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This article will help you make sensible, researched, and clinically based decisions to support optic nerve health with recommendations that include Western herbs, nutritional supplements, Chinese medicine, and additional therapies. You will learn about the underlying causes of glaucoma and be given tools and techniques to develop eye health strategies.

The primary goal of this article is to offer a practical approach, based on the underlying philosophy that emphasizes prevention and support. In doing so, we celebrate the healing power within all of us and the mind/body’s inherent potential for self-healing.

What Is Glaucoma?

Glaucoma is a symptom-free condition that is thought to be caused by damage to the optic nerve, which robs the patient of peripheral vision and can cause blindness. It is often referred to as the “silent thief.” More than three million people in the United States have glaucoma, 2.7 million people of whom have the most common form, open-angle glaucoma. The number is expected to increase to over four million by 2030. African Americans have the highest prevalence rate (3.4%), followed by other races (2.1%), whites (1.7%), and Hispanics (1.5%).¹

Glaucoma can be difficult to detect without a regular eye exam until a significant amount of vision is lost. The reason it is so dangerous is that most people with glaucoma have no symptoms. Many feel no pain, and most have 20/20 visual acuity, although possibly only straight-ahead vision. But left untreated, glaucoma can slowly steal your peripheral vision until you think you are peering through a tunnel (at best) or until you go blind (at worst). Most frightening, 70% of the vision lost to glaucoma occurs before diagnosis. Glaucoma may be due to the result of the loss of retinal ganglion cells and axons (nerve cells that pass along information) in the optic nerve and retina.² Thinning of the optic nerve may occur as well.

Neurodegeneration

Researchers now view glaucoma as a disease of the brain (a neurodegenerative disease) rather than simply an eye disease. Recent research has shown that the complex connection between the eye and the brain is an important key to the disease. The retina and optic nerve are both made up of brain tissue and are part of the brain. Glaucoma shares a number of features with degenerative brain diseases such as Alzheimer’s, Parkinson’s, and Lou Gehrig’s disease. In these diseases, age and family history are major risk factors, and specific areas of the brain are damaged over time.

In glaucoma, changes occur in the back of the eyes. The optic nerve continues to be a focus for researching the underlying causes of glaucoma. Whether due to mechanical trauma, decreased blood flow, or other causes, optic nerve axon injury causes changes in retinal ganglion cells, eventually resulting in cell death. Researchers have observed that specific areas of injured optic nerve axons and retinal ganglion cell loss match the peripheral vision damage from glaucoma.³

Neuroinflammation

Glaucoma, especially if acute, may be largely an inflammatory condition. Researchers believe that high intraocular pressure triggers an inflammatory response.⁴ In experiments, inflammation occurs in the central nervous system and at early stages of glaucoma. Inhibiting the process through which inflammation develops appears to protect the neurons from damage.⁴ Investigations of the precise role of neuroinflammation in causing glaucoma are on-going. Cells known as microglia behave like sensors to damage the nervous system and play a role in the inflammatory response. The process contributes to beta-amyloid accumulations, implicated in Alzheimer’s disease. Similarly, the eye, actually part of the brain, also accumulates beta-amyloid in the retina and optic nerve. Microglia activity and the inflammatory response are linked to protein clumping and nerve cell degeneration.⁵

Oxidative Stress

Increased oxidative stress is a risk factor. Antioxidant drugs and nutrients that reduce enzymes involved in oxidation are reported to be helpful in animals with glaucoma. Although targeting intraocular pressure (IOP) has been a prime therapy, researchers are increasingly looking to antioxidants to target oxidative stress.⁶ Damage to DNA in the tissue layers that regulate aqueous humor outflow is linked to oxidative damage, damage to neurons, and to the optic nerve.^7,8

Causes and Risk Factors

Genetics. There is a strong genetic correlation related to the onset of glaucoma.^9-12

High blood pressure. Although high blood pressure is not a direct cause of glaucoma, many studies have found it to be related.^10,13 In a 2011 study, researchers examined medical records of over two million people older than 40 who were enrolled in a US managed care network. Those with hypertension had a 17% increased risk.¹⁴

Hypertension may be implicated because high blood pressure can result from poor circulation. Poor circulation can also lead to a compromised delivery of nutrients to the eyes, possibly resulting in poor eye drainage, leading to an increase in ocular pressure. Poor circulation also can reduce the supply of critical nutrients to the optic nerve. Perhaps this is why glaucoma can result in vision loss at any level of eye pressure if the optic nerve is weak, due to poor circulation and lack of oxygen and essential nutrients.

