Having glaucoma is no joke. A person has to adhere to a medication regimen just to maintain functional vision, and even then, surgery may still be required. Another reason to take glaucoma seriously is that it is associated with stroke. It sounds unlikely, yet there is evidence linking the two conditions.
A study was done in Taiwan from 2001 to 2010. Over 5,000 people from the country’s National Health Insurance Research Database were a part of the study. Of those, over 900 were identified as having normal tension glaucoma. What makes normal tension glaucoma unique is that there is no elevated intraocular pressure. Additionally, persons with normal tension glaucoma are reported to suffer from migraines and hypertension.
In the normal tension glaucoma group, 107 persons had a stroke. Inadequate blood flow in the central nervous system has been associated with the development of normal tension glaucoma. Cerebrovascular diseases such as strokes and transient ischemic attack (TIA), also known as a mini-stroke, are more common in persons with normal tension glaucoma than in persons with high-tension glaucoma or those who don’t have glaucoma.Optic disc hemorrhage, an indicator of optical disc damage in normal tension glaucoma, has been associated with hypertension and diabetes and those conditions are risk factors for stroke. In addition, damage to blood vessels from hypertension leads to lower amounts of oxygen reaching the cells. While both normal tension glaucoma and primary open angle glaucoma are directed through the interaction of intraocular pressure and vascular factors, this study showed a correlation between normal tension glaucoma and stroke.
What does mean for those who have glaucoma or are at risk for glaucoma? For starters, people need to have regular eye exams that include complete fundus and visual field examinations. Also, care needs to be coordinated with cardiologists, primary care physicians and ophthalmologist so that conditions like glaucoma can be monitored and stroke can be avoided. Patients also need to be educated about conditions such as glaucoma, how it relates to stroke and how taking care of one condition can help prevent another.
Normal tension glaucoma is analogous to a canary in a coal mine. It is an indicator of risk. It needs to be monitored to both preserve vision and avoid the problems that comes with having a stroke.