Glaucoma: Natural Medicine Factors
Nutrition in Glaucoma
The first step in developing a good balanced foundation for your nutritional program is to begin with a broad spectrum multi-vitamin and mineral supplement. A multiple to be used by someone with glaucoma should have both vitamin A and beta carotene according to some doctors. Rapid and sustained pressure reductions of 5 to 7 mm Hg have been achieved in studies using improved diet with supplementation of nutrients including vitamins A, B1, B2, B3, B5, and calcium, which is better than results achieved with current medical therapy. , Malnutrition and malabsorption syndromes should also be ruled out or treated, as they may contribute to optic nerve damage and susceptibility. Glaucoma in a malnourished population was brought under control within one week with the antioxidants 180,000 I.U./day of vitamin A, 200 I.U./day of vitamin E and 3,000 mg/day of vitamin C.
Vitamin A and carotenoids:
Vitamin A deficiency has been observed in the glaucoma population. Blood levels of carotenoids (pro-vitamin A) are lower in people with glaucoma than in normals. Vitamin A is necessary to prevent hydration and swelling of the collagen in the drainage angle of the eye, which can block outflow. Loss of xanthophyll carotenoids in the papillo-macular area is the first detectable indication of loss of optic nerve fibers in glaucoma. Some practitioners recommend 25,000 IU/day of natural source beta carotene or a combination of vitamin A and beta carotene (pro-vitamin A) along with 400 IU/day of either dry or mixed tocopherol vitamin E. Beta carotene dosages up to 30 mg/day have been suggested as safe by the Alliance for Aging Research. Others recommend up to 40,000 IU/day of beta carotene.
Vitamin B Complex:
The entire B complex, with specific emphasis on vitamins B1, B3, B5 B6, B12, folate, inositol and choline (or lecithin, as a source of choline) may be particularly helpful in glaucoma. A 50 mg B complex taken 3 times a day with meals is a good base, and in some cases B vitamin injections (preferably unpreserved) may be needed.
Thiamine (Vitamin B1) deficiency causes optic nerve disease and is depleted by stress. Optic atrophy linked to thiamine deficiency can be reversed in 10 days with large supplemental doses. Thiamine may be poorly absorbed and metabolized, or otherwise demanded at increased levels in glaucoma patients, as they usually have reduced blood levels despite normal dietary intake. This has been associated with lack of digestive enzymes resulting in malabsorption. A dosage of 25 to 50 mg a day has been recommended, except for smokers who should take 300 mg/day until vision improves.
Vitamin B3 cleans out the capillaries, reversing the effects of arteriosclerosis that contributes to glaucoma. B3 also dilates the capillaries, further improving blood flow to and from the eye and optic nerve. B3 raises ATP levels in depleted cells, raising their resistance to stressors like glutamate, which is associated with glaucoma.
Vitamin B5 (100 mg taken 3 times a day) helps to strengthen the adrenal glands.
Vitamin B6 decreases IOP by its diuretic effect. A dosage of 25 to 50 mg/day is recommended.
