The exfoliation syndrome as a risk factor for lens opacification was investigated with pairwise comparisons of lens opacity, visual acuity, refraction, and anterior chamber depth in 126 eyes of 63 patients with unilateral exfoliation syndrome, and in 84 eyes of 42 patients with unilateral capsular glaucoma. As compared with fellow eyes, the exfoliative eyes showed poorer visual acuity (p < 0.05) and more frequent occurrence of subcapsular cataract (2% vs 8%). Compared with the fellow eyes the lenses in the capsular glaucomatous eyes were more opaque, whether without pilocarpine (p < 0.05), or with pilocarpine treatment (p < 0.0001). Visual acuity was poorer (p < 0.01), refraction more myopic (p < 0.05), and anterior chamber depth less (p < 0.05) in the capsular glaucomatous eyes with pilocarpine treatment. Thus, there are slight changes in the lenses of the exfoliative eyes, the cataractous lens changes being more advanced in the capsular glaucomatous eyes.