Glaucoma risk goes beyond your DNA

Genetics may set the stage, but they don't write the whole story when it comes to glaucoma. At Glaucoma Subspecialty Day during the American Academy of Ophthalmology annual meeting, Dr. Inas Aboobakar made the case that polygenic risk scores — while useful — are just one piece of the puzzle. Lifestyle and environmental factors play a significant, and often underappreciated, role in determining who develops the disease.

Diet is one key factor: a 2016 study found that dietary nitrates from green leafy vegetables and beets were linked to lower glaucoma prevalence and a twofold reduction in paracentral scotomas. Cardiovascular health (think blood pressure and metabolic conditions), smoking, caffeine, and alcohol consumption also influence risk — and show strong gene-environment interactions.

Key Takeaways:

• Dietary nitrates (leafy greens, beets) may reduce glaucoma prevalence and paracentral scotoma risk
• High and low blood pressure, vascular, and metabolic abnormalities all affect susceptibility
• Social determinants — including healthcare access, transportation, and housing — are meaningful contributors to risk

Why it matters: Patients with a family history of glaucoma often ask what they can do to protect their vision. An integrated approach combining genetic risk assessment with lifestyle and social factors could pave the way for more personalized, proactive glaucoma care.