B12 may be preventive in low tension glaucoma. Vitamin B12 deficiency, pernicious anemia, can by itself cause damage to the optic nerve. Over one million American seniors have pernicious anemia. The first sign of deficiency in over half of Vitamin B12 deprived animals is damage to the myelin sheath of the papillomacular bundle. In humans, too, B12 deficiency is linked to demyelinating processes like multiple sclerosis. Fortunately, resulting vision loss has been shown to be mostly reversible with B12 supplementation. B12 actually supports regeneration of the myelin sheath. In humans, neurolgical damage including vision loss and optic atrophy are often seen before anemia is detected. Visual disorders associated with alcohol and tobacco clear up with Vitamin B12. Borderline B12 status may contribute to the susceptibility of the optic nerve to damage from other metabolic stress factors, and optic nerve damage from early B12 deficiency can precede any measurable changes in the blood. Pallor of the optic nerve head, considered a sign of glaucoma, is also a classic result of pernicious anemia. This is frequently accompanied by hypochlorhydria, leading to poor assimilation of many minerals and other glaucoma-preventive nutrients, and IOP may be either normal or increased. Over half of seniors lack adequate hydrochloric acid secretion to absorb B12 efficiently. B12 deficiency can cause nervous system related symptoms including memory loss, confusion, dementia, depression and psychosis, all seen more frequently in the elderly. B12 deficiency is also accompanied frequently by photophobia and dependency on sunwear, as is deficiency of other B vitamins, as well as vitamin A and zinc. One 5 year study showed that 1500 mcg/day of vitamin B12 stopped the progression of visual field loss in glaucoma, and a significant percentage of patients actually had some vision restored. Since there was no change in eye pressure with B12 supplementation, different levels of B12, which can be stored in the body for years, may explain why some people can sustain higher pressures without damage to the optic nerve. Numerous studies confirm the beneficial effects of B12 supplementation on optic nerve disease. Supplementation may be especially beneficial when initiated within 6 months of the onset of visual symptoms. Coffee and aspirin are factors which impair vitamin B12 absorption. Zinc, which is necessary for production of hydrochloric acid, and digestive enzymes are recommended for some individuals to aid B12 absorption. A suggested dosage of 1500 to 2500 mcg/day of vitamin B12 has been proposed, as contrasted with the average adult intake of 5 mcg/day. Intramuscular injections may also be necessary initially for smokers and those with hypochlorhydria. Unpreserved injections are far preferrable if they can be obtained. The hydroxycobalamin form has been shown to be effective when cyanocobalamin was not. The preferred form for reversing neurological conditions is Methylcobalamin.
Folate may be preventive in low tension glaucoma. Folate is high in raw, fresh salad vegetables such as asparagus, spinach leaves, garbanzo beans, and bean sprouts, as well as fresh, ripe, raw fruits. This means that it is important to find sources for locally grown organic produce, since folate is the least stable and most often deficient of all vitamins in this country. 400 mcg/ day has been recommended, with 1000 mcg/day suggested for smokers.
Choline (1,000 to 2,000 mg/day) cleans out the capillaries along with Vitamin B3, reversing the effects of arteriosclerosis that contributes to glaucoma. Others have recommended at least 100 mg/day.
Inositol is important in reducing stress that can trigger increased IOP.
Vitamin C reduces intraocular pressure (IOP), according to research at the University of Rome. Daily intake of 35 grams in divided doses was used for patients weighing 150 pounds, with adjustments in this dosage proportional to body weight. Rapid and significant drops in pressure were obtained. A single dose of 500 mg/kg (about 35 grams for a 150 pound person) resulted significantly lowered IOP in 100% of patients, by an average of 16 mm Hg. Unfortunately, at such a high dosage, using the acid form of vitamin C causes diarrhea in may people, so neutral pH polyascorbate vitamin C is recommended by the author. Doses of up to 2 to 10 grams may be taken 4 times a day. Over 90% of patients given 100 to 150 mg/kg ascorbic acid 3 to 5 times a day achieved essentially normal IOP within 45 days, with GI symptoms only persisting for 3 to 4 days. Some of these patients had previously uncontrollable IOP even when taking maximum medical therapy. On the other end of the dosage spectrum, even low levels of vitamin C, such as 1200 mg/day have been shown to reduce IOP, when compared to a near RDA level of 75 mg/day, with a high level of statistical significance (p<.001). A study using .5 gm of ascorbic acid 4 times a day showed significant decreases in IOP after 6 days. Another study showed that .5 gm twice a day for 1 week significantly reduced IOP, which returned to the previous baseline level after 1 week off the vitamin C supplement. Even eye drops made of 10% ascorbic acid used 3 times a day for 3 days significantly lowered IOP of the treated eye compared to patients’ other untreated eye. Vitamin C is accepted as a treatment for glaucoma in European and Asian