Pseudoexfoliation is a disease of the eye where microscopic, flaky, whitish material - resembling dandruff - is deposited primarily on the pupil and iris of the eye, on the front surface of the lens of the eye, and in the trabecular meshwork of the eye. The source of the pseudoexfoliation flakes has not been fully identified, but there is evidence that the pseudoexfoliation material leaks out from blood vessels that supply the eye, and then deposits and accumulates in various parts of the front part of the eye. The pseudoexfoliation flakes that deposit on the pupil and iris can damage the various muscles of the iris and prevent the pupil from dilating properly during eye exams. Additionally, since dilation of the pupil is an important first step of cataract surgery, pseudoexfoliation of the iris and pupil often interferes with and complicates the cataract surgery procedure. The pseudoexfoliation flakes that deposit on the lens of the eye can be a problem during cataract surgery since they can cause the cataract and/or intraocular lens implant (IOL) to loosen inside the eye during surgery, sometimes resulting in serious cataract surgery complications. The pseudoexfoliation flakes that deposit on the trabecular meshwork of the eye can block aqueous humor fluid from exiting out of the eye, causing a buildup of pressure inside the eye. This is called ocular hypertension, and can advance to pseudoexfoliation glaucoma when the increased eye pressure damages the optic nerve of the eye and causes loss of vision.
The best way to determine if a person has pseudoexfoliation of the eye, is to be examined by an eye doctor using a slit lamp - a routine piece of equipment that all eye doctors use. The pseudoexfoliation material can be easily seen on the pupil and lens of the eye, if looked for properly. Since pseudoexfoliation is usually found above age 60, it is very important to have eyes examined at least annually to look for pseudoexfoliation as well as other eye diseases. There are no early symptoms of pseudoexfoliation or pseudoexfoliation glaucoma, so annual exams are important. Pseudoexfoliation frequently occurs in one eye only, but in many people the second eye develops pseudoexfoliation years later.
The exact cause of pseudoexfoliation is not known. However, there is increasing scientific, medical evidence that pseudoexfoliation is a systemic disease affecting the entire body, since microscopic pseudoexfoliation material has been found in numerous body organs including the liver, heart, skin, kidneys and other tissues. There is increasing evidence that pseudoexfoliation may be associated with heart attacks, strokes and possibly dementia. In recent years, discoveries have been made which indicate a possible genetic predisposition for developing pseudoexfoliation, but there are currently no readily available genetic tests or blood tests for pseudoexfoliation. The incidence of pseudoexfoliation varies by country and ethnicity, but in some areas of the world over 10% of people over age 60 have pseudoexfoliation.