However, vascular disturbances in the posterior segment of the eye might after all be of equal importance in these two types of glaucoma; optic disc haemorrhages and venous occlusions have been reported to be as frequent in exfoliation glaucoma as in POAG. Perhaps in exfoliation glaucoma circullatory disturbances combined with high IOP lead to a particularly relentlessly progressing form of the disease.
Abstract Exfoliation syndrome abnormal deposition in the anterior segment of the eye of an unknown substance thought to be related to elastic fibres and basement membrane components is associated with accelerated cataract progression. Publication types Research Support, Non-U. Gov't Review. Often more frequent visits to their eye doctor are necessary to monitor for disease progression.
Exfoliative glaucoma patients seem to respond well to treatment by laser trabeculoplasty , possibly because of the more pigmented meshwork and a higher concentration of enzymes in the meshwork, termed matrix metalloproteinases, that are activated by laser trabeculoplasty. Patients with this disorder respond well to most types of glaucoma surgery. However, whether or not they respond well to trabecular stent devices or the new generation of tubes to the suprachoroidal space remains to be seen.
Another reason to know whether or not exfoliation is present is that these patients sometimes have increased difficulty with cataract surgery. The abnormal protein seen in this condition settles on and weakens the lens zonules which are suspensory fibers that hold the lens in place.
In most patients, the surgical technique can be modified to obtain a good outcome. A positive test with many genetically detected diseases can be helpful by suggesting the need for more careful observation. However, in the case of exfoliative glaucoma, the findings from a slit lamp eye exam are often characteristic, and so readily seen especially when the eye is dilated that expensive genetic testing may not be necessary or helpful.
Detecting exfoliation may require a dilated eye exam, and is one reason why a dilated eye exam is so important. Individuals over 40 with relatives that have exfoliative glaucoma or of Northern European extraction should be particularly vigilant in having yearly or biyearly eye examinations.
John R. It is characterized by "lamellar delamination of the lens capsule". Poor pupillary dilation, transillumination defect on the pupilary borders, white fluffy deposits on the anterior lens capsule. No real symptom is associated with it, most of the finding are based on an eye exam. The intraocular eye pressure elevation may not have associated symptoms. Create account Log in.
Main page. Getting Started. Recent changes. View form. View source. Pseudoexfoliation Syndrome From EyeWiki. These patients can be successfully managed, however, with vigilant follow-up and aggressive treatment. Minnal may be reached at ; vandana.
Nicholas P. Bell, MD, is the A. McNeese, Jr. Bell may be reached at ; nbell cizikeye. Current Issue Archive. Bell, MD. GLAUCOMA Although the risk of glaucoma in eyes with exfoliation syndrome varies greatly based on the population, the disease appears to have a secondary open-angle mechanism in most cases. Lindberg JG. Clinical investigations on depigmentation of the pupillary border and translucency of the iris in cases of senile cataract and in normal eyes in elderly persons.
Acta Ophthalmol. Forsius H. Exfoliation syndrome in various ethnic populations. Ritch R, Schlotzer-Schrehardt U. Exfoliation syndrome. Surv Ophthalmol. Common sequence variants in LOXL1 gene confer susceptibility to exfoliation glaucoma.
Prince AM, Ritch R.
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