• Age: The prevalence of glaucoma increases with age in all ethnic groups.
  
  
• Family history: Close blood relatives (brother, sister, parent, child) of people with primary open-angle glaucoma have a 6-times greater risk for developing glaucoma than those whose relatives do not have it. The greatest risk is to brothers and sisters, followed by parents and children.
  
  
• High intraocular pressure: Typically, people with intraocular pressure above 21 millimeters of mercury (mm Hg) are at risk, although optic nerve damage can occur in some individuals with lower pressure levels.
  
  
• Ethnicity: Black Americans are at increased risk for glaucoma. They should have a dilated eye examination at least every 2 years over the age of 40. Glaucoma is the leading cause of blindness among blacks and is 6- to 8-times more common in blacks than in whites, according to the Glaucoma Research Foundation (see charts below). Studies also show that glaucoma is 4-times more likely to cause blindness in blacks than in whites and 15-times more likely to cause blindness in blacks between the ages of 45 and 64 years than in whites in the same age group, according to the U.S. National Eye Institute. People of Asian descent appear to be at some elevated risk for angle-closure glaucoma. They tend to develop the disease earlier and may lose their vision sooner than other ethnic groups.
  
  » Prevalence of Glaucoma Among Blacks and Whites

Prevalence of Glaucoma in Populations with African Ancestry

The prevalence of glaucoma begins to increase in African-ancestry populations at 40 years of age and rises significantly with age.

Prevalence of Glaucoma in Whites

The prevalence of glaucoma among whites begins to increase around 60 years of age.

• Medications: Long-term steroid or cortisone use has been linked to glaucoma. A study in the Journal of the American Medical Association, March 5, 1997, reported a 40% increase in the incidence of ocular hypertension (elevated pressure of fluids in the eye) and open-angle glaucoma in adults who require 14 to 35 puffs of steroid inhaler a day to control asthma. This is a high dose and tends to be limited to treating people with cases of severe asthma. The study showed that patients who were on high-dose inhaled steroids for longer than 3 months had a higher risk for developing glaucoma. This type of glaucoma is relatively uncommon, but people should tell their ophthalmologist if they are taking cortisone or steroid drugs. Similarly, people should tell their physician if they have glaucoma. One should not take eyedrops if they contain steroids, and one should not use such medications unless directed by an ophthalmologist.
  
• Injury: Eye trauma can cause glaucoma years after the event. The most common causes of injuries are sports-related accidents in which the person sustains a blow to the head or eye from a blunt object that damages the eye’s drainage system.
• Medical conditions: People are at a high risk for glaucoma if they have diabetes, high blood pressure, or migraine headaches.

Your eyes should be checked at:

• Ages 35 and 40 years
• After age 40 years, every 2 to 4 years
• After age 60 years, every 1 to 2 years
• Those with any high risk factor should be examined every 1 to 2 years after age 35 years.

In January 2002, Medicare started to cover the costs of an annual dilated eye examination to help detect glaucoma for Medicare beneficiaries whom it defined as being at high risk but have not had a comprehensive examination within the past two years. The Medicare benefit covers people with diabetes, those with a family history of glaucoma, and African Americans aged 50 years and older. (Medicare provides benefits to those disabled persons less than 65 years of age who meet the program’s eligibility requirements.)