Glaucoma natural treatment, are herbal and dietary supplements of benefit?
What about vitamins? Natural therapy, alternative treatment
September 4 2018 by
Ray Sahelian, M.D.

Glaucoma is a condition in which the eye's intraocular pressure (IOP) is too high. This means that the eye has too much aqueous humor in it, either because it produced too much, or because it's not draining properly. Glaucoma occurs when pressure builds up in the eye from excess fluid. Early detection and treatment can preserve eyesight.

Regular physical activity can lower intra ocular pressure by a little bit.

Diet and food
There is a suspicion that diet may play a role in glaucoma, but little is clearly understood at this time. Studies in rodents indicate that eating fish with the omega-3 fatty acids could reduce intra ocular pressure. Eating more fish and vegetables and reducing intake of sugar, simple carbohydrates and junk food may be helpful.

Natural glaucoma treatment, role of nutraceuticals
It would be best to limit alcohol intake and smoking, and keeping a healthy weight. Whether supplements are helpful for glaucoma is not fully known but fish oils look promising. Perhaps ginkgo biloba can be tried under medical supervision. Forskolin eye drops have been studied for glaucoma. I have not seen studies with eyebright herb.

Q. This question is in regards to treating glaucoma naturally. I have numerous friends asking me for a natural product to reduce eye pressure, they are border line glaucoma. They come to me for the reason that I never take any medicine nor approve of it. Please let me know if you have a real effective product to reduce eye pressure.
    A. In addition to a healthy diet with a good amount of cold water fish and vegetables, perhaps fish oils capsules and ginkgo biloba may be of benefit. Alpha lipoic acid is another option.

Q. Is there a natural supplement treatment for narrow angle glaucoma? If so where can I get it? I am a type 1 diabetic and I am a vegetarian and I select organic foods and omega 3 content.
   A. I have personally not treated patients with this condition but you may wish to review this information with your eye doctor.

Forskolin and the flavonoid rutin given as oral treatment appear to help. J Ocul Pharmacol Ther. 2012. Oral administration of forskolin and rutin contributes to intraocular pressure control in primary open angle glaucoma patients under maximum tolerated medical therapy.

Treatment of glaucomatous patients by means of food supplement to reduce the ocular discomfort: a double blind randomized trial. Department of Sense Organs, Sapienza University of Rome, Rome, Italy. Eur Rev Med Pharmacol Sci. 2013.
Chronic use of multi-dose eye drops containing preservatives, such as it may happen in patients affected by primary open angle glaucoma, often results in a damage of the ocular surface due to the inherent toxicity of preservatives, that with time may lead to a lacrimal dysfunction syndrome and eye dryness This double blind, randomized, pilot study was conducted on 38 glaucomatous patients suffering from dry eye induced by long-term use of eye drops preserved with BAK. Treatment of these patients with a food supplement containing an association of forskolin, rutin and vitamins B1 and B2 for 30 days increased significantly their OPI values and improved the symptoms of dry eye with respect to a placebo-treated control group. The association of forskolin, rutin and vitamins B1 and B2 appears to be protective for the ocular surface, contributing to restore a normal equilibrium of the tear film in those subjects in which toxic agents such as BAK had determined alterations of its homeostasis.

J Ocular Pharmacol Ther. 2016. Oral Administration of Forskolin, Homotaurine, Carnosine, and Folic Acid in Patients with Primary Open Angle Glaucoma: Changes in Intraocular Pressure, Pattern Electroretinogram Amplitude, and Foveal Sensitivity. Twenty-two patients (44 eyes) with POAG, with their IOP compensated by topical drugs, were enrolled and randomly assigned to the food supplement or control treatment group. The additional food supplement treatment consisted of 2 tablets per day (1 in the morning, 1 in the evening) given for 1 year of a balanced association of homotaurine, Coleus forskohlii root extract, L-carnosine, folic acid, vitamins B1, B2, B6, and magnesium. We observed in treated patients a significant further decrease of IOP. The results of the present pilot study indicate that the components of the food supplement reach the eye in a detectable manner, as evidenced by the effects on the IOP. Moreover, they suggest a short-term neuroactive effect, as indicated by the improvement of foveal sensitivity in treated, but not in control patients.

