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How to Control Eye Pressure in Glaucoma

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How to Control Eye Pressure in Glaucoma

The irreversible damage of glaucoma is one of the leading causes of blindness among people ages 60 years and above(1). This condition is diagnosed through visual field tests, tonometry that measures intraocular pressure, and imaging tests that help detect optic nerve damage(2).

Typically, glaucoma is treated with oral medications, eye drops, laser treatment, or surgery, depending on its type(3).

For people who have angle-closure glaucoma, pain-relieving holistic treatments and laser surgery are the priority therapies for the severe pain attack of this glaucoma type(4).

Serious pain experienced by people with angle-closure glaucoma is due to the rapidly rising eye pressure, which causes the cornea to be cloudy(5).

Increased eye pressure or intraocular pressure (IOP) is commonly present in individuals with glaucoma(6). Medications and treatments that reduce the IOP may help slow down the disease(7).

Current Research on Controlling Glaucoma Pressure

A study published in the American Journal of Ophthalmology assessed the effectiveness of intraocular pressure (IOP) reduction treatments for normal-tension glaucoma.

Even if their eye pressure is within the normal ranges, people with normal-tension glaucoma show glaucoma symptoms, such as optic nerve damage and blind spots(8).

The study showed that IOP reduction was observed when the cataract’s impact on the field of view was removed by surgery(9).

Meanwhile, a randomized trial evaluated the effects of IOP reduction in open-angle glaucoma with normal and elevated IOP using The Early Manifest Glaucoma Trial.

This trial evaluated the effects of two approaches in the progression of newly detected open-angle glaucoma.

The first approach entailed immediately lowering the test subjects’ IOP. In contrast, the second one involved delaying or completely not giving treatment to the participants.

Open-angle glaucoma is progressive glaucoma that does not exhibit warning signs in the early stages. However, vision blind spots occur as the disease develops(10).

The authors observed the positive effects of delaying IOP treatment in open-angle glaucoma progression(11).

Another study mentioned that high intraocular pressure (IOP) is associated with simple chronic glaucoma (open-angle glaucoma)(12).

However, other factors, like the degree of oxygenation of the blood and systemic blood pressure, may affect the IOP levels in open-angle glaucoma(13).

In 2010, a study on blood pressure, perfusion pressure, and glaucoma was published in the American Journal of Ophthalmology(14).

The study provided a critical review of the relationship between ocular blood flow (blood supply in the eye), blood pressure, and glaucoma. It also suggested the potential for glaucoma treatment via modulation of ocular perfusion.

Results showed that a decrease in blood pressure and perfusion (fluid passage) pressure may be associated with glaucoma.

However, the researchers did not observe occurrences supporting the value of increasing a patient’s blood pressure as a way to treat glaucoma.

It was further discussed that blood flow autoregulation in the optic nerve head and retina happens in an extensive range of blood pressures and intraocular pressures(15).

This study suggested that low blood pressure and low ocular perfusion are associated with an increased glaucoma risk(16).

The researchers also noted cardiovascular safety concerns on the treatments designed to increase blood flow and ocular perfusion pressure by increasing the subjects’ blood pressure(17). The authors also cautioned against using this approach on elderly people.

The relationship between glaucoma and high blood pressure was further investigated in a British Journal of Ophthalmology study(18).

It was reported that although intraocular pressure is a primary cause of glaucoma development, IOP is not the only factor to look out for in the treatment of glaucoma.

The study reported that despite the reduction of IOP, glaucoma severity may still progress(19).

It also suggested that other factors important in glaucoma treatment are blood pressure and ocular perfusion pressure(20).

A study published in the Journal of Clinical and Experimental Optometry suggested that further research is needed to understand the relationship between glaucoma and blood pressure(21).

Epidemiological evidence offers conflicting ideas about systemic hypertension (high blood pressure) and its role in glaucoma progression(22).

In the study, patients with low blood pressure and patients with high blood pressure exhibited an increased prevalence of glaucoma(23).

The participants with low blood pressure have low ocular perfusion pressure (OPP), resulting in reduced blood flow. However, those with high blood pressure also exhibited increased glaucoma risk.

In the short-term, hypertension (high blood pressure) was seen to improve OPP and protect against ischemia resulting from IOP.

Ischemia is the restriction of blood supply to the body’s tissues, resulting in oxygen shortage.

However, studies also indicated that hypertension makes individuals susceptible to the development of glaucoma(24).

Thus, the authors noted the importance of avoiding the over-treatment or under-treatment of chronic hypertension to achieve an OPP range optimal for glaucoma improvement.

Tips in Preventing Glaucoma

Although glaucoma is an irreversible condition, some preventive tips may help detect and manage the disease.

  1. Schedule a general check-up with the eye doctor before the age of 40. This check-up should be done every two to four years for those who are 40 and below.

People from 40 to 54 years old should be screened for glaucoma every one to three years. In contrast, people 55 to 64 years old should be tested every one to two years.

Seniors 65 years and above should be checked for glaucoma yearly(25).

  1. Use protective eyewear if necessary, as these items shield the eyes from injury and traumatic glaucoma that may be caused by sports or home improvement projects.
  2. Do exercises and light physical activities. It is believed that jogging or walking and other moderate exercises help lower intraocular pressure(26).

Yoga is a regular moderate physical activity option that may help prevent glaucoma.

