In pseudoexfoliation glaucoma, an accumulation of protein-like flakes forms in the eye. The buildup of protein clogs the eye’s drainage system, leading to increased pressure in the eye.
Glaucoma is a group of conditions that cause damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain.
Pseudoexfoliation glaucoma is a subtype that is age-related. It rarely occurs in people
Without treatment, glaucoma can cause progressive damage, which may lead to vision loss.
This article provides a comprehensive overview of pseudoexfoliation glaucoma, including its causes, symptoms, and treatments.
Pseudoexfoliation glaucoma occurs when protein-like deposits build up in the eye. These deposits can clog the eye’s drainage system, preventing the fluid the eye constantly makes from draining away. As a result, the pressure inside the eye increases.
The protein deposits, known as pseudoexfoliative material, consist of flakes that resemble dandruff. They can accumulate in various parts of the eye,
- iris, which is the colored part of the eye
- cornea, which is the transparent tissue over the iris
- ciliary body, which is in the middle layer of the eye wall
When a person has pseudoexfoliation but without any increase in eye pressure or damage to the optic nerve, it is known as pseudoexfoliation syndrome.
Pseudoexfoliation syndrome can affect other areas of the body, such as the lungs, skin, liver, heart, kidneys, and other organs. However, it most commonly affects the eyes.
If the condition does start to damage the optic nerve, it becomes glaucoma.
Without treatment, pseudoexfoliation glaucoma can cause permanent vision loss. Pseudoexfoliation glaucoma is also often
People with pseudoexfoliation glaucoma usually have more episodes of high pressure, more fluctuations of pressure, and higher peak pressures than those with other types of glaucoma.
This kind of glaucoma also tends to be more difficult to manage with medications. It may require more aggressive therapy with laser or surgery, and more frequent visits to the doctor to monitor disease progression.
For people with cataracts, pseudoexfoliation can make the condition worse, and make cataract surgery more difficult for doctors to perform.
Experts are not sure why some people develop pseudoexfoliation syndrome, or pseudoexfoliation glaucoma, while others do not.
Scientists believe it involves transforming growth factor-beta 1 (TGF-B1), a protein that controls cell growth, proliferation, and death. Issues with this protein may lead to the overproduction of certain types of proteins.
There is also evidence that other factors may contribute to the development of pseudoexfoliation glaucoma, including:
- Oxidative stress: This is an imbalance in the production of free radicals, which are molecules that can damage tissues such as the eye.
- Iris hypoperfusion: This refers to a decrease in blood flow to the iris.
- Anterior chamber hypoxia: This refers to a decrease in the oxygen supply to the front part of the eye.
- Imbalances between vasodilators and vasoconstrictors: Vasodilators are substances that widen blood vessels. Vasoconstrictors narrow them.
- Clusterin deficiency: This protein helps prevent the accumulation of material in the eye.
- Dysfunctions of matrix metalloproteinases: These enzymes help break down and clear material from the eye.
Furthermore, several risk factors can increase the likelihood of developing pseudoexfoliation glaucoma. For example, pseudoexfoliation is
In the early stages of pseudoexfoliation glaucoma, people may not experience any symptoms. However, as glaucoma progresses, they may notice that blind spots develop at the sides of their vision.
Other symptoms may include:
- blurry or hazy vision
- difficulty seeing in low light conditions
- halos around lights
- eye pain or discomfort
People with pseudoexfoliation glaucoma also have ocular changes that an eye doctor can detect during a comprehensive eye exam, such as the presence of white pseudoexfoliative material.
To make a diagnosis of pseudoexfoliation glaucoma, an eye doctor provides a comprehensive eye exam, which
- measuring intraocular pressure
- examining the optic nerve
- assessing visual field function
- evaluating the drainage angle of the eye
An eye doctor may also use additional imaging tests, such as optical coherence tomography (OCT) or gonioscopy, to aid their diagnosis.
The goal of treatment for pseudoexfoliation glaucoma is to reduce pressure in the eye and slow the progression of the disease.
Eye drops and oral medications can
Drugs a doctor may prescribe include:
- prostaglandin analogs
- carbonic anhydrase inhibitors
Some procedures may help if medications do not sufficiently control eye pressure. A laser trabeculoplasty can increase fluid drainage from the eye. This treatment is typically successful and can reduce pressure by around
If none of these options works, a doctor may consider surgery. However, this has a higher risk of complications.
It is important for a person to attend regular follow-up and monitoring appointments with their doctor to ensure treatment is working. Regular visits can also detect any changes in the condition.
Pseudoexfoliation glaucoma occurs due to a buildup of protein deposits in the eye. This can prevent fluid from draining, leading to increased pressure in the eye. Over time, this pressure can damage the optic nerve.
The first-line treatment is medication. If medication does not control eye pressure, a doctor may recommend laser or surgical procedures.