Q. I would like to know if you know about the supplement Mirtogenol that lowers intraocular pressure in the eyes.
   A. I am not familiar with Mirtogenol and it does not seem to be sold in the USA as of 2010. According to one website this product is a combination of standardized bilberry extract Mirtoselect and pine bark extract Pycnogenol. Therefore you can buy bilberry extract and Pycnogenol separately.

Alpha lipoic acid, does it help?
Lipoic acid as a means of metabolic therapy of open-angle glaucoma.
Vestn Oftalmol. 1995.
A total of 45 patients (90 eyes) with stages I and II open-angle glaucoma (OAG) were examined, 26 of these were administered lipoic acid in a daily dose of 0.075 g for 2 months and 19 were given 0.15 g daily for 1 month. Control group consisted of 31 patients with OAG who were administered only local hypotensive therapy. Vision acuity and visual field were checked up, tonometry, tonography, and campimetry carried out, and levels of nonprotein SH-groups and activity of gamma-glutamyl transpeptidase measured in the lacrimal fluid. Improvement of the biochemical parameters, visual function, and of the coefficient of efficacy of liquid discharge was more expressed in the patients administered lipoic acid in a daily dose of 0.15 g. Color campimetry results indicate improved sensitivity of the visual analyzer under the effect of treatment. Improvement was attained in approximately 45% of examined eyes, and was more often seen in patients with stage II OAG: in 57% eyes. The effect of lipoic acid may be explained by its antioxidant properties and direct influence on ocular tissue metabolism.

Ginkgo biloba
Acta Ophthalmol. 2018. The effects of antioxidants on ocular blood flow in patients with glaucoma. To investigate the effects of an antioxidant dietary supplement that includes Ginkgo biloba, on retinal and retrobulbar blood flow in patients with open-angle glaucoma (OAG). One-month oral administration of antioxidants produced increases in biomarkers of ocular blood flow within retinal and retrobulbar vascular beds in patients with OAG.

Goji berry, Lycium Barbarum
Neural Regen Res. 2012. Effect of Lycium barbarum Polysaccharides on the expression of endothelin-1 and its receptors in an ocular hypertension model of rat glaucoma. Goji berry, a traditional Chinese anti-aging herb, has been shown to protect retinal ganglion cells (RGCs) in a rat chronic ocular hypertension (COH) model.

Exp Neurol. 2007. Neuroprotective effects of Lycium barbarum, Goji berry, on protecting retinal ganglion cells in an ocular hypertension model of glaucoma.

Omega-3 fatty acids, fish oils
Dietary omega 3 fatty acids decrease intraocular pressure with age by increasing aqueous outflow.
Invest Ophthalmol Vis Sci. 2007.
To determine whether there is an association between dietary omega-3 (omega-3) fatty acid intake, age, and intraocular pressure caused by altered aqueous outflow. Sprague-Dawley rats were fed either omega-3-sufficient or omega-3-deficient diets from conception. The diets had 7% lipid content. The omega-3 diet contained safflower, flaxseed, and tuna oils (5.5:1.0:0.5), and the omega-3 deficient diet contained safflower oil only. Animals raised on high omega-3 diets had a 13% decrease in intra ocular pressure at 40 weeks of age. This lower intraocular pressure in the high omega-3 diet group was associated with a significant increase in outflow facility and a decrease in ocular rigidity. The high omega-3 group showed a 3 times increase in ciliary body docosahexaenoic acid. Results show Increasing dietary omega-3 reduces intra ocular pressure with age because of increased outflow facility, likely resulting from an increase in docosanoids. This indicates that dietary manipulation may provide a modifiable factor for intraocular pressure regulation.

SAM-e supplement
Q. Is it true that sam-e is bad for glaucoma patients? I read an article that said, "SAMe Supplement Not Recommended for Glaucoma Patients - Excess methylation in the central nervous system (CNS) via SAMe (S-adenosylmethionine) may lead to neurodegeneration.  I take 200 mg a day.
   A. I have not come across such studies regarding the influence of SAM-e supplement use on this condition, but it is a good idea to take breaks from SAM-e, anyway, since the consequences of continuous long term use are not clearly understood.

