Glaucoma, a group of eye diseases characterized by progressive optic nerve damage, is a leading cause of irreversible blindness worldwide. While intraocular pressure (IOP) lowering remains the primary focus of glaucoma management, lifestyle and dietary factors can play a significant role in reducing glaucoma risk and helping control the disease. This article summarizes the current evidence regarding the impact of diet and exercise on glaucoma, providing recommendations to support overall eye health.
Understanding Glaucoma and the Role of IOP
Glaucoma is a complex condition often associated with elevated IOP, which damages the optic nerve. However, recent research suggests that non-IOP-dependent mechanisms also contribute to the pathogenesis of glaucoma. While IOP reduction through medication, laser therapy, or surgery remains the mainstay of treatment, complementary approaches, including dietary and lifestyle modifications, can target both IOP-dependent and non-IOP-dependent mechanisms.
General Lifestyle Recommendations
People with glaucoma should generally continue to do the things they love, as the vast majority of activities do not pose a concern. However, some activities may be associated with increased IOP:
- Yoga positions: Avoid positions with the head below or at level with the heart, as these can increase IOP.
- Wind instruments: Instruments that require forceful blowing (e.g., bagpipes, trumpet, trombone) can raise pressure around the face and upper airways, potentially harming those with glaucoma. Instruments played with less force are generally safer.
- Swimming goggles: Smaller goggles that sink inside the eye socket can increase IOP. Opt for larger, snorkeling-type goggles with less impact on eye pressure.
- Weightlifting: When weightlifting, remember to breathe normally, as holding your breath can raise eye pressure.
The Main Components of Glaucoma Diet
A balanced diet rich in essential nutrients, such as antioxidants, vitamins, and minerals, can support overall eye health.
Fruits and Vegetables
Antioxidants and nitrates, found abundantly in fruits and vegetables, may reduce glaucoma risk. Focus on consuming plenty of:
Read also: Nutritional Strategies for Eye Health
- Green leafy vegetables (e.g., spinach, collard greens, kale)
- Carrots
- Cruciferous vegetables
- Berries
- Citrus fruits
- Peaches
These foods are rich in Vitamin A and C, carotenes, and nitrates, which may protect against glaucoma. Studies have shown that a diet rich in green leafy vegetables, or with a higher dietary nitrate intake, seemed to protect against glaucoma.
Vitamin B3
Vitamin B3 might be beneficial in preventing glaucoma, and low levels of B3 might be harmful. However, most people get sufficient B3 in a standard diet, so oral supplements may not be necessary.
Omega-3 Fatty Acids
Omega-3 fatty acids, found in oily fish (e.g., salmon, mackerel, tuna), are essential for overall health and may have a role in glaucoma prevention.
Caffeine
Caffeine consumption can raise eye pressure for about two hours by increasing fluid production within the eye. While this short-term increase does not cause problems for most people, those with a strong family history or advanced glaucoma should consider reducing their caffeine intake if it exceeds the equivalent of 3-5 cups of coffee per day. Tea contains lower caffeine levels and may not pose the same risk.
Tea
Tea drinkers (one cup per day) may have lower rates of glaucoma compared with non-tea drinkers. Tea contains flavonoids that may reduce glaucoma risk by improving blood flow to the optic nerve.
Read also: Diet and Glaucoma Management
Dark Chocolate
Dark chocolate contains flavonoids and has been proven to be beneficial in patients with vascular and cardiovascular diseases. While further research is required to see whether there is any benefit for glaucoma patients, it may be a reasonable addition to a glaucoma diet.
Red Wine
Red wine consumption in moderation may be associated with reduced glaucoma risk, but further studies are required to confirm this.
Water
Staying well-hydrated is essential. However, consuming too much water in a short interval may transiently increase eye pressure.
Dietary Considerations
Low-Carbohydrate Diets
Recent studies have shown that low-carbohydrate diets could not be conclusively associated with the risk of primary open-angle glaucoma (POAG).
Dietary Supplements
There are no proven benefits for using dietary supplements in glaucoma patients. Some patients with glaucoma may also have macular degeneration, for which specific supplements are recommended. However, the AREDS vitamins for macular degeneration are not recommended for glaucoma and may have risks if you don’t have macular degeneration.
