Everything You Need to Know About Pigmentary Glaucoma

An eye doctor looks into a patient's eyes with a medical device

Pigmentary glaucoma is a form of glaucoma that tends to strike at younger ages (20-40 years old), in patients with nearsightedness (myopia), and is more common in men than women. Since the condition develops at such a young age, it can result in a lifetime of vision problems. Pigmentary glaucoma can be treated to slow its progress and save the victim’s remaining sight, but whatever damage occurs before treatment cannot be corrected.

Causes of pigmentary glaucoma

Pigmentary glaucoma occurs when pigment from the iris (the colored part of the eye) is released and becomes trapped in the drainage system of the eye. The pigment clogs normal drainage, which increases eye pressure. Over time, buildup of eye pressure can damage the optic nerve, leading to a loss of peripheral visual and eventual blindness.

Treatment options for pigmentary glaucoma

Eye drops

Eye drops have few side effects and are well tolerated by younger patients. Miotic drops, for example, cause the pupil of the eye to become smaller and keep the iris from rubbing against its supporting fibers of the eye’s lens. Unfortunately, those drops can cause blurred vision.

Argon Laser Trabeculoplasty

This is a laser treatment and typically works well. Using a series of laser shots, the procedure opens up the eye’s drainage system to increase fluid flow.

Laser Iridotomy

In this procedure, the ophthalmologist uses a laser to make a small hole in the iris. This causes the iris to move away from the lens and prevents the lens fibers from scraping the pigment. Iridotomy has its limitations and does not always work well. Laser iridotomy is still under investigation.


Since pigmentary glaucoma can have no warning signs or symptoms, and because it occurs at a younger age, this form of glaucoma is often underdiagnosed. However, if identified early and treated appropriately, patients often do well.

Individuals who are at additional risk for glaucoma include patients whose parents had the disease, are from African American or Latino backgrounds, and patients who suffer from diabetes or cardiovascular problems. These patients need to be on guard and visit their eye specialist annually.

To ensure that your vision is healthy, be sure to schedule an eye appointment with the Florida Eye Specialists at one of their eight conveniently located locations throughout Jacksonville, Saint Augustine, and Palatka.