Is birth control linked to glaucoma?

A recent study suggests women who have used oral contraceptives for three or more years are more likely to develop glaucoma.

However, because the data was collected from a survey rather than controlled clinical trials, Robert Bittel, O.D., chair of the AOA's Health Promotions Committee, looks at the results cautiously.

"Further research is certainly warranted to establish a causative relationship between the use of oral contraceptives and an increased risk of developing glaucoma," Dr. Bittel said.

What the study says

The study—conducted by researchers at University of California, San Francisco, Duke University and Third Affiliated Hospital of Nanchang University in China—used 2005-2008 data from the Centers for Disease Control's National Health and Nutrition Examination Survey (NHANES).

A total of 3,406 participants over age 40 completed the survey, which researchers used along with eye exam results.

Further research is certainly warranted to establish a causative relationship.

The study indicates that women who use oral contraceptives long-term are twice as likely to be diagnosed with glaucoma when compared to those who used oral contraceptives for less than three years, or not at all.

Lead investigator Elaine Wang, a fourth-year medical student at Duke University, acknowledged that more research is necessary. She also pointed out that the study did not distinguish between types of oral contraceptives.

However, Wang, along with fellow study authors, wanted gynecologist and eye care professionals to be aware of the possible association and consider it along with existing risk factors, such as increased intraocular pressure (IOP).

ODs on the front lines of early detection

Glaucoma is the second leading cause of blindness globally. There is no way to prevent the disease, but it can be controlled if caught early, which is why regular eye exams are essential.

"Optometrists on the front-line of glaucoma detection must actively educate our patients with known risk factors for the development of glaucoma about the importance of yearly comprehensive eye examinations and glaucoma testing, including yearly IOP measurements," said Dr. Bittel.

Although taking birth control is not proven to be one of those risk factors at this point, the results of this study may be worrisome for some patients.

"I would advise my female patients who take oral contraceptives to discuss their overall health with their OB/GYN physician as it relates to the use of oral contraceptives—and to have an annual comprehensive eye examination," Dr. Bittel said.

January 24, 2014

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