An Integrative Medicine Approach to Glaucoma
Alternative and Supportive Tools For Coping with Glaucoma
For Marc Grossman's Workshop, Oct. 18, 2014
The following is material taken from the Natural Eye Care Website and other Vision Wellness & Research Websites. See sources as noted.
Glaucoma is often referred to as the "silent thief" as the symptoms are typically missing until the patient one day notices a loss in peripheral vision, or until one's eye doctor sees symptoms through a thorough eye exam.
The development of glaucoma is brought about by damage to the optic nerve, sometimes as a result of increased pressure in the clear fluid that circulates in the inside of the eye between the cornea and the lens.
The anterior (front) chamber of the eye is bounded by the lens and iris behind and the cornea in front. The meibomian gland behind the upper eyelid keeps the anterior chamber filled with aqueous humor, a clear liquid, which provides oxygen and nutrients to the front of the eye. The gland continually produces aqueous humor, which exits the eyes through a mesh of tiny holes behind the lower eyelid, called the trabecular meshwork.
In glaucoma, the trabecular meshwork begins to deteriorate, blocking the normal exit of fluid, and therefore pressure builds up in the anterior chamber, which swells, sending pressure to the vitreous, and eventually starving the nerve cells of nutrients. The nerves that comprise peripheral vision fail first.
However, glaucoma is now defined as a collection of diseases causing optic nerve damage. The diagnosis is no longer determined only on whether this pressure (Intraocular Pressure or IOL) is high.
Conventional treatment depends on the nature and severity of each case. Commonly, open angle glaucoma is treated with eyedrops or oral medications. In the event this treatment does not lower the eye pressure inside the eye, laser therapy or surgery may be considered necessary.
Link Discovered Between Glaucoma and WDR36 Gene
2009 research found that simultaneous mutations of the WDR36 and STI1 gene are causal factors for glaucoma.
In glaucoma, cells in the optic nerve die, preventing the brain from understanding what patients see, first in peripheral vision and gradually in all vision. It is associated with high levels of intraocular pressure and connected to risk factors to and from a number of other conditions including stroke, herpes virus, hypothyroid conditions, and many lifestyle factors.
Researchers have thought for some time that there may be a tie between the WDR36 gene and glaucoma. However, they’ve not been able to understand exactly why that gene has an effect and why some patients with that gene mutated or varied have glaucoma but other patients do not.
A new study indicates that glaucoma develops as a result of changes in several different genes, not only WDR36. This explains the mixed results. The researchers found that 10% of glaucoma incidents arise due to genes that have been understood – the idea of simultaneous changes in several different genes explains much.
The function of the WDR36 gene is to help make specific molecules known as ribosomes that are instrumental in creating proteins to help optic nerve cells function properly. If WDR36 changes and does not help produce ribosome, the entire process falters. Another gene that is critical to the process is STI1 which adapts the ribosome-created proteins to a form that the cell can utilize. So if WDR36 doesn’t produce ribosomes properly AND STI1 doesn’t “package” properly – the 2 mutations synergistically cause glaucoma.
Researcher: Dr. Michael Walter and associates, University of Alberta, Department of Medical Genetics in the Faculty of Medicine & Dentistry
Published: “Genetic Sleuth Solves Glaucoma Mystery”, University of Alberta Express News, March 20, 2009
Types of Glaucoma
A patient deemed a "Glaucoma Suspect" is one typically with a higher than normal eye pressure (IOL), but have not as of yet developed other symptoms such as changes in the optic nerve and/or reduced peripheral vision (as compared to prior visits). Glaucoma suspects could include people with diabetes, hypertension, heart disease, heavy computer users, and people with extreme nearsightedness or farsightedness. They also include people who suffer from obesity, hyperthyroidism, and African Americans. If you are in this category you should have glaucoma testing regularly, and we recommend the nutrients above to protect your vision.
Open Angle or Chronic Glaucoma
Open Angle Glaucoma is most frequently seen. There is a kind of eye tissue called the trabecular meshwork, which acts as a filter for the fluid in the eye. For various reasons, this meshwork gets clogged or obstructed and does not filter the fluid efficiently, which, in turn, leads to high ocular pressure.
Even though elevated eye pressure is one of the diagnostic tests used for glaucoma, approximately 30-40 percent of patients with open angle glaucoma have normal or low eye pressure and develop optic nerve changes and progressive vision loss without having elevated eye pressure. In the case of this common type of glaucoma there are no symptoms that you will notice until the condition has progressed so that there is loss of peripheral vision. Our complementary protocol is recommended for open angle glaucoma.
Narrow Angle Glaucoma
This condition is considered an ocular emergency. This results from a blockage to the aqueous fluid draining brought about by a narrow angle between the cornea and the iris that is too narrow to enable the aqueous fluid to drain as quickly as it is being produced. You might experience sudden red eye(s), with headache and visual halos, and sometimes also vomiting and nausea. If you have these symptoms go straight to emergency and call your eye doctor.
Low Tension Glaucoma
Low Tension Glaucoma is generally an indicator of poor circulation. As a result, not enough oxygen-carrying blood reaches the optic nerve and it becomes damaged. Many conditions, including brain tumors, heart problems, or toxic substances can cause optic nerve damage that is experienced as glaucoma. Also see: optic nerve atrophy and optic neuritis.
Secondary Glaucoma arises as a side result to other health conditions such as injury to the eye, inflammation of the eyes, or various drug side effects..
Congenital Glaucoma is that which begins within the first months after birth.
Complementary Care For Glaucoma
Interestingly, there is a apparently a lot you can do to help alleviate glaucoma - even though conventional treatment is pretty drastic.
For example, research has shown that glaucoma patients who take a brisk, 40-minute walk five days a week for three months can reduce the pressure in their eyes by approximately 2.5 millimeters - similar to the reduction seen when using beta-blockers. Passo, M.S. et. al., Regular exercise lowers intraocular pressure in glaucoma patients. Investigative Ophthalmology 35. In ARVO Abstracts, March 15, 1994.
Preventing Eye Disease
Important diet and nutrition recommendations:
- Maintain a healthy diet with plenty of vegetables, fruits and grains.
- Go organic - know what you are putting into your body
- Limit refined products lessen the amount of sugar (particularly white or refined sugar), and refined carbohydrates. Try stevia as a sweetener rather than sugar. It is far more concentrated so you only need a small amount.
- Avoid aspartame (foods labeled "diet")
- Avoid man-made fats (corn oil and safflower oil, trans fats, and hydrogenated vegetable oils including canola oil).
