Abstract.A retrospective follow‐up study of 206 eyes with exfoliation in 164 patients was carried out. At the time exfoliation (EX) was initially diagnosed, there were 97 patients with unilateral and 42 patients (84 eyes) with bilateral exfoliation. In 25 patients the exfoliation was connected with hypertension or glaucoma in the fellow eye.The average age of the patients with unilateral EX was 66.3 years and that of the patients with bilateral EX 68.0 years. The initial mean IOP (±SD) of 17.9 (±2.9) mmHg in 97 unilateral EX eyes was statistically significantly higher (2p<0.001) than in the normal fellow eye 16.1 (±2.5) mmHg.Of the 97 eyes with unilateral EX, 45.3 % with an initial mean IOP of 17.4 mmHg remained unchanged. The mean follow‐up time was 5.0 years. Conversion of unilateral to bilateral EX was observed in 14.4 % of cases. The mean time of conversion was 4.5 years. Of the 84 bilateral EX eyes with an initial mean IOP of 17.0 mmHg, 66.7 % remained unchanged.Of the total sample of 206 EX eyes, 65.5 % remained normotensive and 34.5 % developed hypertension or glaucoma during the follow‐up period. The initial mean IOP of those eyes which remained normotensive was statistically significantly lower than that of those which later on developed hypertension or glaucoma (2