What is Pseudoexfoliation Syndrome?
Pseudoexfoliation syndrome is condition where deposits of a white flakey looking substance are found on the structures inside the front portion of the eye. It is easily seen on the surface of the lens behind the pupil and also found on ciliary body, endothelium of the cornea and trabecular meshwork. Pseudo means false. There is a true form of exfoliation which is caused by exposure to intense heat or infrared light. Exfoliation occurs most commonly in glass blowers because of the high temperatures they work in. In this case the anterior capsule peels and wrinkles leading to the formation of a cataract. The name of pseudoexfoliation was given as it is different from true exfoliation but appears similar.
Cause of Pseudoexfoliation Syndrome
The exact etiology is unknown. Pseudoexfoliation is an abnormality of the basement membrane of the epithelial layer. Pseudoexfoliation deposits have been found in cell walls of blood vessels, skin, heart, lung, kidney, and connective tissue. Pseudoexfoliation syndrome usually affects both eyes but may appear asymmetrical.
Prevalence of Pseudoexfoliation Syndrome
It occurs worldwide but with a significant variation. It is common in Scandinavian countries and 50% or more of open angle glaucoma is related to pseudoexfoliation in Scandinavia. Pseudoexfoliation syndrome is 3 times more common in women than men. It usually does not develop before age 55.
Complications Associated With Pseudoexfoliation Syndrome
Nearly all people with pseudoexfoliation syndrome will develop cataracts. The structures of the lens capsule and zonules that hold the lens in place become weak with pseudoexfoliation syndrome. This can make cataract surgery more difficult in some cases.
Blockage of the trabecular meshwork from the pseudoexfoliation material causes the intraocular pressure inside the eye to elevate. This elevated eye pressure leads to glaucoma. Approximately 20 % of people with pseudoexfoliation syndrome will develop glaucoma. Normally 1 to2 % of people will develop glaucoma. The glaucoma associated with pseudoexfoliation can be difficult to treat. Many times topical ocular medications will not control the glaucoma. Selective laser trabecularplasty (SLT) does work well with glaucoma associated with pseudoexfoliation syndrome.
Pseudoexfoliation syndrome on its own does not have any symptoms or pose a threat to vision. It is the secondary effects of pseudoexfoliation syndrome that causes the problems. People with pseudoexfoliation syndrome need to be monitored closely in order to detect any of its complications.