In the present study, the authors assessed the prevalence of pseudoexfoliation (PEX) and its associations in a Russian population. Despite previous indications of a high prevalence of PEX in the Russian population, only limited evidence exists. The study provides novel information on PEX among Russians by investigating the urban and rural region in the Russian republic of Bashkortostan at the southwestern end of the Ural Mountains. The authors report an overall prevalence of 3.6% in the population over 40 years. In accordance with other population studies, prevalence is associated with higher age, increased intraocular pressure and open-angle glaucoma. Previous studies have reported a higher incidence of PEX among women, but the present study did not find such a gender association. PEX material has been described in many parts of the body and thus studies have previously related PEX to systemic conditions. The present study did not confirm increased risk of systemic conditions, such as diabetes, arterial hypertension or dementia in patients with PEX. While the study is conducted thoroughly and provide important information on PEX in the Russian population, there are some conflicting information and study limitations. The authors conclude that ethnic Russians have higher prevalence of PEX, but also show that the odds ratio of non-Russians to Russians is 1.5. As the authors report, the prevalence of PEX in the Russian population may have been underestimated, as subjects who have had previous cataract surgery have been excluded. In summary, the present study is well designed and the size of the study population is relatively large. In addition, substantial ocular and systemic parameters are examined. The study thus provides novel and useful information on the prevalence of PEX in the Russian population.