Page 56 - 21st Century Perspective - Glaucoma Supplement

Figure 29.​ A, Iris pigmented debris on the corneal endothelium. B, Iris retroillumination defects. C, Heavily pigmented trabecular
tissues from all the iris pigmented epithelial debris accumulating there.

Pigmentary glaucoma​ occurs when there is consistently elevated IOP with resultant glaucomatous
optic atrophy.

Pigmentary glaucoma

The conversion to pigmentary glaucoma occurs in 30% to 50% of patients with pigment dispersion
syndrome. The typical patient with pigmentary glaucoma is young, myopic and male. Pigmentary
glaucoma usually occurs after several years of pigment dispersion, and it is a bilateral asymmetric
disorder. These patients will have radially shaped iris transillumination defects, best seen when the
room is darkened, the slit lamp is on low power setting and a small beam of light is shown through

the nondilated pupil. This floods the eye with light, thus retroilluminating the iris, thereby revealing

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