Asymmetric pigment dispersion in a patient with the unilateral Adie pupil

Abstract

Purpose: Pigmentary glaucoma is a bilateral disorder. When it occurs asymmetrically or unilaterally, a cause should be sought because it may help us to understand the pathophysiology of this condition better. We describe a patient with unilateral pigmentary glaucoma and the Adie pupil in the same eye and discuss the possible role of the Adie pupil in the development of the pigmentary glaucoma.

Methods: A case report. A 37-year-old woman presented with asymmetric pigment dispersion resulting in pigmentary glaucoma in the right eye and an unilateral Adie pupil in the same eye.

Results: We believe that the dilated Adie pupil in the right eye might have resulted in a decreased amount of relative pupillary block. This, then, might have led to an increased contact between the posterior iris and the zonules, resulting in greater pigment dispersion and trabecular obstruction in the right eye.

Conclusion: It has been proposed that the pigment is liberated from the iris pigment epithelium because of the mechanical rubbing of the posterior iris against the anterior zonular packets. Our case supports this proposed mechanism of pigment release.