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March 2004

Does Sex Matter in Glaucoma?

Arch Ophthalmol. 2004;122(3):374-375. doi:10.1001/archopht.122.3.374

A publication by the Institute of Medicine, Washington, DC, entitled Exploring the Biological Contributions to Human Health: Does SexMatter?1 reported the potential influencethat sex plays in nonreproductive areas of biology. Certainly, it is wellestablished that women are more likely to develop autoimmune diseases suchas lupus erythematosus and that the recovery of language following a strokeis faster in women compared with men. However, not surprisingly, there wasno mention of ophthalmic diseases in this monograph. An editorial by Klein2 explored the potential influence that a patient'ssex may have on diseases such as macular degeneration and cataracts. In fact,she concluded that at least on a population basis, "the assumption (influenceof gender on ophthalmic diseases and therapy) . . . may be less important. . . than non-sex related genetic mechanisms. We may have more to learn by"lumping" the sexes than by dividing them."2(p429) Ultimately, genetic mechanisms may be most important when consideringglaucomatous diseases. However, given a number of reported factors that mayinfluence the glaucomatous process other than intraocular pressure, one iscompelled to question if the significant hormonal changes that a woman undergoesthroughout her life may indeed have an effect. Recent literature suggeststhat sex may be important at least as it relates to the onset of glaucomaand choice of therapy.