- Limit alcohol consumption to one glass of red wine daily. Alcohol helps reduce protective glutathione levels because it interferes with liver functioning.
- Cut down on caffeine, coffee, and soft drinks Watch your intake of soft drinks (3 tablespoons of sugar per can!) and processed foods that contain sugar.
- Avoid monosodium glutanate (MSG), which is used as a flavor enhancer, because it is a potential retinal toxin (Inv Oph 1996; 37: 1618-24)
- Avoid fat blockers like Olestra which impair the absorption of carotenoids (Argus, August 1996;19:18:July 1996;19:22).
- Slow down on the fast foods and fried foods.
- Read the labels when you buy processed foods - avoid artificial sweeteners, flavorings and colorings. Avoid hydrogenated and transfatty acid containing foods which disrupt the digestive process.
- Avoid hydrogenated oils or transfatty acids like those found in margarine, as well as saturated fats.
Important lifestyle recommendations
- Wear wrap-around sunglasses with 100% UVA and UVB protection whenever outside in the sun. The best lens color is amber, which neutralizes blue light. Brown is the next best color. Note: Cheaper glasses may have a coating to block out UV light that can rub off overtime. Many people think it is the tint that helps protect one's eyes, but it is actually the UV filter on, or in, the lens. So, if the filtering coating wears off, a dark lens actually increases pupil dilation, allowing more light to enter the eyes.
- Eliminate smoking. Smoking produces cyanide, a retinal toxin.
- Limit the amount of medications Talk to your doctor or get a second opinion to make sure that you are not taking more (both prescription and non-prescription) medications than you really need and that your medications do not conflict.
- Exercise every day. Get at 20 minutes of aerobic exercise daily by walking, swimming, or other sports or activities that you enjoy.
- Avoid microwaves. Leakage from microwave ovens are a direct cause of cataracts, so avoid peeking into the oven door window while you cook. In addition, food proteins exposed to microwaves can become toxic to the lens, which is made up mostly of proteins.
Manage your mental health.
Emotional well-being is very important to good physical health. Fear, anger, stress, etc, are important factors in many diseases. You can help balance your emotions through meditation, prayer, exercise, martial arts, etc. A 2012 U. California study found that 12 minutes of yoga daily brought about measurable changes in 68 genes, resulting not only in reduced stress, but reduced inflammation - an issue in diabetic retinopathy, optic neuritis, macular edema, heart disease, depression, rheumatoid arthritis, and diabetes.
Glaucoma & Heavy Computer Use
Introduction & Summary of the Research
Those who use computers heavily are at greater risk for glaucoma than the general public, particularly those who are short-sighted. Glaucoma is an insidious disease - because one typically does not notice its development. Glaucoma is characterized by increasing loss of peripheral vision eventually leading to severe vision loss.
A 2004 cross-sectional study in 9124 Japanese workers indicated that there was a possible association between heavy computer users and glaucomatous visual field abnormalities. In other words - if you use computers heavily, ie, programers, software engineers, gamers,
The study looked at typical daily computer use, as well as long-term computer use history. More than 500 participants had problems with their peripheral vision. Of that group, one third were found to have glaucoma ... perhaps more than a third, since some workers with peripheral vision problems didn't receive all the testing to accurately diagnose glaucoma.
Even more significant was that heavy computer users who were farsighted (presbyopia)or nearsighted (myopia) seemed to have a higher risk. Nearsightedness was found in 82% of those with glaucoma.
Heavy Computer Users & Glaucoma Research
Source: Possible association between heavy computer users & glaucomatous visual field abnormalities: a cross sectional study in Japanese workers, Journal of Epidemiology and Community Health 2004;58:1021-1027 Copyright, 2004 BMJ Publishing Group Ltd Masayuki Tatemichi, Tadashi Nakano, Katsutoshi Tanaka, Takeshi Hayashi, Takeshi Nawa, Toshiaki Miyamoto, Hisanori Hiro and Minoru Sugita
This Japanese study assessed whether there is a correlation between extensive daily use of the computer and glaucoma risk. The scientists screened 10,202 randomly selected Japanese employees with a mean age of 43.2 using a portable instrument called a Frequency Doubling Technology Perimeter (FDT) that analyzed whether there is a loss of visual field and which is used for detecting glaucoma. The subjects also received general health checkups and were checked by an ophthalmologist for vision health. The scientists also gathered daily computer use information and whether they had any vision conditions such as near- or far-sightedness..
It was found that 522 of the subjects were found to have visual field limitations. (Glaucoma is a condition in which the peripheral visual field diminishes.) There was also a marked correlation between blurry vision and heavy computer use. It was further found that the risk of glaucoma was higher in those subjects with blurry vision, and highest in those subjects whose blurry vision was caused by myopia.
Glaucoma Increases Risk of Other Health Conditions
African-Americans have higher rates of open-angle glaucoma, high pressure in their eyes and higher rates of death from chronic disease than whites. In a study including 300 subjects surveyed over nine years, that while glaucoma was not associated with higher rates of death overall, they did note that:
"... the risk of cardiovascular death was: 28 percent higher in those with ocular hypertension at the start of the study; 38 percent higher in people who'd previously been diagnosed with or treated for open angle glaucoma; and 91 percent higher in those who'd been treated with a beta blocker drug called timolol maleate."
The researchers also pointed out that inappropriate use of or side effects from medications used to treat glaucoma may damage the cardiovascular system. March, 2008, Archives of Opthamology
Glaucoma is more common in cardiovascular mortality.
Findings from the Blue Mountains Eye Study demonstrate an increased risk of death from cardiovascular problems in persons with previously diagnosed glaucoma. There was a suggestion of higher cardiovascular mortality in glaucoma patients using topical timolol that merits further study.
Glaucoma increases risk of falls and auto accidents.
A study in Halifax reviewed 48 patients with glaucoma and 47 age-matched controls without glaucoma, excluding people in nursing homes, or other significant sensory impairment or eye disease. The patients with glaucoma were on medications and more than half of them had corrective surgery. They were three times more likely to have fallen in the past 12 months compared to the control group, and six times more likely to have been in an auto accident, and 12 times more likely to have been at fault despite driving fewer kilometers per week.
Open Angle Glaucoma increases the risk of stroke.
