Who Is at Higher Risk for Glaucoma?

Glaucoma is a group of eye conditions characterized by damage to the optic nerve, often linked to elevated pressure inside the eye. Without treatment, it can lead to irreversible vision loss and even blindness. Understanding who is at higher risk for glaucoma empowers you and your loved ones to seek timely eye exams and, if needed, early treatment.

Common Glaucoma Risk Factors

Several factors increase the likelihood of developing glaucoma. While having one or more does not guarantee you will get glaucoma, it does mean you should be especially vigilant about regular eye checks.

1. Age

• Risk rises significantly after age 60.
• After age 40, some types (such as normal-tension glaucoma) begin to appear more commonly.
• Regular screening is crucial as you grow older.

2. Family History and Genetics

• First-degree relatives (parents, siblings) of someone with glaucoma face a 4–9× higher risk.
• Certain genetic variants have been linked to open-angle glaucoma.

3. Race and Ethnicity

• People of African or Afro-Caribbean descent:
  • Up to 6–8× higher risk of open-angle glaucoma.
  • Tend to develop it at younger ages and experience faster progression.
• Hispanic/Latino populations:
  • Elevated risk, particularly for open-angle glaucoma.
  • Risk increases further after age 70.
• Individuals of Asian descent:
  • Higher risk of angle-closure glaucoma (a sudden, painful form requiring immediate attention).

4. Elevated Intraocular Pressure (IOP)

• Measured during routine eye exams.
• Consistently higher IOP (above 21 mm Hg) is the strongest modifiable risk factor.
• Not everyone with high IOP develops glaucoma—but it warrants close monitoring.

5. Thin Central Corneal Thickness

• A thinner cornea can lead to underestimation of IOP readings.
• Associated with greater risk of developing glaucoma damage.

6. Ocular Conditions and Eye Injuries

• Severe eye trauma can disrupt fluid drainage.
• Long-term steroid use (depending on dose and delivery) may increase IOP.
• Conditions such as uveitis (ocular inflammation) can elevate glaucoma risk.

7. Systemic Health Factors

• Diabetes: May heighten risk of open-angle glaucoma by 1.5–2×.
• Hypertension: High blood pressure can affect the tiny vessels supplying the optic nerve.
• Migraine or Vasospastic Disorders: May compromise blood flow to the optic nerve.

8. Other Factors

• Myopia (nearsightedness): Strong myopia is linked to higher open-angle glaucoma risk.
• Sleep Apnea: May contribute to optic nerve damage through low oxygen levels.
• Smoking: While more clearly tied to other eye diseases, smoking can worsen blood-flow issues.

Less Common but Notable Risks

• Thin optic nerve heads or specific optic-disc shapes can predispose one to damage even with normal IOP.
• Corneal surgery (e.g., LASIK) can alter IOP measurements, potentially masking risk.
• Female sex: Some studies show a slight female predominance, especially for angle-closure glaucoma.

Signs and Symptoms to Watch For

Glaucoma is often called the “silent thief of sight” because early stages usually lack obvious symptoms. However, certain warning signs warrant an expedited eye exam:

• Gradual loss of peripheral (side) vision.
• Tunnel vision in advanced stages.
• Intense eye pain, headache, nausea, or vomiting (angle-closure glaucoma).
• Halos or rainbow-colored rings around lights.

If you notice any of these changes, especially in combination with risk factors above, don’t delay care—early treatment can preserve vision.

Screening and Early Detection

Routine comprehensive eye exams are the cornerstone of glaucoma prevention. Tests typically include:

• Measurement of intraocular pressure (tonometry).
• Inspection of the drainage angle (gonioscopy).
• Evaluation of the optic nerve (ophthalmoscopy).
• Visual field testing to assess peripheral vision.
• Corneal thickness measurement (pachymetry).

Frequency recommendations:

• Ages 40–54: Every 2–4 years if no risk factors.
• Ages 55–64: Every 1–3 years.
• Age 65+: Every 1–2 years.
• High-risk individuals (family history, elevated IOP, etc.): As directed by your eye care professional, often annually.

You might also consider doing a free, online symptom check for glaucoma to help decide if you need prompt evaluation.

Managing and Lowering Your Risk

While some risk factors (like age and family history) can’t be changed, you can take steps to protect your vision:

• Maintain regular appointments with an ophthalmologist or optometrist.
• Use prescribed eye drops consistently to lower IOP.
• Follow up on systemic health issues—keep blood pressure and blood sugar within target ranges.
• Wear protective eyewear to prevent injury.
• Avoid long-term or high-dose steroids unless medically necessary—and discuss alternatives if you need them.
• Stay informed about new advancements in glaucoma care and monitoring.

Treatment Overview

If you’re diagnosed with glaucoma, treatments aim to preserve vision by reducing intraocular pressure. Options include:

• Prescription eye drops (first-line therapy).
• Oral medications (in select cases).
• Laser procedures (e.g., trabeculoplasty).
• Minimally invasive glaucoma surgeries (MIGS).
• Traditional glaucoma surgery (trabeculectomy or drainage devices).

Your eye doctor will tailor treatment based on glaucoma type, severity, and overall health.

When to Speak to a Doctor

• If you have any high-risk factors or symptoms described above.
• If an online quiz or symptom checker suggests you may need an in-person evaluation.
• If you’re on medications (like steroids) that could affect eye pressure.
• Whenever you experience sudden vision changes, severe eye pain, or nausea with eye discomfort.

Always treat potential glaucoma as a serious matter. Do not delay professional medical advice or treatment for anything that could threaten your vision or overall health.

---

Glaucoma risk factors are varied and often interlinked. By understanding who is at increased risk—and by committing to regular eye care—you can catch early signs before significant vision loss occurs. If you believe you’re at higher risk or have concerning symptoms, speak to a doctor promptly. Early detection and treatment remain the best defense against this sight-stealing disease.