countries. One advantage of vitamin C over drugs therapies is that vitamin C not only lowers IOP through a combination of increased blood osmolarity, decreased aqueous production and improved outflow, but it also provides anti-oxidant protection and enhances impaired collagen metabolism, which appears to be the primary cause of glaucoma. Vitamin C helps to regenerate type I collage, laminin and fibronectin in the trabecular meshwork. A month of topical steroid treatment lowers vitamin C levels by over 50% in the aqueous humor, over 60% in the vitreous humor and nearly 85% in the lens. Thousands of people get cataracts and/or glaucoma while on steroid therapies each year, yet few doctors recommend increased intakes of vitamin C for prevention. One author recommends at least 500 to 1000 mg/day of Vitamin C, and 2000 to 3000 mg/day for smokers. see also: Feldman RM, Steinmann WC, Spaeth GL et al: Oral asorbic acid in the treatment of glaucoma. Glaucoma 1987;19(6):181-183. Bioflavonoids: Rutin, a bioflavonoid, supplemented at 60 mg/day in divided doses reduced IOP by at least 15% in 17 out of 26 eyes with uncomplicated primary glaucoma. These patients were also found to respond better to drug treatment following at least one month on rutin supplementation, as well. Some practitioners now recommend a dosage of 50 mg 3 times a day of Rutin. Mixed bioflavonoids should be taken at a dosage of 1,000 mg/day for all types of glaucoma. Bioflavonoids (which are also active components of herbs such as ginkgo and bilberry, in the herb section) have been shown to further reduce IOP in patients on miotic drops.
Quercetin inhibits histamine release. It also increases cyclic AMP, relaxing smooth muscle. It is also an effective oral chelation agent in removing excess iron that contributes to free radical pathology. Quercetin has been recommended at a dosage of 500 mg/day up to 3000 mg/day. Water soluble quercetin, such as in Pain Guard Forte’, maximizes absorption.
Vitamin D may also be beneficial. The best source of this vitamin is moderate daily exposure to sunlight and the use of full spectrum lighting indoors. It is important to note that excess dietary calcium, vitamin A and vitamin D3(25,OH) from diets high in vitamin A & D fortified commercial dairy products may actually be a contributor to low tension glaucoma.
Vitamin E has been recommended in combination with ginkgo biloba or with vitamins A and C. Dosages of 400 IU/day have been recommended, with smokers requiring double that level. Others also suggest safe dosages of vitamin E up to 800 I.U./day. Esterified natural dry vitamin E (succinate), which I call ‘Ester E’ has been shown to be easier on the liver to absorb and process in research by Jeffrey Bland, Ph.D., President of Health-Comm. The only oil form of vitamin E that is undiluted by vegetable oil and therefore stable against oxidation is Unique E.
CoQ10 can improve impaired heart function, improving the quality of circulation which is especially important in low pressure glaucoma. Together with Vitamin E, CoQ10 has proven beneficial in glaucoma. CoQ10 raises ATP levels in depleted cells, reducing risk of damage by glutamate. A daily dose of at least 30 mg/day of CoQ10, increased to 100 mg/day for low tension glaucoma, has been recommended.
Alpha Lipoic Acid:
150 mg daily of alpha lipoic acid has been reported to improve visual function in patients with open angle glaucoma in stages I and II.
Calcium, when mishandled, can constrict blood vessels. Calcium supplementation often helps to improve calcium handling. Excess calcium, however is linked to arterial-vascular disease.
Chromium & Vanadium:
Depleted chromium levels in body tissues are related to increases in IOP with visual stress. A combination of low dietary chromium, due to the loss of this trace mineral in food refining, together with the loss of this mineral when eating sugar and refined foods, or foods high in vanadium, results in increasing the risk of elevated IOP by 4.7 times. It is well documented that chromium stores in Americans are generally depleted with aging, due to our diet high in sugar and refined carbohydrates. It is also well known that glaucoma incidence also increases dramatically with age. Since age itself is not a potential cause, being merely the passage of time, in the course of which causality may occur, we should be looking for more factors like chromium, heavy metals, and free radical effects at the optic nerve head to understand and prevent glaucoma. Vanadium should be avoided as it antagonizes chromium. Vanadium is more concentrated in low fat dairy products, seaweed, mushrooms, vinegar, chocolate, carob, poultry and large fish (tuna, swordfish and shark), while more chromium is found in red meats, whole grains, molasses, fruits, vegetables, eggs (in the yolk) and dairy products made from whole milk. ,
Chromium improves lipid profiles. Recommended forms of chromium for supplementation are either chromium picolinate or chromium polynicotinate, and not ‘amino acid chelated’ chromium which can contain large unlabeled amounts of vanadium. A dosage of 200 to 600 mcg/day is recommended especially if taking topical or oral beta blockers to counteract their detrimental effects of lipid metabolism. 600 mcg/day increased HDL levels 16% to 38% in people on oral beta blockers, resulting in 12 to 17% reduction in the risk of heart disease.
