A Prospective Study of Patients with Pseudoexfoliation Glaucoma and Its Management in a Tertiary Care Centre in South India
BACKGROUND Pseudoexfoliation syndrome is the most common identifiable cause of open angle glaucoma worldwide. Pseudoexfoliation glaucoma develops in 50 % of patients with pseudoexfoliation syndrome. The purpose of this study was to assess the clinical profile, intraocular pressure (IOP), gonioscopic findings, disc changes and need for medical or surgical line of management for the control of pseudoexfoliation glaucoma. METHODS It was a prospective hospital based interventional study of 68 consecutive patients diagnosed with pseudoexfoliation glaucoma, who presented to the glaucoma clinic at a tertiary care centre from Nov 2017 to Mar 2019. RESULTS 68 patients diagnosed with pseudoexfoliation glaucoma were evaluated during the study period from November 2017 to March 2019. Male predominance of 43 (63 %) was noticed. Mean age group of study population was 68 years with 44 (65 %) of patients in age group of 61 – 75 years. 55 cases had bilateral pseudoexfoliation. 85 (69 %) eyes had a pressure of > 21 mm of Hg. 97 (79 %) eyes had open angles, 4 (3 %) occludable angles, 22 (18 %) had closed angles. 4 (3 %) of eyes had cup disc ratio < 0.5, 49 (40 %) eyes had cup disc ratio of 0.5 - 0.7, 64 (52 %) had > 0.7 cupping. 38 (31 %) eyes were controlled on medical therapy with topical antiglaucoma medications. In 14 (11 %), eyes were treated with Nd: YAG PI (neodymium-doped yttrium aluminium garnet peripheral laser iridotomy) with medical treatment, 59 (48 %) eyes were taken up for triple procedure. 10 (8 %) eyes could not be controlled using medical therapy and had to be taken for surgical treatment. CONCLUSIONS Pseudoexfoliation glaucoma leads to irreversible visual loss if high IOP is not treated leading to glaucomatous optic nerve damage and visual field loss. The response to medical therapy is poor and needs surgical intervention. KEYWORDS Pseudoexfoliation Glaucoma, Intraocular Pressure, Optic Nerve Damage, Dandruff Like Material