Management of the Pulfrich phenomenon secondary to pigmentary glaucoma

The Pulfrich phenomenon can cause annoying symptoms for a patient due to a difference in interocular optic nerve conduction. There are very few reports that describe the successful use of tinted lenses as a treatment modality, while the majority of cases in the literature describe the condition without any reference to treatment. Although there are two previous reported cases of the Pulfrich phenomenon secondary to glaucoma, this article relates the first case of a patient with this phenomenon with glaucoma treated by tinted lenses.

A 42-year-old woman, who was previously diagnosed with asymmetric pigmentary glaucoma, reported dramatic changes in visual perception-especially with driving and motion-related tasks. The evaluation showed asymmetric optic nerve function and a spontaneous Pulfrich phenomenon. The effects of different grades of neutral-density filters over the better eye were quantified by means of the Pulfrich phenomenon, subjective brightness comparison, and the visual-evoked potential. Relief of some of the symptoms from the Pulfrich phenomenon was achieved using an ophthalmic tint.

The majority of patients (89%) reported in the literature who are symptomatic of the Pulfrich phenomenon received no treatment. This report illustrates that the traditional optometric tool of tinted lenses can be dramatically effective in relief of the motion-related symptoms secondary to the Pulfrich phenomenon in a patient with pigmentary glaucoma.