Excess or unnecessary copper should be avoided, as in excess it promotes free radical pathology.
Germanium (100 to 200 mg/day) can help relieve discomfort associated with certain types of glaucoma, as it increases delivery of needed oxygen to the nerve cells.
Excess or unnecessary iron should be avoided, as in excess it promotes free radical pathology.
Magnesium may be beneficial in preventing mishandling of calcium which can lead to vasospasms in the optic nerve. This could be especially important in low tension glaucoma, where it is being suggested that calcium channel blockers might be used to produce this effect. Calcium channel blockers have been shown to increase peripheral vision in people with cold hands. Calcium channel blockers have been found to prevent the progression of optic nerve damage in 100% of glaucoma patients. The problem with calcium channel blocker drugs is their side-effects. Magnesium is nature’s calcium channel blocker, increasing cyclic AMP levels through inhibition of calcium influx into the cell, resulting in relaxation of smooth muscle as well as prevention of platelet aggregation. Smooth muscles control the drainage of fluid from the eye. Cyclic AMP is also the primary intracellular regulator of aqueous humor production and IOP. Magnesium is 85% depleted in farmland soils as this macromineral is not present in the commercial NPK (nitrogen, phosphorus and potassium) fertilizer preparations. As a result, 80% of adults are deficient in Magnesium. Magnesium deficiency is linked to high blood pressure, which in turn is associated with glaucoma. Even patients on oral beta blockers can reduce blood pressure by taking 365 mg/day of Magnesium. 750 mg/day of Magnesium has been shown to improve retinal circulation in patients with hypertensive retinopathy and 243 mg/day improved both circulation and visual fields in glaucoma patients with vasospasm. Magnesium can reverse atrial fibrillation, which is linked to low tension glaucoma. Low Magnesium intake is also linked to deaths from sudden heart attack, making repletion to optimal levels critical in the American population. Low Magnesium combined with high Calcium promotes coagulation of the blood as well as increases in adrenal hormones that increase IOP. Magnesium glycinate is the most absorbable form of magnesium, and generally does not result in diarrhea as other less well absorbed forms do in therapeutic dosages. It may take up to about 6 months to rebuild a deficient magnesium level, so it is important not to give up if there is no apparent immediate benefit. People with Raynaud’s disease (cold extremeties), a condition linked to low-tension glaucoma, for example do not respond as rapidly as healthy adults to Magnesium supplements. Stress, a condition which has been linked to glaucoma, increases the demand for Magnesium. The average American does not even consume the RDA level of Magnesium. A dosage of 250 to 400 mg/day at bedtime has been recommended at a 1:1 ratio with Calcium. It is often suggested to take Calcium at a different time of day to maximize absorption of both Calcium and Magnesium, since they are both divalent cations and thus compete for the same absorption channels. Magnesium glycinate is the most absorbable form of Magnesium, eliminating the common side effect of diarrhea often experienced with high doses of Magnesium. As Magnesium levels are repleted over a period of about 6 months, watch for improvements in visual fields, visual acuity and circulation to the optic nerve. Watch also for muscular weakness as a possible indication that Magnesium levels have been built up higher than necessary. Greater Magnesium levels may be needed by those taking higher levels of Calcium and patients on diuretic medications.
Manganese supplementation at 20 mg/day has been suggested as part of a total nutritional program for glaucoma. Manganese picolinate is an excellent form to use.
