Statins tied to lower glaucoma risk, fewer surgeries

Clinical takeaway: Statin use was associated with a modestly lower risk of developing open-angle glaucoma and fewer surgeries and laser procedures among patients with established disease. These findings suggest a potential eye benefit for patients already taking statins for cardiovascular indications, but do not establish that statins preserve vision or justify prescribing them specifically for glaucoma.

Glaucoma can progress despite treatment to lower intraocular pressure, prompting interest in therapies that might also protect the optic nerve. Statins have potential neuroprotective effects, but previous studies of their relationship with glaucoma have yielded inconsistent results.

A retrospective study published in the British Journal of Ophthalmology linked statin use to fewer new open-angle glaucoma diagnoses and less treatment escalation among patients with established disease.

Using electronic health records, researchers compared adults older than 40 years with recorded statin use against matched nonusers. The incidence analysis included 210,701 patients in each group, all with ophthalmology follow-up.

Over five years, glaucoma was diagnosed in 2.3% of statin users versus 2.6% of nonusers. Statin use was associated with a 15% lower hazard of diagnosis.

A separate analysis included 29,598 patients with existing glaucoma in each matched group. At five years, incisional glaucoma surgery occurred in 2.1% of statin users versus 3.4% of nonusers, corresponding to a 36% lower hazard.

Statin use was also associated with 55% and 60% lower hazards of minimally invasive glaucoma surgery and selective laser trabeculoplasty, respectively, and an 11% lower hazard of pressure-lowering eye-drop prescriptions. Associations persisted at ten years.

The findings raise the possibility that a widely used cardiovascular medication could also benefit patients at risk for glaucoma or with established disease. However, the study lacked eye-pressure measurements, visual-field results, and reasons for surgery, so fewer procedures cannot establish slower disease progression. Randomized trials that measure visual outcomes are needed to determine whether statins have a role alongside pressure-lowering treatment.

Source: Lin F, et al. (2026 Oct 6) Br J Ophthalmol. Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation