Fibrillar white flaky deposits on at pupillary border.Fibrillar white flaky deposits on the anterior lens capsule (Hoarfrost Ring).Poor dilation with peripupillary transillumination defect.Possible glaucomatous damage to optic nerve.Gonioscopy may show increased pigment deposit on the trabecular meshwork. Deposition of white fluffy material on the anterior lens capsule and pupillary margin and iris transillumination defects can be visualized in many cases. Anterior chamber depth less than 2.5mm centrally could be an indication of zonular instabilityĪll of the above may pose a significantly higher risk for intraoperative complications.ĭiagnosis is made using slit lamp biomicroscopy and intraocular pressure measurement.Special precaution and awareness is essential prior and during cataract surgery.Treatment of elevated eye pressure with eye drops, laser or surgery.Biomicroscopic examination (slit lamp) used by an eye doctor to examine the anterior lens capsule, pupillary dilation, intraocular pressure and optic nerve.Routine annual eye exam by an ophthalmologist for the patients over ago 50.

“Because pseudoexfoliation syndrome is associated with abnormalities of the extracellular matrix and the basement membrane, this gene could reasonably play a role in the pathophysiology of the condition.” described a LOXL1 is a member of a family of enzymes that are active in the cross-linking of collagen and elastin in the extracellular matrix, he explained. Unclear, but there is a gentic link to the gene LOXL1. In March 2008 of the American Glaucoma Society in Washington, D.C. Dr. There could appear abnormal material like iron filings on the edge of a magnet on the anterior lens capsule. The iris pigment epithelium may show a “saw-toothed” configuration. B, The iris pigment epithelium demonstrates a “saw-toothed” configuration, consistent with pseudoexfoliation.

A, Abnormal material appears on the anterior lens capsule like iron filings on the edge of a magnet ( arrows). They are coated with the glycosaminoglycan hyaluroni acid. The deposits are composed of elastic fibers (fibrillin and α-elastin)and noncollagenous basement membrane materials (laminin)which form fibrils.

Its prevalence in different human populations: high prevalence in Scandinavia.

It may a generalized disorder involving abnormal production or turnover of extracellular matrix in the basement membrane. It is characterized by 'lamellar delamination of the lens capsule'.Įtiology is unknown. A few decades later, an American ocular pathologist named Georgiana Dvorak-Theobald suggested the term pseudoexfoliation to distinguish it from the true exfoliation syndrome. True exfoliation is caused by heat from glassblowing or infrared radiation exposure in the anterior lens capsule. He reported the classic findings of white/grey flakes on the anterior lens capsule, glaucoma in approximately 50% of eyes, and an increasing prevalence of the condition with advancement of the age. In 1971, Finnish ophthalmologist John Linberg was the first doctor to describe pseudoexfoliation syndrome.

It has been associated with myocardial infarction, cerebrovascular events and systemic hypertension. The disease may be bilateral and asymmetric. These deposits have also been found elsewhere in the body,including in the skin, heart, lungs, liver, kidneys, and elsewhere. The deposits have been found on and in the subconjunctival tissue, pupillary margin, ciliary epithelium, lens epithelium, lens capsule, iris pigment epithelium, trabecular meshwork, cornea, zonules, orbital soft tissues, iris stroma and iris blood vessels. It is most commonly noted in older individuals, typically over 50 years of age.Įxfoliation (pseudoexfoliation) Syndrome is characterized by the fibrillar deposits in the anterior segment of the eye. Exfoliation/Pseudoexfoliation syndrome is a systemic disease.

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