Abstract
Purpose
Primary open angle glaucoma is a chronic optic neuropathy affecting millions of people worldwide and represents a major public health issue. Environmental factors, behaviors, and diet are intimately related to patient health and may play a role in the pathogenesis and progression of glaucoma. This study aims to review the literature, focusing on the last three years, regarding modifiable lifestyle interventions in the management of primary open angle glaucoma.
Methods
Electronic databases were searched for studies published between January 2013 and July 2016 on the topic of lifestyle interventions in primary open angle glaucoma.
Results
Sleeping with the head elevated and avoiding the worst eye-dependent side during sleep may slightly lower intraocular pressure and reduce visual field loss. Some food supplements and moderate aerobic exercise may also reduce intraocular pressure up to 2.0 and 3.0 mmHg, respectively. Frequency of coffee intake may be associated with disease progression. Potential negative effects are associated with weight-lifting and yoga exercises.
Conclusions
Certain lifestyle habits could influence glaucoma progression, yet no specific interventions are currently supported by robust evidence. Awareness of the possible influences of certain habits should help guide clinical advice and is important to help patients avoid adverse outcomes and take an active role in the management of their disease.
Similar content being viewed by others
References
Heijl A, Bengtsson B, Oskarsdottir SE (2013) Prevalence and severity of undetected manifest glaucoma: results from the early manifest glaucoma trial screening. Ophthalmology 120(8):1541–1545
Mutolo MG, Albanese G, Rusciano D, Pescosolido N (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. J Ocul Pharmacol Ther: Off J Assoc Ocul Pharmacol Ther 32(3):178–183
Lazzaro EC, Mallick A, Singh M, Reich I, Elmann S, Stefanov DG et al (2014) The effect of positional changes on intraocular pressure during sleep in patients with and without glaucoma. J Glaucoma 23(5):282–287
Hamilton-Maxwell KE, Feeney L (2012) Walking for a short distance at a brisk pace reduces intraocular pressure by a clinically significant amount. J Glaucoma 21(6):421–425
Baskaran M, Raman K, Ramani KK, Roy J, Vijaya L, Badrinath SS (2006) Intraocular pressure changes and ocular biometry during Sirsasana (headstand posture) in yoga practitioners. Ophthalmology 113(8):1327–1332
Wan MJ, Daniel S, Kassam F, Mutti G, Butty Z, Kasner O et al (2012) Survey of complementary and alternative medicine use in glaucoma patients. J Glaucoma 21(2):79–82
Welte AK, Hahn U, Bussing A, Krummenauer F (2016) Systematic review of the application of complementary and alternative medicine and their potential therapeutic benefits in the treatment of ophthalmology patients. Klin Monatsbl Augenheilkd. doi:10.1055/s-0042-106901
Bhartiya S, Ichhpujani P (2014) Complementary and alternate management of glaucoma: the verdict so far. J Curr Glaucoma Pract 8(2):54–57
Pasquale LR, Kang JH (2009) Lifestyle, nutrition, and glaucoma. J Glaucoma 18(6):423–428
Parikh RS, Parikh SR (2011) Alternative therapy in glaucoma management: is there any role? Indian J Ophthalmol 59(Suppl):S158–S160
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700
Keaney M, Lorimer AR (1999) Auditing the implementation of SIGN (Scottish Intercollegiate Guidelines Network) clinical guidelines. Int J Health Care Qual Assur Inc Leadersh Health Serv 12(6-7):314–317
Giaconi JA, Yu F, Stone KL, Pedula KL, Ensrud KE, Cauley JA et al (2012) The association of consumption of fruits/vegetables with decreased risk of glaucoma among older African-American women in the study of osteoporotic fractures. Am J Ophthalmol 154(4):635–644
