Who Gets Glaucoma?

As many as two and half million Americans have open-angle glaucoma with half of them unaware of this problem because the condition causes no symptoms.

Elevated intraocular pressure (IOP) in the eye occurs in five to 10 million American but only about 10% of such people develop glaucoma because of this pressure. And, in 15% of glaucoma cases, IOP is normal. It is difficult, then, to define clear-cut risk factors for glaucoma:

Age. The prevalence of chronic glaucoma increases with age. In a major study, 0.6% of people aged 60 to 64 had chronic open-angle glaucoma. Among people who were ten years older the prevalence had more than doubled to 1.3%, and among those who were aged 80 to 84, it had more than doubled again to 3%.

Certain Medical Disorders. Diabetes, extreme nearsightedness, and previous eye surgery are risk factors for chronic open-angle glaucoma. People with conditions that require the use of any oral or inhaled steroids should be checked for glaucoma, particularly if they are taking high doses for prolonged periods.

Ethnic background: Chronic glaucoma is four times more common in African Americans than in white Americans. In addition, glaucoma develops earlier in African America; their risk increases after age 45 compared to an increased risk after age 60 in whites. In a study of people in Barbados, over 10% of those 50 and older had open angle glaucoma, and over 15% were afflicted after 70. The risk was higher in men than in women. African-American children who are extremely near-sighted and have relatives with glaucoma should begin regular eye-examinations for glaucoma as early as possible. Among Caucasians, groups at higher risk include Scandinavian, Irish, and Russian.

Family History: Like so many diseases, glaucoma tends to run in families; different genes, however, are involved in different families.
Factors for Determining Risk for Chronic Glaucoma:
Risk Factors Category Score
Age Younger than 50 years 0
50-64 years 1
65-74 years 2
Older than 75 3

Race Caucasian 0
African-American 2

Family History of Glaucoma None or only in non-first degree relatives 0
Parents with glaucoma 1
Siblings with glaucoma 2

Last eye examination
Within two years 0
2-5 years ago 1
More than 5 years ago 2
SCORE: Adding the appropriate numbers will determine your risk. High risk is score of 4 or more; moderate risk is 3; low risk is 2 or less. (Reprinted from FDA Consumer, November 1995)