Exercise and Glaucoma: Staying fit benefits your eyes

Simply going for a walk three or more times a week may be all you need to protect against glaucoma progression.

If you’ve just been diagnosed with glaucoma, you undoubtedly want to do everything you can to be as healthy as possible for as long as possible. As part of that, you may wonder whether changes in your overall lifestyle, including changes in the amount or type of exercise you get, may help control the disease.

While the mainstay of glaucoma therapy remains lowering intraocular pressure (IOP) with medication, laser treatment, or surgery, some evidence does suggest that a regular exercise program can help support your medical therapy. But what kind of exercise is best? Is there anything in particular you should -- or shouldn’t -- do? Here’s an overview of what’s known.

Overall, exercise has been found to lower IOP. Studies also have found that it improves blood flow to the retina and optic nerve. In one study, jogging for 20 minutes lowered IOP by 1 mm Hg to 8 mm Hg. In another, weight lifting also led to decreases in IOP, with IOP dropping by 14.5% after the third set of chest presses and 13.2% after the third set of leg presses. While the jogging and weight training studies were conducted in healthy, athletic people without glaucoma, exercise has also been found to benefit sedentary people with ocular hypertension. For instance, three months of moderate exercise for nine sedentary people suspected of having glaucoma decreased mean IOP by 4.6 mm Hg (20% for these particular patients).

If you aren’t already active, there’s no need to adopt a hard-core exercise program. Simply going for a walk three or more times a week can protect against glaucoma progression. The catch? The exercise benefit continues only as long as you continue exercising. In the study of the sedentary glaucoma suspects, just three weeks of deconditioning undid the beneficial effects.

Caveats to consider. It’s important to avoid the Valsalva effect (the technical term for what happens when, after an inhalation, you hold your breath and apply pressure against your epiglottis), as this appears to have a negative impact on IOP. Thus, if you’re interested in weight lifting or other forms of resistance exercise, be sure to get proper training on breathing techniques. The same holds true for yoga and Pilates, as people sometimes incorrectly hold their breath either going into or coming out of a pose.

Another concern regarding yoga: It’s best to avoid all inverted poses if you have glaucoma. This includes headstand, shoulderstand, and the plow. While few studies have been conducted on yoga and glaucoma, there is some evidence that inverted poses increase IOP, so be sure to discuss alternative poses or modifications with your yoga instructor.

Bottom line on glaucoma and exercise. A regular program of moderate exercise will have multiple benefits for your overall health. While its long-term impact on your glaucoma progression is unknown, it is likely to support your current treatment program. If you have any questions about your existing exercise program, or any concerns about starting a new activity, check with your ophthalmologist.