Information on Glaucoma

Department of Ophthalmology and Vision Science, Eye and Ear Nose Throat Hospital, Shanghai Medical School, Fudan University, No.83, Fenyang Road, Shanghai, 200032, People's Republic of China.

"For normal individuals, IOP was not changed by ingestion of caffeine, while for patients with glaucoma or OHT, IOP increased significantly." Li M et al (1)

IOP is an abbreviation for intraocular pressure. OHT is an abbreviation for ocular hypertension.

Caffeine and Glaucoma

Further information linking caffeine to glaucoma is given in Ref. 2, which is from the Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA. nhjhk@channing.harvard.edu.

"Because IOP levels may be modulated by lifestyle factors, efforts to identify activities that may lower IOP levels may be promising in developing primary prevention strategies for POAG." Kang et al (2)

POAG is an abbreviation for primary open-angle glaucoma. Topical ocular hypotensive medications (eye drops) are used as treatments.

Ref. 3 also reported an increase in intraocular pressure after the consumption of caffeine. The evidence appears to be strong enough to recommend that people with glaucoma should avoid caffeine.

Topical Drugs

Certain topical drugs (eyedrops) are used to treat glaucoma including timolol and combigan. Combigan contains timolol as well as another active ingredient. Unfortunately these two drugs have many drug interactions with other drugs including over-the-counter medications. The interactions can make the eyedrops less effective.

Timolol ophthalmic is used to treat open-angle glaucoma. More information on this is given in Ref. 4. It can cause blurred vision. Do not allow the eye dropper to touch the eye or a hand. This could result in an infection of the eye.

Drug Interactions

Unfortunately 480 medications are known to interact with timolol ophthalmic (4). These are detailed in Ref. 4. There are 48 major drug interactions. This subject is extremely complex and therefore cannot be completely explored here. Nevertheless it is an important topic.

Vitamin C

"Research should be started immediately on population groups near forty years of age and older to determine the long-term effect on the inhibition of glaucoma by means of the continued daily intake of about 3 to 5 grams of ascorbic acid. The use of higher dosages, both orally and intravenously, for the therapy of incipient and advanced glaucoma should be included in the research protocols." Irwin Stone (The Healing Factor)

Stone has also favored the use of vitamin C to fight cataracts. This is in the same book (Ch. 20). Cataracts are beyond the scope of this article, but nevertheless they are very important. They are a major cause of blindness (as is glaucoma). Therefore I may write another article devoted to cataracts.

Lutein and Zeaxanthin

These two carotenoids are thought to have potential in fighting age-related eye diseases (5). They accumulate specifically in the eye (5). Antioxidants are also potential treatments. Vitamin C is one of the antioxidants. Beta-carotene is another. Stone saw vitamin C as almost a panacea. He thought it fought against a wide variety of diseases including glaucoma and cataracts. Stone's work was endorsed by Linus Pauling and Dr. Albert Szent-Gyorgyi, both Nobel prize winners.

Conclusions

Dr. Stone was a noted biochemist. Stone himself lived to a ripe old age as did Pauling and Szent-Gyorgyi. Pauling was from the US. Szent-Gyorgyi was from Hungary but moved to the US. Stone's book was first published in 1972. Ref. 6 supports Stone's theories.

Stone saw vitamin C as a kind of fountain of youth. He thought that it fought against age-related diseases including cancer, heart disease, stroke, etc. If there is interest, and there should be, I will elaborate on this in a future article.

References
1. Graefes Arch Clin Exp Ophthalmol. 2010 Aug 13. [Epub ahead of print] The effect of caffeine on intraocular pressure: a systematic review and meta-analysis. Li M, Wang M, Guo W, Wang J, Sun X.

2. Invest Ophthalmol Vis Sci. 2008 May;49(5):1924-31. Epub 2008 Feb 8. Caffeine consumption and the risk of primary open-angle glaucoma: a prospective cohort study. Kang JH, Willett WC, Rosner BA, Hankinson SE, Pasquale LR.

3. J Glaucoma. 2001 Feb;10(1):25-31. Caffeine and intraocular pressure in a Nigerian population. Ajayi OB, Ukwade MT.
University of Benin, Benin City, Nigeria. Comment in:

• J Glaucoma. 2001 Oct;10(5):440.
• J Glaucoma. 2002 Feb;11(1):76.

5. J Nutr Health Aging. 2010 Oct;14(10):854-61. Nutrition and age-related eye diseases: the Alienor (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) Study. Delcourt C, Korobelnik JF, Barberger-Gateau P, Delyferk MN, Rougier MB, Le Goff M, Malet F, Colin J, Dartigues JF.

6. Head KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern Med Rev. 2001 Apr;6(2):141-66. Review. PMID: 11302779