- Design
- Prospective population-based cohort, 12-year follow-up
- Population
- 826 older adults in Thessaloniki, Greece
- Primary outcome
- Incident open-angle glaucoma
- Effect
- Associated with pseudoexfoliation (p=0.002), higher IOP (p<0.001), cup-to-disc ratio (p=0.02), family history (p=0.029)
The Thessaloniki Eye Study examined an older Greek population and re-invited participants 12 years later using the same methods; 826 met the final criteria for analysing new open-angle glaucoma.
In adjusted analysis, pseudoexfoliation, higher baseline intraocular pressure, a larger vertical cup-to-disc ratio, a family history of glaucoma and a history of heart attack were each associated with developing glaucoma. Participants with untreated blood pressure at or below 140/90 had higher risk than those with higher pressure; lower ocular perfusion is one possible explanation. Longer sleep and alcohol use appeared protective.
The abstract gives p-values rather than effect sizes, a quarter of the original cohort were not re-examined, and the population is white European. The protective associations with sleep and alcohol are likely to reflect confounding and should not be turned into advice. But the core list confirms which patients merit closer follow-up, and pseudoexfoliation also matters at cataract surgery, where it raises the risk of zonular complications. It was published in September 2026.
- Look for pseudoexfoliation at the slit lamp in every older patient, ideally with the pupil dilated.
- Offer closer glaucoma follow-up to patients with pseudoexfoliation, raised pressure, a large cup-to-disc ratio or a family history.
- Ask about glaucoma in first-degree relatives and advise them to have their eyes checked.
- Consider a history of heart attack, and low blood pressure, when judging glaucoma risk.
- Do not advise alcohol or longer sleep to prevent glaucoma; those associations are likely confounded.
Why it matters
It confirms a short, practical list for deciding who needs more frequent glaucoma checks.
Don't overread it
The protective links with sleep and alcohol are observational and should not become advice.
The statistics, in plain English
The abstract reports only p-values, which say whether an association is unlikely to be chance but not how strong it is. Losing a quarter of participants to follow-up can bias results if those lost differed in glaucoma risk.
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