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Blood Groups and Glaucoma


QUESTION

I ahev just been diganosed with open angle glaucoma. Is there any link to blood type? Thanks for a WONDERFUL website!


ANSWER

Glaucoma is a specific pattern of optic nerve damage and visual field loss caused by a number of different eye diseases which can affect the eye. Most, but not all of these diseases, are characterized by elevated intra-eye pressure, which is not the disease itself, but the most important risk factor for the development of glaucoma.

Primary Open-Angle Glaucoma (POAG). Approximately one percent of all Americans have this form of glaucoma, making it the most common form of glaucoma in our country. It occurs mainly in the over 50 age group. There are no symptoms associated with POAG. The pressure in the eye slowly rises and the cornea adapts without swelling. If the cornea were to swell, which is usually a signal that something is wrong, symptoms would be present. But as this is not the case, this disease often goes undetected. It is painless, and the patient often does not realize that he or she is slowly losing vision until the later stages of the disease. However, by the time the vision is impaired, the damage is irreversible.

Normal Tension Glaucoma. Normal-tension glaucoma, also known as low-tension glaucoma, is characterized by progressive optic nerve damage and visual field loss with a statistically normal intraocular pressure. This form of glaucoma, which is being increasingly recognized, may account for as many as one-third of the cases of open-angle glaucoma in the United States. Normal-tension glaucoma is thought to be related, at least in part, to poor blood flow to the optic nerve, which leads to death of the cells which carry impulses from the retina to the brain. In addition, these eyes appear to be susceptible to pressure-related damage even in the high normal range, and therefore a pressure lower than normal is often necessary to prevent further visual loss.

Angle-Closure Glaucoma. Angle-closure glaucoma affects nearly half a million people in the United States. There is a tendency for this disease to be inherited, and often several members of a family will be afflicted. It is most common in people of Asian descent and people who are far-sighted. In people with a tendency to angle-closure glaucoma, the anterior chamber is smaller than average.

Exfoliation Syndrome. This common cause of glaucoma is found everywhere in the world, but is most common among people of European descent. In about 10% of the population over age 50, a whitish material, which looks on slit-lamp examination somewhat like tiny flakes of dandruff, builds up on the lens of the eye. This exfoliation material is rubbed off the lens by movement of the iris and at the same time, pigment is rubbed off the iris. Both pigment and exfoliation material clog the trabecular meshwork, leading to IOP elevation, sometimes to very high levels. Exfoliation syndrome can lead to both open-angle glaucoma and angle-closure glaucoma, often producing both kinds of glaucoma in the same individual.

There are some blood type associations with glaucoma. A series of 474 mixed cases of glaucoma was assessed to determine whether there were any genetic differences between different types of glaucoma. A careful distinction was made between chronic open angle glaucoma (COAG), acute and chronic angle closure glaucoma, ocular hypertension, low tension glaucoma, patients with large cup disc ratios, and various types of secondary glaucoma including pseudoexfoliation of the lens capsule, uveitic and traumatic glaucoma. Using ABO blood groups, Rhesus groups and ABH secretion or non-secretion the researchers identified certain differences.

The differences were significant decrease in Rh-negative patients in chronic closed angle glaucoma. Secretors had lower rates of in ocular hypertension and fewer HB secretors in patients with chronic open angle glaucoma. There was a significant lack of type A secretors and increase type B secretors in both pseudoexfoliation with raised intraocular pressure compared with chronic closed angle glaucoma.

I've found that medication is the only reliable way to control glaucoma. Although following the ER4YT principles and using prudent amounts of vitamin C and the herb Coleus forskolii have allowed many patients to keep their glaucoma under good control for many years.

Brooks AM, Gillies WE. Blood groups as genetic markers in glaucoma. Br J Ophthalmol 1988 Apr;72(4):270-3






The Ask Dr. D'Adamo internet advice column ran from 1996 to 2009, at which time Dr. D'Adamo's teaching and programming responsibilities no longer allowed him to devote time and resources to directly answering visitor questions. However we've recently reorganized this treasure-trove of material and made it again available to his readership. He occasionally posts new entries. These are marked with a NEW tag.



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