Around 3 million Americans have glaucoma, according to the Centers for Disease Control and Prevention (CDC). And yet half of them don’t even know they have this serious eye disease.

How can that be?

“You can’t feel glaucoma,” says Richard G’Sell, O.D., an optometrist who practices at America’s Best Contacts & Eyeglasses in St. Louis, Missouri. “It’s also a progressive disease that develops over years, so you don’t notice you’re losing your vision.”

Glaucoma is actually a group of eye diseases. The most common type in the United States is open-angle glaucoma. All types of glaucoma damage the optic nerve, which is in the back of your eye. The optic nerve is made up of a million tiny fibers that send signals from your retina (the tissue at the back of the eye that connects to the optic nerve) to your brain.

No one knows exactly what causes glaucoma. Doctors think it may have to do with eye pressure from too much fluid buildup. When fluid in the eyes can’t drain properly, the pressure damages the tiny fibers in the optic nerve, causing them to die off.

An eye doctor can spot the signs of eye pressure during a routine eye exam. But there are no warning signs or symptoms you would notice until it’s too late.

If left untreated, glaucoma can lead to blindness. About 9% to 12% of people in the United States with glaucoma eventually go blind, according to the Glaucoma Research Foundation (GRF).

Anyone can develop glaucoma — even babies — but there are certain groups of people whose odds are much higher. Could you be among them? See what can bump up your chances of developing this vision-robbing condition — and what steps you can take to prevent it.

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Who’s at Highest Risk of Developing Glaucoma?

Unfortunately, there’s not much you can do to control some of these high-risk factors, such as race and age. But there are steps you can take to slow or prevent the disease if you fall into one of these groups.

Older Adults

Glaucoma affects close to 2% of adults over 40, according to the National Institutes of Health. But it’s after age 60 that you’re most at risk, the GRF reports.

If you’re 60 or older, you’re six times more likely to develop glaucoma. And if you do develop it, you’re more likely to have it progress quickly.

Here’s why: When you’re older, your eyes may be less efficient at draining fluids, leading to fluid buildup and pressure in the eye that damages the optic nerve, says Dr. G’Sell.

Black People Over the Age of 40

Black people are five times more likely to develop glaucoma than people of European descent, according to the GRF. And they tend to get glaucoma roughly 10 years earlier too.

Black patients are also six times more likely than white patients to have more advanced vision loss after a glaucoma diagnosis, according to research from Mount Sinai Hospital in New York City.

The reasons may have to do with genetics and family history, says Dr. G’Sell. If glaucoma runs in your family and you are Black, you have a 20% higher chance of developing it.

Latinos Over the Age of 40

Up to 75% of Latinos with glaucoma may be undiagnosed, according to the GRF. And they may be up to four times more likely than non-Hispanic whites to develop the disease.

Another concern: Due to social factors, Latinos are less likely to have eye exams and access to vision care, according to the CDC.

People with a Family History of Glaucoma

If a parent or sibling has glaucoma, you have a two to four times higher chance of getting it too, according to the University of Iowa Medical School.  

People Living with Chronic Conditions

High blood pressure and diabetes can raise your risk of glaucoma, especially if the conditions aren’t controlled well with medication, diet, and exercise.

High blood pressure affects blood circulation and can raise pressure in the eye. And people with diabetes can develop diabetic retinopathy, another serious eye disease that can lead to glaucoma. When you have diabetic retinopathy, new blood vessels grow in the retina and block fluid from draining out of the eye, says Dr. G’Sell. That raises the pressure and damages the optic nerve.

Cigarette Smokers

Smoking is bad for your eyes. It’s a risk factor for age-related macular degeneration and cataracts. And it might be for glaucoma as well. This is especially true for those who smoke more than a pack a day.

The chemicals in tobacco smoke can get into your bloodstream and damage blood cells and blood vessels, including the ones in your eyes.

People Who Are Nearsighted

Having poor distance vision (myopia) nearly doubles your odds of developing glaucoma, and that risk factor goes up the more nearsighted you are.

People who are severely myopic have a fourfold risk, a study in the American Journal of Ophthalmology found. Myopia makes your eye longer and thinner, which could leave the optic nerve more vulnerable to eye pressure.

How to Prevent Glaucoma

Sometimes these risk factors overlap. For example: If you’re 65, nearsighted, and diabetic, you’re much more likely to develop the disease.

That’s why preventing glaucoma is so important for everyone, and especially for people whose chances of developing it are higher than normal. Here’s how.

Get a Yearly Eye Exam

Make sure it’s a comprehensive eye exam, says Dr. G’Sell. That means your eyes will be dilated with special eye drops so that the optometrist can examine your retina and optic nerve. The eye doctor may also numb your eye with other drops and then use an instrument to flatten the cornea to measure eye pressure, he explains.

“Yearly eye exams are a general recommendation,” Dr. G’Sell notes. Some people need to get their eyes checked more often. “If you have diabetes, you should get checked every six months, if there’s retinal involvement.”

Even if you have 20/20 vision, it’s not a good idea to skip your yearly eye exam. You may have an undetected eye disease that’s causing damage to your eyes.

Research Your Family History

“Family history of glaucoma is a standard question, since there’s a genetic component to it,” says Dr. G’Sell.  But if your eye doctor doesn’t ask, be sure to bring it up.

If you don’t know, ask your siblings or parents. They might have glaucoma and never mentioned it. Or they may know about a grandparent who lost their eyesight from the disease.

The more information you have, the more you can share with your optometrist. If they know you’re at higher risk of glaucoma, they can monitor your eyes and prepare to take steps to slow the progression of the disease.

Be Mindful of Your Health

A major key to preventing glaucoma? “Take care of any other risk factors,” says Dr. G’Sell.

If you have diabetes or high blood pressure, make a plan with your healthcare provider for keeping them in control. If you want to take steps to prevent both these conditions, he says, “Eat healthy foods, exercise, and don’t smoke.”

Manage Glaucoma if You Get Diagnosed

Being diagnosed with glaucoma doesn’t mean you’ll definitely lose your eyesight.

“With treatment, you can stop it from progressing further,” says Dr. G’Sell.

That usually means lowering your eye pressure with medicated eye drops. “People will respond to the different eye drops in different ways,” says Dr. G’Sell. “Sometimes we have to use a combination of drops.”

That may take a couple of visits. Once your vision is stable, you’ll return to your optometrist for an exam every six months.

Between appointments, your job is to keep using those eye drops, and “not miss a dose,” Dr. G’Sell says. But that’s a small price to pay for keeping your vision.

Press play to see how glaucoma can affect your vision:

See our sources
Glaucoma overview: Centers for Disease Control and Prevention
Glaucoma facts: Glaucoma Research Foundation
Age and glaucoma risk: BrightFocus Foundation
Glaucoma risk factors: Glaucoma Research Foundation
How glaucoma affects Latinos: Centers for Disease Control and Prevention
How glaucoma affects African Americans: Glaucoma Research Foundation
Study on vision loss in Black glaucoma patients: Mount Sinai
Study on cigarette smoking and glaucoma risk: Eye
Study on myopia and glaucoma risk: American Journal of Ophthalmology