Damage to blood vessels. Increased eye pressure (IOP) can be caused by endothelial dysfunction and vascular structural changes. This can substantially alter blood flow within the tissues and elevate IOP, leading eventually to open-angle glaucoma.¹⁵ Vascular changes, such as low blood pressure, and vascular obstruction (poor circulation), have been linked to glaucoma.^16,17

Homocysteine. High homocysteine levels have been identified as a risk factor for open-angle glaucoma.^18,19 Other studies link high levels of homocysteine to the onset of pseudoexfoliation glaucoma.^20-22

Diabetes. Research has shown that glaucoma is closely related to diabetes, indicating a link to circulation and possibly inflammation. Examination of medical records of over 2 million people older than 40 found a 35% increased risk for open-angle glaucoma in people with diabetes.¹⁴

Thyroid disease. According to the CDC’s survey of 12,376 participants, an association has been drawn between thyroid disease and glaucoma. Researchers found that the prevalence of glaucoma was almost double in people with thyroid problems versus those without thyroid problems.²³

Helicobacter pylori. Medical researchers believe that H. pylori, which is the cause of many cases of stomach ulcers, may be implicated in a number of non-digestive conditions. These conditions include cardiovascular disorders, cerebrovascular disorders (blood circulation in the brain), and vascular dysfunctions. This organism may be involved in the pathology of the eye, specifically glaucoma. Meta-analysis suggested a statistically significant association between H. pylori infection and open-angle glaucoma,¹⁰ uveitis, and central serous maculopathy.

Drugs and medications. Non-steroidal anti-inflammatory drugs (NSAIDs) may interfere with effectiveness of IOP-lowering medications such as latanoprost.²⁴ Ongoing use of corticosteroids such as prednisone to reduce inflammation could increase IOP.²⁵ Topiramate (Topamax) can increase IOP and cause acute glaucoma, as well as medications prescribed for depression, Parkinson’s disease, and allergies. Such medications can cause the pupil to dilate, resulting in a smaller drainage angle of aqueous fluid.²⁶

Allergies. One study showed allergic rhinitis is associated with open-angle glaucoma.²⁷

Obesity. Health problems such as obesity can also increase risk of glaucoma.^28,29

Integrative Medical Approach

Through nutrition, diet, and lifestyle modification we can help nourish and support the health of the optic nerve for those with glaucoma or at risk of developing glaucoma.

Oxidative stress and free radicals may play an important role in the onset of glaucoma by causing damage to the trabecular meshwork responsible for effective outflow of the aqueous fluid, and the retinal ganglion cells.^30-32 The optic nerve requires healthy circulation to the eyes and essential nutrients to maintain cell integrity and good vision. Research has shown that circulation to the optic nerve is poorer for those with glaucoma, particularly for normal or low-tension glaucoma.¹⁰ Glaucoma is not just a matter of normal IOP but also of keeping the optic nerve properly nourished. There are numerous nutrients that have been well researched as supporting circulation to the optic nerve and being neuroprotective as well (see causes above). Antioxidants play many roles to help reduce oxidative stress and damage due to free radicals,³³ protect the trabecular meshwork,³¹ and support healthy circulation to the optic nerve.

Nutrients Related to Type of Glaucoma

Open-angle glaucoma. If you are already on eye medications for lowering eye pressure but would like to lower it further and lower it naturally, recommended nutrients include the following (any changes in medication should receive your eye doctor’s approval and management):

• For circulation: Ginkgo biloba and/or vinpocetine. Also, a good Liver tonic such as Revision, which is based on the classic Chinese medical model, helps support healthy circulation and movement of energy in the eyes.

