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Vitamin C (buffered and ascorbated). 2,000 mg per day, divided amongst several meals. Whole fruit, natural vitamin C with bioflavonoids is preferred as opposed to vitamin C synthesized from corn. The eyes of open-angle glaucoma patients were found to have significantly lower vitamin C levels.⁵³ Several studies have determined that low vitamin C levels in blood and in the vitreous humor inside the eye can contribute to meshwork outflow blockage due to aging, and it can contribute to development of glaucoma.⁵⁴ Supplementation with large doses (10,000 mg daily) can significantly lower IOP by 10 points.⁵⁵ For some people, a lower dose is recommended if the larger dose causes loose stools.

In many parts of the world, vitamin C is routine for glaucoma patients because it has the capacity to both decrease aqueous fluid production and improve drainage. In addition, vitamin C supports collagen metabolism, which may be linked to glaucoma.

Vitamin E. 200 IU three times per day (d-alpha-tocopherol and preferably with tocotrienols and not synthetic dl-alpha-tocopherol). Vitamin E is also found in the vitreous humor and provides antioxidant capacity to the eyes. It is most effective when combined with vitamin C, which helps regenerate vitamin E.⁵⁶ One study showed that patients who supplement with 300 IU–600 IU of vitamin E per day, improved blood flow and reduced vision loss. Non-treated subjects showed a significant reduction in their visual field at 6 and 12 months.⁵⁷ The non-treated showed a statistically significant reduction in visual field (change in mean deviation) at 6 and 12 months.

Vitamin E combined with CoQ10 is also more effective than vitamin E alone; CoQ10 increases mitochondrial alpha-tocopherol concentration which improves mitochondrial-mediated neuroprotection and inhibits astrocyte activation (a biomarker for neuro-degenerative disease).⁵⁸

CoQ10. 100 mg-200 mg per day. CoQ10 provided neuroprotection against mitochondrial DNA alterations in an animal model of pre-glaucoma. CoQ10 protected against retinal ganglion cell death, prevented upregulation of certain protein biomarkers, improved other biomarkers, and protected mitochondria and mitochondrial transcription factor A.⁵⁹

Very Important Nutrients

DHA, B complex, and vitamin E. DHA 200 mg–400 mg per day, B complex, and vitamin E 400 IU. Another study showed that the fatty acid DHA (abundant in fish oil), along with B complex and vitamin E, were helpful in preventing or delaying vision loss associated with glaucoma.⁶⁰

Essential fatty acids. 3,000 IU per day. Essential fatty acids can help reduce the chronic inflammatory processes associated with glaucoma. Fish and fish oils are rich in omega-3 fatty acids (as well as DHA and EPA). The best sources of omega-3 fatty acids are cold-water fish such as salmon, mackerel, sardines, anchovies, and codfish. Black currant seed oil and flaxseed oil are also good sources of essential fatty acids. One study showed patients with primary open-angle glaucoma had reduced levels of plasma DHA and EPA compared with healthy siblings. These findings may be significant since DHA and EPA could modulate impaired systemic micro-circulation, ocular blood flow, and optic neuropathy, the main changes associated with glaucoma.⁶¹

Magnesium. 500 mg per day. Magnesium improves micro-circulation in glaucoma patients and may protect the retinal ganglion cell against oxidative stress and cell death. Some studies conclude that magnesium improves peripheral circulation and improves the visual field in glaucoma patients with blood vessel constriction.^62,63

Helpful Nutrients

Coleus forskohlii. 350 mg–500 mg per day. A clinical trial of a glaucoma supplement containing the active ingredient forskolin along with a form of taurine, carnosine, folic acid, B1, B2, B6, and magnesium found that it reduced IOP and improved nerve cell health in the retina.⁶⁴

Green-leafy vegetables, carrots, and beets. Researchers found a 30 percent decline in glaucoma risk in diets that include green leafy vegetables, carrots, and beets. This group of participants also had a 40-50% reduced risk of developing a sub-type of the condition known as early paracentral visual field (VF) loss (peripheral/side vision), which is linked to poor ability to maintain constant blood flow.⁶⁵

Green tea extract. 725 mg per day. One study shows that antioxidants from green tea are absorbed in the lens, retina, and other eye tissue, and reduces oxidative stress in the eyes.⁶⁶

Resveratrol. 125 mg-175 mg daily. The antioxidant resveratrol is able to cross the semi-permeable barriers in the eyes; it is bio-available to eye tissue to help combat oxidative stress in the eye.⁶⁷

