# The Relationship of Menopause to the Onset of Glaucoma in Veterans

> **NIH VA I21** · VETERANS HEALTH ADMINISTRATION · 2024 · —

## Abstract

Glaucoma is the leading cause of irreversible blindness and is projected to affect 112 million people worldwide
by 2040. Unfortunately, Veterans have a 2-fold higher prevalence of developing glaucoma compared to the
general US population. While the exact cause of glaucoma is unknown, recent evidence has shown that early
menopause, mutations in estrogen receptors, and polymorphism mutations along the estrogen metabolic
pathway are linked to developing glaucoma. These data highlight that menopause, and particularly estrogen,
may play a role in the development of this disease. However, there is a gap in our knowledge of quantifying if
menopause, regardless of age, is related to the onset of glaucoma. It is vital to understand this relationship, as
59% of the glaucomatous population are women and the number of female Veterans has doubled over the last
ten years. In addition, nearly 43% of female Veterans are younger than 45 years old and will experience
menopause (average age at 51 years) within the next decade. The evidence of 1) a higher prevalence of
glaucoma in Veterans, 2) the increasing number of female Veterans, and 3) the aging of female Veterans will
make glaucoma a major health issue in the future for this population. The VA formed the Women’s Veterans
Health Research Network (WVHRN) to help focus attention on research and treatments for this portion of the
Veteran population, and this proposal aims to understand the association between menopause, a major life event
for women, and glaucoma.
In this proposal, we hypothesize that menopause is related to the onset of glaucoma and will use the power
of the national VA database to perform a retrospective study to address this hypothesis. We will examine medical
records from female U.S. Veterans in the corporate data warehouse (VINCI – VA Informatics and Computing
Infrastructure) between 2000-2019. Previous studies summarized the impact of age of menopause on
developing glaucoma in the general population. However, this has not been confirmed in the Veteran population
where glaucoma is more prevalent. In addition, no study has directly assessed whether there is a direct
relationship between menopause and the onset of glaucoma. The VA database is a unique resource that can
provide longitudinal care records of patients that will allow us to understand the relationship between the onset
of menopause and glaucoma and the overall incidence of glaucoma in female and male Veterans.
Although glaucoma can occur at any level of intraocular pressure (IOP), elevated IOP remains clinically relevant
as a major causal risk factor for developing this disease. Several studies have shown that postmenopausal
women taking hormone replacement therapy (HRT) containing estrogen had a lower IOP compared to
postmenopausal women not taking HRT. This has led researchers to suggest that estrogen-based therapies
may be a potential treatment for glaucoma. Based on our work and others, we hypothesize that hormone
replacement th...

## Key facts

- **NIH application ID:** 10797837
- **Project number:** 1I21RX004636-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Andrew J Feola
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10797837

## Citation

> US National Institutes of Health, RePORTER application 10797837, The Relationship of Menopause to the Onset of Glaucoma in Veterans (1I21RX004636-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10797837. Licensed CC0.

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