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Practicing a healthy lifestyle is the best recommendation for glaucoma patients interested in “alternative” therapy.
It is estimated that 5-15% of glaucoma patients, reportedly spending billions of dollars annually, take some form of alternative medication based only on their impression that it will help treat their glaucoma.
However, there is little data to support the use of any alternative medicines to prevent glaucoma onset or progression. Some alternatives show promise, while others may have negative effects. Potential side effects and drug interactions could even make these patients' health worse.
Of note, over-the-counter drugs are not as well regulated by the FDA (compared with prescription drugs) and may not always contain the ingredients stated on the label. It is unlikely much significant analysis will come in the near future. Well-controlled studies will require years of unbiased follow-up. This article will hopefully provide some perspective on the value and limitations of alternative treatments and their use.
Some research suggests that antioxidants may be helpful in managing glaucoma, but it is not known whether they can help prevent vision loss. Potentially useful antioxidant medications include, Alpha-lipoic acid, Vitamin C, beta-Carotene, Vitamin E, lutein, zinc, selenium, melatonin, glutathione, green tea, grape seed extract, resveratrol, fish oil, and omega-3. Common fruits and vegetables are also antioxidants. However, none of these have passed the demands of clinical studies.
Ginkgo biloba has been used in the recent past to improve memory in dementia but later studies refuted this claim. Alcohol is known to lower eye pressure but only for a short term and with obvious side effects, making it not recommended. Marijuana, often a subject of interest, also lowers eye pressure, but only a small amount and, again, with significant side effects.
Meditation and acupuncture techniques are sometimes suggested but there is no evidence that these methods are effective for managing glaucoma. The many herbal therapies used extensively in China for thousands of years are a mixed bag of unknown components that are untested clinically.
Moderate exercise lowers eye pressure and perhaps improves blood supply to the optic nerve. This more natural source of therapy is suggested not only with the hope of controlling glaucoma but also toward a generally healthier cardiovascular system. A number of studies have shown that exercise has pressure-lowering effects.
One study reported that moderate exercise was associated with a 14% decrease in intraocular pressure (IOP), another found that persons engaged in aerobic exercise for 10 minutes experienced a decrease in IOP, and two trials reported that persons who exercised for 3 months had a moderate IOP decrease lasting for 3 weeks after the exercise program ended. However, the question remains whether the effect of exercise is limited to lowering IOP or actually has an impact on preventing visual field loss from glaucoma.
As confided to me in an interview, if any alternative medication showed a hint of having an effect on glaucoma, it would be pursued, analyzed, marketed, and made well-known through press releases and fanfare. Since drug companies are always seeking new, effective medications, one can be assured that if an "alternative" medication was truly effective, it would be developed into a new commercial drug.
Based on my review of the available evidence, my conclusion is that the best thing glaucoma patients can do to protect their ocular health and general well-being is to follow the advice of their eye doctor, and maintain a healthy lifestyle with proper diet, adequate exercise, and enough sleep.
Article by John Hetherington, Jr., MD, Clinical Professor of Ophthalmology at the University of California San Francisco and is a past president of the International Glaucoma Society. He is one of the founding physicians of the Glaucoma Research Foundation and has served on the GRF Board since 1978.
Last reviewed on May 01, 2014
This article appeared in the May 2013 issue of Gleams.Subscribe