• Pseudoexfoliation Diagnosis and Treatment

    Reviewed By J Kevin McKinney MD
    Mar. 09, 2021

    How Is Pseudoexfoliation Diagnosed?

    An ophthalmologist can usually find signs of pseudoexfoliation (PXF) during a comprehensive eye exam. Tests they may do include:

    • A slit lamp exam. Your ophthalmologist uses the bright light and microscope of the slit lamp to look for tiny flakes of PXF material at the front of the eye (on the iris and lens).
    • Goniscopy. A gonioscopy lens is a small device that helps your doctor see the drainage angle. They can check if the drainage angle is blocked.
    • Measure intraocular pressure (IOP). A device called a tonometer will be used to check your IOP. If the pressure is too high, treatment may be needed to prevent damage to your optic nerve and loss of vision.
    • Dilation. Your doctor may use dilating eye drops to widen your pupils. This gives them a better view of the retina and the optic nerve in the back of the eye.

    How Is PXF Treated?

    If you have PXF, no treatment is needed unless you develop glaucoma. You do need to see your ophthalmologist at least once per year because of this risk of glaucoma. Depending on your level of risk, your ophthalmologist may want to see you more often.

    During follow-up exams, your ophthalmologist looks for signs of glaucoma. It’s important to go to every exam that is scheduled for you. If your doctor finds glaucoma early enough, you can save your vision.

    How Is Pseudoexfoliation Glaucoma Treated?

    Like most glaucomas, pseudoexfoliation glaucoma is treated by lowering the intraocular pressure. This helps prevent damage to the optic nerve. Treatment may include:

    • Eye drop medicine. Some eye drops reduce the amount of fluid made in the eye and other drops help it flow better out of the eye.
    • Laser surgery. Laser treatment of the drainage angle helps it drain more fluid from the eye.
    • Operating room surgery. Some glaucoma surgery is done in an operating room. It creates a new drainage channel for the fluid to leave the eye.