Pseudoexfoliation syndrome (PXF or PEX) is an age-related systemic syndrome characterized by the gradual deposition of fibrillary white flaky material (dandruff-like) on the lens capsule, ciliary body, zonules, corneal endothelium, iris, and pupillary margin.
These tiny aggregates of protein fibers are found in the heart, kidneys, liver, lungs, and eye and are created throughout the body. However, this substance has only been shown to cause harm inside the eye, where it raises the risk of glaucoma. PXF can potentially exacerbate cataracts, making cataract surgery more challenging.
This substance can accumulate in the drainage angle, which is the space between the iris and the cornea, over time. This causes an increase in intraocular pressure (IOP) inside the eye, which can damage the optic nerve. Pseudoexfoliation glaucoma (PXF glaucoma) is a kind of glaucoma that causes vision loss.
Causes
Doctors are unsure why people get PXF. Most people believe that both genetic and environmental factors play a role. PXF is uncommon in people under the age of 50. This suggests that many eye disorders are caused by age-related changes in the tissues of the eye.
Symptoms and Risks
There are no symptoms associated with PXF glaucoma. Because high pressure inside the eye causes no pain, individuals may gradually lose vision without realizing it.
Pseudoexfoliation (PXF) can affect everyone. However, it is more common in the following groups:
● a person with a Northern European ancestry
● who have PXF glaucoma in their family
● 50 years old or older
Women are also more likely to have PXF. UV radiation exposure, high altitude, northern latitude, and food may all play a part in the development of PXF; however, this has yet to be established.
Diagnosis
During a full eye exam, an ophthalmologist can generally detect evidence of pseudoexfoliation (PXF). They may do the following tests:
● An examination with a slit lamp. The slit lamp’s powerful light and microscope are used by your ophthalmologist to look for microscopic flakes of PXF material at the front of the eye (on the iris and lens).
● Gonioscopy. A gonioscopy lens is a little piece of equipment that allows your doctor to observe the drainage angle to see if it is obstructed.
● Determine the intraocular pressure (IOP). Your IOP will be measured using a device called a tonometer. If your blood pressure is too high, you may need medication to prevent damage to your optic nerve and vision loss.
● Dilation. To enlarge your pupils, your doctor may use dilating eye solutions. This allows them to see the retina and optic nerve in the rear of the eye clearly.
Treatment
There is no need for treatment if you have PXF unless you develop glaucoma. Because of the risk of glaucoma, you should see your ophthalmologist at least once a year. Your ophthalmologist may want to visit you more frequently depending on your level of risk.
Pseudoexfoliation glaucoma, like most glaucomas, is treated by reducing intraocular pressure. This helps to keep the optic nerve from being damaged. The following treatments may be used:
● Medicine for the eyes. Some eye drops help the fluid flow out of the eye by reducing the amount of fluid produced in the eye.
● Laser surgery. The drainage angle can be laser-treated to help it drain more fluid from the eye.
● Surgery is performed in the operating room. Surgery helps create a new drainage route through which the fluid can exit the eye.
