Pseudoexfolation (PEX) is characterised by deposition of fibrillary extracellular material on ocular and extraocular tissue. Studies have shown that deposition in vascular structures cause hypoxia and ischaemia. In the eye, a decrease in blood supply to the optic nerve can lead to glaucoma progression. Forty patients with PEX were included in this study. The diameter of vascular structures in PEX patients was significantly decreased compared with controls, and this was true in all arteries (whereas it was only significant in superior temporal and superior nasal veins). These measurements were taken with OCT. Other studies have demonstrated a strong relationship with glaucomatous damage caused by ischaemic processes and narrowing of the retinal arterioles. In another study comparing retinal vessel diameter of normal eyes with glaucomatous eyes, the diameter of the retinal arteries was greatest in the temporal inferior region and the lowest in the nasal inferior region. This current study indicates that vascular narrowing could occur in the contralateral eye of patients with PEX and they could develop glaucoma despite the lack of PEX deposition. They advise that clinicians take proactive action against this deposition and early glaucoma after detecting early signs in vascular structures.