• For optic nerve health: Coleus forskohlii, taurine, bilberry, grapeseed extract, magnesium, folate, vitamin B6, vitamin B12, N-acetylcysteine, alpha-lipoic acid, CoQ10, omega-3 fatty acids, and vitamin C.

• For helping reduce eye pressure: Coleus forskohlli, vitamin C, and alpha-lipoic acid.

Narrow or closed-angle glaucoma. If surgery is not needed and the eye doctor is monitoring the condition, then the following nutrients can be helpful in supporting optic nerve health:

• For circulation: Ginkgo biloba and vinpocetine. Also, a good Liver tonic such as Revision, based on the classic Chinese medical model (this formula was based on “rambling powder” of xiao yao san), helps support healthy circulation and movement of energy.

• For optic nerve support: Taurine, bilberry, grapeseed extract, magnesium, vitamin B12, N-acetyl-cysteine, alpha-lipoic acid, CoQ10, pyrroloquinoline quinone (PQQ), omega-3 fatty acids, and vitamin C.

• Eyedrops: Cineraria homeopathic eyedrops and Pleo Muc homeopathic eyedrops can help support circulation in the outer layer of the eyes.

Low or normal-tension glaucoma (the appearance of glaucoma is present with normal IOP). Changes resulting in thinning of the cornea, damage due to poor circulation, and/or lack or availability of essential nutrients may be improved using the same nutrients as in chronic glaucoma, but without the nutrients that can help lower eye pressure.

• For circulation: Ginkgo biloba and/or vinpocetine.³⁴

• Optic nerve support: Combination of Ginkgo biloba and bilberry,³⁵ as well as taurine, grapeseed extract, folate, vitamin B6, vitamin B12 (methylcobalamin), N-acetyl-cysteine, CoQ10, and pyrroloquinoline quinone (PQQ).³⁶

Pseudoexfoliative glaucoma (PEX) is distinguished by clumps of amyloid protein that accumulate in the eye and ultimately end up blocking the outflow of aqueous humor by clogging the trabecular network. Recommended nutrients are those that are both natural anti-inflammatories and supporters of optic nerve health.

• Natural anti-inflammatories: These include omega-3 fatty acids, astaxanthin, vitamin D3, MSM, and herbs such as turmeric (curcumin), holy basil, resveratrol, ginger, digestive enzymes, and rutin.

• For optic nerve support: Taurine, bilberry, grapeseed extract, magnesium, vitamin B9, vitamin B12, N-acetylcysteine, alpha-lipoic acid, CoQ10, pyrroloquinoline quinone (PQQ), omega-3 fatty acids, vitamin C.

• Eyedrops: Pleo Muc homeopathic eyedrops, MSM drops (used as eyedrops), castor oil eyedrops, and cineraria maritima homeopathic eyedrops.

Essential Individual Nutrients

Antioxidants. Oxidative free radicals and reactive oxygen species (ROS) appear to damage the trabecular network, a key cause of glaucoma. It is well established that antioxidants are effective in reducing the presence of these antagonists. Treatment with the antioxidants vitamin E or N-acetyl-cysteine induced decreased ROS production in glaucoma trabecular meshwork (GTM) cells.³¹ We recommend 200 IU vitamin E or 600mg n-acetyl-cysteine three times daily.

Alpha-lipoic acid. 150 mg–300 mg per day. Alpha-lipoic acid is the only antioxidant that is both fat and water soluble. Studies have shown that it benefits people with glaucoma by enhancing color vision, general vision sensitivity, and helps protect nerve cells from damage.³⁷ Alpha-lipoic acid is an ideal substance in the treatment of oxidative brain and neural disorders involving free radical processes. It is a powerful antioxidant and supports other antioxidants such as vitamin C and vitamin E. It helps to raise glutathione levels within cells.³⁸ It has also been found to reduce neuronal damage due to over-stimulation by cyanide, glutamate, and iron ions, and protects nerve tissue.³⁹

Aminoguanidine. 75 mg, 3 times per day. This is an anti-glycating agent that inhibits the ‘cross-linking’ or glycosylation of proteins. Glycosylation may cause, or at least contribute to, many of the problems of old age, such as cataracts, glaucoma, and macular degeneration. In an animal study, aminoguanidine was shown to help protect the optic nerve from damage.⁴⁰

