Glaucoma risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan Bir Singh, M.B.B.S.[2]


Common risk factors include a positive family history, increased age, myopia, diabetes mellitus, hypertension, sleep apnea, thyroid disorders, hypercholesterolemia, migraine, raynaud phenomenon.

Risk factors

Common risk factors

  • Age:
    • The risk increases with the increase in age.
    • The visual field defects are 7 times more likely to progress in patients above the age 60 years in comparison to those younger than 40 years.
    • Although an increase in lOP with age has been observed in many populations.
    • Several studies in Japan have shown a relationship between glaucoma and age even with no increase in lOP in the population.[1]
  • Race:
    • The prevalence of POAG is 3-4 times greater in black persons and Hispanic persons as compared to non-Hispanic Caucasian individuals.
    • The loss of vision as a consequence of glaucoma is at least 4 times more common in blacks than in Caucasian population.
    • The Baltimore Eye Survey found that the prevalence of glaucoma increases dramatically with age, particularly among black persons, exceeding 11% in those aged 80 years or older.[2]
  • Family History:
    • A positive family history is a risk factor for POAG. The relative risk of POAG is increased by 3.7-fold for individuals who have a sibling with diagnosed POAG.[3]
  • Myopia:
    • The concurrence of POAG and myopia cause difficulty in diagnosis and management of POAG.
    • There is an increased difficulty in evaluation of the optic disc is particularly complicated in highly myopic eyes that have tilted discs.
    • Myopia-related retinal abnormalities can cause visual field defects along with glaucoma.
    • A high refractive error may also make it difficult to perform accurate perimetric measurement and to interpret visual field abnormalities.
  • Diabetes Mellitus:
    • The role of diabetes mellitus in causing POAG is still not clear.
    • Though some studies have found diabetes plays a significant role in the disease, other studies have not found any corelation.[4]
  • Hypertension:
    • The systemic hypertension is associated with a low risk of the presence of glaucoma in younger patients and with an increased risk in patients above 65 years of age.
    • With advancing age, the adverse effects of chronic hypertension on the optic nerve microcirculation may lead to the nerve's susceptibility to the development of glaucomatous optic neuropathy.
    • Some studeis demonstrate that lower ocular perfusion pressure is a strong risk factor for the development of glaucoma, independent of lOP alone.
    • The overtreatment of systemic hypertension may be a contributing factor to glaucoma progression in some cases and hence, should be avoided.[4]
  • Retinal vein occlusion:
    • The patients with central retinal vein occlusion may lead to an elevated lOP and subsequentlu glaucoma.
    • In some case, there may be presentation of preexisting POAG or other types of glaucoma. After CRVO, patients may develop angle-closure glaucoma or, at a later stage, neovascular glaucoma.
  • Sleep apnea
  • Thyroid disorders
  • Hypercholesterolemia
  • Migraine
  • Raynaud Phenomenon


  1. Iwase, Aiko; Suzuki, Yasuyuki; Araie, Makoto; Yamamoto, Tetsuya; Abe, Haruki; Shirato, Shiroaki; Kuwayama, Yasuaki; Mishima, Hiromu K.; Shimizu, Hiroyuki; Tomita, Goji; Inoue, Yoichi; Kitazawa, Yoshiaki (2004). "The prevalence of primary open-angle glaucoma in Japanese". Ophthalmology. Elsevier BV. 111 (9): 1641–1648. doi:10.1016/j.ophtha.2004.03.029. ISSN 0161-6420. PMID 15350316.
  2. Tielsch, James M. (1991-07-17). "Racial Variations in the Prevalence of Primary Open-angle Glaucoma". JAMA. American Medical Association (AMA). 266 (3): 369. doi:10.1001/jama.1991.03470030069026. ISSN 0098-7484.
  3. "Primary Open-Angle Glaucoma (POAG) Clinical Presentation: History, Physical, Causes". Medscape Reference. 2017-12-01. Retrieved 2018-03-03.
  4. 4.0 4.1 Klaver, Caroline C. W. (1998-05-01). "Age-Specific Prevalence and Causes of Blindness and Visual Impairment in an Older Population". Archives of Ophthalmology. American Medical Association (AMA). 116 (5): 653. doi:10.1001/archopht.116.5.653. ISSN 0003-9950.

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