FORT WAYNE, Ind. (WOWO) — A medication widely prescribed for erectile dysfunction and symptoms associated with an enlarged prostate has been linked to a higher risk of glaucoma, according to a large new study of nearly 74,000 men. Researchers found men taking tadalafil — sold under the brand nam e Cialis — were 22% more likely to develop glaucoma over a period of up to five years than comparable men who were not taking drugs in the same class. The study, published in the British Journal of Ophthalmology, also found tadalafil users were 32% more likely to develop ocular hypertension, or elevated pressure inside the eye, and 33% more likely to develop primary open-angle glaucoma, the most common form of the disease. They were also 33% more likely to begin treatment for glaucoma. The findings do not establish that tadalafil causes glaucoma, and researchers are not advising patients to stop taking the medication because of the study. Instead, the researchers say the results support baseline eye examinations and continued monitoring, particularly for people already at elevated risk of glaucoma or those taking tadalafil over the long term. Tadalafil belongs to a class of medications called phosphodiesterase type 5 inhibitors, or PDE5 inhibitors. The class also includes sildenafil, the active ingredient in Viagra. Tadalafil is commonly used to treat erectile dysfunction, but it is also prescribed as a daily medication for lower urinary tract symptoms associated with benign prostatic hyperplasia, or an enlarged prostate. Those symptoms can include urinary urgency, increased frequency and difficulty emptying the bladder. Researchers from Taiwan and collaborating institutions wanted to investigate tadalafil’s potential relationship with glaucoma because previous evidence concerning PDE5 inhibitors and the disease has been inconsistent, particularly when tadalafil is used on a long-term basis for urinary symptoms. The research team examined anonymized medical records from the TriNetX Global Collaborative Network. The study included 73,854 men at least 40 years old who had lower urinary tract symptoms. About half — 36,927 men — had been prescribed tadalafil or another PDE5 inhibitor, while an equal number had not been prescribed a PDE5 inhibitor. The groups were matched using a range of characteristics that could influence glaucoma risk, including age, ethnicity, smoking and alcohol-related conditions, cardiovascular disease, diabetes, high cholesterol, obesity, kidney disease, chronic obstructive pulmonary disease and other medications. The researchers followed the patients for up to five years and examined whether they developed glaucoma, ocular hypertension or required glaucoma treatment. The tadalafil group had a hazard ratio of 1.22 for glaucoma, meaning the researchers calculated a 22% higher relative risk compared with the matched group that was not using PDE5 inhibitors. The increased association remained after researchers excluded patients who developed glaucoma soon after beginning tadalafil, according to the study report. The study did not find significant associations between tadalafil and some other forms of glaucoma, including low-tension glaucoma and primary angle-closure glaucoma. Glaucoma is particularly concerning because it can develop without obvious symptoms in its early stages. Damage to the optic nerve can progressively affect peripheral vision and, once vision is lost because of glaucoma, that damage is generally irreversible. Dr. Valerie Kattouf, an optometrist with the Illinois Eye Institute who was not involved in the research, told Fox News Digital that glaucoma can be difficult to detect early because patients may not notice changes in their vision. “Glaucoma is an eye condition that especially in its early stages often does not present with visual symptoms,” Kattouf said. Kattouf said a comprehensive eye examination is the best way to identify clinical signs of glaucoma. She also identified several factors that can increase a person’s risk, including a family history of glaucoma, elevated pressure inside the eye and severe nearsightedness. She said people taking Cialis every day for an extended period may warrant closer monitoring. Researchers likewise emphasized that the findings should not be interpreted as a recommendation for patients to discontinue tadalafil. The study’s authors described the increase in glaucoma risk as statistically significant but modest and said their findings do not contraindicate tadalafil use. Instead, they recommended considering baseline ophthalmic assessment and regular follow-up, particularly for patients with existing glaucoma, ocular hypertension, a family history of glaucoma, high myopia or a need for long-term therapy. There are important limitations to the research. Because the study was observational and based on existing medical records, researchers could identify an association between tadalafil use and glaucoma but could not demonstrate a cause-and-effect relationship. Patients were not randomly assigned to take tadalafil or a placebo. Researchers also said they could not fully account for changes in medication use or medical conditions that occurred during the follow-up period. That distinction is important because a 22% increase in relative risk does not mean 22% of tadalafil users will develop glaucoma. The study measures how the likelihood compared between the two matched groups. The findings also come amid conflicting research into the relationship between PDE5 inhibitors and eye disease. Previous studies have investigated possible links between drugs such as tadalafil and sildenafil and problems involving the optic nerve and macula, but evidence concerning glaucoma has remained limited and inconsistent. For men who take tadalafil regularly, researchers say the practical takeaway is awareness rather than alarm. A routine comprehensive eye examination can measure pressure inside the eye and evaluate the optic nerve and other structures for signs of glaucoma. Establishing a baseline can also give an eye-care professional something to compare against during subsequent examinations. And because glaucoma can progress without noticeable symptoms, waiting for a change in vision is not necessarily the best strategy for someone with significant risk factors. The study’s authors say additional research is needed to determine whether tadalafil itself contributes to glaucoma development and, if so, how the drug might affect the eye. For now, the new findings add another reason for physicians and patients to discuss eye health when considering long-term tadalafil therapy — particularly when other glaucoma risk factors are already present. 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