Pseudoexfoliation syndrome, ocular and systemic associations


  • Saif Abbas. Al-Shamarti CABOphth. FRCS. JMC .ICO/Al-Qadisiya University
  • Haider Aswad. Al-Hemidawi CABOphth FRCS. FICO/Al-Qadisiya University
  • Hasenen Hasan. Al-Rekabi FICMS. FICO/Al-Qadisiya University


Background: Pseudoexfoliation syndrome (PXF) is a recognized risk factor for developing cataract, glaucoma and lens dislocation. PXF also associated with increased risk of vascular disorders and hearing loss, this study aims to assess the prevalence of this syndrome among patients (>40years) attend ophthalmology clinic in Diwaniyah teaching hospital with emphasis to both ocular and systemic associations. Methodology: 2680 patients age more than 40 years who attend the ophthalmology clinic in Diwaniyah teaching hospital for the period from July 2013 to January 2015were recruited by the researchers , detailed systemic and ocular history are taken, detailed ophthalmological examination done including visual acuity testing, refraction, slit lamp bimicroscope examination, applanation tonometer and gonioscopy, dilated examinationof the lens using the LOCS II grading system for cataract and fundus with optic nerve examination. All the patients have been sent for the ENT department for hearing examination and assessment, also send for the internal medicine department for detailed cardiovascular examination and risk assessment. Results: Out of 2680 patients who enrolled in this study, 216 had PXF so the percentage of PXF will be 8% in patients above 40, Mean age of the patients is 65.43+13.94 years, range 41 to 93 years, PXF is associated with increased incidence of cataract (50,46%), glaucoma (8,9%), hearing loss (11,57%), Hypertension (36,57%) and DM type II (38,69%). Conclusion: PXF appear to be a common disease in Iraqi population, PXF is significantly associated with increased incidence of cataract, glaucoma, hearing loss, Hypertension and DM type II.


- Kaniski JJ, clinical ophthalmology. 2010; 355.

- Lindberg.JG. Kliniskaunder sokningar over depig mentering enavpupill arrandeno chgenomlys barhetenav iris vid fall avaldersstarrsamt I normalaogon hos gamlapersoner (thesis) Helsinki, Finland. Helsinki University 1917.

- Prince AM. Ritch R. clinical signs of the pseudoexfoliation syndrome. Ophthalmology 1986; 93:803-7.

- Fukisawa K, Sugai S, Inomata H, et al. Relationship between intraocular pressure and age in exfoliation syndrome. Ophthalmologica1995; 209:199-202.

- Davanger M, Ringvold A, Blika S, Pseudoexfoliation, IOP, and Glaucoma, ActaOphthalmol1991; 69:569-73.

- Kjorsvik S, Rossvold I, The middle Norway eye screening II. Prevalnce of simple and capsule glaucoma. Actaophthalmol1991; 69:273-80.

- Ringvold A, Blika S, Elsas T Et al. Increase occurance of exfoliation in the male, Spanish American population of the New Mexico.J Am OptomAssoc1992;63:643-8.

- Konstas AGP, Jay JL, Marshall GE, et al. Prevalence, diagnostic features, and response to trabeculoctomy in exfoliation syndrome. Ophthalmology.1993; 100:619-27.

- Hirvela H, Luukinen H, Laatikainen L, Prevalnce and risk factors of lens opacities in the elderly in Finland. ophthalmology 1995; 102:108-17.

- Rouhiainen H, Terasvirta M. Presence of pseudoexfoliation on clear and opacifiedlensin an aged population. Ophthalmologica 1992; 204:67-70.

- Schlotzer –schrehardt UM, KocaMR, NoumanGOVolkholz H, Pseudo exfoliation syndrome, Ocular manifestation of a systemic disorder? Arch Ophthalmol1992; 110(12):1752-6.

- Cahill M, Early A, Stack S, Balyney AW, Eustace P. Pseudoexfoliation and sensorineural hearing loss. Eye (London) 2002, 16(3):261-6.

- Aasved H, Mass screening for fibrillopathiaepitheliocapsularis, so called senile exfoliation or pseudo exfoliation of the anterior lens capsule. ActaOphthalmol. (Copenh) 1971, 49(2):334-43.

- Forsuis H, Prevalence of PXF of the lens in Finns, Lapps, Icelanders, Eskimos and Russians. Trans Ophthalmol. Soc. UK. 1979,99:296-298.

- Hiller R, Sperduto RD, Kreuger DE: Pseudoexfoliation, IOP, and senile changes in apopulation based survey, Arch Ophthalmol, 1982; 110:1080-2.

- Mitchell P, Wang JJ, Hourihan F, the relationship between glaucoma ndpseudoexfoliation, The Blue mountain eye study. , Arch Ophthalmol1999; 117:1319-24.

- Henry JC, Krupin T, Schmitt M, Long term follow up of pseudoexfoliation and the development of elevated intraocular pressure. Ophthalmology 1987; 94; 545-52.

- Topouzis F, Harris A, Wilson MR, Increased likelihood of glaucoma at the same screeining intraocular pressure in subject with PseudoexfoliationAm J Ophthalmol. 2009; 148; 606-613.