Most ODs who treat glaucoma have been asked a version of this question: “Is there anything I can add or eliminate from my diet to prevent glaucoma from occurring or to help slow down progression?”
When such a question is posed to me, my response is typically: “Never start smoking, get some exercise, eat your vegetables, and don’t treat your body like a garbage can.”
Relative to dry eye and age-related macular degeneration, we have little glaucoma risk or actuality information to offer our patients.
Nutrition and glaucoma
A recent study examining a possible relationship between nutrition and glaucoma was published in JAMA Ophthalmology. Investigators of this study examined data from 3,865 people who participated in the National Health and Nutrition Examination Survey (NHANES) 2005-2008 database. Those included were age 40 or older and participated in the dietary intake and vision health questionnaire of this cross-sectional study.1
Previously from Dr. Casella: Involve patients in monitoring IOP
Study inclusion was predicated upon the availability of laboratory test results, frequency-doubling technology (FDT) visual field loss detection tests, and optic disc photographs.
The study aimed to examine daily dietary polyunsaturated fatty acid (PUFA) intake to determine its potential relationship to the prevalence of glaucoma in study participants. Results showed participants who took in higher daily quantities of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were determined to have a lower likelihood of having glaucoma.
EPA and DHA are omega-3 fatty acids commonly found in supplements commercially available to our patients. Participants who took in higher quantities of “total” PUFAs were determined to have a higher likelihood of a glaucoma diagnosis. Researchers postulate that this finding may be due to the relative ratios of omega-6 and omega-3 fatty acid intake.
Increased omega-6 intake has been related to promotion of inflammation, especially in the arena of cardiovascular disease. Researchers also postulate that this finding may be due to the presence of confounding comorbidities among study participants.
More studies needed
Increased intraocular pressure (IOP) is a common risk factor for the development and progression of glaucoma, and IOP is modifiable.
If a risk factor for glaucoma related to dietary intake could be elicited, clinicians would have another modifiable risk factor to work with besides IOP. Age, family history, and race are not modifiable. Nutritional intake can be augmented, and good nutrition can augment one’s health.
As for this particular study, the investigators state that other longitudinal studies need to be undertaken in order to repeat and verify such a relationship. It would be premature to recommend omega-3 fatty acid supplements for all of our glaucoma patients.
As for my patients, I plan to continue—for now—what I hope is a commonsensical approach to answering their questions regarding glaucoma and nutrition.
1. Wang YE, Tseng VL, Yu F, Caprioli J, Colamen AJ. Association of Dietary Fatty Acid Intake With Glaucoma in the United States. JAMA Ophthalmol. 2018 Feb 1;136(2):141-147.