueous humor. A small flap is made in the white of the eye, allowing for the aqueous humor to be absorbed into surrounding blood vessels.


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