Iris Plateau Configuration With Secondary Pigment Dispersion: A Case Report

Pigment dispersion (PD) and plateau iris configuration (PIC) are ocular conditions associated with increased intraocular pressure (IOP) and the development of glaucoma. PD involves the dispersion of pigment epithelium of the iris into the anterior chamber due to contact between the iris and zonular fibers, which subsequently blocks the trabecular meshwork and elevates the IOP. Anatomical variation in PIC narrows the anterior chamber angle. This case report aims to highlight a rare instance of concurrent PD secondary to PIC, conditions that are underreported despite their significant risk of glaucoma-related sequelae. A 64-year-old male presented with blurred vision, pigmented cells in the anterior chamber, and optic disc cupping. Ultrasound biomicroscopy indicated a closed angle with 360-degree anterior rotation of the ciliary body, absence of ciliary sulcus, and chaffing of the posterior iris with the lens capsule and zonules. Collectively, these findings indicated PD secondary to PIC. The condition was managed with phacoemulsification and intraocular lens implantation to address the dual pathology and reduce the risk of glaucoma. The co-occurrenceof PD and PIC necessitates vigilant monitoring and tailored therapeutic approaches to prevent irreversible optic nerve damage and vision loss. Additional studies are necessary to clarify the underlying mechanism and optimize diagnostic and treatment strategies for these complex ocular conditions. Early detection and collaborative management are essential in decreasing the risk of glaucoma and preserving visual function in affected individuals.