Which family history findings are characteristic of a glaucoma suspect?

Updated: Jul 27, 2020
  • Author: Robert H Graham, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Family history is a definite risk factor. Heritable susceptibility has been shown. Between 10-20% of patients with glaucoma have a positive family history. Ask about family history of glaucoma, especially in first-degree relatives. Family history of glaucoma in a sibling is the greatest risk factor, followed by glaucoma in a parent. Also, ask if glaucoma in other family members resulted in vision loss (the individual may have only had ocular hypertension). The Baltimore Eye Survey found that the relative risk of having glaucoma is increased 3.7-fold for individuals who have siblings with POAG.

Heritable susceptibility (genetics of glaucoma) has been shown for the following:

  • POAG: Juvenile onset; genetic linkage mapped to band 1q23 [16]

  • POAG: Adult onset [17, 18]

  • Pigmentary glaucoma: Gene responsible for fragment dispersion syndrome mapped to band 7q35q36 [19]

  • Aniridia

  • Axenfeld-Rieger syndrome

  • Primary congenital glaucoma

Review of old records: Note previous IOP, cup-to-disc ratios, ocular surgery, and past visual fields. (Caution: Poor agreement and observer variability can occur in disc examinations over time.)

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