Indian Journal of Ophthalmology

: 1965  |  Volume : 13  |  Issue : 4  |  Page : 127--129

Primary glaucoma and blood groups

MP Garg, JM Pahwa 
 Eye Hospital, Sitapur, India

Correspondence Address:
M P Garg
Eye Hospital, Sitapur

How to cite this article:
Garg M P, Pahwa J M. Primary glaucoma and blood groups.Indian J Ophthalmol 1965;13:127-129

How to cite this URL:
Garg M P, Pahwa J M. Primary glaucoma and blood groups. Indian J Ophthalmol [serial online] 1965 [cited 2021 Jan 22 ];13:127-129
Available from:

Full Text

In 1853 Von Arlt drew the atten­tion of the ophthalmic world to the heredity of primary glaucoma, but it is only in recent years that several workers Biro (1951), Kellerman and Posner (1955), have stressed its im­portance. Familial incidence in glaucoma has been seen and studied even upto 6 generations [Francois and collaberators (1950, 1961)]. Re­cent studies carried out by Patterson (1961) on the siblings of patients with simple glaucoma and by Miller and Patterson (1962) on their des­cendants sufficiently signifies that there is a marked hereditary factor in primary glaucoma. The fact that there might be only a single case in a family does not rule out heredity, because it is possible that it may be passed on as a recessive. Moreover mutation of genes has also to he taken into consideration. The gene­tic factor of glaucoma is confirmed by study of monozygotic twins. Westerlund (1947) and Agarwal (1964) In simple primary glaucoma, the first sign of the disease is the in­creased resistance to outflow of the aqueous due to trabecular obstruc­tion diagnosed by means of tono­graphy with the water drinking test, whereas in congestive glaucoma it is the narrowness of the irido-corneal angle seen by gonioscopy coupled with a positive response to the pro­vocative test to darkness, which determines the early stages.

Vol Dungern and Herszfeld (1910) first proved the hereditary nature of blood groups, when they found that agglutinogens A and B are inherited as Mandelian dominants.

Studies of blood groups have been carried out for malignant diseases, anemias, peptic ulcers, diabetes and even tuberculosis in order to establish a hereditary factor. Thus it has been found that the incidence of peptic ulcer is highest amongst group 0 whilst those carrying the agglutinogen A are more prone to cancer of the stomach (Aird et al 1953, 1954).

Besides the blood group, about 85 per cent of persons possess a group- specific A substance in their tissues which is secreted in the saliva, urine, tears, semen, gastric juice and milk. The remainder do not possess this ability. Persons in the two catago­ries are designated as 'secretors' and non-secretors.' The ability to secrete the group-specific substance is in­herited as a simple Mendelian domi­nant character, independent of the inheritance of blood groups or types. The chemical basis for the difference between the secretors and nonsecre­tors is due to the occurence of the group-specific substance in two forms. A lipoidal fraction is present in the body cells of all persons in the blood group. An additional water-soluble form occurs in the body fluids of secretors only and their secretions contain this substance.

 Aim and Objects

This study has been undertaken in order to find the existence of any relationship between the blood groups and the incidence of prima­ry glaucoma and their association if any, between secretors and non- secretors. Provided with evidence of the presence of a specific hereditary factor, help may thus be obtained to screen siblings and immediate des­cendents of these to suspect a glau­comatous tendency. (Dr. Gowin, Hardin and Alsever).

 Method and Material

100 cases of primary glaucoma (both open angle and narrow angle in various stages) who attended the glaucoma clinic in the Eye Hospital, Sitapur, were studied for their blood group and secretors nonsecretors types. No case of secondary glau­coma was included in this study.

The blood groups were done with the high titre grouping sera of A and B blood groups. The secretors and non secretors were classified after collecting the saliva of the patients. The saliva was put in a test tube with equal quantity of normal saline and the mixture was kept in boiling water for 20 minutes and then one drop of grouping sera and a drop of blood of the same patient was also placed and was examined for any agglutination. For classifying the secretors and non secretors of blood group 'O'-anti 'H' substance was used.


All the cases of primary glaucoma examined were chiefly between 3rd and 6th decades of life. The young­est one was 31 years and eldest one 76 years while 62 were males and 38 females.

