Depending on the type
of glaucoma a patient is suffering
from, treatment will vary. In the
case of acute angle-closure glaucoma
(a medical emergency), treatment
must be initiated immediately to
prevent permanent vision loss. In
this case, the patient must always
be treated medically and should not
attempt to use natural therapies or
nutritional supplements. They must
be treated with topical
beta-blockers, IV, or oral carbonic anhydrase inhibitors, and topical
alpha-2-selective adrenergic
agonists.
Conventional
treatment for Chronic Open-Angle
Glaucoma:
The goal of treatment
is to prevent any further damage to
the optic nerve and visual fields by
reducing the intraocular pressure [1]. Prescription medications are used to
treat this condition, as well as
laser therapy. If both of these
modalities are ineffective,
filtration surgery may be performed, or
may be used initially depending
on the individual's condition. There are an increasing
number of medications available for
treatments, including: miotics (pilocarpine and
physostigmine) that increase
aqueous outflow, carbonic anhydrase
inhibitors (methazolamide),
beta-blockers (timolol and
metipranolol0, which which work decrease aqueous
production; and osmotic diuretics
(oral glycerin or IV mannitol) that draw fluid out of the eye by
osmosis.
Conventional
treatment for Chronic Closed-Angle
(Angle-Closure) Glaucoma:
As discussed, for
acute closed-angle glaucoma,
treatment must be initiated
immediately for an attack. The
definitive treatment for these
patients is laser peripheral iridotomy, which has an extremely low
incidence of complications.
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Supplements helpful for Glaucoma |
Vitamin C
Vitamin C has been
shown to be useful for the treatment
of high intraocular pressure,
typical in patients with glaucoma. [4] High dose vitamin C, anywhere from
1-35 grams per day (with an average
of 10g/day), was administered orally
to patients with intraocular
pressure exceeding 20mmHg. Patients
were instructed to take vitamin C to
bowel tolerance (until stool became
loose) in 3 daily doses with meals.
All patients in the study
demonstrated a reduction in
intraocular pressure, with a mean
reduction of 5.6 mmHg. Another study
also showed a smaller reduction in
intraocular pressure with lower doses
(2 grams/day) of prescribed Vitamin C. [5]
Magnesium aspartate
Magnesium aspartate
hydrochloride was administered to
patients with primary open-angle
glaucoma and normal-tension glaucoma
over a course of 4 weeks. [6] These
patients took 250mg/per day in
equally divided
doses. This administration resulted
in an improvement
of visual field defects. The authors
suggest that this specific form of
magnesium exerts its effect via a vasodilatory action, thereby
improving blood flow to the eye,
which leads to improved vision.
Flavonoids
Flavonoids are
compounds found in colored fruits
and vegetables that assist with
collagen stabilization. Flavonoids
also synergize the effects of
vitamin C, therefore could be taken
to augment the effect of vitamin C
noted in the section above.
Furthermore, a specific flavonoid
called rutin, has shown
effectiveness in reducing
intraocular pressure when combined
with prescriptive miotic agents.
This result occured in
patients who were unresponsive to
the medication alone. [7] Patients
took 20mg of rutin three times a day
for 4 weeks. The effect of the flavonoid is thought to be due to a
reduction in excessive permeability
of the blood aqueous membrane within the
eye.
Essential fatty acids
Essential fatty
acids, specifically the omega 3-type found in fish oils (docosahexaenoic
acid (DHA) and eicosapentaenoic acid
(EPA), have a body of evidence in
animal studies and human
epidemiology to support their use
for the treatment of chronic open
angle glaucoma. One mammalian
study demonstrated a reduction in
intraocular pressure when cod liver
oil was administered in both oral and
intramuscular solutions. [8]
Lipoic acid
Lipoic acid is
vitamin like substance that contains
sulfur and has a role in cellular
energy production (ATP). Its use for
treating stage I and II open-angle
glaucoma has been studied in
various controlled settings. [9] Patients
were prescribed either 75 mg of lipoic acid daily for two months or
150mg for one month. Improvement was
measured in almost half of the
participating subjects, more so in those with
stage II glaucoma. Specifically,
there were improvements in visual
acuity, various biochemical
parameters, and the coefficient of
liquid discharge. These
results were
more significant in patients
receiving the higher dosage (150mg
daily).
Gingko biloba
Gingko extracts have
demonstrated effectiveness in the
treatment of glaucoma. [10] The
extract must contain a minimum of 25% gingko flavonglycosides, which are a
category of active constituents
found in this herb. Patients
in one study, suffering from severe glaucoma, took 160mg per day
of the extract for four weeks and
then 120mg daily. The results of the
study showed improvements in
intraocular pressure and visual
field defects. This study was
promising, that such a severe
categorization of glaucoma responded to this
particular herbal
extract.
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