Glaucoma risk factors: who is at higher risk and when to get checked

What glaucoma is

Glaucoma is a group of eye diseases that can cause vision loss and blindness by damaging the optic nerve at the back of the eye. At first it usually has no symptoms, which is why half of people with glaucoma do not know they have it. Over time, vision loss usually starts at the sides (NEI). Open-angle glaucoma is the most common type in the United States: 9 in 10 people with glaucoma have it (NEI types).

Glaucoma is the second-leading cause of irreversible blindness in the US and the leading cause in Black and Hispanic/Latino people. It affects about 2.7 million people in the US, and the number rises with age, from 250,000 people aged 40 to 49 to 1.5 million aged 70 or older (USPSTF 2022).

Who is at higher risk

Anyone can get glaucoma, but some people are at higher risk (NEI).

• Age over 60, especially if you are Hispanic or Latino (NEI) (MedlinePlus).
• Being Black or African American and over age 40 (NEI) (MedlinePlus). Open-angle glaucoma causes almost 2 in 10 cases of blindness in African Americans (NEI types). Black people have the highest prevalence, faster progression and earlier symptoms (USPSTF 2022).
• A family history of glaucoma (NEI) (MedlinePlus).
• Diabetes or high blood pressure. People with high blood pressure or diabetes are at higher risk for open-angle glaucoma (NEI types).
• High eye pressure. High eye pressure increases the risk. For most people, eye pressure above 21 is higher than normal. But not everyone with high eye pressure gets glaucoma, and some people with normal eye pressure do (NEI eye pressure).
• Other eye findings such as a thinner cornea and a large cup-to-disc ratio (USPSTF 2022).
• Steroid medicines. Steroids used to treat uveitis may raise eye pressure as a side effect and may cause or worsen uveitic glaucoma (NEI types).
• Eye injuries can also cause glaucoma, so the NEI advises protective eyewear for sports, construction and home repairs (NEI types).

How often to get checked

The only way to find out if you have glaucoma is a comprehensive dilated eye exam, which includes a test of your side vision (NEI). After the drops, your vision may be blurry and sensitive to light for a few hours, so you will need someone to take you home (MedlinePlus).

What the USPSTF says about screening

For adults 40 or older without vision symptoms, the USPSTF found the evidence insufficient to weigh the benefits and harms of screening for primary open-angle glaucoma in primary care (an I statement) (USPSTF 2022). That is about screening by a primary care clinician; it does not change the eye exam advice above for people at higher risk. The glaucoma screening check walks through the statement.

Can glaucoma be prevented?

There is no way to prevent glaucoma, which is why eye exams matter: they can find it before it affects your vision (NEI). There is no cure, but early treatment can often stop the damage. Treatment does not undo vision loss, but it can stop it from getting worse (NEI). Eye drops that lower eye pressure are the most common treatment; laser treatment and surgery are other options (NEI).

Related checks

The vision screening check for older adults covers vision tests more broadly. Since diabetes raises the risk of open-angle glaucoma (NEI types), the diabetes risk test can show whether you should be tested for type 2 diabetes.

Common questions

My eye pressure is normal. Can I still get glaucoma?

Yes. Some people with normal eye pressure get glaucoma, and what is normal varies from person to person (NEI) (NEI eye pressure).

A parent has glaucoma. What should I do?

A family history puts you at higher risk. Ask your eye doctor how often to get a dilated eye exam; NEI advises every 1 to 2 years for people at higher risk (NEI). The NEI also encourages people with glaucoma to get family members checked, since it can run in families (NEI).

Would I notice glaucoma?

Usually not at first. Vision loss starts slowly, often at the sides, and many people cannot tell their vision is changing (NEI).