Because both exfoliation syndrome (XFS) and inguinal hernias involve connective tissue disruption, researchers with The Utah Project took a closer look at a possible link between the two. Within the population-based study, they identified 2,594 Utah residents aged 40 or older who had surgical inguinal hernia repair and 12,966 controls with no history of hernias.

They found 22 patients with an inguinal hernia and 43 controls were diagnosed with XFS. After matching on sex and age and adjusting for body mass index and tobacco use, they noted a 2.3-fold risk for those with a hernia compared with controls.

The researchers also found the subtype of hernia—direct or indirect—also played a part, as exfoliation syndrome was particularly pronounced in those with an indirect hernia.

While further study is necessary, the researchers note that “associating XFS with comorbid conditions may illuminate their underlying pathophysiology and affect clinical screening and treatment.”

Besch BM, Curtin K, Ritch R, et al. Association of exfoliation syndrome with risk of indirect inguinal hernia: The Utah project on exfoliation syndrome. JAMA Ophthalmol. September 13, 2018. [Epub ahead of print].