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Glaucoma

MagazineApril 2009 (Vol. 20 Issue 1)Glaucoma

Q) My 82-year-old dad has had glaucoma for 18 years

Q) My 82-year-old dad has had glaucoma for 18 years. He uses drops prescribed by his GP several times a day, but has now been told that the pressure in one of his eyes is worryingly high. If it hasn't improved in two months, he will need an operation to drain the fluid. His eyes are also becoming increasingly red, which I suspectis a reaction to the drops. Are there any natural remedies that might help?-H.B., via e-mail

A) Glaucoma refers to conditions characterized by damage to the optic nerve, resulting in progressive vision loss. It can strike at any age, but the elderly are especially vulnerable. Changes in the ageing eye lead to less effective drainage of the aqueous humour (the clear fluid between the iris and cornea), causing a buildup of pressure within the eye. An abnormally high pressure, or ocular hyperten-sion, is a major risk factor for glaucoma (WDDTY vol 15 no 12).

The usual treatment of glaucoma involves the use of beta-blockers or prostaglandin analogues as eye drops to reduce pressure in the eye. But, as you're probably aware, these have a host of horrible side-effects and are often as dangerous as the drugs taken by mouth. Laser and surgical treatments are also available for glaucoma, but these may be invasive, aggressive procedures that don't always work. Happily, however, there is evidence that many patients benefit from alternative approaches.

Treating glaucoma naturally

- Antioxidants. Glaucoma patients often have a weak antioxidant defence system (Altern Med Rev, 2001; 6: 141-66), so the following supplements may help.

- Vitamin C. In 30 patients with open-angle glaucoma (OAG), the most common type, high-dose vitamin C (an average of 10 g/day) lowered eye pressure in all cases-with no adverse effects (J Orthomol Med, 1995; 10: 165-8). Your dad could try taking 3 g/day in divided doses at meal times.

- Vitamin E. This and other fat-soluble antioxidants appear to prevent the eye's drainage system from deteriorating as well as inhibit cell death (Br J Nutr, 2004; 91: 809-29). Have your dad try 500 mg/day.

- Alpha-lipoic acid (ALA). In 45 patients with early-stage OAG, those taking 150 mg/day of ALA for

a month showed the most improvement compared with those taking a lower ALA dose or using medicated eye drops (Vestn Oftalmol, 1995; 111: 6-8).

- Lutein, zeaxanthin. Although it may not apply to humans, an animal study suggests that adding these carotenoids to the diet (6 mg/day) can help to treat glaucoma (Oftalmologia, 2003; 59: 70-5).

- Nutritional therapy. Deficiencies of a number of nutrients are often found in glaucoma patients, so supplementation may play a role in treatment (Altern Med Rev, 2001; 6: 141-66).

- Thiamine. Blood levels of this vitamin (B1) were significantly lower in glaucoma patients compared with controls (Ann Ophthalmol, 1979; 11: 1095-100).

- Magnesium, zinc, chromium, iron. Deficiencies of these minerals have been linked to glaucoma (Altern Med Rev, 2001; 6: 141-66; Med Hypotheses, 2001; 56: 163-70; Vestn Oftalmol, 1994; 110: 24-6). In one study, 121.5 mg of magnesium twice a day for one month improved the size of the visual field of 10 glaucoma patients (Ophthalmologica, 1995; 209: 11-3).

- Omega-3 fatty acids. Glaucoma patients have lower levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) compared with their healthy siblings (Prostaglandins Leukot Essent Fatty Acids, 2006; 74: 157-63), and research-at least in rats-shows that an increased intake of these omega-3 fats can significantly reduce eye pressure (Invest Ophthalmol Vis Sci, 2007; 48: 756-62).

- Herbal remedies. Although more studies are needed, a number of plant extracts have shown promise in the treatment of glaucoma.

- Ginkgo biloba. This herb may help glaucoma patients who have decreased blood flow to the eyes (Can J Ophthalmol, 2008; 43: 351-5). In one study, 40 mg three times a day for one month led to significant improvements in patients with impaired eyesight due to glaucoma (Ophthalmology, 2003; 110: 359-62).

- Coleus forskohlii. Several studies have shown

that eye drops containing forskolin-the active ingredient in this plant-can lower eye pressure in both animals and humans (Altern Med Rev, 2001; 6: 141-66). However, commercial forskolin eye drops are not yet available, and it is still not clear whether extracts of C. forskohlii taken orally will have any benefit.

- Vaccinium myrtillus (bilberry). Preliminary evidence suggests that the anthocyanosides from bilberry may be useful for treating glaucoma. Improvements were noted in eight patients after just one 200-mg dose of anthocyanosides (Altern Med Rev, 2001; 6: 141-66).

- Salvia miltiorrhiza (dan shen; Chinese sage). Used in traditional Chinese medicine, this plant improves the microcirculation of the retina and optic nerve in animal studies of ocular hypertension (Chin Med J [Engl], 1993; 106: 922-7). In humans, daily injections of a solution (2 g/mL) of this plant, either alone or in combination with other Chinese herbs, led to long-term vision improvements in patients with mid-to-late-stage glaucoma (Chin Med J [Engl), 1983; 96: 445-7).


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