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Dense pigmentation on 45 year old patient

Posted by - Posted on 04/12/2015 23:57:11 Glaucoma


piment in angle .jpg


Gonioscopy on a 45 year old . What do you see? Guess what the IOP might be ? What is the preffered first line of treatment in these patients?

Goniscopy suggests dense pigmentation with sampolosi's line. This finding if bilateral would suggest pigment dispersion syndrome. This syndrome is associated Krukenberg spindle (vertical spindle shaped deposit of pigment on corneal endothelium secondary to aqueous convection currents, iris trans illumination defects in the mid periphery, dense pigmentation in the angle, concave appearance of the mid peripheral iris and pigment deposits on the lens capsule, zonules and anterior hyaloid. Typically see in myopic males; 25%-50% develop glaucoma.If topical glaucoma meds fail, SLT with very low power can be tries but effect of SLT is short lived. Filtering surgery is usually successful, but be careful not to use mitomycin C in young myopes because of the risk of hypotony maculopathy.


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