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Association Between Strabismus and Risk of Open-Angle Glaucoma: A Multicenter Retrospective Cohort Study
Chen-Ya Hung1, Shu-Han Chuang2, Bing-Hua Lin3
1School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
Journal of Clinical Medicine
|August 13, 2026
Summary
Strabismus in older adults did not increase the risk of open-angle glaucoma (OAG) or ocular hypertension (OHT). However, antiglaucoma agent initiation was lower in patients with strabismus.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Public Health
Background:
- Strabismus is a common ophthalmic condition in older adults.
- The association between strabismus and glaucoma risk is not well-established.
- Evaluating this association is crucial for understanding glaucoma development in aging populations.
Purpose of the Study:
- To investigate the longitudinal relationship between strabismus and the risk of developing open-angle glaucoma (OAG).
- To assess the association with ocular hypertension (OHT), antiglaucoma agent (AGA) initiation, and OAG interventions.
- To analyze these risks in individuals aged 65 years and older.
Main Methods:
- A multicenter retrospective cohort study was conducted using the TriNetX US Collaborative Network (2003-2022).
- Patients aged 65+ with strabismus were propensity score matched to controls without strabismus.
- Cox models and Kaplan-Meier analyses estimated 3-year risks, with lag-time and subtype analyses performed.
Main Results:
- In a cohort of 20,894 matched patients per group, strabismus was not linked to increased 3-year risks of OAG, OHT, or OAG interventions.
- Antiglaucoma agent initiation was significantly lower in the strabismus cohort (HR=0.629).
- Findings remained consistent across various analytical approaches.
Conclusions:
- First-diagnosed strabismus in older adults is not associated with an elevated risk of OAG, OHT, or related interventions.
- Glaucoma screening should continue to be individualized based on established risk factors.
- Further research may explore the mechanisms behind reduced AGA initiation in strabismus patients.
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