A 40-year-old Scandinavian woman is referred with IOP of 32 mmHg bilaterally. Gonioscopy shows open angles with a grey-white flaky material deposited on the lens equator and anterior lens capsule, trabecular meshwork, and corneal endothelium. The most likely diagnosis is:
- A Pigmentary glaucoma
- B Steroid-induced glaucoma
- C Pseudoexfoliation glaucoma ✓
- D Phacomorphic glaucoma
Correct answer: C. Pseudoexfoliation glaucoma
Explanation
Pseudoexfoliation syndrome (PXF) is the most common identifiable cause of open-angle glaucoma worldwide, particularly prevalent in Scandinavian and Nordic populations. It is characterised by the deposition of grey-white fibrillogranular material (abnormal extracellular matrix protein) on the anterior lens capsule (classic bull's eye pattern), zonules, trabecular meshwork, and corneal endothelium. It causes raised IOP due to trabecular obstruction and carries a higher risk of zonular laxity during cataract surgery.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.