Glaucoma Associates of New York: Robert Ritch, M.D
Joe Jarosz is an engineer who was diagnosed with pigment dispersion syndrome while in his 40s. Relatively young, Caucasian and nearsighted, Joe fits the typical profile for this syndrome.
Although rare, pigment dispersion syndrome and pigmentary glaucoma tend to occur at a younger age than primary open-angle glaucoma.
Pigment dispersion syndrome occurs when pigment granules that normally adhere to the back of the iris (the colored part of the eye), flake off into the clear fluid produced in the eye, called the aqueous humor. Sometimes these granules flow toward the drainage canals of the eye, slowly clogging them and raising eye pressure. This rise in eye pressure can damage the optic nerve, the nerve in the back of the eye that carries visual images to the brain. If this happens, pigment dispersion syndrome becomes pigmentary glaucoma.
Doctors often treat pigmentary glaucoma with eyedrops such as Betagan, Timoptic, Optipranlol and Xalatan. These eyedrops have a relatively low incidence of side effects and are generally well-tolerated in younger patients. Doctors may also use medications such as Pilocar, and Ocusert, which are from a class of drugs called miotics. These medications cause the pupil to constrict (become smaller) and inhibit the iris from rubbing against the supporting fibers of the eye’s lens, helping to prevent further release of pigment. However, miotics have side effects such as blurred vision which can limit their use.
In some patients, a laser treatment called argon laser trabeculoplasty works well. This procedure helps open up the drainage system in the eye to increase fluid flow, which lowers eye pressure and protects the optic nerve.
Another treatment for pigmentary glaucoma is a procedure called a laser iridotomy. A laser is used to make a small hole in the iris, causing the iris to move away from the lens of the eye. This prevents the lens fibers from scraping the pigment from the iris and clogging the eye’s fluid flow. However, it has limitations and does not always achieve its desired effect. Researchers are now conducting more evaluations of this procedure to determine its effectiveness.
The Exercise Connection
Studies have found that vigorous exercise such as jogging and basketball can cause more pigment to be released from the iris, which can further block eye drainage. Patients with pigment dispersion syndrome or pigmentary glaucoma should discuss this issue with their doctor.
Progression of pigment dispersion syndrome into pigmentary glaucoma
It is estimated that pigment dispersion syndrome develops into pigmentary glaucoma in about 30% of cases. Although pigment dispersion syndrome appears to strike both men and women at an equal rate, researchers are investigating why men develop pigmentary glaucoma up to three times more often than women. Studies have also shown this syndrome develops into pigmentary glaucoma at a younger age in men than in women.