Coleman AL, Stone KL, Kodjebacheva G, Yu F, Pedula KL, Ensrud KE et al (2008) Glaucoma risk and the consumption of fruits and vegetables among older women in the study of osteoporotic fractures. Am J Ophthalmol 145(6):1081–1089
Kang JH, Willett WC, Rosner BA, Buys E, Wiggs JL, Pasquale LR (2016) Association of dietary nitrate intake with primary open-angle glaucoma: a prospective analysis from the nurses’ health study and health professionals follow-up study. JAMA Ophthalmol 134(3):294–303
Wang SY, Singh K, Lin SC (2012) The association between glaucoma prevalence and supplementation with the oxidants calcium and iron. Invest Ophthalmol Vis Sci 53(2):725–731
Garcia-Medina JJ, Garcia-Medina M, Garrido-Fernandez P, Galvan-Espinosa J, Garcia-Maturana C, Zanon-Moreno V et al (2015) A two-year follow-up of oral antioxidant supplementation in primary open-angle glaucoma: an open-label, randomized, controlled trial. Acta Ophthalmol 93(6):546–554
Jabbarpoor Bonyadi MH, Yazdani S, Saadat S (2014) The ocular hypotensive effect of saffron extract in primary open angle glaucoma: a pilot study. BMC Complement Altern Med 14:399
Prata TS, De Moraes CG, Kanadani FN, Ritch R, Paranhos A Jr (2010) Posture-induced intraocular pressure changes: considerations regarding body position in glaucoma patients. Surv Ophthalmol 55(5):445–453
Buys YM, Alasbali T, Jin YP, Smith M, Gouws P, Geffen N et al (2010) Effect of sleeping in a head-up position on intraocular pressure in patients with glaucoma. Ophthalmology 117(7):1348–1351
Kim KN, Jeoung JW, Park KH, Kim DM, Ritch R (2014) Relationship between preferred sleeping position and asymmetric visual field loss in open-angle glaucoma patients. Am J Ophthalmol 157(3):739–745
Lee TE, Yoo C, Lin SC, Kim YY (2015) Effect of different head positions in lateral decubitus posture on intraocular pressure in treated patients with open-angle glaucoma. Am J Ophthalmol 160(5):929–36 e4
Kaplowitz K, Blizzard S, Blizzard DJ, Nwogu E, Hamill CE, Weinreb RN et al (2015) Time spent in lateral sleep position and asymmetry in glaucoma. Invest Ophthalmol Vis Sci 56(6):3869–3874
Flatau A, Solano F, Idrees S, Jefferys JL, Volpe P, Damion C et al (2016) Measured changes in limbal strain during simulated sleep in face down position using an instrumented contact lens in healthy adults and adults with glaucoma. JAMA Ophthalmol 134(4):375–382
Park JH, Nam KT, Yoo C, Kim YY (2016) Head elevation and intraocular pressure in glaucoma. Optom Vis Sci: Off Publ Am Acad Optom. doi:10.1097/OPX.0000000000000895
Avisar R, Avisar E, Weinberger D (2002) Effect of coffee consumption on intraocular pressure. Ann Pharmacother 36(6):992–995
Okimi PH, Sportsman S, Pickard MR, Fritsche MB (1991) Effects of caffeinated coffee on intraocular pressure. Appl Nurs Res: ANR 4(2):72–76
Jiwani AZ, Rhee DJ, Brauner SC, Gardiner MF, Chen TC, Shen LQ et al (2012) Effects of caffeinated coffee consumption on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude: a randomized controlled trial. Eye 26(8):1122–1130
Li M, Wang M, Guo W, Wang J, Sun X (2011) The effect of caffeine on intraocular pressure: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 249(3):435–442
Kang JH, Willett WC, Rosner BA, Hankinson SE, Pasquale LR (2008) Caffeine consumption and the risk of primary open-angle glaucoma: a prospective cohort study. Invest Ophthalmol Vis Sci 49(5):1924–1931
Kang JH, Loomis SJ, Rosner BA, Wiggs JL, Pasquale LR (2015) Comparison of risk factor profiles for primary open-angle glaucoma subtypes defined by pattern of visual field loss: a prospective study. Invest Ophthalmol Vis Sci 56(4):2439–2448
Aziz NAA, Ali ANA, Kamarudin MN, Shaari NA, Hitam WHW, Yaakub A et al (2015) Coffee intake and progression of glaucoma. Int J Clin Nutr 3(1):7–11
Liang YB, Wu Y, Li SZ, Sun LP, Wang NL (2011) Physical exercise and intraocular pressure. Zhonghua Yan Ke Za Zhi (Chin J Opthalmol) 47(9):854–857
