Migraine and the risk of glaucoma: a systematic review and meta-analysis

Migraine and glaucoma are prevalent and burdensome conditions worldwide, yet the evidence linking them remains inconsistent. This systematic review and meta-analysis aimed to synthesize available evidence on their association and investigate sources of heterogeneity.

We comprehensively searched PubMed, Embase, and the Cochrane Library from inception to April 8, 2026, for cohort, case-control, and cross-sectional studies examining the migraine-glaucoma link. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was explored via subgroup, sensitivity, and meta-regression analyses. Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist. Publication bias was evaluated via funnel plots, Egger's test, and trim-and-fill analysis.

Nineteen studies involving 3,625,071 participants were incorporated. The pooled analysis demonstrated a significant positive association between migraine and glaucoma risk (OR = 1.28, 95% CI: 1.20-1.37), with moderate heterogeneity (I² = 46.2%). Subgroup analyses indicated stronger associations in studies from America, clinic-based settings, those using self-reported migraine diagnosis and those with higher female participant proportions (≥60%). Egger's test suggested potential publication bias. Following trim-and-fill adjustment (imputing eight potentially missing studies), the pooled estimate remained significant though slightly attenuated (OR = 1.23, 95% CI: 1.13-1.34).

This meta-analysis suggests migraine is associated with a significantly increased risk of glaucoma. While the association persisted directionally after adjusting for potential publication bias, its magnitude varied by data source, diagnostic method, and population characteristics. Further high-quality prospective studies employing standardized criteria are needed to elucidate causality and underlying mechanisms.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261367870, CRD420261367870.