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Glaucoma and Ocular Pigment

Kenneth W. Olander, MD, PhD; Robert M. Mandelkorn, MD
JAMA. 1988;260(3):397. doi:10.1001/jama.1988.03410030113042.
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An increased deposition of ocular pigment characterizes a variety of conditions, including exfoliation syndrome; pigment dispersion syndrome; forms of uveitis, melanosis, and melanoma; and cysts of the iris and ciliary body, among others.1 Exfoliation syndrome and pigment dispersion syndrome, in particular, represent abnormal accumulations of pigment in the eye that may presage the development of openangle glaucoma in two very diverse populations.2 Unfortunately, these types of secondary glaucoma are often refractory to medical treatment and may necessitate a surgical solution, such as trabeculoplasty. Early diagnosis and subsequent observation, therefore, can benefit such patients before intraocular pressures elevate, especially in those with pigment dispersion syndrome, who may suffer rapid-onset glaucoma.

Both syndromes may exhibit similar deposits of pigment involving the width of the trabecular meshwork1; the peripheral cornea (Sampaolesi's line)2; and the anterior surface of the iris (Fig 1), lens, ciliary body, and vitreous.1

Typical patients


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