Quercetin. 250 mg–500 mg per day. Research indicates that supplementing with quercetin has direct effects on protecting the loss of retinal ganglion cells in glaucoma patients.⁶⁸

Turmeric (curcumin). 500 mg per day. The antioxidant curcumin has possible benefit with respect to oxidative stress in the eyes.⁶⁹

Melatonin. Intraocular pressure is usually lowest at night, which is also when natural levels of melatonin are near their high in the circadian cycle. IOP is highest in the morning when melatonin is low. There seems to be a correlation between IOP and melatonin; supplementing with melatonin may lower IOP.⁷⁰

Glucosamine. Caution. A clinical study shows that taking glucosamine sulfate, 750 mg three times daily for three months, can increase intraocular pressure (IOP) in some people.⁷¹

Foods Known to Increase IOP

Coffee. Drinking just one cup of coffee can increase IOP by 1-4 mm Hg for at least 90 minutes.^72,73 Regular coffee drinkers have a higher average IOP (approximately 3 mm Hg).⁷⁴

However, coffee beans also contain antioxidant compounds. These antioxidative effects and their possible neuro-protective implications need further research. One study concluded that oxidative stress can be a causative factor in glaucoma, and targeted nutrients can reduce oxidative stress at the level of mitochondria. This can be achieved by supplementing with Ginkgo biloba and liquids that contain polyphenolic compounds (such as tea, red wine, dark chocolate, or coffee), which all have anti-oxidative properties.⁷⁵

Glutamate. Evidence also exists that glutamate contributes to glaucoma, so it is best to avoid any foods with monosodium glutamate (MSG). Glutamate that is not biochemically bound to other amino acids, causes our inherent glutamate levels to increase rapidly. These “free” forms of glutamate are found in nearly all processed or packaged foods. Genetic predisposition to glutamate sensitivity is being investigated.

Glutamate naturally found in some food is linked to amino acids and is slowly processed by the digestive system. Free glutamate passes through the digestive system rapidly and is quickly absorbed into the bloodstream. In some foods, such as aged or cured cheese or meats, soy sauce, mushrooms, tomatoes, broccoli, peas, walnuts, and gluten, glutamate exists in a free form.⁷⁶

Glutamate is an essential nutrient for proper brain functioning, but excess glutamate results in “excitotoxicity” causing nerve cell death. Normally the brain is protected by the blood-brain barrier, but such protection can break down in cases such as head injury, stroke, or high blood pressure and as a by-product of aging. If the blood-brain barrier is compromised, then excess glutamate in the brain and nerve cell death can be the result.⁷⁷

Artificial sweeteners. Avoid artificial sweeteners as studies indicate possible neurotoxicity. Though more research needs to be done on this, we recommend avoiding all artificial sweeteners.

Foods Known to Decrease IOP

Studies have shown that there are natural ways to reduce intraocular pressure naturally including the following: eating a healthy diet high in fruits and vegetables.⁷⁸ People with glaucoma can reduce their eye pressure by five to seven millimeters of mercury (mm/Hg) with an improved diet and supplement program—a reduction that is as good as, or better than, achieved with drugs. In general, a diet high in beta-carotene, vitamin C, vitamin E, and selenium is recommended. Foods containing those nutrients include garlic, onions, beans, spinach, celery, turnips, yellow and orange vegetables, green leafy vegetables, seaweed, apples, oranges, and tomatoes.

In addition, drinking lots of water helps maintain the flow of nutrients to the eye and drains metabolic wastes and toxins from eye tissues. Optimally, you should drink 16 four-ounce glasses of water per day, every half-hour. Our bloodstream can only handle being diluted by about four ounces at any one time. When you drink more than four ounces at a time, this means more work for the kidneys to filter water that hasn’t had a chance to travel through the lymph system and clean body tissues.

Avoid carbonated, caffeinated, and alcoholic beverages since they can actually dehydrate eye tissues. Your optimal water intake depends upon your particular physiology, diet, climate, and physical activity. Too much water intake can reduce blood salt levels (hyponatremia) and cause cells to flood. A good way to gauge if you are properly hydrated is by the color of your urine. If it is dark yellow, then you are dehydrated and need to drink more water. If your urine is as clear as water, then you have over-hydrated and should cut back intake. Green tea is very beneficial for your health and body, but too much is dehydrating.