As you age, eye exams become increasingly more important. Certain conditions, like pseudoexfoliation syndrome and exfoliative glaucoma, become more prevalent. Learn more about these conditions and the important steps to take in prevention and treatment.*

What are pseudoexfoliation syndrome and exfoliative glaucoma?

Pseudoexfoliation syndrome is caused by a gene abnormality, where pseudoexfoliative flakes and pigment builds up in the eye’s drainage system and other structures of the eye. Over time, this leads to a type of secondary open-angle glaucoma (OAG), called exfoliative glaucoma. Compared to other types of glaucoma, exfoliative glaucoma is more aggressive, showing higher intraocular pressures (IOPs) and faster disease progression.

What are the risk factors?

While this syndrome and type of glaucoma are seen globally, the main risk factors are:

• Certain racial/ethnic groups, including Russian, Scandinavian, Nordic, Greek, Mediterranean populations, and Indian 
• Over the age of 50
• Living in higher altitudes or northern latitudes
• High exposure to ultraviolet (UV) light

Will pseudoexfoliation syndrome always lead to exfoliation glaucoma?

Exfoliative glaucoma is not guaranteed to occur, but it does happen in approximately 40% to 50% of people with pseudoexfoliation syndrome. Therefore, it is important to get eye exams regularly to monitor any development. 

How are both diagnosed?

A thorough eye exam may detect some eye abnormalities, but there are two main ways to diagnosis pseudoexfoliation syndrome and exfoliation glaucoma.

1. A gonioscopy assesses for pigment deposition and will detect pseudoexfoliation syndrome.
2. A slit lamp eye exam with IOP measurement (preferably with a dilated eye) can easily expose findings of exfoliative glaucoma.

What treatment options are available?

Since exfoliative glaucoma is generally more aggressive than other types of glaucoma, it tends to be more difficult to control with medical therapy. Treatment options will depend on your stage of exfoliative glaucoma.

Your doctor may suggest frequent visits to an ophthalmologist to monitor disease progression and/or medication to control eye pressure, though they tend to be less effective in exfoliative glaucoma. A type of laser surgery, called laser trabeculoplasty, has shown positive results in patients to treat eye pressure control.

For patients with pseudoexfoliative deposits near the area of the eye that keeps the lens in position, another type of laser surgery, called laser iridotomy, may be used to prevent the lens from moving forward and causing angle-closure glaucoma.

More information on pseudoexfoliation syndrome and exfoliative glaucoma can be found on the American Academy of Ophthalmology and BrightFocus Foundation websites.

*Samples, J., & Konstas, T. (2019, September 25). Exfoliative Glaucoma. Glaucoma Research Foundation. https://www.glaucoma.org/glaucoma/exfoliative-glaucoma.php

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