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Who can we trust to provide good advice about natural glaucoma treatments?

Submitted by dave on Sat, 01/15/2011 - 2:08pm

The title of an article by Dr. Mercola caught my attention. He wrote an article on his website and entitled it, "Six Sure-Fire Tips to Prevent Glaucoma Naturally".

Let's examine Dr. Mercola's suggestions one by one and see if they are sound.

Glaucoma is the second leading cause of blindness in the world, and belongs to a group of eye diseases that damage your optic nerve, leading to vision loss. In its early stages, glaucoma may produce no symptoms at all, and it’s estimated that half of the more than 4 million Americans with glaucoma do not even realize they have it.

Those statistics are widely quoted and generally accepted.

Because the vision loss caused by glaucoma comes on so gradually, it is sometimes called the “silent thief of sight.” Often, it’s not until the disease is at an advanced stage that the related vision loss becomes apparent, and by then your sight may suffer permanent damage.

This is why it’s so important to take steps now to help protect your vision, even if your eyesight is normal. I’ll be discussing exactly what you can do to help prevent and treat glaucoma later in the article, but first here’s a bit of background on this common eye problem.

I have no problems with these statements as long as Dr. Mercola doesn't have the hidden agenda of trying to sell us vitamin supplements that promise to lower intraocular pressure. Let's keep reading.

What Causes Glaucoma?

The underlying causes of glaucoma are not completely understood, but typically the damage it does to your optic nerve is related to increased pressure in your eye. The pressure typically comes from a buildup of pressure from the aqueous humor, the watery fluid that is naturally present in your eyeball.

In a healthy eye, the fluid is regularly drained, however in those with glaucoma the drainage system doesn’t work properly, so the fluid gradually builds up in your eye, causing increased pressure. Over time, the increased pressure causes nerve fibers that are essential to vision to die.

Dr. Mercola is not grossly wrong, but he's oversimplifying. As Dr. Mercola states below, the characteristic glaucomatous optic nerve cell death can happen without increased pressure.

But even in those individuals with increased pressure, the pressure itself is not the direct cause of the optic nerve cell death. The loss of optic nerve cells is mediated by a complex pathway that involves oxidative stress, the immune system and possibly other factors. In one experiment, when TNF-alpha was removed, the elevated pressure did not cause loss of optic nerve cells. See details here: Glaucoma, Inflammation and Oxidative Stress

Though less common, glaucoma can also occur when eye pressure is normal. It appears some people’s optic nerves may be sensitive to normal levels of eye pressure, or the glaucoma may be related to problems with blood flow to your eye, which may be caused by atherosclerosis -- the accumulation of plaques in your arteries -- or another circulation problem.

While it is true that glaucoma can also occur when eye pressure is normal, it is not true that the cause is known to be from problems with blood flow or another circulation problem. It is just as likely that the problem is related to the immune system.  In fact, that is the current favored hypothesis.

In the most common type of glaucoma, open-angle (chronic) glaucoma, side (peripheral) vision is usually affected first. In the later stages, glaucoma can lead to “tunnel vision,” where you can only see straight ahead, and can eventually lead to blindness. The symptoms are gradual and come on very slowly, so you may not realize your vision is being impacted until much later stages.

I don't see any problems with this paragraph.

About 10 percent of those with glaucoma have what’s called angle-closure (acute) glaucoma, and in these cases a sudden rise in eye pressure can cause:

  • Severe eye pain
  • Blurred vision
  • Sudden visual disturbances
  • Halos around lights
  • Reddening of the eye
  • Nausea and vomiting

This latter form usually requires immediate treatment.

Again, no disagreement with the information in the paragraph above or the one that follows immediately. It is standard, widely available information from any glaucoma-oriented website.

Who is at Risk?

Anyone can get glaucoma, but there are factors that increase your risk:

  • Certain ethnicities: Glaucoma is six to eight times more common in African-Americans than in Caucasians.[2] Mexican-Americans, Asian-Americans and Japanese-Americans are also at an increased risk.
  • Over 60 years old: The risk of glaucoma increases once you are over 60.
  • Chronic diseases: Diabetes, high blood pressure, heart disease and hypothyroidism all increase your risk.
  • Family history: If someone in your family has glaucoma, it may increase your risk.
  • Eye injury and nearsightedness: Eye injuries such as retinal detachment, eye tumors, eye inflammations and eye surgery, as well as nearsightedness, increase your risk.
  • Use of corticosteroids: A prolonged use of these drugs appears to increase your risk, especially corticosteroid eye drops.

