Pigment gives your iris its color. Pigment dispersion syndrome (PDS) happens when the pigment rubs off the back of your iris. The pigment then floats around to other parts of the eye. The tiny bits of pigment can clog your eye's drainage angle. This can cause eye pressure problems.
Your eye keeps a healthy pressure by making a fluid called aqueous humor. As new aqueous flows into your eye, the same amount flows out. If enough fluid doesn't leave the eye, pressure inside the eye (intraocular pressure, or IOP) builds up over time and can damage the optic nerve. This is called glaucoma. When PDS has progressed to this stage, it is called pigmentary glaucoma. Not everyone who has pigment dispersion syndrome will develop pigmentary glaucoma.
What Are Symptoms of Pigment Dispersion Syndrome?
Many people with pigment dispersion syndrome (PDS) do not have any symptoms. Some people may have blurring of vision or see halos after exercise.
Even if you have pigmentary glaucoma, you may not notice any symptoms. In time, as the optic nerve becomes more damaged, you may notice that blank spots begin to appear in your field of vision. You usually won’t notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all of the optic nerve fibers die, blindness results.
In this close-up photograph of an eye, small flecks of pigment are seen floating inside the eye, a sign of PDS
Who Is at Risk for Pigment Dispersion Syndrome?
PDS may be inherited (passed from parent to child). It is more common among:
- people with myopia (nearsightedness)
- people in their 20s and 30s. Other types of glaucoma are usually diagnosed after the age of 40.
- men
- white people
Pigment Dispersion Syndrome Diagnosis
Because there are often no symptoms, PDS is usually diagnosed during a regular eye exam. That is why it is so important to have an eye exam with your ophthalmologist.
During a thorough eye exam, your ophthalmologist will:
- check your eye pressure
- do other tests like a gonioscopy, if PDS is suspected. This lets your ophthalmologist look at the eye's drainage angle. He or she can see if something is blocking the fluid from leaving the eye.
- check for glaucoma. They will examine your optic nerve for signs of damage, and check your side (peripheral) vision.
These tests are the same used for a glaucoma diagnosis and will determine if you have pigmentary glaucoma. Your ophthalmologist looks for the tell-tale signs of pigment floating in the eye (including at the back of the cornea) or small sections of pigment missing from your iris.
Pigment Dispersion Syndrome Treatment
PDS treatment varies depending on how it is affecting your eye pressure:
For pigment dispersion syndrome with normal or only slightly elevated IOP, there is a low risk of damage to the optic nerve. No treatment is needed other than seeing your ophthalmologist one time each year. He or she will monitor your condition by checking your IOP and looking for any changes in your vision.
For pigment dispersion syndrome with elevated IOP, there is a greater risk of damage to the optic nerve. To lower IOP, you may be treated with medicated eye drops or laser therapy.
When IOP from PDS is so high that it damages the optic nerve, this is then called "pigmentary glaucoma." In this case, treatment is needed and it may be medicated eye drops, laser therapy, or surgery.
FAQs
Pigment gives your iris its color. Pigment dispersion syndrome (PDS) happens when the pigment rubs off the back of your iris. The pigment then floats around to other parts of the eye. The tiny bits of pigment can clog your eye's drainage angle. This can cause eye pressure problems.
What is the cause of pigment dispersion syndrome? ›
The mechanisms behind the formation of PDS are due to the constant rubbing and friction between pigment iris epithelium and lens structures during pupil movements, which tend to occur in the presence of reverse pupillary block and posterior bowing of the iris [1-3].
How do you fix pigment dispersion syndrome? ›
The recommended management options are lifestyle modifications, antiglaucoma medications, laser iridotomy, iridoplasty, and filtration surgery.
What are signs of dispersion? ›
Pigment Dispersion Syndrome
- Symptoms may be asymptomatic or present as an intermittent or rapid onset of elevated intraocular pressure associated with corneal edema, ocular pain, intermittent blurring of vision or halos.
- Signs: Radial periphery transillumination defects of the iris.
Diagnosis. Pigment dispersion syndrome is diagnosed clinically based on the presence of iris transillumination defects in the mid-peripheral iris, pigment on the corneal endothelium (Krukenberg spindle, vertically oriented due to convection currents), and heavy pigmentation of the trabecular meshwork.
Does pigment dispersion syndrome change eye color? ›
PDS usually does not cause a noticeable change in eye color. The pigment released in this syndrome is from a tissue layer on the back of the iris, which is liberated when it rubs against the front surface of the lens. Happily, this tissue layer is not the source of one's eye color.
What are the risks of pigment dispersion syndrome? ›
For pigment dispersion syndrome with normal or only slightly elevated IOP, there is a low risk of damage to the optic nerve. No treatment is needed other than seeing your ophthalmologist one time each year. He or she will monitor your condition by checking your IOP and looking for any changes in your vision.
Is pigment dispersion syndrome rare? ›
Pigment dispersion syndrome is a relatively uncommon condition that affects about 1% of the population. Pigment clumps that are normally attached to the back surface of the iris (the colored part of the eye) fall off the iris into the clear fluid in the eye called the aqueous humor.
What is the main cause of dispersion? ›
Different colors of white light have different speeds in the refracting medium, so they bend through different angles inside the prism. Hence, this is the cause of dispersion.
What are the three types of dispersion? ›
Dispersion patterns are the spatial pattern of individuals within a population after the individuals have dispersed. There are three types of population dispersion patterns: uniform, random, and clumped.
Traditionally, pigment dispersion is comprised of three main steps; wetting, deagglomeration, and stabilization. These three steps are outlined in further detail below.
What is pigment dispersion syndrome pain? ›
PDS is often bilateral, has no gender predisposition, and presents at a young age, particularly in myopes. Although most patients experiencing an episode of pigment dispersion are asymptomatic, extreme photophobia, ocular pain, redness, and blurred vision may occur.
Can I run with pigment dispersion syndrome? ›
In two experimental subjects, pre-exercise treatment with pilocarpine appeared to inhibit exercise-induced pigment dispersion. Conclusions: The authors do not believe that all patients with the pigmentary dispersion syndrome or pigmentary glaucoma need to avoid exercise.
What are two causes of pigment disorders? ›
Skin pigmentation is a common condition that can be triggered by various factors. The three leading causes of skin pigmentation are genetics, sun exposure, and particular medications.
What age does pigment dispersion syndrome occur? ›
Pigment dispersion syndrome (PDS) is characterized by pigment shedding from iris pigment epithelium and deposition on other intraocular structures. It is more common in Caucasians, myopes, and the 35–50 age group, and can occur with an autosomal dominant inheritance pattern with variable penetrance.
What causes loss of pigment in the eyes? ›
Pigment loss — There are a few reasons you may lose pigment in the iris. One condition is pigment dispersion syndrome, where pigment rubs off the back of the iris and can increase eye pressure. Black pupils — Trauma or a blow to the eye could cause the pupil to remain dilated, which can make the eye look black.
What is the surgery for pigment dispersion syndrome? ›
Laser iridectomy eliminates the iris concavity in most patients with pigment dispersion syndrome by permitting equalization of pressures between the anterior and posterior chambers.
