Frequency of Exfoliation Syndrome Among Patients Attending an Ophthalmology Outpatient Clinic in the Northeastern Black Sea Coast of Turkey.

Background: Exfoliation syndrome (XFS) is a common age-related disorder and a major risk factor for glaucoma and cataract. This study describes the hospital-based frequency and clinical associations of XFS among patients aged 40 years and older attending a regional ophthalmology outpatient clinic in the Northeastern Black Sea coastal region of Turkey. Methods: This cross-sectional observational study included 938 eligible participants aged ≥40 years with registered birth records and continuous residence within the defined catchment area who underwent a comprehensive ophthalmological examination. XFS was defined by characteristic exfoliative material at the pupillary margin and/or on the anterior lens capsule (phakic eyes) or capsular bag/IOL complex (pseudophakic eyes), with pupillary assessment before and after pharmacologic dilation. Systemic comorbidities were extracted from national medical records. Multivariable logistic regression adjusted for age and gender. Results: XFS was diagnosed in 20.8% (195/938; 95% CI: 18.2-23.5%). The XFS-positive (XFS+) group was older than the XFS-negative (XFS-) group (71.76 ± 0.61 vs. 63.25 ± 0.40 years; p < 0.001). Hypertension was more common in XFS+ participants (57.4% vs. 45.6%; p: 0.002) and remained associated after adjustment (OR: 1.49; 95% CI: 1.05-2.11; p: 0.024). Glaucoma was more frequent in XFS+ participants (23.6% vs. 14.9%; p: 0.005); it remained associated after adjustment (OR: 2.00; CI: 1.31-3.05; p: 0.001). Conclusions: In this hospital-based surveillance, approximately one in five clinic attendees aged ≥40 years had XFS. Findings should not be extrapolated to population prevalence; population-based studies are required to estimate regional prevalence accurately. Nonetheless, these data highlight a substantial clinical burden of XFS in a regional care-seeking population and support vigilant glaucoma surveillance in affected patients.