Aim: to study the prevalence of glaucomatous injury in pseudoexfoliation patients, and the relation of these injuries with IOP values. Methods: 75 PXS eyes were compared with 75 age matched control eyes, and so 21 unilateral PXS patients were studied by comparing their two eyes. The study contained ONH study with Heidelberg Retina Tomograph (HRT), and mean and range of IOP values. Results: ONH parameters which were compared between patients and controls included: disk area, rim area, cup area, mean RNFL thickness, vertical cup\disk ratio, MRA result, and GPS result. The difference was significant in all these parameters between patients and controls, also it was significant in mean IOP and its fluctuation. For unilateral PXS patients, no statistically significant difference was found in ONH parameters between the two eyes, but there was in IOP mean and range. Conclusion: PXS eyes are at high risk for developing glaucomatous optic nerve injuries, which were more probable with raised IOP mean and range; the risk also involved the other normal eye in unilateral PXS, certaining the systemating nature of pseudo exfoliation disease.