Nonprogressive low-tension glaucoma with pigmentary dispersion

Four patients with nonprogressive glaucomatous cupping and nonprogressive visual field damage, three of whom were referred with a diagnosis of low-tension glaucoma, were found to have slit-like radial peripheral iris transillumination defects. Three of these patients had Krukenberg spindles and dense pigmentation of the trabecular meshwork. These findings are considered pathognomonic for pigmentary glaucoma. Little is known of the natural course of this disease. A decrease in corneal and trabecular pigmentation with age and normalization of intraocular pressures after years of treatment have been noted. The patients described here were all much older than the average patient with pigmentary glaucoma, yet in none of them had a diagnosis of glaucoma been made at the time the damage presumably developed. In these patients the pigmentary glaucoma had probably remitted spontaneously.