Abstract. The high risk of glaucoma in patients with pseudoexfoliation syndrome (PEX) is widely known. Intraocular pressure (IOP) fluctuations must be evaluated as the independent risk factor of glaucoma damage in patients with PEX. IOP spikes cause irregular load to the optic nerve and can serve as the early manifestation of glaucoma. 92 eyes of 46 patients with PEX were examined. In all cases the risk of glaucoma was assessed and diurnal IOP was measured every 3 hours. We detected the statistically significant differences in the meanings of the IOP parameters (maximal IOP, IOP fluctuation amplitude) between the groups of patients according to the initial IOP level and the risk of glaucoma. In most of patients (more, than 60%) mean arterial blood pressure growth corresponded to the IOP spikes, that illustrates the lack of ocular perfusion. Diurnal IOP curves can be considered as an important factor for the assessment of the risk of glaucoma in patients with PEX manifestations.