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    Managing glaucoma in women

    Gender and hormones may play a bigger role than previously thought



    We have all heard that 50 is the new 40. In fact, 70 is the new 60! People of this age have more active lifestyles than before and strive to stay healthy. This may include activities such as yoga, golf, and yes, sex.

    Depending on the level of activity, inversions in yoga and lateral extension in golf have been shown to elevate intraocular pressure. On a positive note, sleeping with the head slightly elevated 30 degrees on two pillows has been shown to decrease IOP up to 20 percent. This is a very common position for women in the age group because they are likely to make a weekly visit to their salon for an up-do hairstyle, and they like to maintain their style until the next visit.28-30

    Age does not discriminate for those who like to maintain beauty and sex appeal. Erectile dysfunction (ED) is more commonly discussed as treatment has become more effective. More and more seniors are sexually active. It was long thought that erectile dysfunction was a side effect of the use of beta blockers systemically or topically for glaucoma. On the contrary, there seems to be a correlation between ED and the diagnosis of glaucoma, not its treatment. Because women often take care of their spouse’s health needs, this is a discussion they should be having.31


    Ask questions

    In the past, the pertinent history for glaucoma included family history, age, race, and trauma. Today we need to query further. As we can see, age of menses, use of OC/HRT, and hysterectomy play a key role. A discussion regarding childbearing may have been just in passing, but this information may now be significant because the choice is delayed and our optic nerves age. Six percent of women enter menopause before the age of 45,32,33 and although we don’t typically ask this question, perhaps we should. Many men don’t always disclose all of their medications or their diagnosis of ED because they don’t think it affects their eyes. Perhaps we need to specifically ask them and their partners about this information. Lifestyle choices that may be more focused to our gender should be discussed. Given some of the findings, future treatment may be more targeted toward hormonal control. Globally women live longer and 90 percent of centenarians are women.34 It is important to keep that in mind when determining target IOP and when to treat.

    Click here to read the latest glaucoma news and advice

    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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