Trabecular meshwork pigmentation is a manifestation of the clinical diagnosis of pigmentary glaucoma. Pigmentary glaucoma is a secondary open-angle glaucoma caused by pigmentation of the anterior segment of the eye. So what causes pigmentary glaucoma? Pigmentary glaucoma is a type of glaucoma characterized by the deposition of pigment particles in the atrial angle. It is more common in men between the ages of 20 and 50, and is rare in women, especially those under 20 years of age. The disease is characterized by myopia, deep anterior chamber, vertical shuttle KP (Krukenberg pigmented shuttle), dense, pigmented trabecular meshwork, and pigmentation of the anterior and posterior lens capsules and suspensory ligaments. 1979 Campbell proposed that friction between the suspensory ligaments of the lens and the pigmented epithelium of the posterior surface of the iris, leading to pigment particle dissemination, is the pathologic basis for the development of pigmentary glaucoma. A large number of pigment granules are deposited in the interstitial spaces of the trabecular meshwork, and pigment granules are also phagocytosed in the trabecular cells. Some trabecular cells die and disintegrate, leaving the trabecular column exposed, degenerated, and collapsed, and narrowing the trabecular meshwork. Trabecular cell death, pigment particle deposition in the trabecular meshwork and collecting ducts, and collapse of the trabecular column result in mechanical obstruction of the trabecular meshwork, increasing resistance to atrial aqueous outflow. The posterior depression of the iris is explained by the theory of “reverse pupillary block”: the posteriorly depressed iris sags and lies immediately in front of the lens, acting as a “valve” that prevents the posterior atrial water from flowing back into the posterior atrium from the anterior atrial surface, and the increased pressure in the anterior atrium pushes the peripheral iris closer to the The increased pressure in the anterior chamber pushes the peripheral iris closer to the suspensory ligament of the lens. In patients with pigmentary glaucoma, the posterior iris sulcus disappears after pupil reduction, circumferential iridotomy, or trabeculectomy.