For Patients With Juvenile Glaucoma, Myopia May Indicate Progression

The Optometrist pointing out the snellen chart on the opposite wall to a growing boy, where he will read the letters from the chart while she changes the lenses in the special ophthalmic glasses.
Clinicians should consider myopia progression a red flag in juvenile patients with glaucoma.

Incidence of myopia in patients with juvenile open angle glaucoma (JOAG) could indicate future glaucoma progression, according to findings published in Ophthalmic and Physiological Optics.

Researchers conducted a retrospective study to identify the risk factors for glaucoma progression and its association with myopia among treated JOAG patients with at least 5 years of followup. The study involved analyses of age, inheritance pattern, baseline intraocular pressure (IOP), central corneal thickness, visual acuity (VA), refractive error, spherical equivalent (SE), and duration of followup. Progression was detected using stereo-parametric global trend analysis and Moorfields Regression Analysis on confocal scanning laser ophthalmology. 

The study, which included 37 participants, found glaucoma progression in 14.9% of patients (n=8), and 7.4 years median time to progression. Glaucoma progression was 18 times more likely for patients with myopia than mild or no myopia (P =.03). Myopia was prevalent in 70.3% of JOAG, 87.5% of progressors (PG), and 65.5% of nonprogressors (NPG), and the researchers noted its progression at followup in 70% of patients. Thus, JOAG progressors had a greater baseline myopic refraction and a faster myopia development over time.

The study explains that the incidence of myopia among JOAG patients has a genetic tendency.

“When compared [with] a healthy population of the same ethnicity, the prevalence of myopia amongst our JOAG patients was higher, indicating the strong association between myopia and JOAG,” the study says.

Study limitations included the small sample size due to the rare nature of JOAG, as well as its retrospective nature. Additionally, the researchers note that the finding of a reduction in the overall progression rate over time may be a confounder due to more recent glaucoma management information.


Gupta S, Singh A, Mahalingam K, et al. Myopia and glaucoma progression among patients with juvenile onset open angle glaucoma: a retrospective follow up study. Ophthalmic Physiol Opt. Published online April 7, 2021. doi:10.1111/opo.12805.