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    Managing glaucoma in women

    Gender and hormones may play a bigger role than previously thought


    Women as caregivers

    Women are often the caregivers or manage the family health care, so indirectly they may affect the incidence and detection of glaucoma. A recent study in India published in British Journal of Ophthalmology revealed that in 1,259 pediatric glaucoma cases, five percent were steroid induced due to the overuse of steroids for severe GPC or vernal conjunctivitis. Children are affected by steroids at lower dosing and duration than adults, so it is important to monitor IOP and discontinue treatment in a timely manner. Because mothers might be instilling the medications and treating recurrent conditions, it is important they know the potential risks.23


    Glaucoma in mature populations

    As our gender thrives into more advanced years, dementia becomes another health concern. Treatment success for glaucoma is based on compliance, and the ability for patients to self-administer their medications is reduced with memory loss. As cognitive impairment and glaucoma share a common vascular risk factor, the relationship between Alzheimer’s disease (AD) and glaucoma has been reviewed.

    Previous studies in Europe and the U.S. have not shown a relationship; however, a recently published population-based study in Taiwan has. The study looked at ICD codes and co-morbidity factors of over 15,000 patients. Of interest is that in this population, when compared to the controls, women (not men) with dementia were more likely have a prior diagnosis of open-angle glaucoma. Other studies have shown that women with glaucoma have more severe vision loss. This may be due to longevity, financial burdens, or simply late diagnosis.1,24 This sensory impairment and lack of visual stimulation can easily contribute to the progression of cognitive loss. This study also discussed other similarities between AD and elevation in intraocular pressure including decreased cerebrospinal fluid and amyloid plaques that aggravate in both the brain and retinal ganglion cells.25-27

    Next: Lifestyle

    Louise Sclafani, OD, FAAO
    Dr. Sclafani is clinical associate of ophthalmology and visual science and director of optometric services The University of Chicago ...


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