'Good' cholesterol may be linked to an increased risk of glaucoma in individuals over 55, while, paradoxically, 'bad' cholesterol may be associated with a lower risk. These findings challenge conventional beliefs about factors that may help or harm eye health.
Paradoxically, "bad" (LDL) cholesterol, often associated with negative health effects, may be associated with a lower risk of developing this serious eye condition. Glaucoma damages the optic nerve and can lead to irreversible vision loss or blindness.
The findings challenge received wisdom about what may help and hinder eye health, and suggest that a rethink may be needed of how patients with high blood fats and who are at risk of glaucoma, are treated, say the researchers.
Understanding Glaucoma and Risk Factors
Glaucoma is projected to affect around 112 million people by 2040. Risk factors include age, ethnicity, the build-up of pressure within the eye (IOP), and family history, explain the researchers.
Abnormally high levels of circulating fats (lipids) in the bloodstream have been linked to eye conditions, such as macular degeneration and diabetic retinopathy. Recently published research has also implied a link with glaucoma, but the findings have been inconsistent, and it's not clear which type of lipid might be most influential, they add.
To strengthen the evidence base, the researchers drew on 400,229 participants aged 40 to 69 in the UK Biobank Study. They had all filled in a questionnaire, been interviewed, and had undergone a standard panel of blood tests, including those to measure blood fats.
Their health was tracked for an average of 14 years, during which time 6868 (nearly 2%) of them developed glaucoma.
Compared with participants who didn't develop glaucoma, those who did, tended to be older, and of non-White ethnicity. They had higher HDL, but lower LDL, cholesterol, and a higher waist-to-hip ratio (indicative of central obesity).
They were also more likely to be ex-smokers, and to be taking statins, and they had a higher prevalence of diabetes, high blood pressure, and cardiovascular disease.
Those with the highest level of HDL cholesterol in their bloodstream were 10% more likely to develop glaucoma than those with the lowest level, with every (standard deviation) increase associated with a 5% higher risk.
Similarly, participants with the highest levels of LDL cholesterol and triglycerides were 8% and 14%, respectively, less likely to develop glaucoma than those with the lowest levels.
And each (standard deviation) increase in LDL cholesterol, total cholesterol, and triglycerides lowered the risks by 4%, 3%, and 4%, respectively.
Age and Other Factors Influence the Findings
But these observed associations only persisted among those older than 55, with no significant association seen in those aged 40–55; the findings were also influenced by sex and type of glaucoma.
The researchers drew up a polygenic risk score—a number that provides a personalized measure of genetic susceptibility to diseases by combining genetic risk information from across the genome.
This showed that each additional genetic risk was associated with 5% higher odds of developing glaucoma. But there were no significant individual associations between LDL cholesterol, total cholesterol, or triglycerides and glaucoma.
This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. And the researchers acknowledge various limitations to their findings, including that blood samples weren't taken after fasting and only at a single time point.
The findings might also not be applicable to other ethnic groups, as UK Biobank participants are predominantly of European ancestry.
But they suggest: "These findings challenge existing paradigms about 'good' and 'bad' cholesterol in relation to eye health. This could prompt a re-evaluation of lipid management strategies in patients at risk for glaucoma."
And they conclude: "HDL cholesterol has been regarded as the 'good cholesterol' for seven decades. However, this study demonstrates that high levels of [it] are not consistently associated with a favorable prognostic outcome. Further studies are needed to investigate the mechanisms behind these associations."
Reference: "Associations between serum lipids and glaucoma: a cohort study of 400 229 UK Biobank participants" by Yiyuan Ma, Yue Wu, Leyi Hu, Wen Chen, Xinyu Zhang, Danying Zheng, Nathan Congdon, Guangming Jin and Zhenzhen Liu, 4 February 2025, British Journal of Ophthalmology.
DOI: 10.1136/bjo-2024-326062
News
Can introducing peanuts early prevent allergies? Real-world data confirms it helps
New evidence from a large U.S. primary care network shows that early peanut introduction, endorsed in 2015 and 2017 guidelines, was followed by a marked decline in clinician-diagnosed peanut and overall food allergies among [...]
