Glaucoma

Inside each of your eyes is a gelatinous transparent fluid called the aqueous humor. Normally, this fluid circulates around the eye, then flows through a tiny structure called the drainage angle into a little tube. The tube directs the fluid into your blood­stream.

In glaucoma, something stops the aqueous humor from draining, explains Anne Simons, M.D. With no place to go, the fluid builds up. This creates pressure that gradually destroys the optic nerve, which sends visual messages from the eye to the brain. As a result, your field of vision shrinks.

Some three million Americans have glaucoma, but about half of them don't even realize it. That's why getting your eyes checked is so important. If you catch the disease early, you can usually save your eyesight.

There are two types of glaucoma: openangle and closed-angle. In open-angle glaucoma, the drainage angle functions properly, but the tube attached to it becomes blocked. Fluid backs up into the eye, and pressure inside the eye slowly rises. This produces subtle changes in your peripheral vision-that is, your ability to see things to either side of you. Open-angle glaucoma accounts for 90 percent of all glaucoma cases.

The other 10 percent of cases involve closed-angle glaucoma. In this condition, the drainage angle becomes blocked. The affected eye becomes red, your vision turns blurry, and you see halos around lights. Closed-angle glaucoma is a medical emergency that requires immediate treatment to prevent permanent vision loss.

Glaucoma is most common among people over age 60, which means your risk rises as you get older. But there are other risk factors as well. These include smoking, long-term use of steroid medications, and family history of the disease. African-Americans are three times more likely than Whites to develop glaucoma.

Because glaucoma can lead to blindness, the Glaucoma Research Foundation urges everyone to get periodic screenings-at age 35, at age 40, every 2 to 3 years between ages 41 and 60, and every 1 to 2 years after age 60. If you have any risk factors for glaucoma, your doctor or ophthalmologist may want you to get tested more often. The screenings themselves are quick and painless.

While you can't reverse any vision loss caused by glaucoma, you can stop it from getting worse. That's where the following strategies, paired with your doctor's treatments, can help.

Best Choices

Supplements

Take C to see. The tubes that drain fluid from your eyes are rich in a protein called collagen. Vitamin C plays a key role in maintaining the integrity of collagen, says Joseph Pizzorno Jr., N.D. In addition, several studies have shown that vitamin C supplementation lowers fluid pressure in the eye. Dr. Pizzomo recommends taking 2,000 milligrams of vitamin C a day.

Focus on chromium. The trace mineral chromium helps your eye muscles focus on close objects, explains Richard Barrett, N.D., associate professor of medicine at the National College of Naturopathic Medicine in Portland, Oregon. If your chromium level is low, your body compensates by increasing pressure inside your eyes. Dr. Barrett suggests taking 200 micrograms of chromium a day.

Chinese Medicine

Try an herbal formula. In the early stages of the disease, a Chinese herbal formula called Huang Lian Yang Gan Wan can help, says Efrem Korngold, O.M.D., L.Ac. It contains a number of herbs, including the root of coptis, gentian, philodendron, skullcap, and bupleurum. All of the herbs work together to reduce fluid pressure in the eye.

In addition, oriental medicine doctors may recommend drinking chrysanthemum tea and eating lycii berries. "Chrysanthemum clears Heat and soothes the eyes," Dr. Korngold explains. "Lycii berries are like bilberries. They contain compounds called anthocyanosides." Anthocyanosides prevent the breakdown of vitamin C and protect the collagen in your eyes' drainage tubes.

Both lycii berries and chrysanthemum tea can be purchased in Asian groceries. Eat lycii berries as you would any other berries. To make chrysanthemum tea, put a tea ball containing 1 to 2 teaspoons of bulk herb or a tea bag in 1 cup of boiled water. Steep to taste, strain, and drink.

Reduce pressure with an herbal formula. To drain excess fluid from the eyes, oriental medicine doctors often prescribe Wu Ling San, an herbal formula made from hoelen, polyporus, atractylodes, cinnamon, and alisma. When researchers gave daily doses of this formula to 55 people with glaucoma, 64 percent of the participants experienced_significant decreases in fluid pressure within 1 month.

Let salvia be your salvation. The Chinese herb Salvia miltiorrhiza has shown promise as a treatment for eye diseases. One study suggests that the herb may be an effective long-term treatment for glaucoma.

Visit an acupuncturist. According to Dr. Korngold, acupuncture treatments can help in the early stages of glaucoma by reducing fluid pressure in the eyes. The treatments would likely focus on points around the eyes. In addition, the acupuncturist may stimulate points located just below the base of your skull and on the top of either foot.

