Natural remedies for glaucoma
Are there any natural remedies for glaucoma? We already know that there are no natural remedies that can cure glaucoma. But that doesn’t mean that there are no natural ingredients that are beneficial for those who already have glaucoma or are at risk for it. In this blog article, I further list down five nutraceutical supplements that can make a difference for glaucoma, in addition to the five that I have already previously discussed.
Are there any natural remedies for glaucoma?
Natural remedies for glaucoma: 5 nutraceuticals worth taking [Part 2]
Lutein and zeaxanthin
Lutein and zeaxanthin (and mesozeaxanthin) are carotenoids or natural pigments that are found in many fruits and vegetables. They are known as macular pigments or macular xanthophylls, as they are highly concentrated in the lens and macula (the central and most sensitive part of the retina).
Lutein and zeaxanthin cannot be produced by our body and can only be synthesised by plants, so you have to make sure you have enough from your diet.
So which fruit and vegetables should you eat? Well, carotenoids are responsible for giving bright colours to fruit and vegetables. Think about the orange and red hues of peppers, tomatoes and berries, or the green color of many leafy vegetables such as kale, spinach, lettuce, and broccoli.
What about mesozeaxanthin? Mesozeaxanthin is rarely found in diet. It is likely that mesozeaxanthin is formed from lutein in the retina through specific biochemical reactions. Mesozeaxanthin can be synthetically produced from lutein by the enzyme RPE65 (retinal pigment epithelium-specific protein) in the retina.
Macular pigments accumulate in the lens and macula. They absorb and filter out harmful blue light from the sun and other sources, such as digital screens. They also act as antioxidants. This means they can help to protect your lens and macula from both blue light and oxidative stress.
The vast majority of the scientific research on lutein and zeaxanthin is focused on age-related macular degeneration (AMD).
The AREDS (Age-Related Eye Diseases Study) 2 was a major clinical trial sponsored by the National Eye Institute of the United States. The purpose of the trial was to replace beta-carotene (also a carotenoid) in the original AREDS trial with lutein and zeaxanthin due to beta-carotene increasing the risk of lung cancer in smokers. AREDS 2 found lutein and zeaxanthin to be beneficial in preventing progression of intermediate AMD to late AMD when taken over 10 years, even more so than beta-carotene.
For those with early AMD, lutein and zeaxanthin supplementation increases macular pigment optical density and enhances the sensitivity of the retina.
Similarly for glaucoma, lutein and zeaxanthin supplementation also increases the macular pigment optical density and improves contrast sensitivity in the mesopic range.
My view on lutein and zeaxanthin supplementation (less so for mesozeaxanthin) is that you should definitely consider taking these carotenoids if you are at risk of, or already have, AMD. This is especially important if your diet is not rich in the natural sources of lutein and zeaxanthin.
As for glaucoma, the benefits are less clear cut. Carotenoid supplementation is probably beneficial but certainly not at the expense of the other nutrients that we’ve discussed previously.
Anthocyanins and proanthocyanidins
Anthocyanins and proanthocyanidins are two groups of powerful flavonoid antioxidants. These antioxidants reduce oxidative stress and inflammation, providing protective health benefits against diabetes, age-related decline and vascular disease – all contributory factors for eye disease.
Anthocyanins and proanthocyanidins are obtained from plant sources. The bilberry fruit (vaccinium myrtillus) is an excellent source of anthocyanins, while grape seed (vitis vinifera) has very rich proanthocyanidin content.
Bilberry (vaccinium myrtillus)
The legend goes that during World War II, British Royal Air Force pilots ate bilberry jam with their English tea before their night time bombing flights.
And the reason for the devastating accuracy of their bombing flights? Significantly superior night vision of the pilots, courtesy of the bilberry jam.
Night vision aside, bilberry has long been considered a powerhouse for eye health. Bilberry extract has shown benefits for dry eyes, visual fatigue, and retinal health.
For glaucoma, consumption of bilberry extract after two years was able to improve vision and visual field in some normal tension glaucoma patients.
Grape seed (vitis vinifera)
Grape seed extract is made from the seeds of wine grapes.
The reason we are interested in grape seeds? It’s proanthocyanidin content, which sits at around 92 to 95% concentration. This is much higher compared to whole grapes, grape pulp or grape skin.
Proanthocyanidins are highly bioavailable and provide significantly greater protection against free radicals, lipid peroxidation, and DNA damage than general antioxidants such as vitamins C, E, and beta-carotene.
