Glaucoma

Glaucoma is a slow-progressing disease that causes damage to the eye's optic nerve and can result in blindness. Open angle glaucoma, the most common form of the disease, affects about 3 million Americans. It is the leading cause of blindness in the United States. Since there are usually no early symptoms, half of the people with this disease don't know they have it. With early treatment, most people can avoid serious vision loss and blindness.

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Signs and Symptoms

While symptoms do not initially occur, as the disease progresses, you can lose peripheral (side) vision followed by central vision. Some signs can be detected only during an eye exam, such as increased pressure inside the eye and optic nerve abnormalities. Other patients may complain of blurry vision, pain, brow ache, rainbow-colored halos around lights, or red eye. Headache, nausea, and vomiting are other symptoms.

What Causes It?

A clear fluid flows in and out of the space at the front of the eye, nourishing nearby tissues. Glaucoma causes the fluid to pass through too slowly or to stop draining altogether. As the fluid builds up, the pressure inside the eye increases, causing damage to the optic nerve and vision loss.

Who's Most At Risk?

People with the following conditions or characteristics are at risk for glaucoma:

• Over 60 years of age
• Family history
• African American descent
• Diabetes
• Myopia (near sightedness)
• Taking certain drugs, such as antihistamines or blood pressure medications
• Food sensitivities
• Stress
• Sedentary lifestyle
• Hypothyroidism
• H. Pylori infection

What to Expect at Your Provider's Office

It is important to have your eyes examined on a regular basis to check for glaucoma. If you are having symptoms, you should see your eye care provider immediately.

To detect glaucoma, your eye care professional will perform the following tests:

• Visual acuity. Use of an eye chart measures how well you see at various distances.
• Visual field. Measures your peripheral vision.
• Pupil dilation. Drops are placed into the eye to dilate (widen) the pupil. This gives your eye care professional a better view of the optic nerve to check for signs of damage.
• Tonometry. Determines the fluid pressure inside the eye. One type uses a purple light while another type uses a puff of air.

Treatment Options

Prevention

While glaucoma is not preventable, early detection and treatment are the best defenses against serious visual damage. At risk patients should avoid medicines that increase eye pressure.

Treatment Plan

The primary goal of treatment is to minimize loss of vision by reducing pressure in the eye.

Drug Therapies

Once started, therapy generally continues for the rest of the patient's life. Eye drops and pills to relieve pressure are the most common early treatment for glaucoma. Some cause the eye to produce less fluid while others lower pressure by helping drain fluid from the eye.

Surgical and Other Procedures

While glaucoma surgery may save remaining vision, it does not improve sight.

• Laser surgery. Makes 50 to 100 evenly spaced burns that stretch the drainage holes in the eye, allowing fluid to drain more efficiently.
• Conventional surgery. Creates a new channel for fluid to drain from the eye.

Complementary and Alternative Therapies

A comprehensive treatment plan for glaucoma may include a range of complementary and alternative therapies (CAM). However, only a qualified ophthalmologist should treat glaucoma. Use alternative medicine as support for a healthy body, not as a substitution for conventional medicine. You should tell all of your health care providers about any CAM therapies you are considering.

Nutrition and Supplements

Nutritional tips include the following:

• Eliminate all suspected food allergens, including dairy (milk, cheese, and eggs), wheat (gluten), soy, corn, preservatives, and food additives. Your health care provider may want to test you for food allergies.
• Eat more antioxidant-rich foods (such as green, leafy vegetables and peppers) and fruits (such as blueberries, tomatoes, and cherries). Some studies show that a higher intake of fruits and vegetables is associated with a lower risk of glaucoma.
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.
• Use healthy oils in foods, such as olive oil or coconut oil.
• Reduce or eliminate trans fatty acids, found in such commercially-baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 to 8 glasses of filtered water daily.
• Exercise moderately, if tolerated, 5 days a week.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily. Containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
• Omega-3 fatty acids. Such as fish oil, to help reduce inflammation. Fish oil may increase bleeding in sensitive individuals, such as those taking blood-thinning medications (including aspirin).
• Vitamin C. As an antioxidant.
• Coenzyme Q10 (CoQ10). For antioxidant support. CoQ10 may interfere with the action of blood-thinning medications, such as warfarin (Coumadin) among others.
• Alpha-lipoic acid. For antioxidant support. Check with your doctor to ensure your thiamine levels are adequate when taking Alpha-lipoic acid. Certain populations, including alcoholics, are deficient in thiamine, which could be dangerous when combined with Alpha-lipoic acid.
• Lutein. For antioxidant support in eye health.