Combination of supplements
J Ocul Pharmacol Ther. 2016. Oral Administration of Forskolin, Homotaurine, Carnosine, and Folic Acid in Patients with Primary Open Angle Glaucoma: Changes in Intraocular Pressure, Pattern Electroretinogram Amplitude, and Foveal Sensitivity. To evaluate the effects of a food supplement containing forskolin, homotaurine, carnosine, folic acid, vitamins B1, B2, B6, and magnesium in patients with primary open angle glaucoma (POAG) already in treatment and compensated by intraocular pressure (IOP)-lowering drugs, during a period of 12 months. The food supplement treatment consisted of 2 tablets per day (1 in the morning, 1 in the evening) given for 1 year of a balanced association of homotaurine, Coleus forskohlii root extract, L-carnosine, folic acid, vitamins B1, B2, B6, and magnesium. We observed in treated patients a significant further decrease of IOP.

Marijuana, it is effective?
Consumption of the cannabis plant has been known since ancient times. It can be consumed orally, topically, intra-venous or by inhalation. The main active ingredient of cannabis is THC (Tetra-Hydro-Cannabinol). One of THC's reported effects is the reduction of intra-ocular pressure. Several studies have demonstrated temporary intra-ocular pressure decrease in both healthy subjects and glaucoma patients following topical application or systemic consumption. However, the effects seem temporary. Due to the various side effects of marijuana consumption when used regularly, it does not seem to be an effective treatment for glaucoma but more studies are needed.

Reduce the pressure
Glaucoma is a group of eye disorders that cause progressive changes in the optic nerve head and/or visual field loss. An elevated intraocular pressure (IOP) is often, but not always, present. Data from five large-scale clinical trials suggest that the greater the IOP reduction, the greater the protection against visual field loss. Corneal thickness is now recognized as an important predictor of glaucoma progression. The thinner the cornea, the greater the risk of progression.

Glaucoma symptoms
Some of the symptoms are optic nerve damage leading to vision loss. Glaucoma can trigger loss of peripheral vision, which impairs the ability to move about safely and independently. Glaucoma can make reading difficult, by limiting vision so that only one word can be read at a time. If undiagnosed or untreated, glaucoma can cause permanent, irreversible damage to the eye.
   There is not enough evidence to say whether screening adults without vision problems for glaucoma has any clear benefit, according to a 2013 government-backed panel.

Cause of glaucoma
Elevated intra ocular pressure, if untreated, can be a cause. But what causes IOP increase? This is not fully understood, but we do know of risk factors. Those over the age of 60, African-American, and diabetics those who have a family member with glaucoma are at higher risk than others. Brothers and sisters of patients with glaucoma have about a 20 percent chance of having developed the disease by the time they reach age 70. That's about five times the risk of the whole population at a similar age. Perhaps drinking too many cups of coffee a day is also a risk.

Medical glaucoma treatment
Management of angle closure glaucoma requires an understanding of the underlying pathophysiologic mechanisms. Treatment is aimed at eliminating pupillary block and other causes of angle closure, re-opening the angle, and preventing further damage to the optic nerve by lowering intraocular pressure. Medical therapy plays an important role in the successful management of this condition. Newer classes of glaucoma drugs include topical carbonic anhydrase inhibitors, prostaglandin analogues and selective alpha2- adrenergic agonists.
   Chronic use of multi-dose eye drops containing preservatives, such as it may happen in patients affected by primary open angle glaucoma, often results in a damage of the ocular surface due to the inherent toxicity of preservatives, that with time may lead to a lacrimal dysfunction syndrome and eye dryness.

Ther Adv Chronic Dis. 2014. Glaucoma management: relative value and place in therapy of available drug treatments. Lowering intraocular pressure (IOP) is the only proven therapeutic intervention for glaucomatous optic neuropathy. Despite advances in laser and microsurgical techniques, medical IOP reduction remains the first-line treatment option for the majority of patients with open-angle glaucoma. Prostaglandin analogs are the most efficacious topical agents and carry a remarkable safety profile. Topical beta-blockers, alpha-agonists, and carbonic anhydrase inhibitors are often employed as adjunctive agents for further IOP control. Newer preserved and nonpreserved formulations are available and appear to be less toxic to the ocular surface. Oral carbonic anhydrase inhibitors, miotic agents, and hyperosmotics are infrequently used due to a host of potentially serious adverse events. Medical therapies on the horizon include rho-kinase inhibitors, neuroprotective interventions, and gene therapies.