A 2009 study of about 24,000 people over a 5 year period found that patients with OAG are 1 1/2 times as likely to suffer a stroke.3
Source: Natural Eye Care Glaucoma Page
Eye Pressure can cause Optic Nerve Damage
Elevated eye pressure (intraocular pressure) can cause damage to the optic nerve and is one of the risk factors for glaucoma and other vision conditions. In general ophthalmologists consider 10 mmHg to 20 mmHg to be normal pressure.
Why does high eye pressure damage the optic nerve?
High eye pressure doesn't always damage the optic nerve, but it does mean that you are at risk for glaucoma and so should be tested regularly. It also means that the steps to avoid optic nerve damage are especially important for you. Here's what you can do to reduce your risk.
Optic nerve damage occurs when fluids build up in the eye giving rise to pressure at the back of the eye, where the optic nerve is located. While it would be logical to assume that increased pressure would restrict the flow of blood to the optic nerve, causing damage, Quigley, et al found (1980) that might not be so.10 Rather, he and his collegues determined that mechanical compression of individual nerve fiber bundles was a more likely cause.
It is now known that the spongy trabecular meshwork near the lens at the front of the eye becomes clogged and does not permit correct outflow of acqueous humor into the normal body circular, giving rise to increased intraocular pressure, which in turn can damage the optic nerve due to restricted blood flow and/or mechanical compression of nerve fibers.
It is further understood that damage caused by elevated eye pressure, the amount of damage, the amount of pressure and the duration of pressure are not perfectly correlated. There may be other factors involved, in part, depending on whether the head of the optic nerve, the ganglion cells and other parts of the optic nerve are damaged and to what extent.11
What causes intraocular pressure to fluctuate?
- Exercise decreasing pressure. Researchers have found that some forms of exercise reduce intraocular pressure - both mild forms of exercise such as tai chi, walking, dancing, yoga, and pilates and more obviously vigorous exercise such as jogging and aerobics. One study looking at student runners found that eye pressure was reduced by 4 mmHg after running.(1) Another concluded that including aerobic exercise in one's routine decreases intraocular pressure.(2) And a third study looked at exercise under several controlled circumstances and found that the amount of pressure decrease was associated with the degree of intensitity of exercise.(3)
- Exercise increasing pressure. Resarchers also found that eye pressure may increase due to some forms of exercise, such as doing bench presses (heavy weights), even more so if the subject inadvertantly held their breath while lifting.(4)
- Exercise in sedentary people. Even for people who do not get sufficient exercise, walking and jogging both decrease intraocular pressure.(5)
- Normal variation. When researchers monitored eye pressure over 24 hour periods, noting the high eye pressure often occurs outside doctors' office hours, they found pressure to be higher in 2/3rds of the patients when they were sleeping at night.(6, 7)
- Heart rate. Although pressure has been found to decrease after exercise, it is not necessarily coorelated with heart rate.(8)
- Respiration. Interestingly, one researcher found that after subject breathed through only the right nostril, eye pressure statistically significantly decreased.(9) Not surprisingly, different forms of artificial respiration used during surgery, brought about changes in eye pressure. As with heart rate, respiration rate alone may not necessarily coorelate with changes in eye pressure.
- Drinking water. There is a water drinking test used for glaucoma patients, and it is true that drinking a large amount of water may temporarily raise intraocular pressure. But it is not true that drinking large amounts of water is dangerous because it raises eye pressure and restrictions are not necessary.
- Medications, drugs. Some medications and drugs do raise intraocular pressure and cause increased risk for glaucoma.
- Not only is death from cardivascular problems more likely in glaucoma patients, but drugs used to treat glaucoma may damage the cardiovascular system.
Source & Footnotes: Natural Eye care Intraocular Pressure Information Page
Glaucoma Research: Treatment & Complementary Care
New Vision Training for Glaucoma
New research indicates a breakthrough in repairing vision for patients with glaucoma. A clinical trial published in JAMA Ophthalmology showed vision improvement from daily computer-based training. Retinal damage due to glaucoma is considered irreversible, but this research indicates vision restoration is possible. By continually activating patients’ residual vision, computer training may be able to strengthen vision.
The clinical trial, conducted by Drs. J. Gublin and B. A. Sabel, used a randomized sample of patients with glaucoma (mean age: 61.7 years; age range: 39-79 years). For three months, patients performed one-hour computer training sessions. The objective was to determine if this training would strengthen the residual vision of the patients. The trial was successful. Patients that had performed the vision training showed significant improvement in detection accuracy compared with a placebo group. These patients also showed faster reaction time in comparison.
The study indicated that repeatedly activating residual vision increases detection sensitivity. This was done by training the visual field borders with computer training. The success of this trial indicates that field vision loss due to glaucoma is in part reversible. The research suggests the possibility for new treatment options in patients with glaucoma.
Research study show hypnosis can help lower eye pressure (intracular pressure) for those with glaucoma.
Stress and Glaucoma
Researchers found that stress may be connected to glaucoma risk. After reviewing incidence of above average stress in patients, researchers have indicated that high stress leads to a 3times higher risk for high eye pressure. High levels of pressure have been connected to glaucoma (although glaucoma can also occur with 'normal' levels of eye pressure.
Reference: Grignolo, F.M. et. al. Variations of intraocular pressure induced by psychological stress. Klinische Monatsblaten Augenheilkd 170 (1977): 562-69.
Green Tea Can Help Combat Glaucoma
Researchers in China say that green tea may protect against eye diseases such as glaucoma.
The researchers confirmed that substances found in green tea, which is known for its antioxidant and disease-fighting properties, were absorbed in the lens, retina and other eye tissue. Until this research it was not actually known whether green tea substances actually passed from the gastrointestinal tract into eye tissue.
The researchers analyzed the eye tissue of laboratory rats that drank green tea and found that several "catechins" in green tea that contain antioxidants -- including vitamin C, vitamin E, lutein and zeaxanthin -- were absorbed by the eye in significant amounts.
The researchers said green tea catechins reduced harmful oxidative stress in the eye for up to 20 hours, saying, "Our results indicate that green tea consumption could benefit the eye against oxidative stress."
Reference: Chi Pui Pang of the Chinese University of Hong Kong and Hong Kong Eye Hospital, study published in the April, 2010, Journal of Agricultural and Food Chemistry
Coleus forskolin & Glaucoma
A small double-blind, placebo-controlled study found that .3%, .6% & 1.% effectly lowered the intraocular pressure (IOP) in healthy subjects. The .3% concentration resulted in a 22.8% decrease; the .6% concentration resulted in a 27.8% decrease after 3 hours, and the 1% concentration resulted in a 26.5% decrease after 4 hours.
