Will My Glaucoma Get Worse?
You've been diagnosed with glaucoma. The question keeping you up at night: how likely is this to progress? The answer depends on a combination of clinical factors, lifestyle, and your genetics. Here's what we know and what you can do about it.
The Reality of Glaucoma Progression
Not all glaucoma progresses at the same rate. Some patients remain stable for years with minimal treatment. Others experience faster-than-expected vision loss despite seemingly adequate IOP control. The difference often comes down to factors that aren't visible in a standard eye exam.
Studies show that even with treatment, roughly 15–20% of glaucoma patients experience significant progression within 5 years. The challenge is identifying which patients are at higher risk before damage occurs, not after.
This is why understanding your individual risk profile matters. It's not about living in fear — it's about giving your doctor the information they need to treat you as aggressively as your situation requires.
What Drives Progression?
Researchers have identified several factors that increase the likelihood of glaucoma worsening over time.
Elevated or Fluctuating IOP
High intraocular pressure remains the strongest modifiable risk factor. Large daily fluctuations can be just as harmful as sustained high pressure.
Genetics
Research shows that glaucoma has a strong hereditary component. Having a first-degree relative with glaucoma increases your risk 4–10x.
Age & Ancestry
Risk increases with age. People of African, Hispanic, and East Asian descent face higher progression rates for certain glaucoma types.
Thin Central Corneas
Thinner corneas are associated with faster progression and can cause IOP readings to appear lower than they actually are.
Low Ocular Perfusion Pressure
Poor blood flow to the optic nerve, often linked to low blood pressure or cardiovascular disease, can accelerate damage even at normal IOP.
Late Diagnosis or Advanced Stage
Patients diagnosed at a later stage with existing visual field loss tend to progress faster than those caught early.
The Missing Piece: Your Genetic Risk
Your doctor can measure your IOP, examine your optic nerve, and test your visual fields. But there's one major factor that no eye exam can measure: your genetic predisposition to progression.
Genome-wide association studies have identified hundreds of genetic variants linked to glaucoma. Individually, each variant has a small effect. But when analyzed together as a polygenic risk score (PRS), they paint a powerful picture of your inherited susceptibility.
This is exactly what SightScore™ does. Using a simple at-home saliva test, SightScore™ analyzes over 7 million genetic variants and places you on a risk percentile scale. A patient in the 90th percentile has a meaningfully different risk profile than someone in the 30th — and that distinction can change how your doctor approaches your care.
SightScore™ Risk Percentile Scale
Lower Risk
0–20th percentile
Below-average genetic predisposition
Average Risk
20th–70th percentile
Population-average genetic risk
Elevated Risk
70th–90th percentile
Above-average genetic predisposition
High Risk
90th–100th percentile
Highest genetic predisposition
Why this matters after diagnosis
If you're already diagnosed, SightScore™ isn't about telling you that you have glaucoma — you already know that. It's about answering the next question: how aggressively should we treat it? A high genetic risk score may prompt your doctor to target a lower IOP, consider earlier surgical intervention, or increase monitoring frequency.
What You Can Do About It
A glaucoma diagnosis is not a sentence — it's a starting point. The patients who preserve the most vision are the ones who take an active role in their care.
Know Your Genetic Risk
SightScore™ analyzes over 7 million genetic variants to place you on a percentile scale for progression risk — giving you and your doctor data that no eye exam alone can provide.
Learn about SightScore™Monitor IOP at Home
Office visits capture one snapshot. The iCare HOME2 tonometer reveals your full daily IOP pattern — including nighttime spikes that happen in up to 50% of patients.
Explore home monitoringWork Closely with Your Doctor
Share your SightScore™ report and home IOP data with your ophthalmologist. Together you can set a personalized target pressure and adjust treatment proactively.
See how it worksGenetics + Monitoring = Complete Picture
SightScore™ tells you how much risk you carry. The iCare HOME2 shows you what your pressure is doing right now. Together, they give your ophthalmologist the full context to make the best treatment decisions for your eyes.
SightScore™
- One-time saliva test ($449)
- Lifetime genetic risk profile
- Family risk insights
iCare HOME2
- Rent from $249/week
- Real-time IOP data, day and night
- Ambassador-supported onboarding
Common Questions
Does having glaucoma mean I will go blind?
No. With proper treatment and monitoring, most people with glaucoma maintain functional vision throughout their lives. The key is early detection, consistent treatment, and knowing your individual risk level so you and your doctor can intervene before significant damage occurs.
What does "progression" actually mean?
Progression means measurable worsening of optic nerve damage or visual field loss over time. It can be detected through imaging (OCT), visual field testing, and IOP trends. Some patients progress slowly over decades; others can lose vision more quickly without treatment adjustments.
How does SightScore™ predict progression risk?
SightScore™ uses a polygenic risk score (PRS) built from genome-wide association studies. It analyzes over 7 million genetic variants associated with glaucoma development and progression. Your result is a risk percentile — for example, being in the 90th percentile means your genetic predisposition is higher than 90% of the population. This information helps your doctor tailor how aggressively to treat and how often to monitor.
Can I lower my risk of progression?
You cannot change your genetics, but you can act on what they tell you. Lowering IOP through medication, laser (SLT), or surgery is proven to slow progression. Home monitoring helps ensure your treatment is working around the clock. Lifestyle factors like exercise, avoiding smoking, and managing blood pressure also play a role.
I was just diagnosed. Should I get SightScore™?
Yes — this is one of the most valuable times to test. Knowing your genetic risk early helps your ophthalmologist decide how aggressively to treat from the start. Patients in the highest risk percentiles may benefit from earlier surgical intervention or more frequent monitoring rather than a watch-and-wait approach.
Don't Wonder — Know Your Risk
SightScore™ gives you the genetic insight your eye exam can't. Pair it with home IOP monitoring for the most complete picture of your glaucoma risk.