Glaucoma affects a wide swathe of the elderly population, but its prevalence is greater in some non-Caucasian cohorts. It’s known to be approximately three to four times more common in the African-American population than in those of European ancestry.¹ Some research speculates that these differences are connected to biological features, like thinner corneas or larger optic nerves.

The distinction holds for response to therapy as well. A study published in the American Journal of Ophthalmology finds a new hormone therapy can reduce the risk of incident open-angle glaucoma among black women.² The hormone therapies under examination included estrogen monotherapy and a combination of estrogen and progesterone. The study linked Medicare claims data to 25,535 women in the Women’s Health Initiative and divided them into four groups:

1. Women post-hysterectomy who would receive an oral conjugated equine estrogens (CEE).
2. Women post-hysterectomy who would receive a placebo.
3. Women without a hysterectomy who would receive oral CEE and medroxyprogesterone acetate.
4. Women without a hysterectomy who would receive placebo.

Overall, the hormone therapies did not reduce the risk of open-angle glaucoma in all patients. When the data were modified to include only black women in the hysterectomized group who received the estrogen (but not a combination of estrogen and progesterone) therapy, the benefits were significant.

This therapy may be in the early stages of development and may only impact a single cohort of patients, but any risk factor reduction must be seen as a victory for eye care.