Risk factors for glaucoma: what do they really mean?
Anthea Worley A and Karen Grimmer-Somers A BA International Centre for Allied Health Evidence, University of South Australia, City East Campus, North Terrace, Adelaide, SA 5000, Australia.
B Corresponding author. Email: karen.grimmer-somers@unisa.edu.au
Australian Journal of Primary Health 17(3) 233-239 https://doi.org/10.1071/PY10042
Submitted: 10 August 2010 Accepted: 1 December 2010 Published: 5 September 2011
Abstract
Glaucoma is an insidious eye disease, potentially putting 4% of older Australians at risk of blindness, unless detected sufficiently early for initiation of effective treatment. This paper reports on the strengths of evidence and glaucoma risk factors that can be identified by primary health care providers from a patient’s history. A comprehensive search of peer-reviewed databases identified relevant secondary evidence published between 2002 and 2007. Risk factors that could be determined from a patient’s history were identified. A novel glaucoma risk factor reference guide was constructed according to evidence strength and level of concern regarding risk of developing glaucoma. The evidence is strong and consistent regarding the risk of developing glaucoma, and elevated intraocular pressure, advancing age, non-Caucasian ethnicity and family history of glaucoma. There is moderate evidence of association with glaucoma, and migraine, eye injury, myopia and long-term use of corticosteroids. There is conflicting evidence for living in a rural location, high blood pressure, diabetes and smoking. Early detection of people at risk of developing glaucoma can be initiated using our risk factor guide coupled with a comprehensive patient history. Timely future assessment and subsequent management strategies for at-risk individuals can then be effectively and efficiently actioned.
Additional keywords: detection, primary open angle glaucoma.
References
Adis International (2004) Corticosteroids are the main culprits in drug-induced glaucoma. Drugs & Therapy Perspectives 20, 19–22.| Corticosteroids are the main culprits in drug-induced glaucoma.Crossref | GoogleScholarGoogle Scholar |
AGREE Collaboration (2001) ‘Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument.’ (AGREE Collaboration: London) Available at: http://www.agreecollaboration.com [Verified 18 February 2008]
American Academy of Ophthalmology (2005) ‘Primary open-angle glaucoma preferred practice pattern.’ (American Academy of Ophthalmology: San Francisco)
American Optometric Association (2002) ‘Optometric clinical practice guideline: care of the patient with open angle glaucoma.’ 2nd edn. (American Optometric Association: St Louis)
Bonovas S, Peponis V, Filioussi K (2004a) Diabetes mellitus as a risk factor for primary open-angle glaucoma: a meta-analysis. Diabetic Medicine 21, 609–614.
| Diabetes mellitus as a risk factor for primary open-angle glaucoma: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c3ls12jtw%3D%3D&md5=5e821bd8c9ec73c284d8f39ca91d6d6dCAS |
Bonovas S, Filioussi K, Tsantes A, Peponis V (2004b) Epidemiological association between cigarette smoking and primary open-angle glaucoma: a metaanalysis. Public Health 118, 256–261.
| Epidemiological association between cigarette smoking and primary open-angle glaucoma: a metaanalysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c3isVSgtw%3D%3D&md5=49bdcf43e83b14d30774de21a61334b8CAS |
Budenz DL, Anderson DR, Feuer WJ, Beiser JA, Schiffman J, Parrish RK, Piltz-Seymour JR, Gordon MO, Kass MA, Ocular Hypertension Treatment Study Group (2006) Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study. Ophthalmology 113, 2137–2143.
| Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study.Crossref | GoogleScholarGoogle Scholar |
Burr JM, Mowatt G, Hernández R, Siddiqui MA, Cook J, Lourenco T, Ramsay C, Vale L, Fraser C, Azuara-Blanco A, Deeks J, Cairns J, Wormald R, McPherson S, Rabindranath K, Grant A (2007) The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma: a systematic review and economic evaluation. Health Technology Assessment 11, 1–190.