Making Sure Glaucoma is Diagnosed Correctly

Ophthalmologists typically rely on a simple "air puff" test to check for high pressure inside your eye. However, if you are getting screened for this disease, please make sure you also have your corneal thickness measured using a relatively newer test called pachmyetry. 

Pachymetry, which measures corneal thickness, may be a more reliable indicator of the pressure inside your eye because the thickness of your cornea can significantly influence the readings on the air puff test.

If you have thin corneas, the instrument may give falsely low readings and may miss the diagnosis of glaucoma. If you have thick corneas the air puff test can actually misdiagnosis you as having glaucoma despite the fact that you have normal eye pressures.

Now it becomes obvious that Dr. Mercola is not an ophthalmologist or glaucoma specialist. In fact, we have to wonder if he has ever even been to an ophthalmologist as a patient. I know many glaucoma patients in the group who have a better understanding of correct diagnostic tests for glaucoma than Dr. Mercola demonstrates.

Most ophthalmologists do not in fact rely on "a simple air puff test" to check for elevated intraocular pressure. They typically use a Goldmann applanation tonometer which is not an air puff tonometer. And the ones who are using air puff tonometers are using very advanced instruments such as an Ocular Response Analyzer ("ORA"). An ORA is a $30,000 instrument that uses air puff technology and provides advanced information about intraocular pressure.

Mercola is completely wrong when he says that "pachymetry, which measures corneal thickness, may be a more reliable indicator of the pressure inside your eye because the thickness of your cornea can significantly influence the readings on the air puff test."

That's wrong is several ways. First, a minor correction of grammar is in order because pachymetry is not an indicator (reliable or otherwise) of pressure inside the eye. It is an indicator of corneal thickness. So Dr. Mercola wasn't as clear as he should have been.

However, the serious error is that correcting for corneal thickness is not a valid way to obtain a more accurate reading of intraocular pressure. Making such a correction can even decrease the accuracy of the eye pressure reading. This is a relatively new understanding and not all ophthalmologists are aware of it yet, but it underscores the fact that we should not be looking to Dr. Mercola for information about glaucoma. He's not an expert in this area.

In fact, the air puff technology used in the Ocular Response Analyzer is considered by leading glaucoma specialists to be the reliable way to compensate for corneal biomechanics. Dr. Mercola's advice on this topic is almost backwards.

Conventional Ways Lower Your Eye Pressure

Conventional medicine’s solution to glaucoma is typically drugs or surgery, or a combination of them. Often eye drops are given to glaucoma patients to use for life in an attempt to lower pressure inside of their eyes, but they come with a laundry list of side effects including:

  • Blurred vision
  • Respiratory problems
  • Forgetfulness
  • Lowered heart rate
  • Burning or stinging in the eyes
  • Surgery also carries with it serious risks, among them an increased risk of cataracts.


Natural Ways to Lower Your Eye Pressure

You do have another option, though, as surprising as it may sound the same lifestyle changes that lower blood pressure typically also work to lower your eye pressure, thereby helping to prevent and even treat glaucoma without a risk of side effects.

Dr. Mercola is telling us that there is a natural alternative to anti-glaucoma eye drops and surgery that will lower our eye pressure without side effects. That's a big claim. Let's see what he suggests:

The top two steps are:

Lower your insulin levels: As your insulin levels rise, it causes your blood pressure, and possibly also your eye pressure, to increase. In time this can cause your body to become insulin resistant, and studies show insulin resistance -- which is common in people with diabetes, obesity and high blood pressure -- is linked to elevated eye pressure.

The solution is to avoid sugar and grains, the two “food groups” that will inevitably cause surges in your insulin levels. Even whole, organic grains will rapidly break down to sugars, so they too should be avoided. So in addition to avoiding sugar, if you have glaucoma or are concerned about it, you’ll want to avoid foods like:

  • Breads
  • Pasta
  • Rice
  • Cereal
  • Potatoes 

Exercise regularly: One of the most effective ways to lower your insulin levels is through exercise. A regular, effective exercise program consisting of aerobics, sprint-burst type exercises, and strength training can go a long way toward reducing your insulin levels and protecting your vision.

Those two steps are good suggestions in general but they fall far short of the promise to provide "a natural alternative to anti-glaucoma eye drops and surgery that will lower our eye pressure without side effects."

I would say Dr. Mercola is making a misleading claim.

While I do agree that all of us, including glaucoma patients, would benefit from maintaining healthy insulin levels and exercising regularly, the FitEyes community knows that those two things are not enough. We have many members who have engaged in regular exercise for their entire adult lives while also eating extremely healthily -- and they have gone on to develop glaucoma in spite of this. So, while there is nothing wrong with exercising appropriately and avoiding high glycemic index foods, it does not qualify as a natural alternative to anti-glaucoma eye drops and surgery that will lower our eye pressure without side effects -- not even close! I consider Dr. Mercola's statement to be a seriously misleading claim.