Further, the researchers found that the higher concentrations were about as effective as the lower concentrations, but lasted longer, with the 1% concentration lasting 7 hours, but the .3% concentration only lasting 4 hours.
The subjects noticed only very short term, minor sensations like itching or burning.
Reference: Badian M, Dabrowski J, Grigoleit HG, Lieb W, Lindner E, Rupp W., Effect of forskolin eyedrops on intraocular pressure in healthy males [in German], Klin Monbl Augenheilkd. 1984 Dec;185(6):522-6
Bilberry, pine bark combo ward off glaucoma
A 2008 Italian study tested thirty-eight subjects with elevated pressures. 20 were treated with bilberry and French maritime pine bark, the rest were given nothing. Visual acuity, IOP, and ocular blood flow were measured after 2, 3 and 6 months. After two months the mean IOP decreased. No side effects were observed and ocular blood flow improved.
An improved ocular blood flow may contribute to the prevention of glaucoma.
The researchers also looked at the arteries of the eyes with color Doppler imaging and saw better flood flow in the subjects receiving the treament. This suggests that fluids in the eye were being restored.
One of the researchers, Steigerwalt, said, "Our study is the first demonstration showing that dietary intervention can help to control IOP and increase ocular blood flow in asymptomatic subjects and if taken in time, may prevent an evolution to higher pressure and symptomatic glaucoma."
Reference: Robert Steigerwalt Jr, Belcaro Gianni, Morazzoni Paolo, Ezio Bombardelli,2 Carolina Burki, Frank Schönlau , University of Chieti-Pescara in San Valentino, Italy, Molecular Vision 2008; 14:1288-1292, "Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects"
Acupuncture Takes Pressure Off Glaucoma
New research shows that acupuncture benefits patients with glaucoma. Acupuncture was shown to improve intraocular pressure (IOP) and retrobulbar circulation (circulation behind the globe of the eye). Acupuncture was applied to UB2, Tai Yang (M-HN9), ST2, ST36, SP6, K3, Liv3, GB20, UB18, and UB23 bilaterally. Color Doppler imaging confirmed the improvement in circulation behind the eye. The improvements in IOP and eye circulation suggest that acupuncture is effective in the treatment of open-angle glaucoma (OAG).
Glaucoma can cause blindness. Western medical treatments focus on controlling IOP and retrobulbar hemodynamics. The study concludes that acupuncture is effective in controlling these factors. Using color Doppler imaging, the researchers discovered that acupuncture lowers IOP and vessel resistance in patients with open-angle glaucoma.
The acupuncture needles were retained for 15 minutes on the anterior and posterior sides of the patients during each session. UB2, Taiyang, ST2, St36, SP6, K3, and Liv3 were applied to the patients when in the supine position and retained for 15 minutes. For the prone position, GB20, UB18, and UB23 were retained for 15 minutes. Needle insertion ranged from 3-10 mm in depth. No needle manipulation techniques either manual or through electroacupuncture were applied.
The researchers comment that this is the first study measuring the improvements of eye hemodynamics through the use of acupuncture. The researchers further comment that acupuncture achieves this result by decreasing vessel resistance in the eyes, specifically in the ophthalmic artery (OA) and short posterior ciliary artery (SPCA). The OA and SPCA originate from the carotid artery. The study concludes that a combination of medications combined with acupuncture improves glaucoma patient outcomes over patients who only receive medications.
Reference Shin Takayama, Takashi Seki, Toru Nakazawa, Naoko Aizawa, Seri Takahashi, Masashi Watanabe, Masayuki Izumi, Soichiro Kaneko, Tetsuharu Kamiya, Ayane Matsuda, Akiko Kikuchi, Tomoyuki Yambe, Makoto Yoshizawa, Shin-ichi Nitta, and Nobuo Yaegashi. Short-Term Effects of Acupuncture on Open-Angle Glaucoma in Retrobulbar Circulation: Additional Therapy to Standard Medication. Evidence-Based Complementary and Alternative Medicine. Volume 2011 (2011), Article ID 157090, 6 pages.
Clinical observation on combining acupuncture and eye drops for primary open angle glaucoma
Objective: To observe the clinical efficacy of combining acupuncture and eye drops for primary open angle glaucoma.
Methods: A total of 19 (38 eyes) cases with primary open angle glaucoma were randomized into a treatment group (10 cases) and a control group (9 cases). The treatment group was treated with acupuncture and eye drops, whereas the control group was treated with eye drops alone. Then the intraocular pressure was measured respectively prior to treatment, 1 month and 3 months after treatment to determine the differences.
Results: After 1 and 3 months of treatment, the intraocular pressure in the treatment group were significantly reduced (P less than 0.05); and there was a statistical difference in intraocular pressure between the treatment and the control group (P less than 0.05).
Conclusion: Combining acupuncture and eye drops is better than eye drops alone for primary open angle glaucoma.
Reference:Fei Liu, Bang-lei Li, Jing-feng Yang, Li-na Song, Kai Tang, Xue-ling Song, Journal of Acupuncture and Tuina Science, April 2013, Volume 11, Issue 2, pp 93-95.
Complementary and Alternative Therapy for Glaucoma
by Kimberly K. Reed, O.D., 4.16.10
Green tea and ginkgo biloba for glaucoma? Sleeping upright to bring down IOP? Learn what your patients may be using to treat their glaucoma.
Early in my career, I examined a pleasant woman in her early 40s who had all the signs of moderately advanced primary open-angle glaucoma (POAG). I explained the test results to her as best I could, and recommended that she immediately begin twice-daily therapy with a beta-blocker (the standard of care at that time).
She politely declined, and stated that, instead, she was going to begin meditating and increasing her intake of green tea.
I was flabbergasted, and I’m now ashamed to admit that I dismissed her from my care—I decided that our approaches to her condition were too starkly different to work in her best interest. Remember, in the early 1990s, glaucoma diagnosis and management didn’t leave much room for “alternative” or “homeopathic” therapies. These days, this type of exchange between doctor and patient is a lot more common.
What is CAM?
- Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient’s discomfort following surgery.
- Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation or chemotherapy that has been recommended by a conventional doctor.
Source: National Institutes of Health—National Center for Complementary and Alternative Medicine.
Whether or not we embrace all, some or none of the concepts of complementary and alternative medicine (CAM), we need to be aware of the research supporting—or refuting—their use so that we can provide our patients with the most accurate information possible.
Other Alternative Approaches
Glaucoma is a disease of multifactorial origin. Yet, increased intraocular pressure remains the only modifiable risk factor against the development of glaucomatous-associated optic nerve damage. Still, scientists continue to rapidly develop the body of knowledge about non-IOP-dependent mechanisms in the pathogenesis of glaucoma.
At the same time, many patients are seeking a more active role in their own care, and have access not only to traditional science as reported through popular media, but also to a wide variety of alternative theories.
At last count (10 years ago), at least one in 20 glaucoma patients reported using complementary or alternative medicine for their disease.1 Of these, more than half believed it was helpful. And, one-quarter of patients who used CAM for glaucoma did not discuss it with their eye doctor.
So, it’s not unusual for patients to seek answers by merging the traditional with the alternative: Does my sleeping position affect my glaucoma? Which foods, herbs or supplements might make my glaucoma eye drops work better? Is there anything to the theory of acupuncture augmenting glaucoma therapy?
At first blush, alternative approaches often seem a bit, well, “out there.” But sometimes there’s a scientific basis to explain what often begins as anecdotal evidence, and some of those “out there” ideas eventually become mainstream.
This article reviews a few of the best-understood mechanisms that are believed to contribute to ganglion cell damage in glaucoma—increased intraocular pressure, oxidative damage and vascular dysregulation at the optic nerve head—and discusses the associated alternative therapies for those processes.
The current pharmaceutical approach to glaucoma management is aimed at reducing IOP. For decades, the body of evidence has pointed to elevated IOP as the primary risk factor in the advancement of optic nerve damage in glaucoma.2,3 In addition to mainstream medical therapy, several “alternative” approaches to reducing IOP have been investigated, with variable results.
Perhaps the most well known of these is THC, the active ingredient in marijuana.4 Although its action in lowering IOP is well established, the serious side effects and high abuse liability limit its widespread use.
Other alternative approaches likely hold more promise.
- Melatonin. The hormone melatonin is responsible for several functions, including regulation of seasonal and circadian rhythms.5 Melatonin is also involved in the dynamics of aqueous humor. Topical melatonin receptor agonists have demonstrated fairly impressive effects in reducing IOP in recent animal studies—reductions in IOP with these agents range from 19% to 28%.5,6 These effects are comparable to those achieved with currently available pharmaceutical agents.
To date, no significant adverse effects have been described with the topical application of melanin. However, bear in mind that this hormone is synthesized in many tissues in the body, not just the eye. The systemic absorption profile of topical melatonin drops has not yet been fully investigated, so the range of systemic effects with its potential topical use is not yet known.
Melatonin also serves as an antioxidant, potentially giving it a secondary mechanism by which to offer neuroprotection in glaucomatous eyes.7 Because of this dual action, melatonin receptor agonists may emerge as a useful adjunctive therapy in glaucoma.
- Acupuncture Several recent animal studies have reported an IOP-lowering effect following acupuncture—a 15% reduction was seen in one study.8,9 At least one animal study has concluded that acupuncture preserves retinal function in induced glaucoma.10 But remember, animal studies sometimes involve first creating glaucoma by using destructive techniques, so the “glaucomatous” eyes likely have some structural and/or chemical differences as compared to human patients with glaucoma. So, results should be interpreted while keeping these potential differences in mind.
One small series using human subjects found a mild, transient IOP-lowering effect for up to four weeks following an acupuncture treatment series, but the study lacked a control group.11 A comprehensive evaluation of the literature suggests that the existing evidence lacks sufficient quality and quantity to draw any conclusions about the efficacy of acupuncture in lowering IOP.12 At the same time, there is no evidence indicating that any ill effects will result from using acupuncture to augment conventional medical treatment. Some patients may wish to pursue this as complementary therapy, applying the “can’t hurt, might help” philosophy.
- Sleeping position How patients sleep at night may pose another preventable risk factor in glaucoma. Several studies have recently reported an increase in IOP when patients are positioned in the supine position (lying down) as compared to an upright position.13,14 These differences may be even more pronounced in patients already diagnosed with normal-tension glaucoma.15
As a result, researchers have started looking at whether a simple modification in overnight sleeping position might lower the risk of glaucomatous nerve damage induced by overnight rises in IOP. A recent study found that an action as simple as having the patient sleep at a 30º incline may reduce nighttime IOP by up to 20% in some patients.16 Sleeping with two or three pillows may present a risk-free, non-invasive, no-cost, effective means to boost the effects of other glaucoma therapies, whether traditional or CAM.
Oxidative Stress and Vascular Dysregulation
We know that ocular blood flow disruptions play a direct and/or indirect role in glaucomatous optic neuropathy.7,16,17 Rather than being the result of a steady-state reduction in blood flow to the optic nerve (i.e., hypoperfusion), most experts agree that it is repeated mild reperfusion—resulting from fluctuations in systemic blood pressure and ocular perfusion pressure—that creates damage at the ganglion cell level.7
We also know that glaucoma patients, especially those with normal-tension glaucoma, have more variability in systemic blood pressure than do patients without glaucoma. This difference is most noticeable overnight and in the early morning, and it is more pronounced in older patients than younger patients.18-21 Several mechanisms are likely at play—perhaps the most important among them is oxidative stress caused by the low-level hypoperfusion and reperfusion.7
What is oxidative stress? Living cells use oxygen, and the metabolism of oxygen creates “reactive oxygen species,” or ROS. ROS are sometimes called “free radicals.” In an ideal state, the production of ROS would be counterbalanced exactly by the presence of antioxidants. An excess of ROS relative to antioxidants creates oxidative stress, which is believed to be at least partly responsible for cellular damage in many disease states, including glaucoma.22 In fact, the oxidative stress in glaucoma may actually be the underlying cause of increased intraocular pressure in glaucoma, rather than its result!23,24
Not all ROS are the same; likewise, the actions and behaviors of different antioxidants vary depending on several factors. Much of the current research in this area is aimed at differentiating the various ROS that are produced in eyes with glaucoma, and even further identifying which sub-structure of the ganglion cells (GC) are most affected. It appears that the GC mitochondria play an important role in regulating cell death, so targeting antioxidant therapy at these organelles is the target of much recent research activity.7,25-28 Incidentally, the same principles involving ROS and targeted antioxidant therapy apply in many other diseases, including age-related macular degeneration.