Bilberry (Vaccinium myrtillus). 180 mg–240 mg per day. The anthocyanin antioxidants contained in bilberry have long been confirmed to benefit vision. The combination of bilberry and Ginkgo biloba was found to be very helpful in a study involving over 300 patients with normal tension glaucoma. Another study finds that a combination of bilberry and French maritime pine bark (pycnogenol) could lower IOP up to 24%.⁴¹

Ginkgo biloba. 120 mg per day. Found to improve the visual field in some patients with normal-tension glaucoma,³⁴ Ginkgo biloba supports vascular cell integrity, providing better delivery of anti-oxidants and nutrients to the optic nerve and related cell tissue.⁴² Ginkgo stabilizes cell tissue on the mitochondrial level (where our cells’ energy is manufactured). The mitochondria play a major role in several diseases, particularly neurodegenerative diseases, including glaucoma.⁴³ Several studies have shown mitochondrial irregularities in glaucoma patients.⁴⁴ Finally, ginkgo supports microcirculation.⁴⁵

Taurine. 500 mg-1,000 mg per day. Taurine is an amino acid that protects the eyes against neurotoxin damage. Nerve-damaging toxins include excessive levels of glutamate, which may be responsible for ganglion cell death and optic nerve damage seen in open-angle glaucoma.⁴⁶ It is recommended for glaucoma and retinal disease for its valuable antioxidant properties.⁴⁷

Curcumin. 500 mg per day. Curcumin’s antioxidative capacity provides good protection for the nervous system, due to its anti-inflammatory, antioxidant, and anti-protein-clumping capacity.⁴⁸

Vitamin B1 (thiamine). 50 mg-100 mg per day. Glaucoma patients tend to have low levels of vitamin B1.⁴⁹

Vitamin B6. 100 mg daily. A combination of B6, B9 and B12 helps to lower homocysteine levels that are linked to higher risk of developing glaucoma.⁵⁰ This is taken in divided dosages with food, often part of a vitamin B complex formulation.

Vitamin B9 (folate form). 800 mcg or more per day. Supplementing with folate may be helpful to those with the pseudoexfoliation (PEX) form of glaucoma.⁵¹

Vitamin B12 (methylcobalamin). 1,000 mcg per day (up to 1,000 mcg–1,500 mcg per day) may help protect vision in glaucoma patients.⁵²

Vitamin C (buffered and ascorbated). 2,000 mg per day, divided amongst several meals. Whole fruit, natural vitamin C with bioflavonoids is preferred as opposed to vitamin C synthesized from corn. The eyes of open-angle glaucoma patients were found to have significantly lower vitamin C levels.⁵³ Several studies have determined that low vitamin C levels in blood and in the vitreous humor inside the eye can contribute to meshwork outflow blockage due to aging, and it can contribute to development of glaucoma.⁵⁴ Supplementation with large doses (10,000 mg daily) can significantly lower IOP by 10 points.⁵⁵ For some people, a lower dose is recommended if the larger dose causes loose stools.

In many parts of the world, vitamin C is routine for glaucoma patients because it has the capacity to both decrease aqueous fluid production and improve drainage. In addition, vitamin C supports collagen metabolism, which may be linked to glaucoma.

Vitamin E. 200 IU three times per day (d-alpha-tocopherol and preferably with tocotrienols and not synthetic dl-alpha-tocopherol). Vitamin E is also found in the vitreous humor and pro-vides antioxidant capacity to the eyes. It is most effective when combined with vitamin C, which helps regenerate vitamin E.⁵⁶ One study showed that patients who supplement with 300 IU–600 IU of vitamin E per day, improved blood flow and reduced vision loss. Non-treated subjects showed a significant reduction in their visual field at 6 and 12 months.⁵⁷ The non-treated showed a statistically significant reduction in visual field (change in mean deviation) at 6 and 12 months.

