A new study has found that progression to more severe levels of glaucoma is linked to the increased burden of systemic comorbidities.
The retrospective cohort study, published in The Journal of Glaucoma,1 included almost 12,000 adult patients diagnosed with primary open angle glaucoma, preglaucoma, or ocular hypertension at the Cole Eye Institute in the United States between 2018 and 2024 with at least five years of follow-up.
The age-adjusted Charlson Comorbidity Index (CCI) – a widely used assessment tool designed to predict long-term mortality – was used to assess the presence of diabetes, dementia, and other comorbidities as well as patient age.
Greater score on the age-adjusted CCI correlated with higher odds of glaucoma progression.
“Glaucoma requires early detection and consistent treatment adherence to prevent vision loss,” study authors wrote.
“Recent evidence also suggests that patients with multiple chronic conditions, such as those involving neurological or metabolic disease, face greater challenges in maintaining glaucoma regimens.
“These comorbidities can contribute to lower medication adherence due to competing health priorities, functional limitations, and the complexities of managing multiple medications.”
…the odds of progression from early-stage to moderate-stage glaucoma increased 6% with each additional point on the age-adjusted CCI
According to the results, the odds of progression from early-stage to moderate-stage glaucoma increased 6% with each additional point on the age-adjusted CCI. For progression from early-stage to severe-stage glaucoma, the odds increased 9% with each additional point.
“Our findings underscore the value of considering systemic health when evaluating glaucoma progression risk. The age-CCI represents a practical risk stratification tool that can be easily calculated from existing electronic medical records to identify patients at greater risk of vision loss. Implementation could follow a tiered approach, where patients with low age-CCI and early-stage disease may receive standard surveillance, while those with high scores… should be considered for enhanced monitoring, multidisciplinary care coordination, and treatment simplification strategies.”
Reference
- Zhou MY, Reed H, Li A, et al. Association between systemic comorbidity burden and glaucoma progression: a 5-year cohort study. J Glaucoma. 2026;35(6):386–392. doi:10.1097/IJG.0000000000002712.