So, if fluctuations in blood flow to the nerve create oxidative stress, and oxidative stress causes ganglion cell damage, many would argue that it makes more sense to address these mechanisms—using traditional therapy or CAM—as opposed to just reducing IOP pharmacologically. The following dietary modifications and supplements deal with these mechanisms:
- Salt.Some researchers advocate combating vascular dysregulation, at least in part, by inducing an increase in systemic blood pressure. This can be done by deliberately supplementing the diet with the most commonly cited “culprit” in contributing to high blood pressure: ordinary table salt.29 Obviously, this approach is ill-advised for patients who have coexisting vascular conditions that would be exacerbated by an increase in systemic blood pressure. Nevertheless, in select patients, increasing blood pressure can be protective against those damaging fluctuations, especially the blood pressure “dips” that occur overnight.
- Omega-3 fatty acids. What other dietary modifications can help regulate the vascular system? There is little doubt that omega-3 fatty acids (FAs) are beneficial to virtually every system in our bodies, and the promotion of vascular health is certainly among the benefits. Some studies have found that omega-3 FAs may have a direct therapeutic benefit in glaucoma patients, despite the fact that one of the well-known effects of these substances is a mild reduction in systemic blood pressure—not an elevation, as with salt.
But remember: It’s not the absolute systolic or diastolic pressure that is suspected of causing optic nerve damage in glaucoma, but rather the repeated fluctuations in ocular perfusion pressure. Stabilization is the key concept, which may be why omega-3 FAs are linked to positive outcomes in some glaucoma studies.30,31
- Magnesium. Magnesium is also believed to improve vascular regulation.29,32
- Antioxidants. A host of known antioxidants have been suggested to combat the ROS that seem to be more prevalent in glaucoma patients. The most studied include polyphenolic compounds, notably the widely publicized resveratrol contained in red wine.29 Other sources of antioxidants: dark chocolate, ubiquinone (coenzyme Q10), anthocyanosides (found in bilberries) and turmeric.29
Ginkgo biloba extract (GBE) is unique in this antioxidant class, because it specifically acts upon the mitochondria.28 Additionally, GBE probably acts in other ways, and it may even have a positive effect in vascular regulation.33
And, yes, my former patient’s green tea (in fact, all tea) also contains antioxidants that may be protective against glaucoma.34 No single antioxidant has yet emerged as the “best” antioxidant to potentially reduce the risk of cellular damage in glaucoma—but this is an area of intense interest.
Complementary and alternative medicine is playing an increasingly important role in our available management strategies for our glaucoma patients. Perhaps even more importantly, patients have access to information sources about these therapies, and may choose to experiment with them on their own. So, we need to stay abreast of scientific developments in this area so that we can knowledgeably and open-mindedly discuss all available management options with our patients.
Dr. Reed is an associate professor at Nova Southeastern University, where she teaches ocular disease and primary clinical care.
Source & Footnotes: http://www.reviewofoptometry.com/content/c/20403/
Glaucoma Research Foundation
Alternative medicine may be defined as non-standard, unconventional treatments for glaucoma.
Use of alternative medicine continues to increase, although it must be noted that some of these treatment alternatives have no proven clinical effect.
Regular exercise and relaxation techniques can be beneficial for lowering eye pressure and may have a positive impact on your overall health and other glaucoma risk factors including high blood pressure.
Always talk to your doctor before starting any alternative therapies.
Proponents of homeopathic medicine believe that symptoms represent the body’s attack against disease, and that substances which induce the symptoms of a particular disease or diseases can help the body ward off illness.
The Food and Drug Administration (FDA) has not tested homeopathic remedies for safety or effectiveness. There is no guarantee that they contain consistent ingredients, or that dosage recommendations are accurate. It would be a mistake to use homeopathic remedies and dismiss valid therapies, delaying proven treatment for serious conditions.
Holistic medicine is a system of health care designed to assist individuals in harmonizing mind, body, and spirit. Some of the more popular therapies include good nutrition, physical exercise, and self-regulation techniques including meditation, biofeedback and relaxation training. While holistic treatments can be part of a good physical regimen, there is no proof of their usefulness in glaucoma therapy.
Eating and Drinking
No conclusive studies prove a connection between specific foods and glaucoma, but it is reasonable to assume that what you eat and drink and your general health have an effect on the disease.
Some studies have shown that significant caffeine intake over a short time can slightly elevate intraocular eye pressure (IOP) for one to three hours. However, other studies indicate that caffeine has no meaningful impact on IOP. To be safe, people with glaucoma are advised to limit their caffeine intake to moderate levels.
Studies have also shown that as many as 80% of people with glaucoma who consume an entire quart of water over the course of twenty minutes experience elevated IOP, as compared to only 20% of people who don’t have glaucoma. Since many commercial diet programs stress the importance of drinking at least eight glasses of water each day, to be safe, people with glaucoma are encouraged to consume water in small amounts throughout the day.
The ideal way to ensure a proper supply of essential vitamins and minerals is by eating a balanced diet. If you are concerned about your own diet, you may want to consult with your doctor about taking a mulitvitamin or multimineral nutritional supplement.
Some of the vitamins and minerals important to the eye include zinc and copper, antioxidant vitamins C, E, and A (as beta carotene), and selenium, an antioxidant mineral.
An extract of the European blueberry, bilberry is available through the mail and in some health food stores. It is most often advertised as an antioxidant eye health supplement that advocates claim can protect and strengthen the capillary walls of the eyes, and thus is especially effective in protecting against glaucoma, cataracts, and macular degeneration. There is some data indicating that bilberry may improve night vision and recovery time from glare, but there is no evidence that it is effective in the treatment or prevention of glaucoma.
There is some evidence suggesting that regular exercise can reduce eye pressure on its own, and can also have a positive impact on other glaucoma risk factors including diabetes and high blood pressure.
In a recent study, people with glaucoma who exercised regularly for three months reduced their IOPs an average of 20%. These people rode stationary bikes 4 times per week for 40 minutes. Measurable improvements in eye pressure and physical conditioning were seen at the end of three months. These beneficial effects were maintained by continuing to exercise at least three times per week; lowered IOP was lost if exercise was stopped for more than two weeks.
Benefits of Walking
In an ongoing study, glaucoma patients who walked briskly 4 times per week for 40 minutes were able to lower their IOP enough to eliminate the need for beta blockers. Final results are not available, but there is hope that glaucoma patients with extremely high IOP who maintain an exercise schedule and continue beta-blocker therapy could significantly reduce their IOP.
