Association between Exercise Intensity and Glaucoma in the National Health and Nutrition Examination Survey

Ophthalmol Glaucoma. 2020 Sep-Oct;3(5):393-402. doi: 10.1016/j.ogla.2020.06.001. Epub 2020 Jun 7.


Purpose: To examine the association between exercise intensity and glaucoma in the National Health and Nutrition Examination Survey (NHANES) population.

Design: Retrospective, cross-sectional study.

Participants: Adult participants of the 2005-2006 NHANES aged 40 years and older.

Methods: Objective exercise intensity was assessed based on measurements from accelerometers worn by participants over 1 week. Subjective exercise intensity was assessed with questionnaire responses. Glaucoma was defined with 2 definitions based on (1) the Rotterdam criteria and (2) ophthalmologist grading of optic disc photographs for characteristic features of glaucoma. Covariates included age, gender, ethnicity, blood pressure, body mass index, and spherical equivalent. Logistic regression was performed to assess associations between objective and subjective exercise intensity and glaucoma while controlling for all covariates. All data were weighted based on the NHANES multistage sampling design.

Main outcome measures: Prevalence of glaucoma based on the 2 definitions described.

Results: The study included a sample of 1387 participants, of whom 68 (4.9%) had glaucoma based on Rotterdam criteria and 7 (0.5%) had glaucoma based on disc image grading. This translated to a weighted estimate of 70 246 160 individuals, with an estimated prevalence of glaucoma of 3.1% based on the Rotterdam criteria and 0.3% based on disc image grading. After adjusting for covariates, each 10-count increase in accelerometer intensity was associated with decreased odds of glaucoma using both criteria (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95-0.99 for Rotterdam; OR, 0.90; 95% CI, 0.85-0.95 using disc image grading). With Rotterdam criteria, participants who spent the day standing or walking versus sitting had 58% decreased odds of glaucoma (OR, 0.42; 95% CI, 0.25-0.70). With disc image grading, participants who performed moderate amounts of vigorous activity had 95% decreased odds of glaucoma compared with those who performed no vigorous activity (OR, 0.05; 95% CI, 0.01-0.56).

Conclusions: In the 2005-2006 NHANES adult population, increased exercise intensity is associated with decreased odds of glaucoma. Further population-based studies are needed to examine associations between additional aspects of exercise and glaucoma.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Disease Progression
  • Exercise / physiology*
  • Female
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • Prevalence
  • Retrospective Studies
  • Visual Fields / physiology*