Nanoparticle blueprints reveal path to smarter medicines
Lipid nanoparticles (LNPs) are the delivery vehicles of modern medicine, carrying cancer drugs, gene therapies and vaccines into cells. Until recently, many scientists assumed that all LNPs followed more or less the same blueprint, [...]
How nanomedicine and AI are teaming up to tackle neurodegenerative diseases
When I first realized the scale of the challenge posed by neurodegenerative diseases, such as Alzheimer's, Parkinson's disease and amyotrophic lateral sclerosis (ALS), I felt simultaneously humbled and motivated. These disorders are not caused [...]
Self-Organizing Light Could Transform Computing and Communications
USC engineers have demonstrated a new kind of optical device that lets light organize its own route using the principles of thermodynamics. Instead of relying on switches or digital control, the light finds its own [...]
Groundbreaking New Way of Measuring Blood Pressure Could Save Thousands of Lives
A new method that improves the accuracy of interpreting blood pressure measurements taken at the ankle could be vital for individuals who are unable to have their blood pressure measured on the arm. A newly developed [...]
Scientist tackles key roadblock for AI in drug discovery
The drug development pipeline is a costly and lengthy process. Identifying high-quality "hit" compounds—those with high potency, selectivity, and favorable metabolic properties—at the earliest stages is important for reducing cost and accelerating the path [...]
Nanoplastics with environmental coatings can sneak past the skin’s defenses
Plastic is ubiquitous in the modern world, and it's notorious for taking a long time to completely break down in the environment - if it ever does. But even without breaking down completely, plastic [...]
Chernobyl scientists discover black fungus feeding on deadly radiation
It looks pretty sinister, but it might actually be incredibly helpful When reactor number four in Chernobyl exploded, it triggered the worst nuclear disaster in history, one which the surrounding area still has not [...]
Long COVID Is Taking A Silent Toll On Mental Health, Here’s What Experts Say
Months after recovering from COVID-19, many people continue to feel unwell. They speak of exhaustion that doesn’t fade, difficulty breathing, or an unsettling mental haze. What’s becoming increasingly clear is that recovery from the [...]
Study Delivers Cancer Drugs Directly to the Tumor Nucleus
A new peptide-based nanotube treatment sneaks chemo into drug-resistant cancer cells, providing a unique workaround to one of oncology’s toughest hurdles. CiQUS researchers have developed a novel molecular strategy that allows a chemotherapy drug to [...]
Scientists Begin $14.2 Million Project To Decode the Body’s “Hidden Sixth Sense”
An NIH-supported initiative seeks to unravel how the nervous system tracks and regulates the body’s internal organs. How does your brain recognize when it’s time to take a breath, when your blood pressure has [...]
Scientists Discover a New Form of Ice That Shouldn’t Exist
Researchers at the European XFEL and DESY are investigating unusual forms of ice that can exist at room temperature when subjected to extreme pressure. Ice comes in many forms, even when made of nothing but water [...]
Nobel-winning, tiny ‘sponge crystals’ with an astonishing amount of inner space
The 2025 Nobel Prize in chemistry was awarded to Richard Robson, Susumu Kitagawa and Omar Yaghi on Oct. 8, 2025, for the development of metal-organic frameworks, or MOFs, which are tunable crystal structures with extremely [...]
Harnessing Green-Synthesized Nanoparticles for Water Purification
A new review reveals how plant- and microbe-derived nanoparticles can power next-gen water disinfection, delivering cleaner, safer water without the environmental cost of traditional treatments. A recent review published in Nanomaterials highlights the potential of green-synthesized nanomaterials (GSNMs) in [...]
Brainstem damage found to be behind long-lasting effects of severe Covid-19
Damage to the brainstem - the brain's 'control center' - is behind long-lasting physical and psychiatric effects of severe Covid-19 infection, a study suggests. Using ultra-high-resolution scanners that can see the living brain in [...]
CT scan changes over one year predict outcomes in fibrotic lung disease
Researchers at National Jewish Health have shown that subtle increases in lung scarring, detected by an artificial intelligence-based tool on CT scans taken one year apart, are associated with disease progression and survival in [...]
