27/05/2026
A 15-year follow-up from the Blue Mountains Eye Study gives a useful reminder of why glaucoma risk assessment cannot rely on one measurement alone.
In this older Australian cohort, the age-standardized 15-year incidence of definite and probable open-angle glaucoma was 5.67%. The strongest risk factors were age, pseudoexfoliation, myopia of 3 diopters or more, and intraocular pressure.
IOP mattered, clearly. Each 1 mmHg increase was associated with a 24% higher risk of developing open-angle glaucoma. But the study also found that only 13.6% of participants who developed glaucoma had ocular hypertension at baseline.
That is clinically important.
It reinforces what many clinicians see in practice: glaucoma risk is often visible in the pattern, not just the pressure. Optic nerve appearance, structural change, refractive status, pseudoexfoliation, and longitudinal follow-up all matter.
For optometrists and ophthalmologists, studies like this support a more layered approach to glaucoma detection. Not every patient at risk will present with high IOP. And not every suspicious finding will become glaucoma. The value is in combining data over time and knowing which patients deserve closer attention.
Early recognition is still one of the most practical ways to protect vision.
Read the full study here: https://linkinghub.elsevier.com/retrieve/pii/S0161642z026000151