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Green et al. (2) report that 60% of primary open angle glaucoma (POAG) in Tasmania is familial (i.e., present in at least one fourth-degree or closer relation). This confirms previous studies that have documented not only a strong familial association with POAG, but also hereditability of intraocular pressure and cup:disc ratio. The authors recommend that
First-degree relatives of those with diagnosed glaucoma are at substantially increased risk of having POAG. Even more distant relatives are at increased risk of POAG as wellscreening for POAG include efforts to examine relatives of those with glaucoma since nearly 40% of those with POAG in Tasmania had a first degree relative with POAG.
This study relied on history and used a convenience cohort of twins as a control group, both of which may have introduced biases in recall and ascertainment. The study also took place on Tasmania, a relatively secluded island that may have larger founder effects than would be seen in other locations. Whether the associations are of the same magnitude in other ethnic groups cannot be de-termined. This study supports the need to look carefully at first degree relatives of those with diagnosed glaucoma as they are at substantially increased risk of having POAG. Furthermore, it demonstrates that even more distant relatives are at increased risk of POAG as well.