Appendix
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Ophthalmology

Pigment Dispersion Syndrome

Pigment dispersion syndrome (PDS) is a common type of open-angle glaucoma which is relatively underdiagnosed. It is characterized by the spontaneous dispersion of pigment granules from the pigment epithelium of the iris, which gets deposited in the anterior segment. It is a bilateral condition that is more commonly encountered in myopic young males. Secondary pigment dispersion can be seen after ocular trauma, tumors of the iris, and rubbing the IOL against the surface of the iris. Secondary pig

v1 · Reviewed Nov 8, 2026 by Automated Clinical Reviewer (Strict Verbatim v1)
  • patients may present with pain, redness, extreme photophobia, and reduced visual acuity.
  • The patients may present with field loss or defective vision due to glaucomatous optic atrophy and corneal edema.
  • The essential diagnostic tools for PDS are intraocular pressure assessment, gonioscopy, visual field, anterior segment optical coherence tomography (OCT), posterior segment OCT, posterior segment OCT angiography, and ultrasound biomicroscopy.
  • A detailed history, meticulous anterior segment, posterior segment examination, applanation tonometry, gonioscopy, and Humphrey field analysis are necessary in each case to reach a conclusive diagnosis.
  • Anterior Segment Optical Coherence Tomography (AS-OCT) is a vital tool to assess anterior chamber depth, width, the volume of iris, and iris concavity in patients with PDS.
  • Optic Nerve Head Optical Coherence Tomography
  • Ultrasound Biomicroscopy (UBM)
Grade 0
Krukenberg spindles, dense pigmentation in anterior chamber angle, and irido-zonular touch
Grade 1
Krukenberg spindles, pigmentation of angles, pigment deposition on the iris, irido-zonular contact, anterior lens capsule deposition
Grade 2
Endothelial dusting, pigment deposition on the iris, irido-zonular contact, anterior lens capsule deposition, angle pigmentation (grade 1), intraocular pressure more than 21 mmHg, and no visual field changes
Grade 3
All the above findings, visual field deficits, and signs of pigmentary glaucoma
  • lifestyle modifications
  • antiglaucoma medications
  • Laser Peripheral Iridotomy
Pilocarpine
Not specified in source
Adult
2%
Renal
Not specified in source
Duration
Not specified in source
  • Laser Trabeculoplasty
  • Filtration Surgery
  • Glaucoma Drainage Devices
  • Minimal Invasive Glaucoma Surgery
  • Trabectome
  • Goniotomy
  • Canaloplasty
  • The patients with PDS should be followed up annually to rule out the development of OHT and optic nerve damage.
  • In the case of advanced glaucoma, the patient should be followed up every 4 to 6 months, and these patients can have rapid vision loss associated with risk factors like myopia and PDS.
  • Corneal edema
  • Non-resolving uveitis
  • Angle-closure glaucoma
  • Intractable glaucoma
  • Post SLT IOP elevation
  • Endophthalmitis
  • review
    Pigment Dispersion Syndrome. StatPearls [Internet] — Bharat Gurnani, Kirandeep Kaur — StatPearls Publishing, 2023

Decision support only. Verify against local protocols and current labeling. Source: www.ncbi.nlm.nih.gov