Vitamin E combined with CoQ10 is also more effective than vitamin E alone; CoQ10 increases mitochondrial alpha-tocopherol concentration which improves mitochondrial-mediated neuroprotection and inhibits astrocyte activation (a biomarker for neuro-degenerative disease).⁵⁸

CoQ10. 100 mg-200 mg per day. CoQ10 provided neuroprotection against mitochondrial DNA alternations in an animal model of pre-glaucoma. CoQ10 protected against retinal ganglion cell death, prevented upregulation of certain protein biomarkers, improved other biomarkers, and protected mitochondria and mitochondrial transcription factor A.⁵⁹

Very Important Nutrients

DHA, B complex, and vitamin E. DHA 200 mg–400 mg per day, B complex, and vitamin E 400 IU. Another study showed that the fatty acid DHA (abundant in fish oil), along with B complex and vitamin E, were helpful in preventing or delaying vision loss associated with glaucoma.⁶⁰

Essential fatty acids. 3,000 IU per day. Essential fatty acids can help reduce the chronic inflammatory processes associated with glaucoma. Fish and fish oils are rich in omega-3 fatty acids (as well as DHA and EPA). The best sources of omega-3 fatty acids are cold-water fish such as salmon, mackerel, sardines, anchovies, and codfish. Black currant seed oil and flaxseed oil are also good sources of essential fatty acids. One study showed patients with primary open-angle glaucoma had reduced levels of plasma DHA and EPA compared with healthy siblings. These findings may be significant since DHA and EPA could modulate impaired systemic micro-circulation, ocular blood flow, and optic neuropathy, the main changes associated with glaucoma.⁶¹

Magnesium. 500 mg per day. Magnesium improves micro-circulation in glaucoma patients and may protect the retinal ganglion cell against oxidative stress and cell death. Some studies conclude that magnesium improves peripheral circulation and improves the visual field in glaucoma patients with blood vessel constriction.^62,63

Helpful Nutrients

Coleus forskohlii. 350 mg–500 mg per day. A clinical trial of a glaucoma supplement containing the active ingredient forskolin along with a form of taurine, carnosine, folic acid, B1, B2, B6, and magnesium found that it reduced IOP and improved nerve cell health in the retina.⁶⁴

Green-leafy vegetables, carrots, and beets. Researchers found a 30% percent decline in glaucoma risk in diets that include green leafy vegetables, carrots, and beets. This group of participants also had a 40-50% reduced risk of developing a sub-type of the condition known as early paracentral visual field (VF) loss (peripheral/side vision), which is linked to poor ability to maintain constant blood flow.⁶⁵

Green tea extract. 725 mg per day. One study shows that antioxidants from green tea are absorbed in the lens, retina, and other eye tissue, and reduces oxidative stress in the eyes.⁶⁶

Resveratrol. 125 mg-175 mg daily. The antioxidant resveratrol is able to cross the semi-permeable barriers in the eyes; it is bio-available to eye tissue to help combat oxidative stress in the eye.⁶⁷

Quercetin. 250 mg–500 mg per day. Research indicates that supplementing with quercetin has direct effects on protecting the loss of retinal ganglion cells in glaucoma patients.⁶⁸

Turmeric (curcumin). 500mg per day. The antioxidant curcumin has possible benefit with respect to oxidative stress in the eyes.⁶⁹

Melatonin. Intraocular pressure is usually lowest at night, which is also when natural levels of melatonin are near their high in the circadian cycle. IOP is highest in the morning when melatonin is low. There seems to be a correlation between IOP and melatonin; supplementing with melatonin may lower IOP.⁷⁰

Glucosamine. Caution. A clinical study shows that taking glucosamine sulfate, 750 mg three times daily for three months, can increase intraocular pressure (IOP) in some people.⁷¹

Foods Known to Increase IOP

Coffee. Drinking just one cup of coffee can increase IOP by 1-4 mm Hg for at least 90 minutes.^72,72 Regular coffee drinkers have a higher average IOP (approximately 3 mm Hg).⁷⁴

