A white daisy on intraocular lens

We report two patients with precipitation of Pseudo-exfoliative material (PXF) material on intraocular lens (IOL), a rare entity, years after uneventful cataract surgery. The PXF material was present on the anterior surface of the IOL optic in a characteristic radiating spoke-like manner, a pattern resembling shape of a white daisy flower. Emphasis is given on differentiating features between PXF deposition on natural lens and PXF deposition on IOL. Furthermore, how opacification of IOL is different from PXF on IOL is briefly explained. In the first case, PXF deposits were not found elsewhere except on anterior IOL surface and in the second patient, pupillary involvement was also noted along with settling on IOL optic. The fellow eyes in both the patients did not have PXF. PXF on IOL is a vital sign and should not be overlooked as it can be the only clue warranting thorough glaucoma evaluation.