Centre for Allied Health Evidence (2009) Final Report: Systematic Literature Review on the Detection, Diagnosis, Management and Prevention of Glaucoma. Prepared for NHMRC and the Department of Health and Ageing. Available at http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/cp113.pdf [Verified 1 July 2010]
Friedman DS, Vedula SS (2006) Lens extraction for chronic angle-closure glaucoma. Cochrane Database of Systematic Reviews 3, CD005555
Friedman DS, Wilson MR, Liebmann JM, Fechtner RD, Weinreb RN (2004) An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma. Archives of Ophthalmology 138, S19–S31.
| An evidence-based assessment of risk factors for the progression of ocular hypertension and glaucoma.Crossref | GoogleScholarGoogle Scholar |
Glaucoma Australia (2010) ‘What is glaucoma?’ (Glaucoma Australia: Sydney). Available at http://www.glaucoma.org.au/what.htm [Verified 26 May 2010]
Goldberg I, Graham SL, Healey PR (2002) Primary open-angle glaucoma. The Medical Journal of Australia 177, 535–536.
Hatt S, Wormald R, Burr J (2006) Screening for prevention of optic nerve damage due to chronic open angle glaucoma. Cochrane Database of Systematic Reviews 4, CD006129
Hollows FC, Graham PA (1966) Intraocular pressure, glaucoma, and glaucoma suspects in a defined population. The British Journal of Ophthalmology 50, 570–586.
| Intraocular pressure, glaucoma, and glaucoma suspects in a defined population.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaF2s%2Fls1CktQ%3D%3D&md5=308040d3ccabc138fd06ee8d8d46afd0CAS |
Leibowitz HM, Krueger DE, Maunder LR, Milton RC, Kini MM, Kahn HA, Nickerson RJ, Pool J, Colton TL, Ganley JP, Loewenstein JI, Dawber TR (1980) The Framingham Eye Study monograph: an ophthalmological and epidemiological study of cataracts, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Survey of Ophthalmology 24, 335–610.
Leone FT, Fish JE, Szefler SJ, West SL (2003) Systematic review of the evidence regarding potential complications of inhaled corticosteroid use in asthma: collaboration of American College of Chest Physicians, American Academy of Allergy, Asthma, and Immunology, and American College of Allergy, Asthma, and Immunology. Chest 124, 2329–2340.
| Systematic review of the evidence regarding potential complications of inhaled corticosteroid use in asthma: collaboration of American College of Chest Physicians, American Academy of Allergy, Asthma, and Immunology, and American College of Allergy, Asthma, and Immunology.Crossref | GoogleScholarGoogle Scholar |
Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, Early Manifest Glaucoma Trial (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Archives of Ophthalmology 121, 48–56.
Madden AC, Simmons D, McCarty CA, Khan MA, Taylor HR (2002) Eye health in rural Australia. Clinical & Experimental Ophthalmology 30, 316–321.
| Eye health in rural Australia.Crossref | GoogleScholarGoogle Scholar |
Medeiros FA, Zangwill LM, Bowd C, Vasile C, Sample PA, Weinreb RN (2007) Agreement between stereophotographic and confocal scanning laser ophthalmoscopy measurements of cup/disc ratio: effect on a predictive model for glaucoma development. Journal of Glaucoma 16, 209–214.
| Agreement between stereophotographic and confocal scanning laser ophthalmoscopy measurements of cup/disc ratio: effect on a predictive model for glaucoma development.Crossref | GoogleScholarGoogle Scholar |
Merlin T, Weston A, Tooher R (2009) Extending an evidence hierarchy to include topics other than treatment: revising the Australian ‘levels of evidence’. BMC Medical Research Methodology 9, 34
Mitchell P, Smith W, Attebo K, Healey P (1996) Prevalence of open-angle glaucoma in Australia: the Blue Mountains eye study. Ophthalmology 103, 1661–1669.
