Association of glaucoma and glaucoma treatments with cataract in the UK Biobank: a cross-sectional observational study

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BACKGROUND: Glaucoma and cataract are among the leading causes of visual impairment worldwide. Both are prevalent in older adults, but it remains unclear whether their association is independent of age and shared risk factors. AIM: To assess whether glaucoma and its treatments are independently associated with cataract odds using a population-based sample. METHODS: Cross-sectional analysis of UK Biobank participants recruited between 2006 and 2010. (Analysis completed in April 2026). Glaucoma and cataract were defined using self-report and International Classification of Diseases-codes from hospital and primary care records. Participants were grouped as no glaucoma, glaucoma with no recorded treatment, topical medications, laser procedures or glaucoma surgery. Multivariable logistic regression estimated cataract odds ratios (OR, 95% CI). Models adjusted for demographic variables, clinical comorbidities and ocular parameters. RESULTS: Among 497 109 adults, glaucoma was associated with higher odds of cataract (OR 3.09, 95% CI 2.73 to 3.49, p<0.01) in fully adjusted models. Odds were higher among those using topical glaucoma treatments (OR 3.14, 95% CI 2.54 to 3.89, p<0.01). Participants who had undergone glaucoma surgery had the highest odds of cataract (OR 12, 95% CI 8.99 to 16.2, p<0.01). Findings were consistent in sensitivity analyses using alternative case definitions. CONCLUSION: Glaucoma and its management were associated with increased odds of cataract, although the adjusted analysis for the first-line laser subgroup was limited by sample size and cannot be reliably estimated. Longitudinal studies are needed; if confirmed, the results may inform cataract surveillance and timing of operation, relevant in ageing populations.

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