Exfoliation syndrome and glaucoma

Exfoliative glaucoma (XFG) is the most common type of secondary open-angle glaucoma.1 Its worldwide prevalence makes it critical for ophthalmologists to be familiar with the full clinical spectrum of the disease.1-3 Exfoliation syndrome (XFS) and XFG were initially described in 1917 by the Finnish ophthalmologist John Lindberg. In 1924, it was determined that XFG develops from XFS. Both conditions currently affect 60-70 million people worldwide. Of these, 15-17 million people have increased intraocular pressure (IOP) and 5-6 million are estimated to suffer from XFG.3 Both XFS and XFG are characterized by the systemic synthesis and accumulation of an abnormal fibrillar material, called exfoliation material. Originally it was believed that the sole source of this abnormal material is the lens. The terms exfoliation material, XFS, XFG, and capsular glaucoma were introduced based on this early theory. True exfoliation of the lens capsule is a different and an exceedingly rare entity, which occurs as a consequence of thermal damage of the lens.