Abstract
A pigmentary glaucoma is a form of secondary open angle glaucoma caused by pigment liberated from the posterior iris surface in patients with pigment dispersion syndrome. The pigment cells slough off from the back of the iris due to its concave configuration causing it to rub against the zonules and lens. These pigment cells accumulate in the anterior chamber in such a way that it begins to clog the trabecular meshwork causing elevation of intraocular pressure. Anterior segment optical coherence tomography (ASOCT) is a non contact, easy to use, reproducible method for examination of the anterior segment. It allows detailed evaluation of the cornea, the angle of eye and the iris. It has extensively been used to evaluate angle closure glaucoma. It can also be used in cases of pigmentary glaucoma. We present a male, myopic patient with advanced stage of pigmentary glaucoma at a relatively young age. We used ASOCT to demonstrate the concave iris configuration in our patient and its disappearance following laser iridotomy. We thus highlight the importance of use of ASOCT in patients of pigmentary glaucoma
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