Pseudoexfoliation Syndrome

Question 1

Describe pseudoexfoliation syndrome:

Answer 1

Build up of white flaky dandruff like material which clogs up the trab and prevents outflow of aqueous which leads to an increase of iop

Question 2

Who is pseudoexfoliation most common in?

Answer 2

In older px’s and increases with age

Question 3

Who is pseudoexfoliation rare in?

Answer 3

Px’s younger than 50

Question 4

What is the prevalence of pseudoexfoliation in 55-65 yrs?

Answer 4

0.80%

Question 5

What is the prevalence of pseudoexfoliation in over 85s?

Answer 5

6.25%

Question 6

Which gender is more at risk of pseudoexfoliation?

Answer 6

Women

Question 7

Which ethnicity is pseudoexfoliation more common in?

Answer 7

Scandinavian and Greek px’s

Question 8

Is pseudoexfoliation unilateral or bilateral?

Answer 8

Unilateral but the fellow eye will follow over time

Question 9

What is pseudoexfoliation caused by?

Answer 9

Abnormal and excessive production of extra cellular material. The fibrous material is then deposited on several structures including the lens capsule, lens zonules, iris and trab and the increase of material in the trab leads to inhibition of aqueous drainage leading to an increase of iop

Question 10

What does a rise in iop cause?

Answer 10

Onh and ganglion cell death damage

Question 11

In pseudoexfoliation what will the anterior lens demonstrate?

Answer 11

A bullseye pattern which is a central and outer disc separated by a clear band

Question 12

What is the clear band in pseudoexfoliation caused by?

Answer 12

By the movement of the iris across the mid zone of the lens during mydriasis and miosis

Question 13

What does the central disc in pseudoexfoliation appear like?

Answer 13

White and granular appearance and dine feathery threads of material may form in the periphery

Question 14

Why is dilation needed for pseudoexfoliation?

Answer 14

To ensure there’s no peripheral pseudoexfoliation in the periphery (fine feathery threads)

Question 15

Does having pseudoexfoliation mean glaucoma is present?

Answer 15

No

Question 16

What is the prevalence of px’s that have pseudoexfoliation who show signs of glaucoma?

Answer 16

Less than 1/3

Question 17

What is the risk of developing glaucoma 5 years after the detection of pseudo?

Answer 17

50%

Question 18

If the optom suspects that pseudo is present, what do they need to do?

Answer 18

they need to carry out full assessments of glaucoma for example fields, iop and DISC assessment)

Question 19

What is more aggressive, pseudo or POAG?

Answer 19

Pseudo

Question 20

what are px’s with pseudo at risk of?

Answer 20

Substantial glauc damage and increased iop and spikes in iop

Question 21

What is needed to be monitored in px’s with pseudo?

Answer 21

Anterior chamber depth with gonioscopy

Question 22

What is the referral for px’s with pseudo?

Answer 22

Refer routine regardless of whether there’s glauc damage or not