Glaucoma is a serious eye disease with many risk factors. Some risk factors are controllable; other risks are not. The main problems with glaucoma are late detection, permanent damage, and no cure. People who skip going to the eye doctor often notice no symptoms until glaucoma is well-established. Glaucoma is often referred to as the “silent thief.” Typically, are no eye symptoms until the person notices that peripheral vision is reduced. Glaucoma is not curable but with proper treatment often very manageable. Therefore, knowing your glaucoma risks and managing them can help prevent irreversible optic nerve damage.
Types of Glaucoma
The most common form of glaucoma is open-angle glaucoma. This eye disease is associated with high pressure in the eye. A fluid called aqueous humor keeps the shape of the outer part of the eye, circulates nutrients, and eliminates waste. The trabecular network is the drainage area between the iris and cornea. In glaucoma, this exit flow through becomes partially blocked. This blockage causes eye pressure to increase, which compresses the optic disc. The optic disk is progressively and permanently damaged. The eye doctor screens for high intraocular pressure (IOP) using a puff of air or a device that looks like a pen light. Optic disc damage is often visible during a dilated eye exam.
A minority of glaucoma patients have normal IOP (30% to 40%). They are still at risk of optic nerve damage. This is called “normal tension glaucoma.” There are also a small percentage of people with low IOP that may be diagnosed with glaucoma. The symptoms are the same as those with open-angle glaucoma.
Glaucoma slowly destroys peripheral vision, resulting in tunnel vision if left untreated. Glaucoma is one of the most common causes of vision loss in the world.
Most patients have open-angle glaucoma, a chronic condition. Sudden onset of red-eye, visual halos, and/or headache might be closed-angle glaucoma, and warrants emergency treatment. An eye doctor in a typical exam should be able to identify this issue.
Glaucoma Risk Factors
The risk factors for glaucoma are broad, and you have limited control over most of them:
- high myopia (nearsightedness) and hyperopia (farsightedness)
- thin cornea / thinning of optic nerve / high iop
- blood pressure
- high intraocular pressure
Age and Glaucoma Risk
People over the age of 60 are at the highest risk for developing glaucoma. Since glaucoma has no symptoms until damage is done, seniors should have a dilated eye exam every 1 to 2 years. Seniors absorb nutrients less efficiently and therefore can benefit from targeted eye supplements. Early-onset glaucoma strikes after age 40, especially in African Americans. Some patients develop glaucoma from inflammation due to eye injury or multiple eye surgeries. Some children are born with eye problems that cause glaucoma.
Genetics and Glaucoma
Glaucoma tends to run in families, but not always. If one or more close relatives have glaucoma, your risk is higher than average. In the United States, African Americans, Asian Americans, and Hispanic Americans are at higher risk for glaucoma.
High Myopia (Nearsightedness) and Hyperopia (Farsightedness)
Nearsightedness, in which the eyeball is too long, is a risk factor for open-angle glaucoma. Myopia is quite common, with both genetic and environmental risk factors. Distant objects appear blurry, while near objects are in focus. A meta-study1 found that the higher the myopia, the higher the risk for glaucoma.
Farsightedness means that distant objects are clear and close-up objects are blurry. Farsightedness is associated with closed-angle glaucoma.
Glaucoma and Medication Risk
Certain medications are associated with a higher incidence of glaucoma. Some are very popular medications. Do not stop taking any medication without a discussion with your doctor. If you are taking any of these medications long-term, see “Some Drugs Increase the Risk of Glaucoma.” The risks are usually small and may outweigh the benefits of needed medications.
- Steroids: Prescription cortisone tops the list of drugs that can damage the eyes if taken long term. Discuss with your doctor whether you could use a natural cortisone such as hydrocortisone. Nasal steroids for allergies and very heavy use of asthma inhalers are also linked to glaucoma.
- NSAIDs: Non-steroidal, anti-inflammatory drugs such as aspirin and ibuprofen.
- Anti-depressants Venlafaxine and Remeron. Contra-indicated for glaucoma patients: valium, cialis
- Gastric antispasmodics, including hyoscyamine and dicyclomine
- Appetite suppressant and decongestant ephedrine is a potential glaucoma risk.
Untreated low-functioning thyroid is a glaucoma risk, according to a meta-study.2 Hypothyroidism is especially common in women, particularly over age 60. A blood test measures thyroid functioning.
Corneal Thickness and Optic Nerve Thinning
If the central corneal is less than 0.5 millimeters thick, the individual is at a higher risk for glaucoma. Thinning of the optic nerve is also a risk for glaucoma. Both these abnormalities may be warning signs that the eye is not receiving sufficient nutrients and blood flow. Supplements, regular exercise, and a healthier diet may help. If the cornea is thicker than average, a slightly higher IOP may be normal for that patient.
