Pigmentary glaucoma
Last reviewed: 23.04.2024
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The most important pigment, contained in biological tissues and providing skin color, is melanin. The pigment layer contained in the eye absorbs excess light that is not used by the retina in the process of the visual act. It is located between the retina and the choroid of the eye (pigment epithelium).
The iris, which performs the function of the diaphragm, also contains a pigment that absorbs light. The greatest amount of melanin is normally found in the back sheet of the iris. Melanin, contained in the front sheet of the iris, determines the color of the eyes: from blue (with an insignificant amount of pigment) to dark (with its expressed content).
Pigment lumps may be deposited on the surface of the eye's structures (this is called dispersion syndrome). This condition in some cases contributes to increased intraocular pressure and the development of pigment glaucoma.
Most often, the deposition of pigment is observed on those surfaces of the eye, which are constantly washed with watery moisture, for example, on the back surface of the cornea, forming the so-called Crookenberg spindle.
[Symptoms of pigmentary glaucoma
Pigmentary dispersion syndrome is characterized by a specific eye structure: a deep anterior chamber, a wide angle. Often with this pigment syndrome, myopic refraction is observed. Iris has a concave shape with a slant back, because of which the iris is in contact with the cinnamon ligaments. This leads to mechanical erasing of the pigment from its back surface and the formation of defects in it as rays. Especially a large amount of pigment accumulates in the trabecular network, which can lead to the development of pigment glaucoma. In a patient with pigmentary dispersion syndrome, when blinking (with the corresponding structure of the eye), watery moisture is squeezed out from the back chamber into the anterior chamber, which leads to an increase in the pressure in it. The reverse current of the watery spine is no longer possible, since the iris, which performs the function of the valve, is pressed against the lens.
Pigment syndrome is more common in men and is accompanied by myopia. The age of patients is 20-50 years. In elderly people, the syndrome is less common. This is due to the fact that with age the lens grows in thickness and pushes the iris forward from the zinn ligaments. With age, there is a weakening of accommodation and a decrease in melanin stocks.
With pigment glaucoma, pigmentation of the anterior chamber angle is noted. This glaucoma can take a severe course, especially with marked fluctuations in intraocular pressure.
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Treatment of pigment glaucoma
In most cases, surgical intervention is necessary.
Peripheral laser iridotomy is also used, in which the difference in pressure between the anterior and posterior chambers is reduced and thus prevents the peripheral iris from deflecting back.