Glaucoma

I spend an enormous amount of my professional time treating glaucoma.  When I graduated, a senior private practice doctor asked me if they had taught me anything about a connection between cardiac health and glaucoma.  I admitted they had not.  But I promised to research it.  A year later, our office had started a project to contact every patient that had never returned for a follow-up of any type, and inquire about why they had chosen not to return.  Much to my shock, many of the people I had identified as a glaucoma suspect, did not return for follow-up for one very important reason.
They had died.

Fast forward 20 years.  A study recently published in Arch of Ophth concluded that patients who were placed on a glaucoma medication experienced a 74% improvement in mortality.  Wow.

I have observed that young patients who present with high IOP commonly have multiple bypass surgery within a couple of years. When I have such a patient, I send them for a full cardiac workup.  But since they do not meet typical screening criteria, the referral is not taken seriously.  We know that in a heart attack, enzymes, which we use as markers, are released and detectable in the blood stream.  Perhaps when the heart is under stress, the same or other factors are released that influence IOP?  Someone needs to find out.