The relationship between pigment dispersion in the anterior chamber of the eye and glaucoma has been the subject of much debate. There have been differences of opinion as to whether pigmentary glaucoma is a discrete entity unrelated to primary openangle glaucoma or a specialized form of primary open-angle glaucoma.
The entity pigmentary glaucoma was delineated by Sugar and Barbour.1 Classically this glaucoma was described in young myopic males and was accompanied by Krukenberg's spindles and pigment deposition in and on the angle structures. Concentric atrophy of the iris pigment epithelium, demonstrable by transillumination, was suggested as the primary abnormality by Bick.2 Pigment dispersion then led to the spindle and deposits on the trabeculum and around the circumference of the lens. Glaucoma was postulated to occur if the pigment granules severely taxed the patient's filtering mechanism, perhaps superimposed on other damage. Scheie3 has espoused similar views. In
BECKER B, PODOS SM. Krukenberg's Spindles and Primary Open-Angle Glaucoma. Arch Ophthalmol. 1966;76(5):635-639. doi:10.1001/archopht.1966.03850010637003