Purpose: To examine incident relationships between elevated intraocular pressure (IOP), open-angle glaucoma (OAG), and use of glaucoma medications with 5- year incident cataract. Design: Population-based cohort study. Participants: The Australian Blue Mountains Eye Study examined 3654 participants 21 mmHg in either eye were classified as having ocular hypertension (OH), as were non-OAG subjects with IOP < 22 mmHg using glaucoma medications. Wisconsin levels 4 to 5 were graded as nuclear cataract, at least 5% lens involvement was graded as cortical cataract, and any PSC defined its presence. Results: The 5- year incidence of nuclear cataract was 23.4% (592/2532), or 23.1% (574/2486) after excluding subjects using glaucoma medication. A marginally significant association was found for elevated IOP or OH at baseline and incident nuclear cataract (odds ratio [OR] 1.93 95% confidence interval (CI), 0.97- 3.89, and OR, 1.83 95% CI, 0.96- 3.48, respectively) in subjects not using glaucoma medications, after multivariate adjustment. Age-and gender-adjusted analyses showed similar but statistically significant associations. The association between elevated IOP or OH and nuclear cataract was signifi-cant in multivariate analyses (OR, 2.07 95% CI, 1.04- 3.12, and OR, 1.78 95% CI, 1.05- 3.01 , respectively). Use of glaucoma medications was associated with nonsignificantly increased adjusted odds for incident nuclear cataract (OR, 1.90 95% CI, 0.92- 3.92). No associations, however, were found with incident cortical cataract or PSC. Conclusions: Elevated IOP may increase the risk of nuclear cataract, but not that of other types. The use of glaucoma medications could magnify this risk.
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