WHAT CAUSES GLAUCOMA?

Medically reviewed by Andrew Greenberg, MDMedically reviewed by Andrew Greenberg, MD

Glaucoma refers to a group of eye conditions that can gradually make you lose some or all of your eyesight. Glaucoma develops due to damage to your optic nerve, a place in the back of the eye responsible for carrying signals between your eye and brain.

The way the optic nerve is damaged depends on the type of glaucoma. In most cases of glaucoma, it's damaged by pressure due to excess fluid buildup in the eye. The fluid buildup usually occurs because the eye can't drain properly. Blind spots can develop as the pressure rises and nerve fibers in the optic nerve are damaged.

Sometimes, the exact cause of glaucoma is known, like when a traumatic injury disrupts the eye's functioning and increases pressure. Secondary glaucoma is caused by an injury or other medical condition.

However, experts aren't always sure why people experience higher eye pressure and develop glaucoma, including the most common type, open-angle glaucoma. Primary glaucoma is glaucoma with no known cause.

Is Glaucoma Hereditary? 

Research indicates that there is a genetic link to glaucoma, meaning that if you have family members with glaucoma, you may be more vulnerable to developing the condition. The more relatives you have with glaucoma, the likelier you may be to develop it yourself. People who develop glaucoma at an early age are likelier to have inherited it.

Some people may experience glaucoma because their genes have mutations that affect the way the eye regulates pressure, or they inherit changes in the way their eyes are structured. However, much of the available research is based on people's understanding of their family history, which can be limited since not everyone is aware of their family members' glaucoma.

Who Gets Glaucoma? 

Although anyone can develop glaucoma, some people are more likely to develop it.

• Age: The risk of glaucoma increases as you age, with people over 40 at higher risk than younger people.
• Sex: People assigned male at birth are more likely to experience open-angle glaucoma, while people assigned female at birth are more likely to develop angle-closure glaucoma (when a bulging iris prevents eye fluid from draining effectively). Because females tend to live longer than males, older females may get glaucoma at higher rates compared to older males.
• Ethnicity: People who identify as Hispanic, Latino, African, African American, or Asian are more likely to develop glaucoma.

Risk Factors 

Certain risk factors may make you more predisposed to developing glaucoma. If multiple risk factors apply to you, it’s important to ask your healthcare provider about your individual risk of glaucoma. 

Frailty

Frailty refers to a state in which your body and cognitive functions decline rapidly. While frailty is connected to age, the two don't always necessarily go hand-in-hand. You might become frailer at a younger age, perhaps due to a chronic disease. Being frail at a young age may make you more vulnerable to developing glaucoma.

Eye Injuries

Eye injuries can lead to secondary glaucoma. Any injury to the eye can lead to a build-up of pressure. Glaucoma caused by an injury is known as traumatic glaucoma.

When working in construction, performing repairs around your home, or playing sports, it’s critical to wear protective eyewear to cover your eyes. You can buy protective glasses and goggles from your eye care provider, home repair stores, or sporting goods stores.

Cardiovascular Conditions

People with hypotension (low blood pressure) or hypertension (high blood pressure) may be at risk for certain types of glaucoma.

For instance, people with hypertension may be at risk for the most common type of glaucoma, open-angle glaucoma, which occurs when there is pressure built up in the eye. Hypertension may also lead to a secondary glaucoma known as neovascular glaucoma. This can develop when the eye makes extra blood vessels that cover the part of the eye where fluid would normally drain.

People with hypotension may be at risk for normal-tension glaucoma, which is a type of open-angle glaucoma that happens in people with normal eye pressure.

You may also develop normal-tension glaucoma if you have an irregular heartbeat.

Poor blood circulation can also put you at higher risk for developing glaucoma.

Eye Conditions

Certain conditions that affect the eyes can make you more likely to develop glaucoma. You may be vulnerable to glaucoma if you:

• Are farsighted (can't see near things clearly) or nearsighted (can’t see far things clearly)
• Have a thin cornea or optic nerve
• Have pigmentary dispersion syndrome (when pigment falls off the back of your iris and blocks eye fluid from draining)
• Have pseudoexfoliation syndrome (when flaky materials from the eye build up and block eye fluid from draining)
• Have uveitis (a condition that causes swelling and inflammation in the eye)

Diabetes

Diabetes can increase your risk of glaucoma. In particular, people with diabetes may be at higher risk for developing open-angle glaucoma or neovascular glaucoma. It’s important to manage your diabetes with the help of your healthcare provider to reduce this potential complication.

Migraine

Research shows there could be a connection between migraine and glaucoma. When it comes to neovascular glaucoma in particular, the connection may be a vascular one. The connection between migraine and open-angle glaucoma was only seen among people aged 70-79.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a sleep disorder where your breathing is interrupted due to a blockage of the upper airway.

A recent analysis of research showed that people with OSA tend to be more likely to experience glaucoma than people without OSA. People with OSA and glaucoma are also more likely to experience more severe symptoms of glaucoma, including greater vision loss. Further research is needed to understand the potential connections.

Medications

Treatments for other conditions may increase your risk of glaucoma. For instance, calcium-channel or alpha-blocker medication used to treat Raynaud's syndrome or hypertension have been linked to a higher risk of primary open-angle glaucoma. Raynaud's syndrome is a condition that affects the small blood vessels (arteries) in your arms and legs.

Long-term steroid use has also been associated with a higher risk of glaucoma.

Smoking

On its own, smoking may or may not be a risk factor for glaucoma—the research has been mixed. However, some research suggests that for people who are genetically predisposed to developing glaucoma, smoking can cause glaucoma at an earlier age. This is especially true for men.

A Quick Review 

Glaucoma is a chronic eye disease that can cause vision loss. There are different types of glaucoma, all of which occur when the optic nerve becomes damaged. Usually, a build-up of pressure and fluid causes the damage.

Most cases of glaucoma are primary, meaning the underlying cause is unknown. With secondary glaucoma, experts can pinpoint the exact cause, such as an injury.

Many risk factors can make you more vulnerable to developing glaucoma, including a family history of the disease. Talk to your eye care specialist about your individual risk if you have concerns.

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2024-07-03T12:12:45Z dg43tfdfdgfd