Consider family history of glaucoma before genetic testing, counseling
Though genetic testing can identify some types of glaucoma, risk assessment and counseling based on family history is more helpful for most patients than genetic testing, said Wallace L.M. Alward, MD.
Iowa City, IA-Though genetic testing can identify some types of glaucoma, risk assessment and counseling based on family history is more helpful for most patients than genetic testing, said Wallace L.M. Alward, MD.
“There are a lot of genetic risk factors for glaucoma coming out of family studies and genome-wide association studies,” said Dr. Alward, professor and Frederick C. Blodi Chair in Ophthalmology and director, glaucoma service, University of Iowa Carver College of Medicine, Iowa City, IA. “Those associations are very useful for understanding the biology of glaucoma, but only in very rare occasions is it clinically useful to test for any of those mutations. For the vast majority of glaucoma, we don’t know the genetic underpinning of the disease.”
A positive family history of glaucoma remains the single most important factor when it comes to counseling and, for a very few patients, genetic testing, he noted.
Every physician should be soliciting family history from every patient, Dr. Alward said. In ophthalmology, patients with a positive family history for glaucoma should be counseled that they may be at increased risk for the disease themselves. Children of glaucoma patients may similarly be at increased risk for developing glaucoma.
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