They were of following varieties:-

1. Simple primary wide angle glaucoma: ... 56 cases.

2. Narrow angle glaucoma: ... 39 cases.

3. Could not be classified: 5 cases.

Out of 100 cases of primary glau­coma 45 belonged to group A, 30 belonged to group B, 19 belonged to group 0, while 6 were of group AB.[Table 1]

Further it was noticed that amongst 100 cases 69 belonged to non secretors type and 31 were secretors. It was also observed that the percentage of non-secretors was highest in the blood group A and B and least in Blood group AB.

From these findings it is apparent that primary glaucoma is more com­mon in secretors than in non secre­tors, the normal ratio being 15:85. This leads to a tentative conclusion which lends support to the theory that glaucoma is inherited as a Men­delian dominant.

Westerlund (1947) Posner and Schlossman (1949) accept a dominant heredity, but recent authors such as Waardenburg, (1950) Biro (1951), Robert (1952) Weekers et al (1955) and others have found a percentage of cases which showed recessive characteristics also.

The clue to these conflicting re­ports may well be in the nature of glaucoma itself. In the case of the narrow angle type, Barkan, Sugar and Tornquist have shown that the depth of the anterior chamber and the iridocorneal angles are inherited as genetic factors, thus we may be dealing with two different types of inheritance. Von Graefe, (1869)

Groenowe (1904), Bell (1938), Posner and Schlossman (1949) have drawn attention to the fact that within any family, glaucoma is generally of the same type; if one member has open glaucoma the other siblings, parents or children will also suffer from the the same type. Similarly for closed angle glaucoma.

Further we know that blood group substances are mucopolysaccharides and may be that persons with group substance A and B, have an increased amount of, or an altered form of, mucopolysaccharide in their trabe­cular tissue, which may account for the raised intra ocular tension in primary simple open angle glaucoma.

We must admit that this is just a preliminary report and we have ex­tended our study to examine blood groups in siblings and immediate des­cendants and relations of known glaucoma patients, and we think that this may be an additional source of help in our screening programme of early diagnosis of primary glaucoma. Similarly it may also help in differen­tiating some cases of primary and secondary glaucoma which clinically look similar.[20]


Primary glaucoma is very common in blood group A and B less common in group O and AB. It is also noted that the incidence of this disease is high in non secretors rather than secretors. It is hoped that determi­nation of such groups may help in the early diagnosis of primary glau­coma cases.


1Agarwal L. P. Madan Mohan, Malik S. R. and Gupta A.K. (1964) J. All. India Ophthal Soc. 12, 132.
2Aird T. (1953) B.M.J. 1, 759.
3 (1954) B.M.J. 11, 315.
4von. Ant C.G. (1853) Die Krankheiten des Auges fiir praktische Arzte. Vo. 12, p. 199 (as cited in 10).
5Bell Julia, (1933) The Treasury of Human Inheritance, Cambridge Uni­versity Press London.
6Bernstein (1924).
7Biro I. (1951), Ophthalmologica, 122, 228.
8von Dungern and Herszfeld (1910) Z. Immunoforsh., 6, 284.
9De Gowin, Hardin and Alsever ( ) Blood Transfusion p. 58.
10Frangoise J. (1961). Heredity in Oph­thalmology, p. 225 C. V. Mosby Co. St. Louis.
11Frangoise J. Deweer T. P. and Van­denburghe (1950) 1. Bull. Soc. beige Opht. 96, 665. (as cited in 10)
12Groenouw (1904); Graefe - Sae­misch's Hdb. des Augenh. 11, 464. (as cited in 10)
13Kellerman L. and Posner A. (1955) Amer. J. of Ophthal. 40, 681.
14Miller S. (1961), Trans Ophthal Soc. U.K. 81, 577.
15Miller S. J. H., and Patterson G. D. (1962). Brit. J. Ophthal. 46, 513.
16Patterson G. (1961). Trans Ophthal Soc. U.K. 81, 561
17Posner A. and . Schlossman A. (1949) Arch. of Ophthal 41, 125.
18Waardenburg P. J. (1950) Ophthal­mologica, 119, 250.
19Weekers R. Gougnard-Rion C. and Gougnard L. (1955) Bull Soc. Beige Opht. 110, 255 (cited in 10)
20Westerlund E. (1947) Clinical and Genetic Studies on Primary Glauco­mas (cited in 10)