Risk factors in Glaucoma: Insights from a prospective case–control study, Belagavi, India

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Abstract
Introduction: Glaucoma is an optic neuropathy and degeneration of retinal ganglion cells, causing irreversible visual damage and blindness. While raised intraocular pressure (IOP) is the most important established risk factor, the exact pathogenesis and other risk factors for glaucoma are not fully understood, particularly in developing countries. Early identification and management of risk factors are important for reducing incidence and burden. This study assessed the risk factors for glaucoma at Dr. Kodkany’s Eye Center in Belagavi, India. Method: This case-control study examined 24 cases with confirmed diagnosis of glaucoma and 20 age- and sex-matched controls. A pre-designed questionnaire was used to collect sociodemographic data along with detailed eye examination findings. All glaucoma participants underwent thorough ophthalmic examinations, including visual acuity, intraocular pressure (IOP), central corneal thickness, anterior segment abnormalities, anterior chamber angle, fundus photography, and visual field testing. Results: Of the 24 cases, 14 (58.3%) were diagnosed with open-angle glaucoma, with bilateral involvement noted in 13(54.2%) cases. IOP was considerably higher in glaucomatous patients compared to non-glaucomatous (right eye: 27.86±8.97 vs 15.85±2.84 mmHg [Mean difference: 12.01 (95% CI: 8.24–15.78]; left eye: 28.27±8.75 vs.16.05 ± 3.02 mmHg; [Mean difference: 12.22 (95% CI: 8.49–15.95)] p<0.001 for both). None of the studied factors — age (OR=0.990, 95% CI: 0.937-1.045, p=0.705), female gender (OR=1.667, 95% CI: 0.500-5.559, p=0.416), or hypertension (OR=2.538, 95% CI: 0.697-9.240, p=0.160)—predicted glaucoma risk. Conclusion: This study confirms that elevated IOP is a key characteristic of glaucoma. However, age, female gender, and hypertension were not recognised as important risk factors for glaucoma. This suggests that other risk factors might have contributed to the risk of glaucoma. Screening beyond traditional risk factors helps in identifying at-risk patients.