Glaucoma: Protecting Against a Silent, Devastating Disorder

Monday, October 27, 2014
By: Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

Glaucoma, a neurodegenerative disease, is a leading cause of blindness and impacts over 2.2 million Americans. It is a silent disorder that affects people of any age with African Americans being much more susceptible than Caucasians. 

Glaucoma is a group of eye conditions that damage the optic nerve. The optic nerve sends images of what you see to the brain. Many times symptoms are completely silent until there is significant vision loss. Less commonly, there are symptoms such eye redness, eye feels swollen, eye pain, rainbow like halos around lights, sensitivity to light, cloudy vision, and tearing or watery eyes.

Leading medical organizations say that there is no cure for this devastating disorder. Recent research, however, demonstrates empowering evidence for nutrition and prevention and reveals a startling connection with Alzheimer’s disease.

Risk Factors: Old and Newly Identified

There are many risk factors for glaucoma including being over 60, diabetes, family members of those already diagnosed, obesity, elevated cholesterol levels, and people who are severely nearsighted. There are more recently identified factors that increase the risk and development of glaucoma. Severe obstructive sleep apnea, steroid use (steroid eye drops, oral steroids, steroid inhalers) methylation defects, hormone replacement therapy, birth control pills, excess glutamate levels in the brain, low levels of BDNF, abnormal blood clotting, poor circulation disorders, and autoimmune diseases. Recent research also shows eye circulation problems associated with low blood pressure and carotid insufficiency increase glaucoma risk.

In addition to these factors, researchers are investigating the effects of short wavelength light or visual blue light on the retina and the mitochondria in the retina. The retina is the only part of the central nervous system that is exposed to light radiation. Visual blue light or short wavelength light (400-480 nm) is emitted from fluorescent lamps with cool white or broad spectrum tones. Research suggests that mitochondria that are already damaged experience increased negative effects from the blue short wavelength light. This light exposure may be responsible for increased amount of oxidative stress to the retina that damage the mitochondria and stimulate more cell death and vision loss. 

Eye Pressure

Glaucoma treatment focuses on keeping the pressure inside the eye (intraocular pressure) under control as a way to hopefully stall out the disease. However, even with stable intraocular pressure, the disease process can still progress and lead to blindness. Eye pressure may be related to high intraocular blood pressure, or “eye hypertension,” which is the most common or that of low, mild unstable pressure. The unstable low pressure fluctuation creates mild chronic reperfusion injury or an oxidative stress response to the surrounding tissue. This is like having the garden hose attached to the faucet with the water slightly turned on and the hose kinked. You untwist the hose and the backed-up water comes through with a small surge or pulse. A reperfusion injury is akin to a blood vessel spasm which then relaxes and contents rush forward flooding the area,  creates more free radicals. The more times it happens, the worse the result. In this circumstance, improving blood vessel stability helps protect the eye. Medical treatment often focuses on calcium channel blockers. Magnesium is a natural calcium channel blocker that is often used to support healthy vascular flow.

Glaucoma and Alzheimer’s Link

Compelling and enlightening new research shows that there is a powerful link with microglial cell inflammation and glaucoma. Researchers are seeing that glaucoma, macular degeneration and other age-related neurological degenerative diseases like Alzheimer’s disease have similar mechanisms. They all occur from a build-up of beta amyloid plaques within tissues. A growing body of evidence demonstrates a link on a cellular level between Alzheimer’s disease and glaucoma. High levels of oxidative stress cause damaged and irregular proteins and depletion of redox signaling compounds and glutathione. This results in immune system activation and overactive microglial cells. This build-up of inflammatory amyloid plaque and mitochondrial breakdown leads to degenerative changes in the optic nerve, retina, and the visual processing centers of the brain. This stress eventually causes the cells within the retina to die (autophagy) and progresses to loss of vision. 

Viewing glaucoma caused by neurological inflammation sheds a completely different light on why vision loss still occurs with stable intraocular eye pressure and shifts the entire focus of support. These discoveries provide powerful insight and expanded possibilities of preventing this devastating, life altering disorder. Truly an ounce of prevention is worth a pound of cure in this circumstance. 

Prevention and Management of Glaucoma

Work on removing or improving the obvious risk factors of obesity, diabetes, problems with sleep apnea, steroid use, HRT and birth control use, and cholesterol damage. See your optometrist or ophthalmologist for periodic evaluations. They can see what you can’t. In addition, identification of genetic methylation defects with your health provides tremendous insight into not only glaucoma risks but many other disorders. This test is readily available with most commercial labs. Methylation defects are a gene defect that is present in about 40% of the population, which may or may not be expressed. This defect affects many disorders including brain and eye health, cholesterol, circulation, blood clot risk, and homocysteine. Most important for nutritional support, it determines how well you use certain B vitamins, i.e. B12 and folic acid. Methylation defects must be managed with the right type of nutrients. Taking the non-methylated forms of these nutrients, found in fortified foods or low quality supplements, may lead to a marked increase in homocysteine and oxidative damage because of the inability to process the substance. This substantially increases disease risk including glaucoma.

Take steps to avoid glutamate intake (MSG, not to be confused with glutamine) and production of glutamate in the brain. Minimize or avoid light therapy that uses the monochromatic (479 nm) blue light, but opt for light in the 500-530 nm wavelength (blue-green). Work on building up BDNF, the brain repair molecule, with physical activity, learning new skills, curcumin, blueberries, and fatty cold water fish.

Nutritional support for eye health and reducing glaucoma risk is an important piece to the puzzle. Consume several servings of richly colored vegetables and fruits per day to ensure intake of carotenoids, vitamins A and C, zinc, and coenzyme Q10, vital for eye and brain protection. In addition, nutrients such as lipoic acid, fish oils, carnosine, B vitamins (especially B1 and B2), grape seed extract, and melatonin also help reduce retinal microglial cell inflammation and protect against high levels of neurological oxidative stress and damage protein build-up.

Not being able to drive, read a book, see your loved ones due to loss of vision, and loss of independence creates tremendous fear in the aging population. We are seeing powerful information that gives us hope and tools for preventing and managing our vision. After cancer and heart disease, blindness is the most feared disorder of aging. Take charge of your diet. Reduce risk factors, and improve nutrient status. These steps all go a very long way in keeping your eyesight intact. By the time you experience vision loss with glaucoma, it is too late. The damage is done. Don’t let this blindside you. Take charge of your eye health today.

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