However, coffee beans also contain antioxidant compounds. These antioxidative effects and their possible neuro-protective implications need further research. One study concluded that oxidative stress can be a causative factor in glaucoma, and targeted nutrients can reduce oxidative stress at the level of mitochondria. This can be achieved by supplementing with Ginkgo biloba and liquids that contain polyphenolic compounds (such as tea, red wine, dark chocolate, or coffee), which all have anti-oxidative properties.⁷⁵

Glutamate. Evidence also exists that glutamate contributes to glaucoma, so it is best to avoid any foods with monosodium glutamate (MSG). Glutamate that is not biochemically bound to other amino acids, causes our inherent glutamate levels to increase rapidly. These “free” forms of glutamate are found in nearly all processed or packaged foods. Genetic predisposition to glutamate sensitivity is being investigated.

Glutamate naturally found in some food is linked to amino acids and is slowly processed by the digestive system. Free glutamate passes through the digestive system rapidly and is quickly absorbed into the bloodstream. In some foods, such as aged or cured cheese or meats, soy sauce, mushrooms, tomatoes, broccoli, peas, walnuts, and gluten, glutamate exists in a free form.⁷⁶

Glutamate is an essential nutrient for proper brain functioning, but excess glutamate results in “excitotoxicity” causing nerve cell death. Normally the brain is protected by the blood-brain barrier, but such protection can break down in cases such as head injury, stroke, or high blood pressure and as a by-product of aging. If the blood-brain barrier is compromised, then excess glutamate in the brain and nerve cell death can be the result.⁷⁷

Artificial sweeteners. Avoid artificial sweeteners as studies indicate possible neurotoxicity. Though more research needs to be done on this, we recommend avoiding all artificial sweeteners.

Foods Known to Decrease IOP

Studies have shown that there are natural ways to reduce intraocular pressure naturally including the following: eating a healthy diet high in fruits and vegetables.⁷⁸ People with glaucoma can reduce their eye pressure by five to seven millimeters of mercury (mm/Hg) with an improved diet and supplement program—a reduction that is as good as, or better than, achieved with drugs. In general, a diet high in beta-carotene, vitamin C, vitamin E, and selenium is recommended. Foods containing those nutrients include garlic, onions, beans, spinach, celery, turnips, yellow and orange vegetables, green leafy vegetables, seaweed, apples, oranges, and tomatoes.

In addition, drinking lots of water helps maintain the flow of nutrients to the eye and drains metabolic wastes and toxins from eye tissues. Optimally, you should drink 16 four-ounce glasses of water per day, every half-hour. Our bloodstream can only handle being diluted by about four ounces at any one time. When you drink more than four ounces at a time, this means more work for the kidneys to filter water that hasn’t had a chance to travel through the lymph system and clean body tissues.

Avoid carbonated, caffeinated, and alcoholic beverages since they can actually dehydrate eye tissues. Your optimal water intake depends upon your particular physiology, diet, climate, and physical activity. Too much water intake can reduce blood salt levels (hyponatremia) and cause cells to flood. A good way to gauge if you are properly hydrated is by the color of your urine. If it is dark yellow, then you are dehydrated and need to drink more water. If your urine is as clear as water, then you have over-hydrated and should cut back intake. Green tea is very beneficial for your health and body, but too much is dehydrating.

Lifestyle – Activities That Increase IOP

Excessive exercise. Exercise where the heart rate is at 80% maximum increases short-term IOP by 4.7 mm Hg.⁷⁹ Weight lifting can cause a temporary increase in IOP of approximately 4 mm Hg.⁸⁰

Breath control. Playing a high-resistance wind instrument such as an oboe can double IOP during playing.⁸¹ It returns to baseline after playing ceases.