Intraocular pressure
Some patients with glaucoma may have greater pressure in their eyes during sleep, meaning that the severity of the disease can go unrecognized during exams that only involve daytime office visits. Higher intraocular pressure, the force within the eyeball, and greater daily fluctuation in pressure may increase the risk that glaucoma will develop or worsen. Untreated glaucoma can lead to vision loss. High intraocular pressure is recognized, perhaps, as the most important risk factor for the development of open-angle glaucoma and its progression. Many physiological and environmental conditions can affect intraocular pressure, and a single determination of intraocular pressure during regular clinic hours may not fully reveal its relationship to the optic nerve damage that accrues with glaucoma. Intraocular pressure may be higher when a person is lying down probably because the eye is level with the heart when lying down, increasing the resistance in flow of fluid in the eye and possibly creating additional pressure.

Globally around the world
Global cases of the eye disease glaucoma are expected to reach 60 million by 2010 and 80 million by 2020.
Glaucoma is a preventable cause of blindness. It is a treatable disease. If left untreated it may result in blindness. The disorder is more common in people over 60 years old and is second only to cataracts as the leading cause of blindness.

I read your newsletter about alternative glaucoma treatments. Just wanted to add that I had high pressure in my eyes around -22 and 23.A Glaucoma specialist wanted to put me on drops. I delayed treatment for 6 months in order to give Pycnogenol, a therapy I had read about (Mirtoginol) a try. My pressure went down to 20 and 21 and has remained there for over a year. I take Life Extension Pressure Support Mirtogenol 2 x a day along with fish oil, Lutein and Astazanthin and zeazanthin for macular degeneration.

Glaucoma natural treatment questions
I have read about your formula for better vision, Eyesight Rx, and I must say I got very excited. However, I am not exactly sure if it is the dream drug that I have been waiting for or whether it is even suitable for me. I am a 23 year old female, and have congenital glaucoma in one eye (the right is artificial). Aside from the glaucoma, I have also had cataract many years ago and since has been removed. While the glaucoma has also been stable for some years now, it is now my cornea which is playing up. I have had two cornea transplants thus far, with the first one being rejected. This second one I have right now is not rejecting, but due to scarring of the eye, is blurring up once again. My question is, will Eyesight Rx help this type of condition? Also, will I be able to use it together with other eye drugs such as Combigan / Alfagan / timoptol and Flarex, including herbal pills such as St Johns Wort, vitamins etc?
    Eyesight Rx was formulated for age related vision loss since it helps the retina, we don't know how it will influence the cornea since we have not studied this issue.

I was just told that I have glaucoma. Iím a woman in my 50s. I read a report by an herbalist, Dr. John Heinerman, that taking eyebright 6 capsules per day can help early stages of glaucoma. Do you have any feedback on whether Eyesight Rx can help glaucoma? Has anyone with glaucoma wrote you about how this formula has helped them with this eye condition?
    We have not had feedback from Eyesight Rx users regarding an influence on glaucoma.

I am a 39 year old African American woman in fairly good health. I have been wearing contacts for over 20 years. I donít wear glasses. My eye doctor recently showed me my eye xray. On it were some small white spots that they have been monitoring since 2000. They think maybe it is glaucoma. Do you think lutein pills can help me?
    It is impossible for us to predict in any individual what supplements would help them with glaucoma or any other eye condition. You may consider reading some info on eyesight and glaucoma at the above page and share the info with your doctor.

Would you please tell me if there is research showing that any of the following cause an increase in eye pressure, and thus should be of concern to those with glaucoma? Rhodiola rosea, ashwagandha, yohimbe, horny goat Weed herb.
    I have not come across any research regarding the influence of these herbs on eye pressure.

Did you hear of Meo Pluc that is purchased from Germany and seems to be very effective? Now it is not available anymore.
    I have not heard of Meo Pluc.

I have pigmentary glaucoma. I just wondered whether you know of any herbal supplements which have documented evidence to lower ophthalmic eye pressure. Currently, I'm on Dorzolamide and Timolol; however, I'd rather not be on them the remainder of my life and would rather take something natural to accomplish the same thing in regard to ophthalmic pressure.
   A. Some of the dietary supplements discussed above could be of benefit.