Can you tell me what treatment is recommended for pseudoexfoliation glaucoma?

Similar to other types of glaucoma, the goal with pseudoexfoliation glaucoma (when flaky dandruff-like deposits inside the eye block fluid from leaving the eye, causing pressure to rise) is to reduce eye pressure to prevent additional damage to the optic nerve.

Typically, we first try topical eye drops to reduce eye pressure. Patients with pseudoexfoliation glaucoma that is mild to moderate also tend to respond particularly well to selective laser trabeculoplasty, which is a low-risk, in-office procedure.

There are also some minimally invasive glaucoma surgery options for mild to moderate pseudoexfoliation glaucoma, such as iStent, trabectome, or endoscopic cyclophotocoagulation. If the glaucoma is more advanced or the patient needs significant eye pressure lowering, more traditional glaucoma surgery such as trabeculectomy or aqueous shunt implant is recommended.

The best thing a patient with pseudoexfoliation glaucoma can do is to live a generally healthy lifestyle with good diet and exercise, be diligent about following their ophthalmologist's instructions for using medications, and returning for regular follow-up with their ophthalmologist so any changes in the glaucoma or eye pressure can be noted right away.

Finally, it is important to note that some patients with pseudoexfoliation also have narrow angles (when the colored part of your eye is pushed too far forward), which can put you at risk for angle closure attacks of elevated eye pressure. Everyone with pseudoexfoliation should be evaluated by their ophthalmologist for narrow angle.