Inverted yoga postures. An inverted posture where the eyes are below the heart can cause a doubling of IOP (returns back to baseline after 5 minutes). Certain yoga exercises such as Shirshasana leads to a two- to three-fold rise in IOP from baseline for a short duration.⁸²

Tight neckties. These can increase IOP 2mm Hg (returns to baseline when loosened).^83,84

Computer use. In a large study of programmers, software engineers, and gamers with a mean age of 43 years, one third were found to have glaucoma. Even more significant was that heavy computer users who were farsighted (presbyopia) or nearsighted (myopia) seemed to have a higher risk. Nearsightedness was found in 82% of those with glaucoma.⁸⁵

The connection between computer use and glaucoma may be physical. Computer users tend to have a hunched over posture over their keyboard which makes it necessary for them to raise their head to see the screen. The head weighs on average 7-10% of body weight and its effective weight increases for every 1 cm (.393 inches) away from the spine. Over a period of time, the weight of keeping the head up causes the muscles of the neck to shorten (side and back), which compresses the nervous, vascular, and lymph systems of the neck, and compromises circulation to the brain (and eyes). This hunched posture eventually becomes habitual, so the person, even when standing, maintains the slouched posture. Additionally, the hunched posture collapses the lungs, which reduces the capacity of oxygen.

Note. To help reduce the effect of chronic computer use, take regular breaks, at least every hour, to relax the eyes, and do some eye exercises.

Alcohol and glaucoma. Intake of large quantities of beer or water increases IOP significantly because the kidneys cannot process large quantities of liquid quickly. However, a few studies did not report any association between alcohol intake and IOP.⁸⁶ Neuro-protective effects of red wine have also been reported. Although consuming one alcoholic drink per day may have some cardiovascular benefits, it also increases the risk of liver disease.

Both acute and chronic alcohol consumption have severe effects on the structure and function of the gastrointestinal tract.⁸⁷ The eyes rely on receiving significant amounts of essential nutrients from the food we eat to maintain healthy vision; compromises in absorption and gut health can severely affect eye health.

Activities That Lower IOP

Regular exercise. Studies have shown that people who exercise regularly and are more physically fit have a lower average IOP.^88-90 Regular exercise means exercise five days a week such as a brisk walk.⁹¹ Other studies reinforce exercise as a way to lower eye pressure and reduce the risk of developing glaucoma.^92-94

Hormone supplementation. Hormonal use in postmenopausal women reduced IOP and improved blood flow to the optic nerve.⁹⁵ The use of estrogen plus progesterone (but not estrogen alone) was associated with a 42% reduced risk of high tension POAG.⁹⁶ Women under 45 years of age entering menopause showed a 2.6% increase in risk of glaucoma.⁹⁷

Other health risks, however, are associated with hormone supplementation, including increased risks of endometrial cancer in women with an intact uterus, urinary incontinence, dementia, stroke, blood clots, heart attack, and breast cancer.⁹⁸

Breathing. Breathing through the nose, versus breathing through the mouth, and a correctly aligned posture that expands the lung can increase oxygenation by at least 20% and release nitric oxide, a vasodilator.⁹⁹ It is the exhale stroke of breathing which pumps the most oxygen into the lungs. Reduced breathing occurs due to a hunched over posture, which compresses the lungs. Shallow breathing causes an imbalance in the oxygen and carbon dioxide ratio, reducing the ability of oxygen being transferred into tissues, and this causes stress through activation of the sympathetic nervous system.

Sleep position. One study reported that a low head position elevates IOP compared to lying on one’s right side. Proper adjustment of the pillow height may help lessen IOP elevations that result from lying with a low pillow or with no pillow.¹⁰⁰ Another study concluded that asymmetric sleep behavior is common. Right-sided sleep was preferred and correlated with a lower visual field index for those sleeping on their left side.¹⁰¹

Manage stress. Above average stress has been shown to increase the risk for high eye pressure by almost three times.^102,103 We recommend meditation, yoga, tai chi, qi gong, psychotherapy, or a combination of these to help with life stress.

Marijuana. This cannabinoid has been proposed as an IOP-lowering agent for a long time. The active ingredient in marijuana (delta-9-tetrahydrocannabinoid) reduces IOP by reducing aqueous humor production.^104-106 However, the IOP-lowering effect of marijuana is short term, and one would need to smoke marijuana every three hours for 24-hour IOP control. Note: The essential ingredient in marijuana is now available in CBD oil that can be ingested by mouth, without causing any effect of getting “high,” or having the negative effects of inhaling smoke. We recommend this over smoking marijuana, though more research is needed.

