• Diseases that affect blood flow to the optic nerve (such as diabetes, high blood pressure, and migraine; people with type 2 diabetes should be regularly screened for glaucoma.)
• Hypothyroidism (underactive thyroid gland)
• Sleep apnea
• Physical injury to the eye
• Extreme nearsightedness (myopia)
• Previous eye surgery
• Other disorders, including leukemia, sickle cell anemia, and some forms of arthritis

Corticosteroids. Corticosteroids, commonly called steroids, have multiple effects on the trabecular meshwork. Steroids pose a higher or lower risk depending on the form:

• Taking topical steroid treatments in the eye poses the highest risk. Use of topical steroids must be monitored carefully since, in some cases, damage may be permanent.
• Taking oral corticosteroids, particularly in high doses or for long periods, increases the chance of glaucoma. In such cases, the eye disorder typically develops almost immediately and reverses within 2 weeks after the drug has been withdrawn.
• Inhaled steroids do not appear to cause glaucoma, but there may be some risk in people with a family history of glaucoma and other risk factors.

Syndromes Associated with Increased Optic Pressure and Glaucoma

Specific syndromes have been identified with glaucoma. Many have an inherited component, although in most cases other factors must be present to activate the disease process.

Pseudoexfoliation Syndrome. Pseudoexfoliation (PEX) syndrome (also known as exfoliation syndrome) is the most common condition associated with glaucoma. PEX syndrome is marked by dandruff-like flakes that accumulate on the surface of the eye’s lens. The material can clog the drainage angle of the eye and lead to build-up of intraocular pressure. People can have this condition and not develop glaucoma, but they are at high risk. PEX has a strong genetic component but other factors (possibly sunlight, an autoimmune response, or slow virus) may be needed to trigger the disease.

Pigment Glaucoma. Pigment glaucoma starts with a condition called pigment dispersion syndrome, an inherited condition in which granules of pigment (the substance that colors the iris) flakes off into the intraocular fluid. These fragments clog the trabecular meshwork and can increase intraocular pressure.

Irido Corneal Endothelia Syndrome. In irido corneal endothelial syndrome (ICE), cells on the back surface of the cornea spread to the drainage angle, sometimes forming scars that connect the iris to the cornea.

Neovascular Glaucoma. Neovascular glaucoma is always associated with other disorders, usually diabetes, that result in abnormal formation of new blood vessels on the iris and in the drainage system.

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Review Date: 06/23/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)