Evidence that environmental factors can play a role in the etiology of glaucoma arises from studies of twins in which the disease was not uniformly manifest in monozygotic twins. These data suggest that while genetic factors contribute to the development of glaucoma, environmental and behavioral factors are also important. Through the use of longitudinal epidemiologic studies (eg, the TwinsUK Registry, the United States Department of Veterans Affairs Normative Aging Study, and the Nurses’ Health Study), a number of environmental factors have been identified that possibly modulate the risk for glaucoma. These factors include sun and low ambient temperature exposure (for pseudoexfoliation syndrome), estrogen exposure, cholesterol levels and statin use, and lead exposure.
Kang JH, Loomis, Wiggs JL, Stein JD, Pasquale LR. Demographic and geographic features of exfoliation glaucoma in 2 United States–based prospective cohorts. Ophthalmology. 2012;119(1):27–35.
Stein JD, Pasquale LR, Talwar N, et al. Geographic and climatic factors associated with exfoliation syndrome. Arch Ophthalmol. 2011;129(8):1053–1060.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.