Ayurvedic Medicine

Praise potato power. According to Ayurvedic medical doctrine, glaucoma results from an excess of Kapha dosha. To balance Kapha, Ayurvedic physicians prescribe drying herbs, says Karta P. S. Khalsa, C. D. N., an Ayurvedic physician in Seattle. Among the herbs that are prescribed is the kaffir potato, whose root contains a compound called forskolin. Forskolin reduces fluid pressure in the eyes.

"In the studies I've seen, forskolin eyedrops can keep fluid pressure low for about 5 hours," reports James A. Duke, Ph.D. If you'd like to try forskolin, consult an Ayurvedic physician, a naturopath, or an herbalist.

Home Remedies

Be cautious with caffeine. Caffeine is known to raise blood pressure. For this reason, researchers suspect that it may increase fluid pressure in the eyes. So far, they haven't reached a definitive conclusion, Dr. Barrett says. Some studies have found that as little as one cup of espresso significantly raises fluid pressure. Other studies have shown that as much as four cups of coffee doesn't affect fluid pressure at all. Still others suggest that caffeine elevates fluid pressure, but only very briefly.

Until researchers know for certain what effect caffeine has on fluid pressure in the eyes, Dr. Barrett suggests that anyone with glaucoma steer clear of the substance. That means cutting back on coffee, tea, and cola and avoiding over-the-counter drugs that contain caffeine. (The label will tell you.)

Snuff out those butts. People who smoke have a higher risk of developing glaucoma. That's something to keep in mind if you're a smoker who is trying to quit.

Other Good Choices

Nutrition

Eat less protein and margarine. Researchers polled 52 people with glaucoma and 348 people with other eye conditions about their eating habits. Upon analyzing the survey results, the researchers determined that the people with glaucoma consumed significantly more proteins­specifically, meats and dairy products-than everyone else. They also consumed more trans fatty acids, the fats found in margarine. This study adds to evidence that eating less meat, whole-milk dairy products, and margarine is a good idea.

Herbal Medicine

Make berries your buddies. Bilberries-also known as European blueberries­have a centuries-old reputation for improving vision, Dr. Duke says. During World War I, British fliers munched bilberries to sharpen their eyesight for bombing missions. By all accounts, the berries helped. That's because they contain high levels of eye-friendly anthocyanosides.

European herbalists have developed a standardized bilberry extract that contains 25 percent anthocyanosides. Dr. Pizzomo suggests taking 80 to 160 milligrams of the extract three times a day. It's available in many health food stores and from most naturopaths.

Drop in a remedy with natural roots. Mainstream physicians may treat glaucoma with eyedrops containing the active ingredient pilocarpine. Originally an extract of the South American jaborandi tree, the drug is synthesized in laboratories and prescribed by doctors. Ask your doctor about this "herbal" remedy that's gone mainstream.

Homeopathy

Consult a homeopath. When treating glaucoma, a homeopath selects the medicine that best suits a person's symptoms, explains Edward Kondrot, M.D., an ophthalmologist and practicing homeopath in Pittsburgh. The most commonly prescribed remedies include Aconitum, Belladonna, Bryonia, and Nux vomica.

Medlcal Measures

Since glaucoma is not a disease that you should try to manage by yourself, it's important to seek the help of an ophthalmologist. To manage the disease, you need to consistently maintain low eye pressure. Your ophthalmologist will help you do this-so be sure to keep your scheduled appointments and sustain the recommended treatments.

Always tell your doctor about any alternative therapies that you're using. It's possible that some alternative treatments may conflict with your conventional treatments.

Mainstream physicians treat glaucoma with drugs that reduce fluid pressure in the eyes. These medicines-most often from a class of pharmaceuticals called beta­blockers-come in eyedrop form. You administer the drops yourself, a few times each day. If they don't help, your doctor may recommend laser surgery to open blocked drainage tubes.

A nonprofit organization called Light­house International provides an array of support services for people who experience any degree of vision impairment as a result of glaucoma. You can write to the organization at 111 East 59th Street, 12th Floor, New York, NY 10022-1202.

Red Flags

Closed-angle glaucoma is an urgent medical problem characterized by the sudden onset of pain, redness, and blurred vision in the affected eye. The pain may be severe, and it may be accompanied by nausea or vomiting. Some people report seeing halos around light sources. These symptoms may occur as occasional, momentary episodes for weeks or months before a major attack.

If you experience any combination of these symptoms, contact your family doctor or ophthalmologist immediately, or have someone take you to a hospital emergency room. You must get treatment within 12 hours of the attack. Otherwise, you may experience permanent vision loss within 3 to 5 days.

Treatment for closed-angle glaucoma usually involves a surgical procedure called an iridotomy. The surgeon uses a laser to create a new opening for fluid to drain from the eye. This technique is much faster and safer than traditional scalpel surgery.