Clinical features of pseudoexfoliation of the lens capsule: suggested management

BACKGROUND: Pseudoexfoliation of the lens capsule (PEX) is found in widely varying proportions across the population of regional groups. It is strongly associated with open angle glaucoma and to a lesser extent angle closure glaucoma. This association makes PEX a very important risk factor for glaucoma, which should be sought actively in all patients over 50 years of age who seek eye care. Our ageing population may give rise to a future high caseload of PEX glaucoma, which will create challenges in diagnosis and treatment. METHOD: Selected literature is reviewed. It includes a description of the course of PEX and suggested optometric clinical procedures to diagnose and assess the significance of PEX. An algorithm for guidance of optometric and ophthalmological management is presented. CONCLUSIONS: PEX is a common condition in the aged. It is an easily detected strong indicator of open angle glaucoma and to a lesser extent the risk of angle closure glaucoma. The presence of PEX should alert the clinician to the need for a full glaucoma assessment.