Exfoliation syndrome in the southeastern United States. II. Characteristics of patient population and clinical course.

Fifty-three patients with the exfoliation syndrome, seen at the Duke University Eye Center, Durham, North Carolina, were characterized by a mean age of 71.3 years, a predilection toward women (38:15), and a marked preponderance of whites to blacks (51:2). There were 31 unilateral and 22 bilateral cases on the initial exam, with glaucoma in 62 of the 75 eyes with exfoliation, as well as 15 of the fellow, non-exfoliation eyes. The incidence of glaucoma is undoubtedly skewed, since the patients were from a glaucoma referral practice. Twenty-four patients were followed from six months to ten years, with a mean of three years, during which time four patients progressed from unilateral to bilateral exfoliation and five more patients acquired glaucoma in eyes with the exfoliation syndrome. The glaucoma associated with the exfoliation syndrome was typically difficult to treat with a high percentage of patients requiring multiple medications or surgical intervention.