Zinc supplementation with zinc picolinate or zinc monomethionine is often recommended, and a simple taste test using Zinc Sulfate solution can be used to monitor the degree of deficiency as well as the response to supplementation. A dosage of 15 to 25 mg/day of zinc has been recommended.
Food Sensitivities, Allergies and Diet
A study of 113 patients with chronic simple glaucoma showed immediate IOP increases of up to 20 mm Hg upon challenge (exposure) with food or other allergens. Another study of 3 individual cases of simple glaucoma, showed that elimination of food allergens markedly improved treatment outcomes compared to treatment with drugs and surgery or drugs alone. In one case, intraocular pressure could only be controlled once allergens were eliminated from the diet. In two other cases, despite adequate control of IOP with a combination of drugs and surgery, visual field loss continued to progress. Visual fields actually improved markedly upon beginning an allergen-free diet. This illustrates an important factor in glaucoma, that it is not simply a matter of pressure, but rather a complex interaction of biophysical and biochemical parameters that influence the cellular metabolism and function in the retinal ganglion cells and their axons in the optic nerve. Allergy responses are known to cause altered vascular permeability and vasospasm which could result in the congestion and edema found in glaucoma.
Sjogren first identified the relationship between allergy and IOP. As early as 1947, research showed that uncontrollable cases of glaucoma resolved on an allergy-free diet. Antihistamine treatment has proven effective in glaucoma patients with allergies, after conventional treatment failed. Glaucoma in just one eye has even been found to be frequently due to sleeping with that eye against a feather pillow. In the trabecular meshwork, histamine increases intracellular influx of calcium, increasing smooth muscle tension and potentially reducing circulation. Histamine has been shown to cause a reduction in the ability of the trabecular meshwork cells to keep the meshwork clear of debris, resulting in increased intraocular pressure. Antigen studies now also show a link to autoimmune processes.
Until individual testing of food reactions can be performed, many practitioners recommend as a minimum beginning with elimination of tobacco, sugar, coffee and tea (including decaf; herb teas are allowed), alcohol, white flour and other refined and processed foods, with reduction of commercially raised dairy products and red meats. Any beverages, preferably microwater (which can pass through the eye more readily), should be taken evenly throughout the day rather than drinking alot at one time, which can raise IOP. Airborne allergens should be eliminated through the use of ozone, oxozone, or HEPA filtration units, although oxozone appears to be the most efficient method.
MSG may be a significant trigger of glaucoma, too. Glutamate has been found at elevated levels in the vitreous of glaucoma patients. Glutamate is known to be toxic to retinal ganglion cells and is known to cause circulatory disturbances such as vasospasms. Glutamate is an excitatory amino acid linked to neurological diseases such as Parkinson’s and Alzheimer’s. Acetyl-L-Carnitine, glutathione, vitamin B3, and CoQ10 are neuroprotective by preventing depletion of ATP , since it is in low energy states (Phase 1) that nerve cells are damaged by glutamate.
It has been suggested to reduce commercial meats, dairy, salt and nuts, while including lots of vegetables along with cold water fish and eggs from free-ranging chickens. Moderate egg consumption may increase beneficial HDL without significant increase of LDL. One study using a low fat diet centered on rice and vegetables together with nutritional supplements achieved rapid (within 2 days) and sustained reduction in IOP of 5 to 7 mm Hg, which is better than results with current medical therapies. , This study was done at Duke University in 1949! Five servings of fresh organic produce (fruits and vegetables) per day is recommended. Green leafy vegetables, such as collards, kale, mustard greens and spinach are suggested as a source of xanthophyll carotenoids which help protect the optic nerve fibers, especially in the central vision area. Buckwheat is beneficial due to its high content of the bioflavonoid rutin.
