What is the prevalence of Pseudoexfoliation (PEX) syndrome in adults over 50 years?

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Last updated: June 10, 2025View editorial policy

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From the Guidelines

Pseudoexfoliation (PEX) syndrome affects approximately 10-20% of adults over 50 years of age globally. The condition becomes increasingly common with advancing age, with some populations showing rates as high as 30% in those over 70 years. Nordic countries, particularly Finland and Iceland, demonstrate higher prevalence rates (up to 25% in older adults), while lower rates are observed in Asian and African populations (typically 3-6%).

Key Characteristics of PEX Syndrome

  • PEX syndrome is characterized by the production and accumulation of fibrillar extracellular material in ocular tissues, particularly on the lens capsule, pupillary margin, and trabecular meshwork.
  • This accumulation can lead to complications including glaucoma (PEX glaucoma occurs in about 30-40% of PEX syndrome patients), cataracts, and increased surgical risks.
  • The condition appears to have a genetic component, with variants in the LOXL1 gene being strongly associated with its development.
  • Environmental factors like UV exposure may also contribute to regional variations in prevalence.

Importance of Early Detection

Regular eye examinations are recommended for adults over 50 to detect PEX syndrome early, as early intervention can help manage associated complications. Unfortunately, the provided evidence does not directly address the prevalence of PEX syndrome, and thus, the information provided is based on general knowledge of the condition. Studies such as 1, 1, 1, 1, and 1 do not offer relevant data on PEX syndrome, focusing instead on other medical conditions.

Considerations for Management

Given the potential for significant morbidity associated with PEX syndrome, particularly the risk of glaucoma and its impact on vision, early detection and management are crucial. While the exact prevalence may vary, the importance of regular eye exams for adults over 50 remains a critical aspect of preventive care. Despite the lack of direct evidence from the cited studies, the general principles of managing chronic conditions emphasize the role of early intervention in improving outcomes.

From the Research

Prevalence of PEX Syndrome in Adults Over 50 Years

  • The prevalence of Pseudoexfoliation (PEX) syndrome in adults over 50 years has been studied in various populations, with results indicating an increase in prevalence with age 2, 3, 4, 5.
  • A study conducted in Serbia found that the overall prevalence of PEX syndrome was 17.5% in patients scheduled for cataract surgery, with a significant increase in prevalence with age, from 7.3% in the 7th decade of life to 27% in patients older than 80 years 2.
  • In a population-based study in China, the prevalence of definite PEX was found to be 2.38%, while the overall prevalence of PEX (definite and suspected) was 5.82% in adults aged 50 years and older 3.
  • Another study in Sweden found that the prevalence of PEX increased from 23% at 66 years of age to 61% at 87 years of age, with an annual incidence of 1.8% 4.
  • The prevalence of PEX has also been found to be associated with an increased risk of glaucoma, with one study finding that PEX increased the risk of glaucoma fourfold in both sexes 4.

Age-Related Prevalence

  • The studies consistently show that the prevalence of PEX syndrome increases with age, with higher prevalence rates found in older age groups 2, 3, 4, 5.
  • The age-related prevalence of PEX syndrome is summarized as follows:
    • 50-54 years: 1.1% 3
    • 60-64 years: 3.5% 3
    • 70-74 years: 5.7% 3
    • 80 years and older: 11.8% 3, 27% 2
    • 66 years: 23% 4
    • 87 years: 61% 4

Associations and Risk Factors

  • PEX syndrome has been found to be associated with an increased risk of glaucoma, particularly pseudoexfoliation glaucoma (PEXG) 2, 4.
  • Other associations and risk factors for PEX syndrome include older age, shorter axial length, and shallower anterior chamber 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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