Complementary and Alternate Management of Glaucoma: The Verdict so Far.

Parul Ichhpujani

doi:10.5005/jp-journals-10008-1161

Parul Ichhpujani

Open Access

https://doi.org/10.5005/jp-journals-10008-1161

Copy DOI

Abstract

ABSTRACTComplementary and alternative medicine deserves scientific scrutiny as patients with glaucoma often lose vision despite adequate medical or surgical treatment. Most glaucomatologists abstain from recommending alternative medicine as there is little evidence to support most of the recommendations for complementary and alternate management (CAM) use in glaucoma. Megavitamin supplementation has not been shown to have a long-term beneficial effect on glaucoma. In a glaucomatous eye, a very modest benefit of IOP-lowering may be offset by the temporary elevation in IOP that accompanies exercise. There is little evidence to support the use of special diets, acupuncture, relaxation techniques, or therapeutic touch for the treatment of glaucoma. Marijuana can have a profound lowering of IOP, but the low response rate, short half-life, and significant toxicity are strong indicators that it is not an appropriate therapeutic agent. Future research must be carried out to document the effect of CAM not only on IOP, but also on perimetric tests or other objective parameters, such as ocular blood fow and nerve fiber layer thickness.How to cite this article: Bhartiya S, Ichhpujani P. Complementary and Alternate Management of Glaucoma: The Verdict so Far. J Curr Glaucoma Pract 2014;8(2):54-57.

Highlights

The National Center for Complementary and Alternative Medicine defines alternative medicine as ‘... those treatments and healthcare practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by medical insurance companies.’[1]
Glaucomatous nerve damage has been known to progress despite good intraocular pressure (IOP) control
Complementary and alternate management becomes increasingly relevant for end stage glaucomas, normal tens ion glaucomas, and those patients who continue to progress despite good IOP control

Summary

Introduction

The National Center for Complementary and Alternative Medicine defines alternative medicine as ‘... those treatments and healthcare practices not taught widely in medical schools, not generally used in hospitals, and not usually reimbursed by medical insurance companies.’[1]. The IOP-glaucoma-optic nerve damage paradigm remains open ended for now. Almost 90% of patients with elevated IOP never develop damage to the optic nerve, while more than one-third of patients with POAG, never have docu mented elevations in IOP. Glaucomatous nerve damage has been known to progress despite good IOP control. There is sufficient evidence, to indicate that glauco matous optic nerve damage is multifactorial, vascularischemic factors being an important contributory element. Current glaucoma therapy is only directed toward IOP reduction. Nonpressure-dependent risk factors are getting considerable attention in glaucoma manage ment, but the disease modifying capability of these approa ches are yet to find widespread clinical application. Complementary and alternate management becomes increasingly relevant for end stage glaucomas, normal tens ion glaucomas, and those patients who continue to. Glaucomas associated with vasospastic phenomenon are potential candidates for CAM

Available Modalities

Lifestyle Modification

Dietary Supplements

Alternate Systems of Medicine

Findings

Conclusion