Regular exercise may be a useful addition to the prevention of visual loss from glaucoma, but only your eye doctor can assess the effects of exercise on your eye pressure. Some forms of glaucoma (such as closed-angle) are not responsive to the effects of exercise, and other forms of glaucoma (for example, pigmentary glaucoma) may actually develop a temporary increase in IOP after vigorous exercise. And remember -- exercise cannot replace medications or doctor visits!
Yoga and Recreational Body Inversion
The long-term effects of repeatedly assuming a head-down or inverted position on the optic nerve head (the nerve that carries visual images to the brain) have not been adequately demonstrated, but due to the potential for increased IOP, people with glaucoma should be careful about these kinds of exercises.
Glaucoma patients should let their doctors know if yoga shoulder and headstands or any other recreational body inversion exercises that result in head-down or inverted postures over extended periods of time are part of their exercise routines.
The results of studies regarding changes in IOP following relaxation and biofeedback sessions have generated some optimism in controlling selected cases of open-angle glaucoma, but further research is needed.
However, findings that reduced blood pressure and heart rate can be achieved with relaxation and biofeedback techniques show promise that non-medicinal and non-surgical techniques may be effective methods of treating and controlling open-angle glaucoma.
A Novel Nitric Oxide Releasing Prostaglandin Analog, NCX 125, Reduces Intraocular Pressure in Rabbit, Dog, and Primate Models of Glaucoma
Purpose: Nitric oxide (NO) is involved in a variety of physiological processes including ocular aqueous humor dynamics by targeting mechanisms that are complementary to those of prostaglandins. Here, we have characterized a newly synthesized compound, NCX 125, comprising latanoprost acid and NO-donating moieties.
Methods: NCX 125 was synthesized and tested in vitro for its ability to release functionally active NO and then compared with core latanoprost for its intraocular pressure (IOP)-lowering effects in rabbit, dog, and nonhuman primate models of glaucoma.
Results: NCX 125 elicited cGMP formation (EC50 = 3.8 ± 1.0 μM) in PC12 cells and exerted NO-dependent iNOS inhibition (IC50 = 55 ± 11 μM) in RAW 264.7 macrophages. NCX 125 lowered IOP to a greater extent compared with equimolar latanoprost in: (a) rabbit model of transient ocular hypertension (0.030% latanoprost, not effective; 0.039% NCX 125, ∆max = −10.6 ± 2.3 mm Hg), (b) ocular hypertensive glaucomatous dogs (0.030% latanoprost, ∆max= −6.7 ± 1.2 mm Hg; 0.039% NCX 125, ∆max = −9.1 ± 3.1 mm Hg), and (c) laser-induced ocular hypertensive non-human primates (0.10% latanoprost, ∆max = −11.9 ± 3.7 mm Hg, 0.13% NCX 125, ∆max = −16.7 ± 2.2 mm Hg). In pharmacokinetic studies, NCX 125 and latanoprost resulted in similar latanoprost-free acid exposure in anterior segment ocular tissues.
Conclusions: NCX 125, a compound targeting 2 different mechanisms, is endowed with potent ocular hypotensive effects. This may lead to potential new perspectives in the treatment of patients at risk of glaucoma.
Melatonin, Glaucoma And Intraocular Pressure: Initial Iop Results
Posted on September 26th, 2006, Free Radical Federation by Dave
Like most people, my intraocular pressure (IOP) is lowest at night. This is also when natural levels of melatonin are near their high in the circadian cycle. My IOP is highest in the morning when melatonin is low. There seems to be a correlation between my IOP and melatonin. Recognizing that relationship lead me to have a discussion with my physician.
My physician agreed to carefully monitor my IOP while I try melatonin. I'll tell you how the results of the first day turned out. But first, let me tell you what I know about melatonin and glaucoma.
My physician gave me some background on melatonin. It is known that levels of melatonin in the blood are highest prior to bedtime. He said melatonin is a neurohormone produced in the brain by the pineal gland. The amino acid tryptophan is a precursor for melatonin. The synthesis of melatonin is stimulated by darkness; its release is suppressed by light. For this reason, melatonin is believed to be involved in the circadian rhythms. It is also involved in the regulation of diverse bodily functions.
One of melatonin's diverse functions is to oppose the action of natural corticosteroids (glucocorticoids) and corticosteroid drugs. As you may be aware, corticosteroids are known to increase IOP.
Of additional interest is the fact that melatonin is a well-studied free radical scavenger. There are well over one hundred laboratory and animal studies of the antioxidant (free radical quenching) properties of melatonin. (I won't list those references in this article because I am focusing on the IOP effects). Melatonin is often used as a supplement to prevent or treat many conditions that are associated with oxidative damage. However, there are many other antioxidants I think I would consider before I resorted to using a neurohormone purely as an antioxidant. I understand melatonin can potentially do more for the eye than just lower IOP and serve as an antioxidant, but because it also affects so many other bodily functions, I would not use it primarily as an antioxidant.
In my case, I do have some trouble falling asleep, so melatonin's well-studied effects on improving sleep quality and reducing sleep latency (the time it takes to fall asleep) are of interest to me.
My physician also cautioned me that theoreticallly, melatonin could increase intraocular pressure and the risk of glaucoma, age-related maculopathy and myopia (1), or retinal damage (2) due to effects on photoreceptor renewal in the eye. This is thought to be possible with high doses of melatonin. However, I do not believe these effects have ever actually been seen.
What has been seen is that melatonin may actually decrease intraocular pressure (3, 4). Furthermore, it has been proposed that melatonin may be protective against the optic nerve damage characteristic of glaucoma (5). That's why my physician agreed that we could investigate it as a possible therapy for my glaucoma. Keep in mind that the research in this area is preliminary. There are now some studies on melatonin and glaucoma but in one early study of healthy people, supplementing with 0.5 mg of melatonin lowered intraocular pressure (3). That's the result that prompted me to try my own IOP-melatonin experiment with my own tonometer.
I have pigmentary glaucoma. So what happended when I took my first dose of melatonin? I took 2.5 mg sublingually. Within an hour, my IOP had fallen by 26%. By bedtime, 5 hours later, my IOP had fallen 46%. Of course part of that decline is normal. My IOP is always lower around bedtime. So the information that seems most relevant to me is the 26% decrease within an hour of taking the melatonin.
What do these first day results mean? Probably not much. I would want to know a lot more about the effects and side effects over a long period of time before I got too enthusiastic about long term use of melatonin. And for anyone other than me, my simple test means nothing at all. A lot more testing would be needed before anyone could make general recommendations. Quite frankly, I'm not sure I even want to be the guinea pig for continuing my own little experiment. I'm planning to call my physician and tell him that I'm going to discontinue the melatonin until I learn more. I learned enough to understand firsthand that melatonin is probably involved the daily cycle that causes my IOP to be lowest in the evenings. That's worthwhile knowledge and I think I'll stop there for now.