Other Modalities

Chinese Medicine and Glaucoma. In Chinese medicine, the Liver “opens to the eyes” and is the primary meridian for supporting overall flow of energy and circulation through the eyes. The Kidney meridian nourishes the blood to the eyes. The Spleen meridian also nourishes the blood, while also helping to keep fluids from leaking from blood vessels and reducing dampness (build-up of fluids). Other meridians may be out of balance as well, and that can affect eye health. An evaluation by an acupuncturist can best determine where the out-of-balances are located, and then, offer the optimal treatment strategy. The following are patent formulas used for glaucoma:

• Xiao yao san. Rambling powder is a classic Liver tonic used in Chinese medicine. The Liver “opens to the eyes” and is the primary meridian (flow energy) that supports healthy circulation and the free flow of energy in the eyes and throughout the body.

• Qi ju di huang wan. Rehmannia 6 plus chrysanthemum and lycii nourishes Kidney and Liver blood and yin. Qi ju di huang wan is a classic adaptation of rehmannia 6 (liu wei di huang wan) with a special emphasis on the eyes, in particular dry eyes, redness, and heat caused by yin (fluid) deficiency.

• Shu gan tang regulates Liver qi.

• Wen dan tang. Warm the Gallbladder decoction nourishes Kidney and Liver yin and brightens the eyes. This is formulated for disharmony between Gallbladder and Stomach meridian systems.

• Medicinal mushrooms. Reishi, maitake, bitter tooth, and lion’s mane are helpful for glaucoma as they are reported to have neurite outgrowth and neuronal health benefits.

Treatment strategies can vary based on the TCM practitioner’s evaluation and intake.

Acupuncture. Combining acupuncture and eye drops is better than eye drops alone for primary open-angle glaucoma,¹⁰⁷ and regular acupuncture treatments improve intraocular pressure (IOP) and retrobulbar circulation (circulation behind the globe of the eye).¹⁰⁸

Homeopathy. Glaucoma homeopathic pellets. 1–3 pellets dissolved in mouth 2–3 times per day, preferably before meals, or an hour or more after meals. You can keep taking these pellets for as long as you like, keeping in mind that regular check-ups from the eye doctor are essential.

Chelation Therapy. Calcium overload and dysregulation have been found in both trabecular meshwork¹⁰⁹ and lamina cribrosa¹¹⁰ from human glaucomatous eyes.¹¹¹ Ethylenediaminetetraacetic acid (ETDA), particularly combined with MSM,¹¹² may help reduce excess calcium and zinc, as well as other metals, which in excess, may contribute to eye problems.

Hypnosis. Hypnosis may help lower IOP according to some researchers.¹¹³

Microcurrent stimulation. Daily use of microcurrent stimulation helps stimulate circulation in the back of eyes, and helps the eyes eliminate waste.¹¹⁴ This is particularly relevant for those where circulation and nutrition are a factor in maintaining healthy optic nerve.

For more information on integrative medical protocols for vision conditions visit www.naturaleyecare.com

Our goal is that the information shared here will help people keep their precious gift of sight.

References

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3. Sachin, J., Aref, A.A. (2015). Senile Dementia and Glaucoma: Evidence for a Common Link. J Ophthalmic Vis Res, Apr-Jun; 10(2): 178–183.

4. Soto, I., Howell, G.R. (2014). The Complex Role of Neuroinflammation in Glaucoma. Cold Spring Harb Perspect Med, Jul 3;4(8).

5. Ramirez, A.I., de Hoz, R., Salobrar-Garcia, E., Salazar, J.J., Rojas, B., et al. (2017). The Role of Microglia in Retinal Neurodegeneration: Alzheimer’s Disease, Parkinson, and Glaucoma. Front Aging Neuroscience, Jul 6;9:214.

6. Kimura, A., Namekata, K., Guo, X., Noro, T., Harada, C., et al. (2017). Targeting Oxidative Stress for Treatment of Glaucoma and Optic Neuritis. Oxid Med Cell Longev, 2017:2817252.

7. Izzotti, A., Bagnis, A., Sacca, S.C. (2006). The role of oxidative stress in glaucoma. Mutat Res. Mar;612(2):105-14.

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