A Self Help Approach to Glaucoma

Glaucoma is the name give to a condition where the pressure increases within the eye. This pressure, if untreated, can lead to cataracts and loss of sight. The following research, notes and ideas have been put together in this place to share a resource of self-help approaches. This is not a medical approach but a resource to help understand glaucoma and offer natural approaches to try to reduce the effects of glaucoma.

The pressure that builds up in glaucoma happens because the production of fluid to the eye outstrips the outflow from the eye. The ensuing imbalance results in pressure. This can be caused by structural problems in the eye (usually from birth) such as poor collagen performance; eye syndromes; aging; radiotherapy; drug reactions to corticosteroids. When you see your medical specialist they will measure the eye pressure.

1. Normal intraocular (within the eye) pressure is 10 to 21 mm Hg.
2. In chronic glaucoma it is 22 to 40 mm Hg with gradual loss of peripheral vision and blurriness.
3. In acute glaucoma it is greater than 40 mm H with throbbing pain and severe blurred vision. Nausea and vomiting are common. Pupil (black part of eye) becomes dilated and fixed.

Treatment is dependent on:

1. Reducing the internal eye pressure
2. Improving collagen metabolism in the eye

Normally your doctor will give you eyedrops and you may also be given medication.

Self help with diet, supplements, botanicals and herbs.

Diet

Diet plays a significant role in cataract risk. One study found that people who eat the highest amounts of butter and salt have double the cataract risk compared to those who eat the lowest amounts of these foods. Notably spinach, peppers, melons, tomatoes and citrus fruits halve the risk of needing cataract surgery. People who do not eat five servings of fruits and vegetables per day are 5 to 13 times more likely to develop cataracts. Insufficient dietary vitamin C intake also dramatically increases cataract risk 4 to 11 times. The typical Western diet provides about 110 mg/day of vitamin C, but the minimum amount of vitamin C required to prevent cataracts is closer to 300 mg/day – about five oranges. It is unlikely that consumers will eat this much fruit, so vitamin C supplements are often more practical. The eye’s lens is also sensitive to high blood-sugar levels, which can cause inflammation, vision changes and eventually diabetic cataracts. Sugar can harden in the lens so it’s best to avoid too many sugary foods.

Increasing macular pigment density by eating plenty of dark green and orange fruits and vegetables might prevent people who are mildly impaired from advancing to the worst stages of the disease. 6 mg lutein/day through a diet rich in dark-green leafy vegetables significantly reduces the risk of advanced macular degeneration.

Dark-green leafy vegetables such as kale, collard greens, spinach, cress, swiss chard, parsley, mustard greens, beet greens, okra, red pepper, dark green lettuce, leeks, broccoli and green peas are rich sources of beta-carotene as well as lutein and zeaxanthin. Blue-eyed people need more lutein and zeaxanthin because they have less of these protective pigments in their retinas.

Foods such as cantaloupe, carrots, sweet potato and yams  are rich in beta-carotene but provide no lutein. Also pumpkin, yellow squash, yellow and green peppers, avocado, tomato Puree, orange fruits

Magnesium: 200 – 600 mg per day.
Magnesium supplements have been shown to lower intraocular eye pressure (IOP) in the same way that drugs such as ‘channel blockers’ do as it blocks the uptake of calcium which relaxes the arteries. In a clinical study, 10 gaucoma patients were given 121.5 mg magnesium twice a day for a month. After a month the blood supply to the eye and their field of vision improved. Natural high sources of magnesium include spinach, beans, peanuts, nuts and seeds, whole grain bread and halibut. Foods with lower levels of magnesium include: milk, cheese, bananas, and avocadoes.

Vitamin C: Minimum 2000 mg per day (effective dose could be as high as 35 grams per day).
Vitamin C both reduces IOP pressure and repairs collagen integrity. Clinical studies where 0.5 g (500 mg) per kilo (2.2 lbs) of body weight was taken, reduced IOP by an average of 16 mm Hg. It seems quite high but does seem effective. Under your doctor of medical herbalists supervision it would be worth trying it and if necessary building up to a high dose. Remember your body also needs zinc to absorb Vitamin C. In 1990, James Robertson, (Department of Epidemiology, University of Western Ontario, Canada), compared adults with cataracts to those without. He found that taking 300 to 600 mg Vitamin C reduced cataract risk by 70 percent and 400 IU Vitamin E for more than a year reduced cataract risk by 50 percent.

Linner E. The pressure lowering effect of ascorbic acid in ocular hypertension. Acta Ophthamol 1969;47:685-9.
Fishbein SL, Goodstein S. The pressure lowering effect of ascorbic acid. Ann Ophthamol 1972 Jun:487-9.

Fish Oil Capsules:
Greenland Eskimos have lower rates of glaucoma than other Caucasian populations, attributed to the consumption of Omega-3 fish oil. Omega-3 fats appear to help prevent optic nerve disorders. A combination of DHA-rich fish oil, vitamin E, and vitamin B complex widened the visual field of 30 glaucoma patients within 90 days in an open-label, nonrandomized study.

(Cellini M, et al. Fatty acid use in glaucomatous optic neuropathy treatment. Acta Oph Scand 1998;227:41-2.)

Carotenoids: Lutein and Zeaxanthin
Lutein and zeaxanthin have been found to protect against macular degeneration, glaucoma and cataracts. In 1992, a study at Harvard Medical School in Boston surveyed 50,828 nurses and found women who ate spinach five or more times per week, as well as those who took vitamin C supplements for 10 years or more, reduced their risk of cataract surgery by more than 45 percent. Although other carotenoids in spinach could have been at work, this study suggests the benefits of dietary lutein and zeaxanthin.

For a good supplement I recommend Lambert’s Eyewise. Each capsule contains 10mg Lutein (Pure, free-form); 400mcg Zeaxanthin; 200mg Bilberry (Provided by 50mg of a 4:1 extract); 200mg Blackberry (Provided by 50mg of a 4:1 extract); 500mg Grapeseed (Provided by 10mg of a 50:1 extract). You can take up to 2 per day.

Hankinson SE, et al. Nutrient intake and cataract extraction in women: a prospective study. Br Med J 1992;305:335-9.
Seddon JM, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. J Am Med Assoc 1994;272:1413-20.
Dagnelie G, et al. Lutein improves visual function in some patients with retinal degeneration: a pilot study via the Internet. Optometry 2000;71:147-64.

Vitamin B12
Japanese researchers prescribed 28 glaucoma patients a high oral-dose of 1,500 mcg/day vitamin B12 for five years. The patients receiving B12 experienced less measurable loss of peripheral vision, more stable visual acuity, and better control of eye fluid pressure compared to a group that did not take B12. The effects of vitamin B12 are attributed to the preservation of myelin, which insulates nerve cells.

Sakai T, et al. Effect of long-term treatment of glaucoma with vitamin B12. Glaucoma 1992;14:167-70.