LOWERING YOUR RISK OF GLAUCOMA
Having a diagnosis of glaucoma can be daunting and many patients want to know what they can do to help themselves in their glaucoma journey. Currently, lowering your intraocular pressure is the only management that is shown to slow the progression of glaucoma. Is there anything that we can do that may help glaucoma?
Find out more about each of these risk factors below.
Aerobic Exercise Lowers Intraocular Pressure (IOP)
Aerobic exercise (walking, jogging or cycling) lowers IOP, even after 5 minutes. This reduction is greater with longer duration and higher intensity. It may have more effect in individuals with glaucoma.
Once regular exercise is established (for at least 3 months), this IOP lowering effect continues for up to 3 weeks after cessation of exercise. Physically fit individuals have a lower baseline IOP, and get much less additional lowering of IOP with exercise.
Interestingly, this reduction with exercise is additive to the effect of any glaucoma drops.
Exercise also lowers blood pressure.
It must be remembered that in pigment dispersion, aerobic exercise may increase IOP when pigment is dispersed.
NB: aerobic exercise differs from weight lifting and yoga, which may increase IOP.
One study showed that foods with antioxidant properties may reduce the risk of glaucoma. These foods include:
We would recommend a balanced diet with five fruits and vegetables a day, trying to include the above.
Use of a cholesterol lowering medication (statin or non-statin) for more than 24 months has been shown to reduce the risk of glaucoma.
High Body Mass Index (BMI) and Obesity
Being overweight is associated with high IOP, but there is conflicting evidence about the association with glaucoma. A high BMI is associated with sleep apnoea.
Sleep apnoea syndrome (SAS) is associated with glaucoma. SAS is the repetitive collapse of the airway during sleep. Due to the poor quality of sleep, patients have chronic fatigue, daytime sleepiness and reduced cognitive function. People are more at risk for SAS if they are male, obese, snore, drink excessive alcohol, and smoke.
Current smoking is possibly related to glaucoma risk. No study has found an association between glaucoma and past history of smoking.
Excessive Water Drinking
A significant rise in IOP may occur after drinking a high volume of water (500mL to 1L) over a short time period (15minutes). Glaucoma patients should avoid ingesting large volumes of fluid rapidly.
Caffeinated coffee is known to elevate IOP. It seems safer to ingest caffeine in moderation – no more than 2 cups of coffee a day.
Alcohol may lower IOP initially, but daily alcohol causes a slight elevation in IOP. We recommend moderation.
High Blood Pressure
Untreated systemic hypertension is associated with glaucoma. This is not a direct association, rather indirect, possibly due to high blood pressure damaging the blood vessels to the optic nerve over time. It is recommended that high blood pressure is treated.
NB: High blood pressure is not correlated with high eye pressure.
Low Blood Pressure
Some glaucoma patients have progressive visual field loss despite adequately controlled IOP. One possible cause is excessive lowering of blood pressure, in patients on BP medications who may be over-medicated. 24-hour blood pressure monitoring can detect this.
Increasing Intraorbital Pressure – Playing Wind Instruments
IOP can almost double within 20 seconds when playing a wind instrument, but returns to baseline almost immediately.
The inverted position in yoga has been associated with significant increases in intraocular pressure in some people and could lead to worsening of glaucoma.
Several lifestyle factors affect IOP, but there are no studies confirm whether these changes influence glaucoma progression. However, there is significant evidence that these lifestyle changes are good for general health, and they seem unlikely to cause more glaucomatous damage. Hence, with the current information available, we recommend them.