Coleus forskohlii is an herb (related to mint) used traditionally in folk medicine in Northern India. It is the only known source of forskolin, a labdane diterpene compound which activates the enzyme adenylate cyclase, which elevates cAMP, which can then result in a reduction in intraocular pressure (IOP) when applied topically to the eye. Forskolin’s unique stimulation of the main catalytic subunit of adenylate cyclase has made it the subject of over 1,000 published scientific studies. Forskolin essentially acts as an amplifier for intracellular communication via the endocrine system. A double-blind study found that a 1% forskolin suspension produced a definite drop in intraocular pressure for 6 hours following use. Another controlled study showed that two instillations of 1% forskolin resulted in a 2.4 mm Hg drop in IOP in just 1 hour, with a 13% reduction in aqueous flow rate. Additional experiments showed that 1% forskolin lowered IOP in humans as well as in rabbits and monkeys, with a drop in outflow pressure of 34 to 70%. Coleus works like Magnesium, by relaxing smooth muscle, plus it has antihistamine properties, perhaps reducing allergic components of increased IOP as well. A dosage of 200 to 400 mg/day of the herb in capsule form has been recommended given the herbs long record of safety. Coleus, for example lowers blood pressure which often accompanies elevated IOP and is beneficial in asthma and congestive heart failure, conditions which contraindicate the use of beta blocker eye drops. Unlike beta blockers, forskolin enhances ocular blood flow, while having no systemic side effects and not inducing miosis. Higher doses are required by those with darker eye color than for those with light colored eyes. Synergistic effects can be achieved by combining coleus with omega 6 fatty acids.
How effective is forskohlii at lowering eye pressure? Here is the example of Dr. Kuakiniokalani Keeaumoku Kawananakoa-Prible, His Serene Highness, Hawaiian Prince and European royalty (he grew up in Buckingham Palace). In his own words, Doctor Kuakini reported to me, “Eye pressure at Hawaiian Eye Clinic: 42 & 46. One month later, eye pressure at Hawaiian Eye Clinic: 30 & 31 without using any eye drops or chemical drugs. Used only herbal caps of Forskohlii.” The ophthalmologist at Hawaiian Eye, the #1 eye clinic in Hawaii, had prescribed eye drops which he had informed Dr. Kuakini he did not expect to work. He was amazed at the reduced eye pressures, thinking that the prescription had worked. When Dr. Kuakini informed him that he had not filled the prescription, since he was told they would not work anyway, but had instead taken an herbal remedy, the ophthalmologist was even more amazed and said that it was the first time he had ever actually seen a natural substance actually reduce a patient’s eye pressure.
Ginkgo biloba was found to actually produce mild improvements in a study on patients with glaucoma and other severe degenerative disorders of the circulation in the back of the eye. This was considered very significant given the very poor prognosis for the conditions treated. Treatment began with 160 mg/day for the first 4 weeks followed by maintenance on 120 mg/day.
Ginkgo biloba has several biological actions that help against glaucoma:
improves central blood flow including the optic nerve and retina
improves peripheral blood flow
neuroprotection by inhibiting apoptosis
Chung HS, Harris A, Kristinsson JK, Ciulla TA, Kagemann C, Ritch R. Ginkgo biloba extract increases ocular blood flow velocity. J Ocul Pharmacol Ther 1999 Jun;15(3):233-240.
Ritch R. Potential role for Ginkgo biloba extract in the treatment of glaucoma. Med Hypotheses 2000;54: 221-35.
In a prospective, randomized, placebo-controlled, double-masked crossover trial at the Glaucoma Center, Clinica Oculistica Università di Brescia, and the Clinica Oculistica, Università di Catania, in Italy, GBE improves preexisting visual field damage in some patients with normal tension glaucoma (NTG).
27 patients with bilateral visual field damage resulting from NTG received 40 mg GBE orally three times daily for four weeks, followed by a washout period of eight weeks, and then four weeks of placebo treatment (40 mg fructose). Other patients took the fructose first and the GBE last. Visual field tests were performed at baseline and the end of each phase of the study.
Significant improvement in visual fields indices were found after GBE treatment. Mean deviation (MD) at baseline was 11.40 +/- 3.27 dB versus 8.78 +/- 2.56 dB MD after GBE treatment; corrected pattern standard deviation (CPSD) at baseline was 10.93 +/- 2.12 dB versus 8.13 +/- 2.12 dB CPSD after GBE treatment. No significant changes were found in intraocular pressure (IOP), blood pressure, or heart rate after placebo or GBE treatment. The study concluded that ginkgo biloba extract administration improves preexisting visual field damage in some patients with NTG.