Herbs

Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should speak with your provider before starting treatment.

You may use herbs such as dried extracts (capsules, powders, and teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. (5 g) herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.

• Bilberry (Vaccinium myrtillus). Standardized extract, for antioxidant and vision support. Bilberry may interact with diabetes medication and may increase the effect of blood-thinning medications, such as aspirin and warfarin (Coumadin). DO NOT take Bilberry if you are pregnant or breastfeeding. More research is needed.
• Ginkgo (Ginkgo biloba). Standardized extract, for antioxidant and immune support. Ginkgo may increase bleeding in sensitive individuals, such as those taking blood-thinning medications, including aspirin. Ginkgo may not be appropriate for people who have diabetes, infertility, seizure history, or bleeding disorders.
• Green tea (Camellia sinensis). Standardized extract, for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you.

An experienced homeopath could prescribe one of the following acute remedies:

• Phosphorus. For vertigo.
• Physostigma. For muscle spasms and neurological problems.
• Spigelia. For sharp pains.

Acupuncture

While several studies have investigated whether acupuncture can relieve glaucoma pressure, results have been mixed. Speak to your doctor.

Prognosis/Possible Complications

If glaucoma is not treated early, some vision loss can occur. If you have glaucoma in one eye, your eye care provider may recommend treating your other eye as well. Preliminary studies suggest an association between glaucoma and an increased risk for dementia.

Supporting Research

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Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

Coleman AL, Miglior S. Risk factors for glaucoma onset and progression. Surv Ophthalmol. 2008;53(11):S3-S10.

Coleman AL, Stone KL, Kodjebacheva G, et al. Glaucoma risk and the consumption of fruits and vegetables among older women in the study of oseoporotic fractures. Am J Ophthalmol. 2008;145(6):1081-1089.

Fontani G, Corradeschi F, Felici A, et al. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005;35(11):691-699.

Head KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern Med Rev. 2001;6(2):141-166.

Jampel HD, Singh K, Lin SC, et al. Assessment of visual function in glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology. 2011;118(5):986-1002.

Kang JH, Pasquale LR, Willett W, et al. Antioxidant intake and primary open-angle glaucoma: a prospective study. Am J Epidemiol. 2003;158(4):337-346.

Law SK, Li T. Acupuncture for glaucoma. Cochrane Database Syst Rev. 2013;5:CD006030.

Lin AP, Biggerstaff KS. Glaucoma. In: Bope ET, Kellerman RD, eds. Conn's Current Therapy 2016. Philadelphia, PA: Elsevier; 2016:327-330.

Owen CG, Carey IM, Shah S, de Wilde S, Wormald R, Whincup PH, Cook DG. Hypotensive medication, statins, and the risk of glaucoma. Invest Ophthalmol Vis Sci. 2010;51(7):3524-3530.

Pandi-Perumal SR, Srinivasan V, Maestroni GJ, et al., Melatonin. FEBS J. 2006;273(13):2813-2838.

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Wan MJ, Daniel S, Kassam F, et al. Survey of complementary and alternative medicine use in glaucoma patients. J Glaucoma. 2012;21(2):79-82.

West AL, Oren GA, Moroi SE. Evidence for the use of nutritional supplements and herbal medicines in common eye diseases. Am J Ophthalmol. 2006;141(1):157-166.

Zeng J, Liu H, Liu X, Ding C. The relationship between helicobacter pylori infection and open-angle glaucoma: A meta-analysis. Invest Ophthalmol Vis Sci. 2015;56(9):5238-45.

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Review Date: 11/20/2016  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.

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