Both high and low blood pressure may be risk factors for glaucoma. High blood pressure increases intraocular pressure slightly (0.25 mmHg increased intraocular pressure per extra 10 mmHg blood pressure).3 On the other hand, the eye needs enough blood flow. Low blood pressure can deprive the eye of oxygen and nutrients, possibly leading to glaucoma. Those with low blood pressure can have blood pressure dips during the night. These dips can cause optic nerve damage. Balancing blood pressure through diet, exercise, and medications if prescribed are important, especially as we age.
Fluctuating blood sugar levels damage the eye heavily. Diabetes increases the risk of three types of glaucoma. Primary open-angle glaucoma is more common in Type II Diabetes patients than the general population. Diabetic retinopathy can lead to neovascular glaucoma. New blood vessels grow over the iris and drainage angle. The treatment for diabetic macular edema is usually steroid drops. These steroids increase glaucoma risk. To preserve their vision, diabetic patients should take every measure to control blood sugar.
Seniors are at a disadvantage regarding nutrition. Their caloric needs are lower. And their absorption of nutrients also goes down. Therefore, they face an uphill battle to keep their eyes healthy. Eat plenty of brightly-colored fruits and vegetables, particularly green, leafy vegetables. Consume fresh juices, lean protein, less sugar, and fewer processed foods. Try the Vision Diet (a variation on the Mediterranean Diet) or the South Beach Diet. Vitamins and supplements that directly target the eye can help stave off eye disease.
Glaucoma patients are often found to be deficient in one or many crucial eye nutrients. These include lutein, zeaxanthin, taurine, alpha lipoic acid, antioxidants, selenium, bioflavonoids, zinc, essential fatty acids, and vitamin B-complex. Learn more about supplements that support the optic nerve.
Shallow breathing associated with high stress deprives the head of blood flow. The eyes need sufficient blood flow to stay healthy. Blood flow appears to have an impact on the development of some glaucoma cases.5 Exercise both reduces stress and increases blood flow throughout the body.
High Intraocular Pressure (IOP)
If your IOP is high, clearly you must make every effort to reduce it. Work with your eye doctor, who may offer eye drops to prevent or delay the onset of glaucoma. People who had high IOP and used ocular hypotensive drops cut their risk of developing glaucoma by 50% (9.5% vs 4.4% over 5 years).6 Be careful of medications, activities, and sleeping habits that increase intraocular pressure. Also, look into supplements designed help protect the optic nerve naturally such as the Viteyes Optic Nerve Formula.
If faced with a glaucoma diagnosis, follow your eye doctor’s advice. The doctor may recommend eye drops, laser treatments, and/or surgery. Also, research has found that certain vitamins and nutrients can slow down the pace of glaucoma progression. Look into ginkgo biloba, folate (vitamin B9 or folic acid), taurine, omega-3 fatty acids, and vitamin B12. Natural Eye Care offers the Optic Nerve Formula, which could help protect the optic nerve.
- Int J Ophthalmol. 2012; 5(6): 750–753. Published online 2012 Dec 18. doi: 10.3980/j.issn.2222-3959.2012.06.18 PMCID: PMC3530820 PMID: 23275912 “High myopia as a risk factor in primary open angle glaucoma” by Sheng-Ju Chen, Peng Lu, Wen-Fang Zhang, and Jian-Hua Lu ↩
- PLoS One. 2017; 12(10): e0186634. Published online 2017 Oct 25. doi: 10.1371/journal.pone.0186634 PMCID: PMC5656411 PMID: 29069095 Hypothyroidism as a risk factor for open angle glaucoma: A systematic review and meta-analysis. Ted S Acott et al. ↩
- “Chronic Hypertension Increases Susceptibility to Acute IOP Challenge in Rats” by Zheng H. et al. Investigative Ophthalmology & Visual Science December 2014, Vol.55, 7888-7895. doi:10.1167/iovs.14-15207
- Nurses’ Health Study and the Health Professionals Follow-up Study and Nitrate in vegetables ‐ Scientific Opinion of the Panel on Contaminants in the Food chain. European Food Safety Authority (EFSA). First published: 05 June 2008 https://doi.org/10.2903/j.efsa.2008.689 ↩
- Prog Retin Eye Res. 2002 Jul;21(4):359-93. The impact of ocular blood flow in glaucoma. Flammer J et al. ↩
- Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Kass MA et al. ↩