Family key in glaucoma risk

glaucoma family risk: mother holding hands with little blonde girl

The increased risk of glaucoma for people who have a family member with the condition will be a focus for this year’s Glaucoma Week (8-14 March), says Glaucoma Australia CEO Geoff Pollard.

“The theme is glaucoma runs in families, the idea being that if a person already has a family member diagnosed with glaucoma, their risk is about 10 times higher than the general population of having glaucoma themselves if it’s a direct relative,” Pollard told the AJP.

“That means a lifetime risk of 23%, or just under one in four. So if you’ve got four kids in your family and you have glaucoma, statistically, one is going to have it.”

But Australia has a fairly high non-detection rate for the disease, which means many people don’t realise they have it until they have lost at least some sight.

“The non-detection rate is about 50%, which is similar to other developed countries, and a high proportion of those people will have a relative who’s already been diagnosed,” Pollard says. “It would make a big difference if people with relatives who have glaucoma went and got a check.

“It means they might be diagnosed earlier than they might otherwise have been. That helps bring down the vision loss rates as well, as if diagnosed and treated early you can expect to halt or at least slow the progression of the disease.

“The later you’re diagnosed, the more likely you won’t have much sight left or that you’ll go blind during your lifetime.”

Pharmacists can have a vital role in helping customers make the best use of this treatment, Pollard says. Pfizer has worked with pharmacists targeting glaucoma, asking pharmacists to hand over surveys so that customers can assess whether they have risk factors, including family history, or a history of elevated blood pressure, for example.

The PSA and the Guild are also doing good work in glaucoma, he says – for example, webinars and other educational resources available to pharmacists.

“The statistics around asymptomatic chronic conditions indicate that generally, a third of people will drop their medication within a year,” Pollard says. “In glaucoma, it’s worse.

“For most people, an eye drop is harder than taking a tablet, and a lot of people have complicating factors like arthritis that makes it even harder to apply. Data from the World Glaucoma Congress in Paris in 2011, presented by Professor Paul Healey from Westmead, showed that 52% of people with glaucoma had gone off their medicine within 12 months.

“That’s a bit of a disaster. The 48-month data was around 75%. So it’s a big problem, and pharmacists can play a fantastic role in helping out – and it’s in their interest to be able to do so, as there’s financial incentives, as well as getting a better result for a patient.”

Vision loss from glaucoma can have significant flow-on effects that can also require pharmacist input, he warns.

“You have elements of depression, and an increase in falls – and when we’re talking about an older population who may have osteoporotic hips and the like you just don’t want that to be occurring. People become isolated from their community because they can’t see as well, may lose their licence earlier because they can’t pass the test – there’s a lot of elements affecting quality of life.”

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