Krukenberg's Spindle and Pigment Dispersion Syndrome?

Question

just diagnosed with Pigment Dispersion Syndrome (also called Krukenberg's Spindle) and was wondering if anyone else has it?? or if they know anything about it. My eye doctor wasn't very informative about it all he said was I have a 30 percent chance of getting pigmentary glaucoma!!

Answer 1

The iris has pigment on the back surface. This pigmented layer is actually the inner part of the optic cup which when it collapses together forms the retina and retinal pigment layers. In the front, it's the back layer of the iris which is darkly pigmented. It lays against the surface of the lens.

As the iris moves with light, it rubs against the lens. In some people, the pigment isn't as 'tight' as most, and some of the pigment cells will 'rub off'. These cells will move into the anterior chamber suspended in the aqueous. This aqueous fluid is produced behind the iris near the wall of the eye in an area called the ciliary body.  As the fluid moves in front of the lens and into the anterior chamber, those loose cells become suspended in it.

As the front of the anterior chamber is the back of the cornea which is against the atmosphere, this part of the anterior chamber is 'cooler' than the back part which is near the iris. The fluid will move up the back of the anterior chamber and down in the front in a circular flow. The pigment will 'hit' the cornea and form a sort of triangle or spindle with the apex up, widening at the bottom. It's easy to see in a slitlamp exam. If there's a LOT of pigment, it can block the drain of the eye and cause restriction in the outflow. The guys making the fluid don't know about the restriction and keep on making fluid at the normal rate. But the pressure in the eye goes up until the fluid is pushed out of the drain at the same rate it's being produced

If that increase in pressure causes damage to the optic nerve, that's called glaucoma. Because it's due to pigment in the drain or trabecular meshwork, it's called pigmentary glaucoma. If there's blood, it's hemorrhagic glaucoma. If there's lens capsule exfoliation sort of like paint peeling, it's called exfoliation glaucoma.

Most pigment dispersion glaucomas are fairly easy to treat by using medications or drops that slow the production of fluid or increase the outflow one way or another. And there are lots of newer glaucoma surgical procedures these days that easily control the eye pressure.

Answer 2

I have it.  Basically over time the pigment can clog up the drainage system in your eye and cause the pressure to go up.  Don't lose any sleep over it.  Just get an exam every year to monitor it.  If your pressure starts to creep up, then they can treat it if needed.