Pigmentary dispersion syndrome and pigmentary glaucoma. A prospective study of the natural history.

The natural evolution of pigmentary dispersion syndrome and pigmentary glaucoma was studied in 55 patients for six to 43 months (mean, 27 months). Active dispersion of pigment was observed in 45 eyes in 31 patients and was associated with worsening of glaucoma in 32 eyes. Dispersion of pigment was defined as active when there was increase in iris transillumination, increase in corneal pigmentation, or appearance of pigment granules on the surface of the lens in the pupil. There were no differences in the frequency of active dispersion of pigment and worsening of glaucoma comparing patients aged less than 44, 45 to 64, and 65 or more years. This study demonstrates that active dispersion of pigment is clinically detectable, is correlated with elevation of intraocular pressure, and continues to occur in older patients.