The big problem with melatonin is that no one really knows what problems it could lead to if taken in the morning. And that is when I would need to take it if it were really going to do much to help my IOP.
However, today's results will probably cause me to investigate some other options. For example, because I often have trouble falling asleep, I would be interested in an herbal product that naturally stimulates melatonin.
Chasteberry (Vitex agnus-castus) is an example of a product that may increase natural secretion of melatonin. This is based on preliminary research (mentioned here and here), but I plan to investigate it further. If I find a good traditional herbal formula that contains chasteberry, I will consider trying it while closely monitoring my IOP with my physician.
Another thing to note is that some preliminary studies have found that meditation and yoga prior to bedtime may increase melatonin levels that evening.
But for anyone with glaucoma, the morning intraocular pressure levels probably need more attention than the evening IOP. So it seems that using melatonin, whether directly as a supplement or indirectly via herbs, yoga or meditation, is not a complete solution.
That said, more research on melatonin and glaucoma would be welcome. Stay updated here: Melatonin and Glaucoma | FitEyes.com
DISCLAIMER: Anyone with glaucoma should be monitored by a healthcare professional while taking melatonin.
Source & Footnotes: http://freeradicalfederation.com/PreviewMelatoninIOP
Neckties and glaucoma
Men should avoid wearing a necktie! Yes I will give you a doctor’s excuse!
Researchers at State University of New York Downstate Medical Center evaluated the results that neckties had on the IOP. They enrolled healthy men and 20 men with glaucoma. They tested pressure first with an open-collar shirt , then after three minutes after donning a tie, and again three minutes after loosening their ties.
60% of the men with glaucoma and 70% of the healthy men experienced a significant increase in IOP after wearing the tie for only 3 minutes. The increases ranged from more than 2 mm Hg to over 4 mm Hg.
The researchers concluded that overly tight neckties can definitely affect eye health, interfere with the treatment of glaucoma, and possibly even increase the risk of developing glaucoma. (Br J Ophthalmol 03;87(8):946-9)
New Hope and Cure for Glaucoma Treatment
Townsend Letter, January 1, 2014, Marks, Edith S.; De Moraes, Gustavo
Although the tools for glaucoma care have become more sophisticated and advanced over the past two decades, the goal of cure is still beyond our reach, despite advanced technology and worldwide research. One of the problems lies in the fact that, unlike other medical problems wherein transplants have successfully restored an organ, the optic nerve --part of the brain--does not fall into this category. Nevertheless, the ophthalmological community has been hard at work assembling a medical tool kit that promises effective and less invasive care. As well, the pharmaceutical companies are constantly evaluating different substances in an effort to provide medications with greater efficacy and fewer side effects. Dr. Gustavo De Moraes, research associate professor at New York University Medical Center and senior researcher at the New York Eye and Ear Infirmary, and research fellow Dr. Camilla Netto reported on some of the current research for glaucoma treatment. De Moraes has authored over 75 research papers and authored/coauthored 7 book chapters.
The therapy today among practitioners consists of a number of strategies, with focus on lowering the intraocular pressure with medication, laser, and incisional surgery, but also on protecting the optic nerve from the ravages of toxic compounds.
The pharmaceutical community continues to develop improved medications. There are a few in the pipeline now in trial, and if these succeed in lowering the pressure sufficiently with minimal side effects, they will be introduced to the marketplace. In the past few years, we have witnessed a wider range of both laser treatments and incisional surgeries, especially with minute stents. Fortunately, these surgeries are minimally invasive and therefore possess fewer side effects, leading to quicker recovery periods. Newer forms of therapy using different sites in the eye offer better control, and the research on stem cell vision replacement continues apace. Nanotechnology offers new release methods inside the eye for medication.
Nitric oxide (NO) and other compounds that act synergistically with it to keep the intraocular pressure low and stable are among some of the newer medical approaches under investigation. …
PEMF and Eye Problems
Abstracts of scientific studies on the use of PEMF with Eye Problems
[Effectiveness of magnetotherapy in optic nerve atrophy. A preliminary study]
Magnetotherapy effects on visual functions (vision acuity and field), on retinal bioelectric activity, on conductive vision system, and on intraocular circulation were studied in 88 patients (160 eyes) with optic nerve atrophy. A Soviet Polyus-1 low-frequency magnetotherapy appartus was employed with magnetic induction of about 10 mT, exposure 7-10 minuts, 10-15 sessions per course.
Vision acuity of patients with low (below 0.04 diopters) values improved in 50 percent of the cases. The vision acuity of patients with vision acuity of 0.2 diopters has increased from 46 before treatment to 75 after treatment.
Magnetotherapy improved ocular hemodynamics in patients with optic nerve atrophy, it reduced the time of stimulation conduction along the vision routes and stimulated the retinal ganglia cells. The maximal effect was achieved after 10 magnetotherapy sessions. A repeated course carried out in 6-8 months promoted a stabilization of the process.
Zobina, L. V. and Orlovskaia, L. S. and Sokov, S. L. and Sabaeva, G. F. and Konde, L. A. and Iakovlev, A. A. , 1990 Link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2264232
[The effect of a pulsed electromagnetic field on the hemodynamics of eyes with glaucoma]
The influence of pulse electromagnetic field (PEMF) on hemodynamics of the eye in open-angle glaucoma has been studied by means of a method and a device proposed at the Filatov Institute. The PEMF characteristics are: impulse frequency--50 Hz, exposition--0,02 sec., impulse shape--square, rate of impulse rise--4.10(4) c rate of magnetic induction rise--2.10(4) mT/c, amplitude value of magnetic induction at the impulse height--9.0--8.5 mT, duration of the procedure--7 min., a course--10 sessions.
Observations over 150 patients (283 eyes) with latent, initial and advanced glaucoma have shown a positive influence of PEMF on hemodynamics of a glaucomatous eye: a rise of rheographic coefficient and relative volume pulse in 87.99 and 81.63%, respectively. The degree of the rise and restoration frequency of rheographic values of the glaucomatous eye under the influence of PEMF to the age norm was more expressed at initial stages of the glaucomatous process (latent and initial glaucoma).
Tsisel'skii Iu, V. and Kashintseva, L. T. and Skrinnik, A. V. , 1990, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2255478