Older people may have glaucoma without realizing it

It can be hard to know that you have glaucoma. In a study carried out at the University of Gothenburg, almost 5% of 70-year-olds were found to have glaucoma, and half of those diagnosed were unaware that they had the disease.

Glaucoma is a common eye disease that damages the optic nerve and thereby the field of vision. In the most serious cases, glaucoma can lead to blindness.

The research was carried out by Lena Havstam Johansson, a Ph.D. student at the University of Gothenburg and a specialist nurse at Sahlgrenska University Hospital. The study shows that 4.8% of the 560 study participants examined by eye specialists had glaucoma.

The results have been published in two articles in the journal Acta Ophthalmologica:

• The prevalence of glaucoma in a 70-year-old Swedish population in the city area of Gothenburg
• Vision-related quality of life among 70-year-olds diagnosed with glaucoma

"Of those who were diagnosed with glaucoma via the study, 15 people—or 2.7% of all participants—were unaware that they had the disease before being examined," says Lena Havstam Johansson. "So half of those who turned out to have glaucoma were diagnosed because they took part in the study."

For those who were newly diagnosed, the discovery of the disease meant they could start treatment with daily eye drops that lower the pressure in the eye and slowing down the damage to the optic nerve.

Reduced vision affects daily life

Compared to people without the disease those with glaucoma had similar levels of physical activity and did not smoke more, or drink more alcohol. They rated their overall quality of life as being just as good as others, they were not more tired or more depressed.

"This was a positive surprise, and was a finding that I hope can bring comfort to many people who have been diagnosed with glaucoma. It's hard to live with a disease that gradually impairs vision, but life can still be good in many ways."

By contrast, people with glaucoma reported that their vision-related quality of life was poorer.

"It's harder to climb stairs, see curbs in the evening, and notice things in your peripheral vision. This means that people with glaucoma may avoid visiting others, or going to restaurants or parties, and instead stay at home. They lose their independence, and may feel frustrated about it."

The research was carried out as part of the H70 study, examining the health of older people, which has been conducted at the University of Gothenburg for 50 years. The H70 study continuously invites all 70-year-olds born in a certain year in Gothenburg to attend several comprehensive physical and cognitive examinations.

The 1,203 70-year-olds included in the glaucoma study were born in 1944. For these studies, almost everyone (1,182 people) answered written questions about their eye health and the presence of glaucoma in their family. Eye specialists at Sahlgrenska University Hospital also examined 560 of the participants.

The research confirms that there are hereditary factors behind the disease, as those diagnosed with glaucoma were more likely to have a close relative with the same diagnosis. The results also confirm that glaucoma involves higher eye pressure, although they also show that the majority of those who were newly diagnosed (67%) still had normal eye pressure.

During the early stages of the disease, the healthy eye can compensate for the loss of vision, meaning that many people believe their vision is as good as before. These studies confirm that glaucoma often does not initially involve a loss of visual acuity, which may make it harder to detect the disease.