Prevalence and Associations of Pseudoexfoliation Glaucoma in a Group of Tertiary Eye Care Facilities in Southwest Nigeria

Background: Globally, glaucoma is the leading cause of irreversible blindness. Pseudoexfoliation glaucoma is the most common form of secondary open angle glaucoma. Purpose: To determine the prevalence and characteristics of pseudoexfoliation glaucoma (PXG) among newly diagnosed glaucoma patients in Eye Foundation Hospital Ikeja, Guinness Eye Center, Lagos University Teaching Hospital and Deseret Community Vision Institute, Ijebu Imushin. Methods: This hospital-based, descriptive cross-sectional study included newly diagnosed adult glaucoma patients at the glaucoma clinics of three tertiary eye care centers. A study proforma was used to obtain socio-demographic information, medical history, ocular history and relevant findings on ocular and systemic examination. Descriptive and comparative statistical analyses were performed. Values were considered statistically significant where P < 0.05. Results: One hundred and forty adult glaucoma patients aged 60.5 ± 11.9 SD years and male to female ratio of 2:1 were examined. The prevalence of PXG among the glaucoma patients was 16.9%. The pseudoexfoliative material (PXM) was most commonly found on the pupil (39%). Common ocular features seen among PXG patients were poor pupillary dilation with mydriatic agents (44%) and Sampaolesi’s line in the anterior chamber angle (41%). A higher proportion of PXG patients than primary open angle glaucoma (POAG) patients showed signs of severe glaucoma, including severe optic disc cupping (P = 0.019) and visual field defects (P = 0.014). Hearing defects were the only significantly associated non-ocular feature (P = 0.0005). Conclusion: The prevalence of PXG was 16.9%. This implies that it is relatively common in Nigeria. Hearing loss is an important non-ocular association. Careful ocular examination of glaucoma patients is recommended to identify PXG, which runs a more severe clinical course than POAG.