Exfoliation Syndrome with Marcelling

This 63 year old man was referred with asymmetric glaucoma. The right eye had a large cup with an intraocular pressure of 36 mmHg while the left eye had a pressure of 20 mmHg and no cup whatsoever. One can see these ridges of light and dark bands that are characteristically seen in exfoliation syndrome. There is also heavy angle pigmentation. The patient was pseudophakic and therefore we were not able to evaluate whether he had typical pseudoexfoliative debris on the anterior lens capsule. The iris changes and angle pigmentation are certainly suggestive of exfoliation syndrome.