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PSEUDOEXFOLIATION SYNDROME

Pseudoexfoliation syndrome is a condition where a snowflake-like substance accumulates on the structures within the eye.  This substance can often be seen on the lens and iris.   Pseudoexfoliation is commonly found in people of northern European descent but can be seen in individuals of any heritage.

There are 2 main concerns in patients who have pseudoexfoliation syndrome:

1.  Elevated eye pressure and glaucoma

The snowflake-like material that accumulates in the eye can lead to elevated eye pressure resulting in glaucoma.  This can be seen in as many as 50% of people with pseudoexfoliation syndrome.  Sometimes relatively frequent visits  can be necessary to monitor the eye pressure.  Patients with glaucoma (pressure damage to the optic nerve) due to pseudoexfoliation may require eye drops to control the eye pressure.  Additionally, laser treatment or even surgery could be required to control the pressure and prevent blindness from glaucoma. 

2.  Risk of complications during cataract surgery 

Cataracts occur when the lens inside of our eye becomes cloudy.  The lens is held in place behind the iris by tiny fibers known as zonules.  Pseudoexfoliation weakens these zonules causing them to break more easily.  Pseudoexfoliation often causes the pupil to dilate poorly as well.  This can result in a increased risk of surgical complications. 

Some of the complications that may occur more frequently with pseudoexfoliation are lens fragments becoming loose and floating down to the back of the eye.  If this occurs, a second surgery by a retina specialist to remove those lens fragments could be required.  This does not mean that you will lose your vision but it can mean that the recovery from surgery will be longer.  If the lens is poorly supported by weak zonules, your doctor may need to place the intraocular lens implant in the front part of the eye (anterior chamber) as opposed to behind the iris.  Again, this can prolong the recovery from surgery but usually good vision is achieved over time.

Drs. Holtz, Ditkoff and Gould are highly trained in operating on eyes that have pseudoexfoliation syndrome.  Nonetheless, the rate of surgical complications is higher when someone has pseudoexfoliation syndrome under any circumstances. 

Pseudoexfoliation syndrome cannot be prevented or cured but can be managed effectively in cooperation with your doctor.  There is some evidence to show that sun exposure plays a role and sunglasses should be worn when outdoors.

Please speak with your doctor if you have any further questions about pseudoexfoliation syndrome.