However, there are yoga poses that should be avoided. Headstands and some other poses may increase one’s intraocular pressure level.

  1. Strictly follow appropriate eye treatment plans. It is best to follow the doctor’s prescribed medications and treatments to slow down glaucoma progression(27).
  2. Opt for a healthier lifestyle. Glaucoma patients must maintain a healthy diet with high portions of antioxidants, vitamins A, E, and C for healthier eyes.

Eating healthy may not prevent the worsening of glaucoma(28). However, it may help individuals get the nutrients necessary for optimal eye health.

Who Are at Risk of Glaucoma?

Glaucoma often occurs in people over 60 years of age(29). However, Asians, Hispanics, and African Americans ages 40 and above are more prone to glaucoma(30-31).

This condition is also hereditary, which means that a person who has a family member with glaucoma has a higher risk of developing the eye condition(32).

Individuals with high blood pressure, diabetes, and heart disease are prone to developing glaucoma(33).

A study reported that 35% of people with diabetes and 17% of people with hypertension have an increased risk of developing open-angle glaucoma(34).

This high risk is due to diabetic retinopathy or the condition that may harm the retina’s blood vessels(35).

Eye injury, surgery, and excessive use of corticosteroids or eye drops may also increase one’s chances of developing glaucoma.

Immediately seek a doctor’s opinion if severe eye pain and vomiting are experienced.

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References

1. Mayo Clinic, (n.d.), Glaucoma, retrieved from https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839
2. Ibid.
3. Ibid.
4. Ou, Y., (n.d.), Is Glaucoma Painful?, Bright Focus Foundation, retrieved from https://www.brightfocus.org/glaucoma/article/glaucoma-painful#:~:text=The%20eye%20pain%20can%20be,notice%20their%20vision%20has%20decreased.
5. Ibid.
6. Glaucoma Research Foundation, (n.d.), High Eye Pressure and Glaucoma, retrieved from https://www.glaucoma.org/gleams/high-eye-pressure-and-glaucoma.php#:~:text=Glaucoma%20is%20a%20multi%2Dfactorial,range%20IOP%20can%20develop%20glaucoma.
7. Glaucoma Research Foundation, (n.d.), High Eye Pressure and Glaucoma, retrieved from https://www.glaucoma.org/gleams/high-eye-pressure-and-glaucoma.php#:~:text=Glaucoma%20is%20a%20multi%2Dfactorial,range%20IOP%20can%20develop%20glaucoma.
8. Boyd, K., (October 2020), What Are Common Glaucoma Symptoms?, American Academy of Ophthalmology, retrieved from https://www.aao.org/eye-health/diseases/glaucoma-symptoms
9. Collaborative Normal-Tension Glaucoma Study Group, (October 1998), The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma, retrieved from https://www.sciencedirect.com/science/article/pii/S0002939498002724?casa_token=GsLbWR9v5IAAAAAA:fj9lvkN18j-22W0DtFXDBPrqSaqcTba0jBwyYptUra8goyVcYMMThxQcsF0Mb9gpZjYKGgJ8hg.
10. Boyd, K., Op. Cit.
11. Heijl, A., Leske, M. C., et. al., (October 2002), Reduction of Intraocular Pressure and Glaucoma ProgressionResults From the Early Manifest Glaucoma Trial, retrieved from https://jamanetwork.com/journals/jamaophthalmology/article-abstract/272258.
12. Drance, S. M., (1963), Diurnal Variation of Intraocular Pressure in Treated Glaucoma Significance in Patients With Chronic Simple Glaucoma, retrieved from https://jamanetwork.com/journals/jamaophthalmology/article-abstract/627294.
13. Ibid.
14. Caprioli, J., Coleman, A. L., et. al., (May 2010), Blood Pressure, Perfusion Pressure, and Glaucoma, retrieved from https://www.sciencedirect.com/science/article/pii/S0002939410000346?casa_token=8i94mO9ua60AAAAA:oWxujTm0Pt-Gf_coXupaB6Xqko7INfTzVQ_AZRgvJ_u-Ssk2_R_Jn8MfN5s46MGLP_VMd0YUXQ.
15. Ibid.
16. Ibid.
17. Ibid.
18. Costa VP, Arcieri ES, Harris ABlood pressure and glaucomaBritish Journal of Ophthalmology 2009;93:1276-1282., retrieved from https://bjo.bmj.com/content/93/10/1276.
19. Ibid.
20. Ibid
21. Zheng, H. E., Algis, J. V., et. al., (January 2011), The role of blood pressure in glaucoma, retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/j.1444-0938.2010.00564.x.
22. Ibid.
23. Ibid.
24. Ibid.
25. Glaucoma Research Foundation, (n.d.), What Can I Do to Prevent Glaucoma?, retrieved from https://www.glaucoma.org/gleams/what-can-i-do-to-prevent-glaucoma.php.
26. Ibid.
27. Ibid,
28. Mayo Clinic, Glaucoma, Op. Cit.
29. NIH National Eye Institute, Op. Cit.
30. Ibid.
31. Mayo Clinic, Glaucoma, Op. Cit.
32. Ibid.
33. Ibid.
34. University of Michigan Health System, (August 2011), Relationship between glaucoma and diabetes, hypertension, retrieved from https://www.sciencedaily.com/releases/2011/08/110817120237.htm.
35. Ibid.

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