Pigment is the material that gives your iris its color. Pigment dispersion syndrome (PDS) happens when the pigment rubs off the back of your iris. This pigment then floats around to other parts of the eye. The tiny bits of pigment can clog your eye’s drainage angle. This can cause eye pressure problems.
Your eye maintains a healthy eye pressure by constantly making a fluid called aqueous humor. As new aqueous flows into your eye, the same amount should flow out. If enough fluid doesn’t leave the eye, pressure inside the eye (intraocular pressure, or IOP) builds up over time and damages the optic nerve. This is called glaucoma. When PDS has progressed to this stage, it is called pigmentary glaucoma. Not everyone who has pigment dispersion syndrome will develop pigmentary glaucoma.
Many people with pigment dispersion syndrome (PDS) do not have any symptoms. Some people may have blurring of vision or see halos.
Even if you have pigmentary glaucoma, you may not notice any symptoms. In time, as the optic nerve becomes more damaged, you may notice that blank spots begin to appear in your field of vision. You usually won’t notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all of the optic nerve fibers die, blindness results.
PDS is often diagnosed when people are in their 20s or 30s. It is more common among males and Caucasians and may be inherited (passed from parent to child). People with myopia (nearsightedness) are also more likely to be diagnosed with pigment dispersion syndrome.
If PDS is noted, additional tests will be done on a yearly basis to check for glaucoma. The eye pressure will be measured. Photographs and OCT scans will be taken to document and monitor the health of your optic nerves. A Visual Field test will be conducted to check for any changes in peripheral vision. The eye doctor will periodically examine the eye’s drainage angle with a special lens (gonioscopy).
Treatment for pigment dispersion syndrome varies depending on how it is affecting your eye pressure and optic nerve health. If pigmentary glaucoma is diagnosed, treatment typically consists of medicated eye drops to lower the pressure. In some cases, laser treatment or surgical intervention may be warranted. Because damage to the optic nerve is asymptomatic in early stages, it is very important to be monitored by your eye doctor on a consistent basis so changes can be caught early and treatment initiated promptly if indicated.