Pigmentary glaucoma: symptoms and causes of its appearance

Pigmentary glaucoma is one of the rare forms of pathology in which a special pigment is washed out of the epithelial layer in the iris of the eye. Most often, this disease is diagnosed in males aged 30 to 45 years.

Causes of the development of the pathology of

Pigmentary glaucoma mainly affects a person after 30 years. Active production of pigment occurs due to overexertion during physical exertion or due to active pupil movement, as these signs contribute to the acceleration of the process of increasing intraocular pressure and provoke corneal edema.

Symptoms of pathology

More often, pigmentary glaucoma affects people with a special eye structure - a wide angle and a deepened anterior chamber. Iris usually has a concave shape and slightly evades back, due to which, it comes into contact with the cinnamon ligaments. For this reason, the pigment is mechanically erased from the back of the iris and defects appear in it. A large amount of pigment accumulates in the trabecular network, which provokes the formation of pigment glaucoma.

In a patient with pigment glaucoma during blinking, moisture enters the anterior chamber from the posterior, resulting in increased intraocular pressure. The reverse current is simply impossible, since the iris, which is a valve, is tightly pressed against the lens.

Pigmentary glaucoma often affects men and is supplemented by myopia. In the elderly, pathology is very rare, as the lens grows in size and moves the iris forward, distancing it from the zinn ligaments.

With the development of pigment glaucoma, pigmentation of the angle in the anterior chamber takes place. This form of the disease can be severe, especially when there is a strong pressure fluctuation within the eye.

Diagnosis of pathology

There are several basic ways to diagnose pigmentary glaucoma:

• Biomicroscopy - when it is organized, the following symptoms appear: pigment deposition on the front side of the iris, defects in the periphery of the iris, deposition of the pigment at the attachment of fibrils in the central part of the lens.
• Gonioscopy - marked deflection of the periphery of the iris back and an increase in the contact surface of the iris and lens. In this case, there is a moderate or pronounced pigmentation along the perimeter of the eye circumference.
• Posterior pole - with long-term increase or constant jumps in intraocular pressure, glaucoma optic nerve atrophy occurs. Patients with pigment glaucoma are at risk of peripheral ruptures in the retina, so a thorough examination is organized for them.

Treatment of pathology

The process of treatment of pigment glaucoma is based on the principle of curative therapy for open-angle glaucoma. One of the most effective means are myiotics. They increase the outflow of the eye fluid. But myotics have the main drawback - they increase the degree of development of myopia.

At the very beginning of the pathology development, trabeculoplasty provides a good effect, but during the next 5 years the patient may need to organize trabeculectomy.

Laser iridotomy is well suited to reduce the activity of pigment emission and to prevent defects and displacements of the iris.

If each of these treatments fails to produce the expected results, trabeculectomy is necessarily performed. The use of antimetabolites improves the quality of surgical intervention.

Forecasts for pathology treatment

With properly organized therapy, the prognosis remains positive, because after a while it becomes much easier to control the pressure inside the eye. In the best case, the intraocular pressure can be brought to a normal level. Patients who have not been diagnosed with pigment glaucoma in time may later make the wrong diagnosis of normal pressure glaucoma.