Patients with pseudoexfoliation syndrome often have loss of hearing and should be referred for audiometry

The Science behind the Tip

Pseudoexfoliation syndrome is an important cause of glaucoma. It has been known for many years that pseudoexfoliation material is not only found in ocular anterior segment structures, but is also found in other organs of the body (1).

A significant proportion of patients with pseudoexfoliation syndrome have sensorineural hearing loss in both ears when compared with age-matched controls, regardless of whether there is associated glaucoma (2). This was initially thought to involve high frequency hearing thresholds, but a recent study has shown that hearing thresholds that are important for comprehension of speech are also significantly altered (3)(4). This is presumably caused by deposition of pseudoexfoliation fibrils in the organ of Corti of the inner ear (1).

Patients with pseudoexfoliation syndrome should be referred for audiometry so that an appropriate hearing aid can be supplied.

Contributor: John Salmon, Oxford, UK

References

1. Schlotzer-Schrehardt UM, Koca MR, Naumann Got et al Exfoliation syndrome. Ocular manifestation of a systemic disorder? Arch Ophthalmol 1992; 110: 1752-1756

2. Cahill M, Early A, Stack S et al Pseudoexfoliation and sensorineural hearing loss. Eye 2002; 16:261-266

3. Detorakis ET, Chrysochoou F, Paliobei V et al Evaluation of the acoustic function in pseudoexfoliation syndrome and exfoliation glaucoma: audiometric and tympanometric findings. Eur J Ophthalmol 2008; 18: 71-76

4. Yazdani S, Tousi A, Pakravan M et al Sensorineural hearing loss in pseudoexfoliaton syndrome. Ophthalmology 2008; 115: 425-429

Tip Reviewer: Roger Hitchings
Tip Editors: John Salmon and Gordana Sunaric Mégevand