TOPLINE: 

Adults aged 40 years or older with metabolic syndrome were more likely to have glaucoma than their peers, whereas those with higher BMI or larger waist circumference were less likely to have this eye condition.

METHODOLOGY: 

• In this cross-sectional analysis, researchers examined whether having obesity or metabolic syndrome was associated with the prevalence of glaucoma.
• They included 156,362 US adults aged 40 years or older (mean age, 59.94 years; 60.29% women) using data from a research program collected from May 2018 to January 2022.
• Obesity was measured using BMI categories (normal/underweight, < 25; overweight, 25-29.9; obese, ≥ 30 for non-Asian individuals, with lower thresholds for Asian individuals) and by central obesity on the basis of waist circumference (> 88 cm for women; > 102 cm for men).
• Metabolic syndrome was defined as having at least three of the following: central obesity, triglyceride levels of 150 mg/dL or more, low high-density lipoprotein cholesterol levels (< 40 mg/dL in men; < 50 mg/dL in women), blood pressure of 130/85 mm Hg or more, and elevated glucose levels (fasting ≥ 100 mg/dL; nonfasting ≥ 140 mg/dL); a metabolic syndrome severity score was also calculated.
• Researchers assessed the prevalence of glaucoma using diagnostic codes from electronic health records. They calculated odds of having glaucoma after adjusting for multiple variables.

TAKEAWAY: 

• Overall, 8640 adults (5.53%) were diagnosed with glaucoma.
• Adults with overweight and obesity were 20% and 21%, respectively, less likely to have glaucoma (P < .001 for both) than were those with normal weight or underweight.
• Adults with central obesity were 13% less likely to have glaucoma than those without (P < .001). Each 10 cm increase in waist circumference was associated with 3% lower odds of having glaucoma (P = .001).
• Adults with metabolic syndrome were 35% more likely to have glaucoma than those without the syndrome (P < .001). Each one-point increase in the metabolic syndrome severity score was associated with 19% higher odds of glaucoma (P < .001).

IN PRACTICE: 

The findings “can potentially serve as a foundation to recommend glaucoma screening in individuals with [metabolic syndrome] and encourage physicians to treat elements of [metabolic syndrome] for those at increased risk of having glaucoma,” the researchers reported.

SOURCE: 

The study was led by Megan Paul, MD, of Stanford Health Care, California. It was published online January 28, 2026, in the British Journal of Ophthalmology.

LIMITATIONS: 

The cross-sectional observational design of the study could not establish that overweight, obesity, or metabolic syndrome caused glaucoma. Glaucoma and other measures were identified from electronic health records and baseline data, which may have led to misclassification. Excluding participants with missing data may have introduced selection bias.

DISCLOSURES:

The study received support from Research to Prevent Blindness to the Department of Ophthalmology at University of California, Los Angeles. Researchers used data from All of Us Research Program, which is supported by several organizations. One author reported receiving the Research to Prevent Blindness Medical Student Fellowship Award, and another author reported receiving multiple awards. One author reported serving as a consultant for the Alcon Research Institute Foundation and Laboratoires Théa.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.