Posterior Capsular Pigment Deposition: A Rare Presentation of Pigment Dispersion Syndrome

A 41-year-old white male patient with right posterior lenticular pigmentation detected during a routine ophthalmologic workup 2 months before was referred for further evaluation. On ophthalmic examination, the visual acuity was 20/20 without correction in both eyes. Biomicroscopy revealed bilateral Kruckenberg spindles and right inferior posterior subcapsular pigmentation, with no transillumination defects. Fundus examination displayed symmetric cupping of 0.4 bilaterally. Intraocular pressure was 20 mmHg in the right eye and 18 mmHg in the left. Gonioscopy showed a bilaterally open angle with dense, uniform pigmentation and the concave iris position. Inter-zonular and equatorial lens pigmentation was also remarkable bilaterally. Ultrasound biomicroscopy revealed no solitary or cystic lesions of the iris and ciliary body. In conclusion, based on the ophthalmologic findings and after ruling out cystic or solid intraocular mass lesion leading to pigment dispersion, we diagnosed the case as an atypical presentation of pigment dispersion syndrome.