The purpose of this study is to learn how pigment is released from the iris (the colored
part of the eye) in patients with pigment dispersion syndrome. It will do this by examining
the response of the pupil (the central opening of the iris) to a flash of light to determine
what is happening in the iris to cause release of the pigment.
In pigment dispersion syndrome, pigment released from the iris is deposited in other parts
of the eye, including the trabecular meshwork-a filter-like tissue in the front of the eye.
Aqueous fluid (fluid continuously produced by the eye) normally flows out of the eye through
the trabecular meshwork. In some patients, the pigment deposits may block tiny holes in the
meshwork, preventing the fluid from flowing out. This can cause an increase in eye pressure
that may lead to glaucoma and some loss of vision. Understanding how pigment is released
from the iris may help predict the course of pigment dispersion syndrome and identify which
patients will likely develop increased eye pressure.
Patients with pigment dispersion syndrome and normal volunteers may be eligible for this
study. All participants will have the following procedures, which will be completed in two
1. Examination of the front of the eyes, including the cornea, iris and lens.
2. Vision testing and measurements of visual field and eye pressure.
3. Examination of the trabecular meshwork. For this test, a contact lens is placed on the
eye after the eye has been numbed with anesthetic drops.
1. Refraction (dilation of the pupils with drops) and examination of the back of the eyes,
including the optic nerve.
2. Reaction of the pupils to low-level infrared light (pupillography). During this
15-minute test, the patient or volunteer wears a lightweight headband with two small
cameras mounted on it. The cameras-one which views the eye and the other the subject's
field of view-record pupil dilation and position.
The test results in patients with pigment dispersion syndrome will be compared with those in
normal volunteers. Patients will be followed every 6 months (or more often, if medically
indicated) during the 3-year study to determine changes in eye pressure or visual field.
Volunteers will be asked to return about once a year for 3 years for repeat pupillography.
The purpose of this study is to conduct a comprehensive ophthalmologic evaluation and
comparison of two types of patients and to compare them to normal controls. The two types
of patients are those with pigment dispersion (PDS) with normal intraocular pressure (IOP)
and those with PDS and elevated IOP. The hypothesis to be tested is that a developmental
abnormality of the iris pigment epithelium (IPE) and the dilator muscle is the fundamental
defect responsible for the pigment dispersion. This defect may involve other structures of
the eye such as the ciliary and retinal pigment epithelium. The results of pupillography in
PDS with or without elevated IOP and asymmetric PDS (one eye versus fellow eye) will be the
All patients entering the study must have black pigment deposition on the trabecular
meshwork at the site of Schlemm's canal equal to or greater than 2-plus on the
goniophotographic scale of 1 to 5 plus.
Although this condition is rare amongst African-Americans, every effort will be made to
recruit such individuals.
Patients with exfoliation syndrome, uveitis, trauma, pigment dispersion with posterior
chamber intra-ocular lens, pigmented tumors, primary open-angle glaucoma, other conditions
with associated pigment dispersion such as acute angle-closure glaucoma, ocular
hemorrhage, Horner's syndrome.
In addition, normal volunteers will be recruited as controls. They will be free of any
eye disease and be matched for age, sex and degree of myopia.