pigment dispersion syndrome (Krukenberg's Spindle)

Epidemiology

• rare
• most common in Caucasians
• 20-40 years of age
• more common in men

Pathology

• pigment cells slough off from the back of the iris & float in the aqueous humor
• over time, these pigment cells can accumulate in the anterior chamber & clog the trabecular meshwork, impairing aqueous humor drainage
• intraocular pressure tends to increase with periods of spikes & normal pressure
• pigmentary glaucoma occurs when the intraocular pressure is great enough to cause damage to the optic nerve

Clinical manifestations

• syndrome lessens & stops after age 40 years

Diagnostic procedures

• tonometry to measure intraocular pressure

Complications

• pigmentary glaucoma

Management

• see glaucoma
• lower intraocular pressure
  • acetazolamide (carbonic anhydrase inhibitor)
  • timolol
• YAG laser procedure is used to break up the pigment, & reduce intraocular pressure
• avoid contact sports, long-distance running or martial arts
  • strong impacts can cause more pigment cells to slough

More general terms

• syndrome
• chronic eye disease (chronic ophthalmopathy)