This website uses cookies to help us give you the best browsing experience. By continuing to use this portal, you agree to our use of this tool.
To learn more about how we use cookies and how to manage them please read our notice here.
Tip of the Month
Tip of the month - In every patient with ocular hypertension, search for signs of pseudoexfoliation syndrome as these patients are at significant risk of converting to glaucoma
In every patient with ocular hypertension, search for signs of pseudoexfoliation syndrome as these patients are at significant risk of converting to glaucoma

Publishing date: May 2015


The science behind the tip

Patients with ocular hypertension and pseudoexfoliaton syndrome are twice as likely to convert to glaucoma as those without this condition (1). The IOP is often high on presentation and tends to fluctuate widely.  If glaucoma develops in pseudoexfoliaton syndrome the rate of progression is greater than that found in patients with primary open-angle glaucoma (2).

In the early stages of pseudoexfoliation syndrome the ocular signs are subtle and easily missed on clinical examination.  The pupils should be dilated to check for fibrillar material on the anterior lens surface. Gonioscopy should be undertaken, as signs of excessive trabecular meshwork pigmentation may precede the detection of pseudoexfoliaton syndrome (3).


Contributor: John F Salmon MD FRCS, Oxford UK


References:

1. Grodum K, Heijl A, Bengtsson B.  Risk of glaucoma in ocular hypertension with and without pseudoexfoliation.  Ophthalmology 2005; 112: 386-90

2. Heijl A, Bengtsson B, Hyman L et al.  Natural history of open-angle glaucoma.  Ophthalmology 2009; 116: 2271-6

3. Wishart PK, Spaeth GL, Poryzees EM.  Anterior chamber angle in the exfoliation syndrome.  Br J Ophthalmol 1985; 69: 103-7



Tip Reviewer: Roger Hitchings
Tip Editors: John Salmon and Gordana Sunaric Mégevand





back to top
X