From the clinical point of view for the eyes, this has mainly translated to improved outcomes for diabetic eye disease.
Note: You may be aware of another rich source of proanthocyanidins: French maritime pine bark extract. French maritime pine bark is well known, but has a lower concentration of proanthocyanidins (85%) and is also very expensive.
On their own, the scientific data is not particularly exciting. But when anthocyanins and proanthocyanidins were combined together – that’s when the magic occurred!
The combination of bilberry and French maritime pine bark was first reported in 2008 to reduce eye pressure and improve blood flow to the eye in individuals with high eye pressure (but without glaucoma damage). After 3 months of treatment, the eye pressure decreased by an average of 3 mmHg, in almost all (19 out of 20) subjects.
Subsequent trials have confirmed this pressure lowering effect, and importantly for glaucoma patients, this combination was also able to reduce eye pressure by an additional 8.7% after one month’s use.
You will have noted that in the studies above, the combination of bilberry-French maritime pine bark was used rather than bilberry-grape seed. As far as I am aware, there have not been any studies looking at the bilberry-grape seed combination but my expectation is that it should achieve similar eye pressure results as bilberry-French maritime pine bark.
The reason I am highlighting grape seed more than French maritime pine bark is because grape seed should have similar clinical efficacy (given its higher proanthocyanidin content), is less expensive, and is much more easily available in Australia.
Would I recommend this bilberry-grape seed/French maritime pine bark antioxidant combination? Given the overall beneficial effects for glaucoma, retinal health and diabetic eye disease, I certainly would especially if you are having issues with consistent eye pressure control.
Ginkgo biloba
The ginkgo biloba tree is the national tree of China and can live for over a thousand years, hence its symbol of longevity and endurance.
Ginkgo biloba is an important ingredient in traditional Chinese medicine. It is derived from the ginkgo leaf and contains 60 bioactive compounds; 30 of these compounds cannot be obtained from any other source. These compounds fall into two main groups: flavonoids (which have antioxidant properties that act at the level of the mitochondria), and terpenoids (which have blood thinning properties).
Note: Ginkgo seeds contain ingredients that can be poisonous and cause serious side effects if not properly prepared before being eaten.
- Improving blood microcirculation
- Reducing blood viscosity
- Reducing inflammation
- Reducing oxidative stress
The clinical effects of ginkgo biloba in glaucoma are likely due to a combination of its antioxidant and anti-inflammatory properties, as well as its ability to improve blood flow to the optic nerve and brain.
One of the first clinical trials on the benefits of ginkgo biloba for glaucoma was published in 2003, which showed that for low pressure glaucoma patients, 40 mg of ginkgo biloba extract 3 times daily (or 120 mg total daily dose) could improve pre-existing visual field loss after 4 weeks. Although the trial had its shortcomings (short duration and only a small sample size of 27 patients), the fact that visual field loss could be improved was very promising.
In a subsequent clinical study, Korean researchers demonstrated that ginkgo biloba extract 80 mg twice daily (160 mg total daily dose), when taken over an average period of 12 years, could significantly slow down progression of existing visual field loss in low pressure glaucoma patients.
Ginkgo biloba has also been studied for macular degeneration (AMD). A German trial evaluated the benefits of ginkgo biloba for dry AMD at two different daily doses: 240 mg and 60 mg. The result? Both 240 mg and 60 mg ginkgo biloba resulted in improved visual acuity after 24 weeks, with the 240 mg dose showing a greater beneficial effect.
My opinion is that it is worthwhile taking ginkgo biloba, particularly so if your glaucoma and AMD are progressing. I would start with a daily dose of 120 mg daily.
Finally, I would like to address the concern about the possible increased risk of bleeding with ginkgo biloba. This concern stems from the publication of several isolated case reports. However when analysing the data from clinical trials, the results are unequivocal: ginkgo biloba reduces viscosity of blood but does not significantly increase the risk of bleeding.
Having said that, please use ginkgo biloba with caution particularly if you are on blood-thinning medications (such as warfarin) or if you have a health condition that increases bleeding (such as chronic liver disease or low blood platelets).
Always talk to your eye specialist and GP before taking supplements
As always, if you are considering supplementing with any of the nutrients and vitamins listed above, please discuss this with your eye specialist and other healthcare providers first. This is particularly important if you are taking other medications.
For example, bilberry may lower your blood sugar, so be cautious when taking it in combination with your diabetes medications.
And as mentioned earlier, please use ginkgo biloba with caution if you are on blood-thinning medications or if you have a health condition that increases bleeding.