Read also: Eye Health and Glaucoma
Ginkgo Biloba Extract
Ginkgo biloba extract is a herbal remedy that may improve blood flow, including to the optic nerve. However, it can interfere with prescribed medication, so it’s important to seek advice from your GP if you’re thinking about taking it.
Salt
Salt consumption should be kept to a minimum to maintain blood pressure.
The Role of Exercise
Being active is great for general health, so having glaucoma should not stop you from getting daily exercise. Cardiovascular exercises enhance general eye health and vision and are particularly advantageous for individuals with glaucoma. Aerobic workouts reduce IOP, a key mediator in protecting the retinal ganglion cells. Moderate activity like brisk walking 30 minutes a day, three to five times a week, has been shown to slow progression. Even a little aerobic exercise has a positive impact on lowering IOP! For anyone who feels they cannot incorporate exercise into their lifestyle-any kind of movement, even walking, may be beneficial.
Stress Management
Stress is known to have a significant impact on various health conditions, including glaucoma. Excessive stress may exacerbate glaucoma by increasing IOP. Incorporating stress-reduction techniques into daily life can be helpful:
- Meditation: Regular meditation can lead to a more relaxed state of mind, reducing stress levels.
- Deep Breathing Exercises: Deep breathing techniques can quickly alleviate acute stress, helping to lower heart rate and reduce blood pressure.
- Yoga: Yoga combines physical postures, breathing exercises, and meditation. It is known for its ability to reduce stress and improve overall well-being. Care must be taken to avoid positions where the head is below the heart, such as “downward dog,” which can elevate IOP.
- Mindfulness Practices: Mindfulness involves staying aware and engaged in the present moment.
It’s essential for individuals with glaucoma to consult with their healthcare provider before starting any new stress-reduction technique, mainly to ensure that any physical activities are safe and appropriate for their specific condition.
Other Lifestyle Factors
- Smoking: Smokers tend to have higher eye pressure than non-smokers.
- Sleep: Getting regular, good-quality sleep-not too much and not too little-is better for glaucoma. If one eye is worse, avoid sleeping on that side. Sleeping with your head propped up on a pillow reduces eye pressure but burying your face in a pillow may not be so good.
- Flying: People with glaucoma can usually fly on an airplane without any problems.
- Protective eyewear: Wearing protective eyewear is also important to prevent glaucoma caused by eye injuries.
Obesity and Metabolic Syndrome
Body mass index (BMI) has been linked to elevated IOP. Other components of metabolic syndrome (MetS), such as diabetes mellitus (DM) or hypertension (HTN), have also been linked to elevated IOP and glaucoma.
Alcohol
Some laboratory research has found that drinking small amounts of alcohol may lower eye pressure. Other observational studies have found that drinking any alcohol is linked to higher eye pressure. Still others have found no link. Drinking large amounts of alcohol can damage the optic nerve as well as having many other negative effects on health.
Complementary and Alternative Medicine (CAM)
The use of complementary and alternative medicine (CAM) in glaucoma has received interest from some ophthalmologists and glaucoma patients. A major domain of CAM in glaucoma is the utilization of dietary interventions.
Important Considerations
- Consult your ophthalmologist: Before embarking on an exercise program to improve your eye health, consult with your ophthalmologist.
- Compliance with glaucoma treatment: For patients diagnosed with glaucoma, the most important lifestyle change is the compliance with glaucoma treatment. Most glaucoma treatments involve instilling glaucoma eye drops, so understanding how to use eye drops properly is imperative.
- Regular ophthalmologic check-ups: Since glaucoma typically has no warning signs, having an annual comprehensive eye exam will allow for early detection of glaucoma (especially if you are at high risk, such as family history).
- No substitute for medical treatment: Healthy eating is not a substitute for glaucoma treatment, however, good nutrition can play a role in glaucoma prevention, as well as helping maintain eyesight in glaucoma patients.
- Avoid excessive intake: Glaucoma patients should always consult their ophthalmologist before beginning any supplement regiment since it is possible to take in too many vitamins and minerals. Consuming too much of certain herbs, vitamins or minerals can result in serious health problems.
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