Glaucoma is a group of degenerative eye diseases marked by damage to the optic nerve, our brain-eye connection. Glaucoma is an international health crisis, with some 111 million people around the globe projected to have the disease by 2040. 

Primary open-angle glaucoma (POAG) is the most common type of glaucoma, and there are no noticeable symptoms until the late stages. Because of this, optometrist Jared Cox, O.D. says it’s important to be aware of POAG’s risk factors so those with undiagnosed glaucoma, and those at higher risk for developing it, can receive earlier diagnoses and treatment.*

Non eye-related risk factors for POAG

Cox outlines four major glaucoma risk factors unrelated to the eye.

• Older age. While people in their 40s may be vulnerable to glaucoma, such as those of African descent or with a family history, risk increases progressively after age 60.
• Race. African Americans are six times more likely to develop glaucoma than Caucasians, and develop the disease a decade earlier. Latin and Asian people are also at greater risk than Caucasians.
• Family history. About 60% of people with glaucoma have at least one person in their family with the disease. Having an immediate family member with glaucoma can increase your risk by up to nearly 15 times. 
• Underlying medical conditions. Diabetes, high blood pressure, migraine headaches, and peripheral vasospasm (narrowing of a blood vessel) have been linked to glaucoma.

Eye-related risk factors for POAG

There are a handful of eye-related factors that can increase risk of glaucoma progression.

• Extreme nearsightedness
• Greater length of your eye from front to back
• Higher than normal internal eye pressure
• Less thickness in your central cornea 
• Increased curvature of the disc on your retina where it meets the optic nerve

Testing for glaucoma

When glaucoma is suspected, your doctor will measure your visual field, the entire area you can see when focused on a single point straight ahead. While visual field measurement is generally considered to be better at identifying later glaucoma-related changes in the eye, these two tests are better at detecting early damage. 

• Ocular coherence tomography (OCT)
• Matrix frequency doubling technology (FDT) 

Diagnosing POAG

“Primary open angle glaucoma is a complex disease that is often difficult to diagnose,” says Cox. “Considering the patient’s risk factors, IOP, ocular anatomy, and advanced diagnostic testing results in a systematic way will greatly aid in the diagnosis.”

A key diagnostic factor when distinguishing between a POAG suspect and someone with POAG is any worsening of the optic nerve’s structure or function over time. “Keep this in mind and diagnosing POAG will hopefully be a bit less difficult.”

It’s important to keep up with your routine eye doctor visits, particularly if you are at high risk for developing glaucoma or other eye-related disorders.

*Cox, J. (2022, June 20). Major Risk Factors in Primary Open-Angle Glaucoma. Eyes on Eyecare. https://eyesoneyecare.com/resources/know-major-risk-factors-primary-open-angle-glaucoma