Is Glaucoma Hereditary?

Is Glaucoma Hereditary

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The answer is yes. Many forms of glaucoma are inherited. The most common form of glaucoma that is inherited is Early-onset Glaucoma followed by Primary congenital Glaucoma.  These two conditions have been associated with two mutated genes that are believed to cause glaucoma. Not only is glaucoma inherited but many other diseases that cause secondary glaucoma are also inherited such as hypertension and diabetes. 

Inherited Glaucoma

Early Onset Glaucoma which has the strongest hereditary links can be seen in the form of Primary congenital Glaucoma or Juvenile open-angle glaucoma. The parents of a child with Primary Congenital Glaucoma usually don’t have the disease because it is autosomal recessive. So they both carry it but do not express the traits.  In the case of Juvenile Open-Angle Glaucoma, it is a dominant gene so one of the parents will likely have it.  A common question is “if my mom has glaucoma will I get it” and the answer is … probably If she had Juvenile Open-angle Glaucoma.

What is Glaucoma

Glaucoma is a group of conditions that cause the nerves in the back of the eye to atrophy and die. Some of these conditions cause an increase in pressure of the fluid in the eye to choke off the blood supply to the nerves and also the nerve conduction itself.  Some of the conditions cause a lack of drainage of the fluid and others to cause an overproduction of the fluid. Early-onset glaucomas have a couple of different proteins that are produced and either accumulate in the drainage part of the (the trabecular meshwork) blocking flow or actually cause the malformation of the meshwork which causes it to not drain properly.  The two genes responsible for these proteins are MYOC and CYP1B1. The strong association with these two genes definitely answers the question “Is glaucoma hereditary?”.

Groups with higher risk of inheriting Glaucoma

  • African American are five time more likely to have glaucoma. The cause is unknown as of now but they are also more likely to have related conditions that can cause glaucoma such as Diabetes.
  • Asians are more likely to suffer from angle-closure glaucoma, which is associated with high myopia.  The Japanese also have a strong genetic trait for low tension glaucoma or normal-tension glaucoma
  • Hispanics are at higher risk for open-angle glaucoma and also associated secondary glaucoma due to diseases like diabetes.  Their risk rises with age and is much more likely to develop it after the age of 60.
  • If your family has glaucoma, you are 4-9 times more likely to inherit it. This number also includes other conditions that can cause secondary glaucoma.  So, it is just as important to be aware of the other diseases and their prevention to avoid not only the effects of the primary disease but also getting glaucoma as a result of it.

Other risk factors for Glaucoma

  • Eye injuries can have an immediate or long-term effect that cause glaucoma.
  • High myopia causes the drainage structures to be narrowed reducing exit flow.
  • Hypertension reduces oxygen to the drainage tissue which can cause new blood vessel growth which obstructs the trabecular meshwork.
  • Diabetes like hypertension also causes neovascularization (new blood vessel growth) which is obstructive.
  • Central corneal thickness less than .5mm is associated with also having a thinner protective layer around the nerves, this makes them more vulnerable to the effects of the higher pressure of the eye.
  • All of these other risk factors can be genetically inherited with the exception of having an eye injury which would be environmental. So even though it causes glaucoma as a secondary side effect of the primary disease I would still say that the effect is glaucoma is inherited.
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Reducing your risk of expressing glaucoma inherited genes

When asking the question, “Is glaucoma hereditary?” we should also be asking ourselves if we are at risk for many of these other diseases as well. For the two big risk factors, hypertension and diabetes we can control a lot of the risk with our actions and environment. Eat a healthy diet with special attention to reducing high fat and high carb foods. Get plenty of exercises. Reduce your stress, take a vacation or find ways to unwind. Stress causes cortisol to be released which causes weight gain. Weight gain causes hypertension and diabetes, and they can cause glaucoma.

  • Don’t smoke, smoking reduces oxygen to all of your tissues. Smoking hardens the arteries and can lead to hypertension, as we know hypertension can lead to glaucoma.
  • Get regular eye exams. The old saying “an ounce of prevention is greater than a pound of cure” is applicable here. Healthy people under the age of 40 should have an eye exam every two to three years. 40-50 should get one every 1-2 years and after the age of 50 every year.
  • Glaucoma is genetically inherited, however, we know that genetic traits can be turned on and off by our environment. So educate yourself and know your risks. Get regular eye exams and try to live a healthy lifestyle. 
About the Author:
Dr. Shaun Larsen

Dr. Shaun Larsen

Dr. Shaun Larsen is an optometrist who specializes in low vision services and enhancing vision with contact lenses. He has a passion for making people's lives better by helping them see well enough to read, write, or drive again. He always keeps up with the latest technology so he can help people regain their independence.


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