March is Glaucoma Awareness Month in New Zealand, an initiative led by Glaucoma New Zealand to raise awareness about this often silent eye disease.
Glaucoma is one of the leading causes of irreversible vision loss worldwide. Because early glaucoma typically develops without symptoms, many people are unaware they have the condition until vision changes occur. Regular comprehensive eye examinations are the most effective way to detect glaucoma early and protect long-term sight.
If you have been diagnosed with glaucoma, treatment usually focuses on lowering intraocular pressure (IOP) through medications, laser treatment, or surgery. These approaches remain the only proven methods to slow disease progression.
However, research also suggests that certain lifestyle factors may influence eye pressure, optic nerve health, and overall glaucoma risk. Understanding these factors can help people with glaucoma support their treatment and maintain good overall health.
The following guide by our Optometrist, Ella Ewens, who is qualified to manage glaucoma, outlines evidence-based lifestyle considerations that may help support glaucoma management, while recognising that glaucoma is a complex condition and advice may vary depending on the type and stage of disease.
Managing glaucoma primarily involves reducing intraocular pressure (IOP) through eye drops, laser, or surgery - as this is the only treatment proven to slow or prevent disease progression. However, several lifestyle factors may influence IOP levels and overall eye health. This guide outlines evidence-based habits that may help support your treatment.
Remember glaucoma is not a single disease, there are many different types of Glaucoma. For instance the impact of lifestyle factors may differ in normal-tension glaucoma vs high-pressure glaucoma, or in early vs advanced disease. Always discuss with your health care practitioner.
Exercise and Physical Activity
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Aerobic exercise (e.g. brisk walking, cycling, jogging) lowers IOP, often within minutes, and this effect increases with intensity and duration. The benefit is additive to glaucoma medications.
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Regular aerobic activity over at least 3 months can have lasting IOP-lowering effects - even if you stop temporarily.
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Physically fit individuals tend to have lower baseline IOP.
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Caution: People with pigment dispersion syndrome or pigmentary glaucoma may experience temporary IOP spikes with aerobic activity due to pigment release.
Avoid heavy weightlifting or straining (Valsalva manoeuvre), as this may increase IOP.
Yoga and Head-Down Postures
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Inverted positions such as headstands, handstands or downward-facing dog can significantly raise IOP, especially with prolonged or repeated practice.
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If you have glaucoma, you should avoid or modify these positions during yoga.
Nutrition and Diet
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A diet rich in fruits, vegetables, and omega-3 fatty acids may reduce glaucoma risk and support optic nerve health.
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Recommended Foods
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Leafy greens (kale, spinach, silverbeet
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Carrots, sweet potatoes (high in Vitamin A and carotenes)
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Berries and citrus (Vitamin C, antioxidants)
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Cruciferous vegetables (broccoli, cabbage)
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Chia seeds, flaxseeds, walnuts (omega-3s)
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Nitrates (e.g. in beetroot and leafy greens) may enhance blood flow to the optic nerve.
Supplements and Glaucoma
Supplements are not a replacement for glaucoma treatment, but some research suggests that certain nutraceuticals may positively influence optic nerve health and ocular blood flow. Evidence is still early-stage, and in many cases the benefit of supplements for glaucoma remains uncertain or inconclusive.
Omega-3 Fatty Acids (e.g., algae oil, flaxseed oil) – may help lower intraocular pressure (IOP) and improve blood vessel function.
Ginkgo Biloba – may improve blood flow to the optic nerve and support visual field stability, particularly in normal-tension glaucoma. Use with caution if taking blood thinners, and discuss with your GP or healthcare providers.
Vitamin B3 (Nicotinamide) – emerging evidence indicates that high-dose nicotinamide (e.g., 1.5–3 g/day under supervision) may support retinal ganglion cell function and potentially slow glaucoma progression.
Coenzyme Q10 (CoQ10) – may help protect optic nerve cells from oxidative damage and has been used as an adjunct to standard glaucoma therapy.
Magnesium – may promote blood vessel dilation and improve circulation to the optic nerve, especially in normal-tension glaucoma.
Vitamins A, C, D, and E
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Vitamin A: dietary intake may be beneficial for primary open-angle glaucoma (POAG).
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Vitamin C: may offer protective effects for POAG.