Vieira GM, Oliveira HB, de Andrade DT, Bottaro M, Ritch R (2006) Intraocular pressure variation during weight lifting. Arch Ophthalmol 124(9):1251–1254
Risner D, Ehrlich R, Kheradiya NS, Siesky B, McCranor L, Harris A (2009) Effects of exercise on intraocular pressure and ocular blood flow: a review. J Glaucoma 18(6):429–436
McMonnies CW (2016) Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk? J Optom 9(3):139–147
Agrawal A (2015) A prospective study to compare safety and efficacy of various anti-glaucoma agents and evaluate the effect of aerobic exercise on intra-ocular pressure in newly diagnosed primary open angle glaucoma patients in a tertiary care hospital. Value Health: J Int Soc Pharmacoeconomics Outcome Res 18(7):A415
Cramer H, Krucoff C, Dobos G (2013) Adverse events associated with yoga: a systematic review of published case reports and case series. PLoS One 8(10):e75515
Jasien JV, Jonas JB, de Moraes CG, Ritch R (2015) Intraocular pressure rise in subjects with and without glaucoma during four common yoga positions. PLoS One 10(12):e0144505
Ma KT, Chung WS, Seo KY, Seong GJ, Kim CY (2007) The effect of swimming goggles on intraocular pressure and blood flow within the optic nerve head. Yonsei Med J 48(5):807–809
Morgan WH, Cunneen TS, Balaratnasingam C, Yu DY (2008) Wearing swimming goggles can elevate intraocular pressure. Br J Ophthalmol 92(9):1218–1221
Starr CE, Radcliffe NM (2009) Swimming goggles and elevated intraocular pressure. Br J Ophthalmol 93(5):700
Wakely LA, Reeves G, Ashraff N, Wells AP (2004) Swimming goggles suck. Br J Ophthalmol 88(12):1600–1601
Franchina M, Yazar S, Booth L, Wan SL, Cox K, Kang MH et al (2015) Swimming goggle wear is not associated with an increased prevalence of glaucoma. Br J Ophthalmol 99(2):255–257
Talty P, O’Brien PD (2005) Does extended wear of a tight necktie cause raised intraocular pressure? J Glaucoma 14(6):508–510
Kang JH, Willett WC, Rosner BA, Hankinson SE, Pasquale LR (2007) Prospective study of alcohol consumption and the risk of primary open-angle glaucoma. Ophthalmic Epidemiol 14(3):141–147
Zhou Y, Zhu W, Wang C (2016) The effect of smoking on the risk of primary open-angle glaucoma: an updated meta-analysis of six observational studies. Public Health. doi:10.1016/j.puhe.2016.04.016
Jain V, Jain M, Abdull MM, Bastawrous A (2016) The association between cigarette smoking and primary open-angle glaucoma: a systematic review. Int Ophthalmol. doi:10.1007/s10792-016-0245-0
Joy JE, Watson SJ Jr, Benson JA Jr (1999) Marijuana and medicine: assessing the science base. National Academies Press (US), Washington (DC)
Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M et al (2002) Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 120(10):1268–1279
Drance SM (1963) Diurnal variation of intraocular pressure in treated glaucoma. Significance in patients with chronic simple glaucoma. Arch Ophthalmol 70:302–311
Agnifili L, Mastropasqua R, Frezzotti P, Fasanella V, Motolese I, Pedrotti E et al (2015) Circadian intraocular pressure patterns in healthy subjects, primary open angle and normal tension glaucoma patients with a contact lens sensor. Acta Ophthalmol 93(1):e14–e21
Age-Related Eye Disease Study Research G (2001) A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol 119(10):1417–1436
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
No funding was received for this research.
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.
Human and animal rights and informed consent
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Hecht, I., Achiron, A., Man, V. et al. Modifiable factors in the management of glaucoma: a systematic review of current evidence. Graefes Arch Clin Exp Ophthalmol 255, 789–796 (2017). https://doi.org/10.1007/s00417-016-3518-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-016-3518-4