A 28-year-old myopic man has pigmentary glaucoma. Which combination of findings constitutes the classic diagnostic triad of pigment dispersion syndrome?
- A Vertical iris transillumination defects, Sampaolesi line, and pseudoexfoliation material on the lens capsule
- B Krukenberg spindle, posterior synechiae, and Koeppe nodules
- C Krukenberg spindle, mid-peripheral radial iris transillumination defects, and dense homogeneous trabecular pigmentation ✓
- D Horizontal corneal striae, peripheral anterior synechiae, and iris atrophy
Correct answer: C. Krukenberg spindle, mid-peripheral radial iris transillumination defects, and dense homogeneous trabecular pigmentation
Explanation
Pigment dispersion syndrome gives the classic triad of a vertical spindle of endothelial pigment (Krukenberg spindle), slit-like radial mid-peripheral iris transillumination defects caused by mechanical rubbing of zonules against a posteriorly bowed iris, and heavy uniform pigmentation of the trabecular meshwork. Reverse pupillary block drives the iris concavity. Sampaolesi line and pseudoexfoliation belong to exfoliation syndrome, while synechiae and nodules indicate uveitis.
Reference: American Academy of Ophthalmology, BCSC Section 10: Glaucoma, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.