Second, adult-onset glaucoma follows a distinct polygenic architecture where <i>APOE</i> ε2 confers a near five-fold risk for primary angle-closure glaucoma (OR = 4.82), an effect absent or inconsistent in global datasets, and <i>NOS3</i> variants associate with primary open-angle glaucoma specifically in men, a sex-stratified signal unreported outside Saudi cohorts. This evidence concerns the gene APOE and primary angle-closure glaucoma.