What are the risk factors for glaucomatous optic neuropathy in primary open-angle glaucoma (POAG)?

Updated: Mar 16, 2020
  • Author: Kristin Schmid Biggerstaff, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

Strong implications are as follows:

  • History of elevated IOP; advanced age, particularly after 50 years; African American descent; positive family history of glaucoma (first-degree relative, especially correlative if present in a sibling; relative risk 3.7-fold higher than if no family history of glaucoma); myopia

  • Be specific when asking family history (Which family members? Was there actual visual loss from glaucoma or other causes of visual field loss? Are they under control on one or more medications? Did they require surgery for adequate control?)

Possible implications are as follows:

  • Systemic cardiovascular disease

  • Diabetes mellitus

  • Migraine headache

  • Systemic hypertension

  • Vasospasm

Anecdotal risk factors are as follows:

  • Obesity

  • Smoking

  • Alcohol

  • History of stress

  • Anxiety

  • Sleep apnea


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