Looking Beyond Traditional Risk Factors
Glaucoma is characterised by optic nerve fibre atrophy and damage to the optic nerve head which results in the deterioration of the visual field and vision loss. Elevated intraocular pressure (IOP) is currently known as the primary and only evidence-based, treatable risk factor for open-angle glaucoma. Glaucoma is suspected to be a multifactorial disease with IOP-dependent and IOP-independent risk factors. Traditional risk factors for glaucoma include family history and ethnicity. The risk of glaucoma also increases with advancing age. There is growing evidence supporting the roles of other factors that predispose a person to glaucoma damage, including circulation to the eye and optic nerve. These ‘non-traditional’ risk factors include low blood pressure or perfusion pressure and other vascular factors. There are also a number of lifestyle factors that may contribute to the development of glaucoma through their direct influence on IOP and/or through other mechanisms of glaucomatous optic neuropathy. The role of these modifiable risk factors will be reviewed using evidence in the current literature.