National Cancer Institute (2010) ‘Dictionary of cancer terms – watchful waiting.’ (National Cancer Institute: Bethesda, MD) Available at http://nci.nih.gov/dictionary/?CdrID=45942 [Verified 19 July 2010]
National Health and Medical Research Council (2009) ‘NHMRC additional levels of evidence and grades for recommendations for developers of guidelines: Stage 2 consultation.’ (NHMRC: Canberra) Available at http://www.nhmrc.gov.au/guidelines/_files/Stage%202%20Consultation%20Levels%20and%20Grades.pdf) [Verified 20 June 2010]
Netland PA, Wiggs JL, Dreyer EB (1993) Inheritance of glaucoma and genetic counseling of glaucoma patients. International Ophthalmology Clinics 33, 101–120.
| Inheritance of glaucoma and genetic counseling of glaucoma patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3szhsFaksQ%3D%3D&md5=3088b3c26878cc1110d6b60cebf0b6e9CAS |
Phelps CD, Corbett JJ (1985) Migraine and low-tension glaucoma. A case-control study. Investigative Ophthalmology and Visual Science 26, 1105–1108.
Public Health Resource Unit (2006) ‘10 questions to help you make sense of reviews.’ (Public Health Resource Unit: Oxford) Available at http://www.phru.nhs.uk/Doc_Links/S.Reviews%20Appraisal%20Tool.pdf [Verified 18 February 2008]
Royal College of Ophthalmologists (2004) ‘Guidelines for the management of open angle glaucoma and ocular hypertension.’ (Royal College of Ophthalmologists: London)
Schmier JK, Halpern MT, Jones ML (2007) The economic implications of glaucoma – A literature review. PharmacoEconomics 25, 287–308.
| The economic implications of glaucoma – A literature review.Crossref | GoogleScholarGoogle Scholar |
Sommer A, Katz J, Quigley HA, Miller NR, Robin AL, Ritcher RC, Witt KA (1991) Clinically detectable nerve fiber layer atrophy precedes the onset of glaucomatous field loss. Archives of Ophthalmology 109, 77–83.
Tielsch JM, Sommer A, Katz J, Royall RM, Quigley HA, Javitt J (1991) Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey. Journal of the American Medical Association 266, 369–374.
| Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M3nvValtw%3D%3D&md5=6a3f8562801ca3858c390f01b5dc8329CAS |
Tielsch JM, Katz J, Sommer A, Quigley HA, Javitt JC (1994) Family history and the risk of primary open angle glaucoma. The Baltimore Eye Study. Archives of Ophthalmology 112, 69–73.
Tripathi RC, Tripathi BJ, Haggerty C (2003) Drug-induced glaucomas mechanism and management. Drug Safety 26, 749–767.
| Drug-induced glaucomas mechanism and management.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXnslGmtr4%3D&md5=ee7c511b6c8ec6da2925438d4913a89bCAS |
Weih L, Nanjan M, McCrty C, Taylor H (2001) Prevalence and predictors of open-angle glaucoma: results from the visual impairment project. Ophthalmology 108, 1966–1972.
| Prevalence and predictors of open-angle glaucoma: results from the visual impairment project.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mnmslaisg%3D%3D&md5=201161bfa5af5b4018d3613aaf3e74d0CAS |
Wolfs RC, Klaver CC, Ramrattan RS, van Duijn CM, Hofman A, de Jong PT (1998) ‘Genetic risk of primary open-angle glaucoma. Population-based familial aggregation study. Archives of Ophthalmology 116, 1640–1645.
Wood JM, Lacherez PF, Black AA, Cole M, Boon M, Kerr G (2009) Postural Stability and Gait among Older Adults with Age-Related Maculopathy. Investigative Ophthalmology & Visual Science 50, 482–487.
| Postural Stability and Gait among Older Adults with Age-Related Maculopathy.Crossref | GoogleScholarGoogle Scholar |
Worley A, Grimmer-Somers K (2009) Should we be worried about glaucoma? Why the prevalence of glaucoma is variably reported. Primary Health Care Research and Development 10, 343–356.
| Should we be worried about glaucoma? Why the prevalence of glaucoma is variably reported.Crossref | GoogleScholarGoogle Scholar |