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Glaucoma

Lifestyle Tips for Controlling IOP

Exercise

Research findings show that physical activity can have a long-term beneficial effect on ocular perfusion pressure (OPP) (OPP is a measurement derived from IOP and blood pressure), which reflects the status of blood vessels at the optic disc (Yip 2011). This is an important finding given that low OPP is a risk factor for glaucoma.

The benefit appears to be related to cardiovascular fitness. In a study of over 5,500 men and women, researchers questioned participants about rates of earlier physical activity (15 years previously) and then tested them for intraocular pressure (IOP) and blood pressure. They found an association between higher levels of activity and a 25% reduced risk of low OPP.

Caffeine and glaucoma

Older research shows that caffeine can cause a temporary increase of IOP (Peczon 1964). The increase lasts for about 2 hours. Researchers looked at dietary histories of nearly 80,000 women in the Nurses' Health Study (NHS) and over 42,000 men in the Health Professionals Follow-up Study (HPFS) to determine whether repeated caffeine intake throughout the day would sustain IOP elevation and increase the risk of developing primary open angle glaucoma. They found no such association between overall caffeine intake and increased risk of primary open-angle glaucoma (Kang 2008)

Could coffee be protective against glaucoma?

Green coffee beans and brewed coffee contain antioxidant compounds that have neuroprotective actions (Wen 2004). The antioxidant properties of green coffee come largely from the phenol chlorogenic acid. Other antioxidants in coffee include caffeic acid, quinic acid, and furulic acid. Researchers report that green coffee has the strongest antioxidant properties, followed by instant coffee. Antioxidant activity decreases during roasting by 50-90% (Clifford 1979; Stich 1991). The antioxidant properties of instant coffee are partially related to the production during roasting of the free radical scavenger ApV, which is a zinc chelating substance formed from chlorogenic acid, sugar, and proteins.

The neuroprotective effect of chlorogenic acid has been demonstrated in cell cultures of rat retinal ganglion cells where researchers found that chlorogenic acid produced a concentration-based inhibition on oxidative stress-induced neurotoxicity (Nakajima 2007).

Emotional stress and glaucoma

As described earlier, closed-angle glaucoma can be related to a structural abnormality in the eye where a narrow angle between the iris and cornea impedes the outflow of aqueous fluid. Acute stress (the flight-or-fright reaction) can narrow the angle even further (by dilating the pupil) and cause an acute glaucomatous event.

Smoking and glaucoma

Cigarette smoking has been linked to several age-related eye diseases, including age-related macular degeneration, cataract, and severity of diabetic eye disease (Zhang 2011). Although some findings have suggested a role for smoking in glaucoma (Klein 1993), others, including a systematic review of 11 earlier research studies, show little evidence that cigarette smoking causes primary open-angle glaucoma (Edwards 2008). However, the authors of the review article question the quality of several of the studies that showed no influence of cigarette smoking on glaucoma and, given the clear link between smoking and other eye diseases, believe that further research is needed to confirm their findings.

Sunglasses and glaucoma

Although exposure to bright light and sun does not appear to be a risk factor for glaucoma, many people with glaucoma experience a sensitivity to light and glare. The problem can be solved by wearing sunglasses that block at least 99 percent of UVB rays and 95 percent of UVA rays.

Summary

Glaucoma is a common cause of blindness worldwide. It occurs more often in African Americans, Latinos, and Asians than in Caucasians. The most common event associated with glaucoma is an increase in intraocular pressure. Many therapies are designed to lower IOP in order to decrease pressure on the retina and optic nerve. Uncontrolled pressure damages retinal ganglion cells and their axons and causes the loss of peripheral vision and, if untreated, can lead to complete blindness. Glaucoma is a multifactorial condition. Genetic defects and nutritional deficiencies are risk factors for glaucoma. Certain behaviors influence IOP and may impact the development and/or progression of glaucoma.

New natural interventions, including a combination of pine bark and bilberry, show great promise in reducing the underlying symptoms of glaucoma, especially when used in combination with traditional glaucoma medications. Antioxidants are also valuable to reduce oxidative damage to the eyes, while minerals are important for general eye health.

In the future, more research is needed to understand the multiple underlying factors that contribute to glaucoma and develop conventional and natural interventions that will help prevent and reverse this major cause of blindness.