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Does Lithium Lower the Risk of Glaucoma-A Danish Nationwide Study
Tomas Hajek1, Orestes Forlenza2, Marcelo Nicolela3
1Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Acta Psychiatrica Scandinavica
|July 4, 2025
Summary
Lithium (Li) prescriptions were linked to an increased glaucoma risk in the general population, but not in individuals with bipolar disorder (BD). Some higher cumulative Li exposures may offer protection against glaucoma.
Area of Science:
- Ophthalmology
- Neuroscience
- Psychiatry
Background:
- Glaucoma involves neurodegenerative loss of retinal ganglion cells (RGCs).
- Mechanisms of RGC death overlap with those in bipolar disorder (BD) and are targeted by lithium (Li).
Purpose of the Study:
- To investigate the association between lithium prescriptions and the risk of developing glaucoma.
- To explore potential links between lithium use and glaucoma in a large population cohort.
Main Methods:
- A nationwide, register-based, historical prospective cohort study in Denmark.
- Inclusion of over 7.6 million individuals aged 18+ from 1996-2019.
- Follow-up for glaucoma diagnosis and analysis of lithium prescription data.
Main Results:
- Lithium exposure was associated with an increased glaucoma risk in the general population (HR=1.10).
- This association was not observed in individuals with bipolar disorder (HR=1.07).
- Higher cumulative lithium dosages (365-5x365 DDDs) showed a reduced risk of glaucoma compared to no or single prescriptions.
Conclusions:
- Bipolar disorder, indicated by lithium prescription, correlates with a higher glaucoma risk.
- While not a clear dose-response, higher cumulative lithium exposure may be protective against glaucoma compared to single prescriptions.
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