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One study showed that high-dose intake of vitamins A and B, but not vitamins C, D, or E, was associated with a lower prevalence of glaucoma.
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A large cohort study (SUN Project) found that combined intake of vitamins A, C, and E (the “ACE-Vitamin Index”) was linked with a lower risk of developing glaucoma. However, when analysed individually, vitamins A, C, and E did not show statistically significant protective effects.
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Dietary intake of vitamins A and C showed a beneficial association with open-angle glaucoma, although blood levels of these vitamins did not show a clear relationship with glaucoma risk.
Overall, while several supplements show potential, current evidence for nutraceuticals in glaucoma remains uncertain and inconclusive, and supplementation should always be discussed with a healthcare professional.
Fluid Intake
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Avoid drinking large volumes of water quickly (e.g. >1 litre in under 15 minutes), which can cause a temporary IOP spike.
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Instead, sip fluids gradually throughout the day.
Caffeine and Beverages
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Coffee: Caffeinated coffee may raise IOP temporarily. Limit intake to 1–2 cups per day.
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Tea: Green and black tea contain less caffeine and may actually reduce glaucoma risk due to flavonoids that support optic nerve blood flow.
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Alcohol: Occasional alcohol may lower IOP short-term, but regular or excessive use may increase long-term risk. Moderation is key.
Cholesterol and Statins
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Long-term use (2+ years) of cholesterol-lowering medications, particularly statins, may modestly reduce glaucoma risk.
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Discuss with your GP if you're on or considering cholesterol-lowering treatment.
Blood Pressure
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High blood pressure (hypertension) can damage blood vessels, including those supplying the optic nerve. Keep BP well-controlled.
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Low blood pressure - especially at night, may impair optic nerve perfusion, contributing to glaucoma progression even if IOP is controlled.
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If you are on BP medication, speak to your doctor about the possibility of nocturnal hypotension; 24-hour monitoring may help.
Sleep and Sleep Apnoea
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Obstructive Sleep Apnoea (OSA) is strongly associated with glaucoma due to intermittent oxygen deprivation and poor optic nerve perfusion.
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Risk factors include snoring, obesity, and daytime fatigue. If suspected, consider a sleep study and treatment (e.g. CPAP).
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Poor sleep quality is also linked with faster glaucoma progression.
Weight and Metabolic Health
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High BMI is associated with elevated IOP, though the direct relationship with glaucoma progression is still under investigation.
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Weight loss, especially if accompanied by improved cardiovascular health, may support overall eye health.
Other Factors
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Tight collars or neckties may restrict venous drainage and raise IOP - ensure they’re not too tight.
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Playing wind instruments (e.g. trumpet, clarinet, flute) can cause short-lived IOP spikes during performance.
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Swimming goggles: Tight-fitting, small goggles may increase IOP. Use larger, looser-fitting styles.
Summary & Recommendations
While no lifestyle change can replace medical treatment, several habits may support healthy eye pressure and blood flow to the optic nerve:
- Engage in regular aerobic exercise (but avoid heavy weights, straining or prolonged head-down positions).
- Eat a colourful, plant-rich diet high in antioxidants and omega-3s.
- Sip fluids slowly and avoid rapid water intake.
- Limit caffeine and alcohol to moderate levels.
- Maintain a healthy weight and manage sleep apnoea if present.
- Monitor blood pressure closely- avoid it being too high or too low.
- Choose loose collars, and be mindful of wind instruments and small goggles.
There is currently limited but growing evidence that these lifestyle factors can influence glaucoma progression. They are widely considered safe and beneficial for your overall health, and many of them support optimal blood flow to the optic nerve.
If in doubt, or if you're making significant lifestyle changes, consult your optometrist or ophthalmologist.
At Illume Eye Care, Ella Ewens specialises in Glaucoma Management and Prescribing and all our Clinicians provide comprehensive eye examinations for detection, diagnosis and monitoring of glaucoma using advanced imaging and analysis, OCT and visual field testing to give you clear answers and personalised care.
SiGHTWiSE – Support You Can See
Start your SiGHTWiSE journey with Glaucoma NZ. We’re here to offer free education, guidance and support to help you feel confident and in control of your glaucoma care.
Whether you’ve just been diagnosed or have been living with glaucoma for years, the SiGHTWiSE programme is for you. It connects you to the knowledge, tools and encouragement you need to stay on track.