Quaranta L, Bettelli S, Uva MG, Semeraro F, Turano R, Gandolfo E. Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmology 2003;110: 359-62.
Some doctors now recommend ginkgo together with vitamin E in glaucoma management. A dosage of 100 to 240 mg/day of ginkgo has been recommended.
Salvia miltiorrhiza is an herb used traditionally in oriental medicine. A study of patients with middle to late stage glaucoma received a preparation made from the root of this herb for one month. Visual acuity improved in 43.8% of the eyes studied, while 49.7% showed increased visual fields (statistically significant at p<0.01 compared to untreated controls). Followups as long as 30 months continued to show either stable or improved visual fields. Pilocarpine is a natural source drug long used to treat glaucoma, being derived from the herb Pilocarpus jaborandi. It has also been used in homeopathic doses for this purpose, which is a preferrable form especially for people under the age of 40 due to the severe side affects of headaches that often accompany its use in young people. Research has explored the possible use of the herb Cannabis sativa (hemp), either topically on the eye or systemically, to reduce IOP. With the potential to decrease eye pressure by 51%, it is the most effective agent known for IOP reduction. Smoking this herb unfortunately results in numerous side effects including tachycardia (speeding heart rate by 22 to 65%, the opposite of beta blockers), low blood pressure, a false sense of euphoria, photophobia, blepharospasm, dry eyes, and loss of short term memory. Extracts of this herb were used widely in medicine until early in this century. Now, hemp oil is becoming available, and is an excellent source of essential fatty acids to nourish the nerves of the eye. Tinctures and homeopathics, however, remain unavailable. The herb has been banned even for medical purposes since 1992. Bilberry (Vaccinium myrtillus), taken at a dosage equivalent to 1/4 teaspoon of solid extract 3 times a day has been recommended for all types of glaucoma. This herb has been shown to improve visual function in a variety of conditions including myopia, night blindness and diabetic retinopathy. The blue-red pigments (anthocyanosides) found in this and other berries have been show to improve vitamin C utilization, improve capillary integrity, provide anti-oxidant protection and stabilize the collagen matrix by directly cross-linking with collagen and preventing enzymatic breakdown of this backbone of the connective tissue. , , Ginger (Zingiber officinalis) stimulates improve heart function and increased circulation. A dosage of 100 mg/day of ginger has been recommended. Capsaicin cream (from cayenne pepper: Capsicum) increases circulation in the choroid of the eye, as does electrical stimulation of the trigeminal nerve. Capsicum capsules can also be taken internally, reducing cholesterol, providing antioxidant activity, relaxing smooth muscle for vasodilation and improved circulation, as well as stimulating digestive functions for better nutrient assimilation. Garlic (Allium sativum), which improves circulation, blood pressure and cholesterol levels, while providing antioxidant properties, has been recommended at a dosage of 500 to 1000 mg/day. Hawthorne berries have been suggested to improve heart rhythm and thus enhance circulation, while lowering hypertension and cholesterol where such cardiovascular problems are present together with glaucoma. Spirulina has been reported to help restore vision lost due to glaucoma. Vegetable source glycerin (1 to 2 g/kg body weight) mixed with an equal amount of water or juice can be used for first aid in acute angle closure glaucoma attacks. Several herbs may be combined or alternated as a warm eyewash or in eyedrop form (3 drops in each eye, instilled 3 times a day), including fennel, chamomile and eyebright.
Epinephrine is a natural neuro-hormone, released by the adrenal glands, which is often used to treat glaucoma in conventional medicine. Adrenal glandulars, including adrenal cortex and other nutritional supports for rebuilding the adrenal function should be used whenever the adrenals are run down. Vitamin C and the B complex are particularly important for supporting the adrenals. Adrenal hormones seem to be the primary daytime regulators of IOP.