What’s pseudoexfoliative glaucoma?

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Pseudoexfoliation glaucoma is caused by protein buildup in the eye, leading to clogged drainage and increased intraocular pressure. Risk factors include age, exposure to UV light, and living at high altitudes. Treatment options include medication, laser therapy, and surgery. Yearly eye exams are recommended for those with pseudoexfoliation syndrome.

Pseudoexfoliation glaucoma is an eye disorder seen in people who have a condition known as pseudoexfoliation syndrome. In pseudoexfoliation syndrome, protein strands build up in tissues throughout the body, including the eye. Inside the eye, flakes of protein matter are deposited around the colored part of the eye, or the iris, and throughout the structures at the front of the eyeball. Around the edge of the iris, fluid from inside the eye normally drains through a filter called a trabecular meshwork, and in pseudoexfoliative glaucoma this becomes clogged with protein strands. As fluid is prevented from flowing out of the eye, the pressure inside the eyeball, known as intraocular pressure, increases, resulting in the condition called glaucoma.

The risk of developing pseudoexfoliative glaucoma increases with age and is rarely seen in people under the age of 50. Although the condition is associated with pseudoexfoliation syndrome, only about a third of people who have the syndrome develop glaucoma. Women are more likely to develop it than men. Factors that increase the chance of having pseudoexfoliative glaucoma include exposure to ultraviolet light and living in the north or at high altitudes.

Pseudoexfoliative glaucoma tends to start in only one eye but can continue to involve both eyes. There may be no symptoms, and the condition may be discovered after you notice an increase in intraocular pressure during an eye exam. This elevated pressure, or ocular hypertension, is a problem because it can damage the optic nerve that feeds the eye, leading to vision loss. When the affected eye is examined using a special microscope, called a slit lamp, a flaky white substance is seen that forms a ring around the edge of the pupil. Sometimes a typical bullseye pattern is seen, consisting of three rings.

Treatment options for pseudoexfoliative glaucoma include using medications to lower the pressure within the eye and prevent the disease from progressing. Techniques such as argon laser trabeculoplasty are used in cases where medications don’t work. In argon laser trabeculoplasty, a laser is used to burn small holes that increase fluid drainage from the eye, lowering the pressure inside. If such methods are unsuccessful, so-called trabeculectomy surgery is sometimes used, in which a special drainage hole is created to allow fluid to flow out of the eye. Early diagnosis is important, and people with pseudoexfoliation syndrome have yearly eye exams to check for signs of glaucoma.




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