Why Knowing Your Risk Matters

Glaucoma is one of the leading causes of irreversible sight loss in the UK, and it is also one of the most quietly behaved. The most common form, primary open-angle glaucoma, usually develops over years without pain, redness or any obvious change to your vision. By the time someone notices they are missing things at the edges of their sight, a substantial number of optic nerve fibres may already have been lost.

The encouraging part is that glaucoma is very manageable when it is picked up early. Eye drops, laser treatment and surgery can all slow or stop the damage, and most people who are diagnosed in good time keep useful vision for life. What makes the difference is timing — and timing depends on knowing whether you are more likely than average to develop it. If you recognise yourself in any of the factors below, it is worth mentioning them at your next eye appointment, and it may be worth bringing that appointment forward.

Age: The Factor Nobody Can Avoid

Risk climbs steadily with age. Glaucoma is uncommon before the age of 40, but the numbers rise noticeably after 60 and again after 70. This is partly because the drainage channels inside the eye become less efficient over time, and partly because the optic nerve becomes more vulnerable to pressure as the years pass.

Age alone is not a reason to worry, but it is a reason to be consistent. If you are over 40 and have not had a full eye examination in the past two years, book one. In the UK, sight tests are free on the NHS for anyone aged 40 or over who has a parent, sibling or child with glaucoma, so there is no financial reason to put it off.

Family History: A Strong and Often Overlooked Clue

Having a close relative with glaucoma is one of the most significant risk factors there is. The risk is higher if a parent, brother, sister or child is affected, and higher still if more than one relative has the condition. Many people are unaware of a family history simply because they have never asked, or because an older relative was never formally diagnosed.

• Ask your relatives directly whether anyone in the family has glaucoma, and if so, at what age it started.
• Tell your optometrist at every appointment — it changes how closely they look and how often they want to see you.
• Remember that a normal test today does not rule out future problems if your family history is strong.

Ethnicity and the Shape of Your Eye

Certain ethnic backgrounds carry a higher risk, and the reasons are partly anatomical. People of African, Caribbean and African-Caribbean heritage are considerably more likely to develop open-angle glaucoma, tend to develop it at a younger age, and often experience faster progression. This makes regular screening particularly important.

People of South Asian and East Asian heritage have a higher risk of angle-closure glaucoma, where the drainage angle in the eye is unusually narrow. This form can cause a sudden, painful attack with blurred vision, halos around lights, headache and nausea — a medical emergency requiring immediate attention. Being long-sighted also increases the chance of narrow angles, as the eye tends to be shorter than average.

Medical Conditions and Medicines That Raise the Stakes

Several health conditions and treatments are linked to a higher glaucoma risk, so it is worth keeping your optometrist informed about your wider medical picture:

• Diabetes — raised blood sugar can damage the small vessels supplying the optic nerve and increase pressure inside the eye.
• High blood pressure — particularly when it fluctuates or drops sharply at night, which can reduce blood flow to the optic nerve.
• Short-sightedness (myopia) — longer eyes are more prone to open-angle glaucoma.
• Long-term steroid use — eye drops, inhalers, creams and tablets containing steroids can all raise eye pressure in susceptible people.
• Migraine and cold hands and feet — both can indicate reduced blood flow that leaves the optic nerve more vulnerable.
• Previous eye injury or surgery — trauma and certain procedures can disturb the eye's drainage system.
• Obstructive sleep apnoea — linked to lower oxygen levels at night and a higher risk of glaucoma.

If any of these apply to you, this is not a cause for alarm. It simply means your optometrist should know, so they can tailor how often you are checked and which tests they use.

Turning Awareness into Practical Action

Knowing your risk factors is only useful if it changes what you do next. A few straightforward habits make a real difference:

• Book a full eye examination every two years, or more often if your optometrist advises it.
• Ask specifically for your eye pressure and optic nerve to be checked, and whether a visual field test is appropriate.
• Keep every appointment, even when your vision feels perfectly fine — glaucoma rarely announces itself.
• Use prescribed eye drops exactly as directed, and tell your clinician if they cause irritation or are hard to manage.
• Do not stop drops because you feel well; the pressure-lowering effect is what protects your sight.
• Seek urgent help for sudden eye pain, redness, halos, or a rapid drop in vision.

Glaucoma is a condition where small, steady actions pay off enormously. You cannot change your age, your family or your heritage — but you can make sure your eyes are being watched by someone who knows what to look for.