PIGMENTARY GLAUCOMA

Pigmentary glaucoma is a type of inherited open-angle glaucoma which develops more frequently in men than in women. It most often begins in the twenties and thirties, which makes it particularly dangerous to a lifetime of normal vision. Nearsighted patients are more typically afflicted. The anatomy of the eyes of these patients appears to play a key role in the development of this type of glaucoma. Let us examine why.

Myopic (nearsighted) eyes have a concave-shaped iris which creates an unusually wide angle. This causes the pigment layer of the eye to rub on the lens. This rubbing action causes the iris pigment to shed into the aqueous humor and onto neighboring structures, such as the trabecular meshwork. Pigment may plug the pores of the trabecular meshwork, causing it to clog, and thereby increasing the IOP.

Miotic therapy is the treatment of choice, but these drugs in drop form can cause disabling visual blurring in younger patients.

Fortunately, a slow-release form is available. Laser iridotomy is presently being investigated in the treatment of this disorder.