Asymmetric pigment dispersion in a patient with the unilateral Adie pupil

PURPOSE: Pigmentary glaucoma is a bilateral disorder. When it occurs asymme trically or unilaterally, a cause should be sought because it may help us t o understand the pathophysiology of this condition better. We describe a pa tient with unilateral pigmentary glaucoma and the Adie pupil in the same ey e 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 pigme nt dispersion resulting in pigmentary glaucoma in the right eye and an unil ateral 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, mi ght have led to an increased contact between the posterior iris and the zon ules, resulting in greater pigment dispersion and trabecular obstruction in the right eye. CONCLUSION: It has been proposed that the pigment is liberated from the iri s pigment epithelium because of the mechanical rubbing of the posterior iri s against the anterior zonular packets. Our case supports this proposed mec hanism of pigment release. (Am J Ophthalmol 2001;132:410-411. (C) 2001 by E lsevier Science Inc. All rights reserved.).