In fact, sprint-burst type exercises, and strength training can be dangerous for certain glaucoma patients. In some (but not all) patients , weight lifting can elevate intraocular pressure. So can sprint-burst type activities. Exercises like walking are much more effective in helping most glaucoma patients manage their intraocular pressure.

But our evidence suggests that diet and exercise are not enough when it comes to managing intraocular pressure. 

Dr. Mercola does not offer us anything in the remainder of the article in the way of a natural alternatives to anti-glaucoma eye drops and surgery that will lower our eye pressure without side effects. Nothing.

Other Tips to Keep Your Vision Healthy

As part of your overall program to keep your eyesight clear and problem-free, even as you age, make sure you are doing the following:

Taking an animal-based omega-3 fat supplement. A type of omega-3 fat called docosahexaenoic acid (DHA) may help protect and promote healthy retinal function. DHA is concentrated in your eye's retina and has been found to be particularly useful in preventing macular degeneration, the leading cause of blindness.

Omega-3 fat, including DHA, is found in fish, but I don't recommend eating fish due to the concerns of mercury and other toxins that have been found in fish from oceans, lakes and streams and farm-raised fish. Instead, my most highly recommended source for omega-3 fat is krill oil.

Getting loads of lutein and zeaxanthin. Many have never heard of these two vision powerhouses, but they are incredibly important for your eyesight. Lutein, which is a carotenoid found in particularly large quantities in green, leafy vegetables, acts as an antioxidant, protecting cells from free radical damage.

Some excellent sources include kale, collard greens, spinach, broccoli, brussels sprouts and egg yolks, particularly raw egg yolks. Egg yolks also have zeaxanthin, another carotenoid, in an equal amount to lutein. Zeaxanthin is likely to be equally as effective as lutein in protecting eyesight.

It is important to note that lutein is an oil-soluble nutrient, and if you merely consume the above vegetables without some oil or butter you can't absorb the lutein. So make sure you’re eating some healthy fat along with your veggies,

Eggs yolks are also loaded with these nutrients but once the egg is cooked they tend to be damaged and non useful. So you can consume them raw by whipping them up in a shake or cooking them minimally as in sunny side or poach them with runny yolks.

Avoiding trans fats:  Trans fat may interfere with omega-3 fats in your body, which are extremely important for your eye health. A diet high in trans fat also appears to contribute to macular degeneration. Trans fat is found in many processed foods and baked goods, including margarine, shortening, fried foods like French fries, fried chicken and doughnuts, cookies, pastries and crackers.

Eating dark-colored berries. The European blueberry, bilberry, is known to prevent and even reverse macular degeneration, and bioflavonoids from other dark-colored berries including blueberries, cranberries and others will also be beneficial. They work by strengthening the capillaries that carry nutrients to eye muscles and nerves.

In regard to lutein and zeaxanthin, please note that I do not recommend using supplements that contain isolated carotenoids, including these -- just eat super foods such as those listed on There are over 600 naturally occurring carotenoids in food. We know that taking one or a few of these can lead to imbalances. In some studies those imbalances have had very serious side effects (e.g., increased risk of cancer.) If you must take a carotenoid supplement, educate yourself about the dangers and then pick one that is entirely food-based. See more information about foods that are generally good for your eyes at these links:

I specifically discuss krill oil here:

Even though I agree that krill oil is worth considering as an alternative to commonly available fish oil supplements, I believe glaucoma patients should still consider a very high quality DHA supplement or a fermented cod liver oil supplement too. It doesn't have to be one or the other. Furthermore, it is possible to get a very high quality vegan DHA product. It's a bit more expensive, but it is available.

Dr. Mercola missed the most promising nutrients that might be of interest to glaucoma patients. In particular he missed things like magnesium, turmeric, quercetin, resveratrol, ginkgo biloba and more. See these links:

I haven't posted the rest of Dr. Mercola's article. He absolutely failed to deliver "Six Sure-Fire Tips to Prevent Glaucoma Naturally." If you must read it, you can register on his site and read the rest of the article. However, I suggest not looking to Dr. Mercola for advice about glaucoma. (If not for the grossly misleading title, I would likely have ignored Dr. Mercola rather than taking the time to point out all the shortcomings of his article. In general, I don't spend my time like this. But maybe this article will prompt Dr. Mercola to remove the misleading parts of his article and change the title.)

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