Pigment Dispersion Syndrome: An Overview

Abstract : Pigment dispersion syndrome (PDS) is an ocular condition defined by the release and subsequent dispersion of pigment granules from the iris pigment epithelium throughout the anterior segment of the eye. This process arises from the mechanical rubbing of the posterior iris surface against the lens zonules, leading to pigment shedding. The released pigment circulates within the aqueous humor and accumulates on various ocular structures, most notably the trabecular meshwork, the eye's drainage system. Clinically, PDS presents with characteristic signs, including iris transillumination defects, a Krukenberg spindle (pigment deposition on the corneal endothelium), and increased pigmentation of the trabecular meshwork. Notably, PDS is often associated with myopia and is more prevalent in young, Caucasian males. A significant concern is the potential progression to pigmentary glaucoma (PG), a secondary open-angle glaucoma, where pigment accumulation obstructs aqueous humor outflow, elevating intraocular pressure (IOP) and potentially damaging the optic nerve. Diagnosis relies on thorough slit-lamp examination and gonioscopy to visualize these signs. Management primarily focuses on lowering IOP through medications, laser trabeculoplasty, or surgery. As PDS can be asymptomatic, regular eye examinations are crucial for early detection and intervention to prevent PG and preserve visual function. Ongoing research also explores the genetic components that may contribute to PDS.