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Munich, July 2024 – If you’re carrying a few extra pounds, the news from science and research rarely has anything good in store for you. Two studies published by researchers from Australia and the USA now report on a notable exception to this rule. As they show, a slightly increased body mass index (BMI) is apparently associated with a lower risk of developing glaucoma. The progression of an already diagnosed glaucoma also occurred less quickly if the BMI was slightly above normal weight. The German Ophthalmological Society (DOG) is using the studies published in the American and British Journal of Ophthalmology as an opportunity to educate people about glaucoma and known risk factors.

Glaucoma, also known as glaucoma, is a common eye disease that affects more than 900,000 people in Germany alone. If left untreated, they face a progressive and irreversible loss of vision that can lead to complete blindness. “The tricky thing about glaucoma is that it is initially symptomless and can therefore go unnoticed for a long time,” says Professor Dr. Alexander Schuster from the Department of Ophthalmology at the University Medical Center Mainz. “It is not painful, and many sufferers do not initially notice that their field of vision is getting smaller.” The changes are usually only discovered during an early detection examination by an ophthalmologist.

This should therefore be done at regular intervals. Because the risk of glaucoma increases with age, screening is recommended from the age of 40 at the latest. “For people with risk factors, the examinations should begin even earlier,” emphasizes the DOG expert, who also holds a professorship for ophthalmological health care research in Mainz. This includes people whose parents or siblings have already suffered from glaucoma, people who are very short-sighted with more than four diopters, or people with dark skin. The most important risk factor, however, is too high intraocular pressure. “The interval at which the ophthalmological examinations should be repeated also depends on the known risk factors – it can be between one and five years,” says Schuster.

The Australian and US studies now both indicate that particularly slim people are more likely to suffer from glaucoma. Both studies looked at the most common form of glaucoma, so-called primary open-angle glaucoma. This was diagnosed more frequently the lower the body mass index of the participants. The loss of visual field also progressed more quickly in underweight people than in people who were normal or slightly overweight. “There have been contradictory study results on a possible connection between body weight and the risk of glaucoma,” says Schuster. Body weight was therefore not included with a specific recommendation in the recently updated guideline for assessing risk factors for open-angle glaucoma. “The current studies shift the balance in the direction of a possible protective effect that could arise from normal to slightly increased BMI values,” says the Mainz ophthalmologist. Research suspects that being underweight makes people more susceptible to disease overall.

It remains to be seen whether the effect of weight should be taken into account in the screening decision for glaucoma. “Body weight is certainly not the decisive risk factor for or against a screening test,” emphasises Schuster. The DOG expert advocates that, if in doubt, it is better to test too often or too early than too late: “Optic nerve fibres that have been destroyed are irretrievably lost. However, if glaucoma is detected in time, the loss of visual field can usually be stopped easily and safely with eye drops or laser procedures.”