How should you change your life?

“You mean I’m going to have to take these drops for the rest of my life?” For those choosing eye drops, this is a major reality of how glaucoma will change your daily activities, though if it’s one 5 minute period getting the drop in once per day, and the occasional refill of the bottle at drug store or prescription plan, that isn’t a huge time commitment. More than anything, it is the knowledge that something (another thing) is wrong with our body that is depressing, at first. The more we realize that glaucoma can be managed and generally kept from changing our life, the less depressing it should be.

Often, we are asked: “What else can I do in my daily activities that will help my glaucoma?” In comparing glaucoma to other diseases, especially the major eye diseases, there are only a few things that you will wish to consider. We know, for example, that cigarette smoking and sunlight exposure are both big causes of the eye diseases called cataract and age-related macular degeneration. Interestingly, these are not related to glaucoma. You still shouldn’t smoke, and you shouldn’t be outside without eye protection, because these diseases happen to people of your age, too. But, in extensive studies of personal habits, we and others have found that diet, alcohol consumption, and caffeine intake are pretty much unrelated to causing glaucoma or making it worse. Clearly, eating a healthy diet containing fruits and vegetables and limiting booze and caffeine to a small amount per day will help you to live longer and healthier. So, do that for yourself and to last long enough to watch your grandkids grow up. If you drink more than one caffeinated beverage per day, knock it down to one and make the rest of what you drink caffeine-free.

One major thing you can do that is proven to lower eye pressure and improve blood flow to the brain and the eye is aerobic exercise. This means doing something at least four times per week for more than 20 minutes that raises your pulse rate to a level that makes your heart work. Generally, it means walking, swimming, biking, or stationary machine use at a level that keeps you a bit out of breath. You should be able to talk to the person with whom you’re running or walking, but with difficulty. The term aerobic exercise was coined by Dr. Kenneth Cooper and his Institute. The Institute’s web site provides information on how to do the right thing for your heart and your retinal ganglion cells. First, check with your medical doctor before starting anything. Second, you may wish to be referred to a physical therapist for good hints on what and how to do it. Third, pick something that you really will do four times a week. If you hate to swim, don’t try that. If you can’t afford a health club membership, pick walking. Fourth, get a partner. When Dr. Quigley ran marathons, one of his training systems was that two guys were going to show up to run with him at his back door every dark, cold morning. If he thought that rolling over in bed and going back to sleep was a good idea, having them bang on the kitchen door reminded him to get his running shoes on. You will enjoy walking and talking with someone or a group more than solo. Fifth, make a standard time when the exercise is going to happen. With our busy schedules, we have to find a slot for exercise every day. In studies with older adults with early glaucoma, eye pressure fell by two points or so as they began consistent exercise. It’s almost as good as adding another eye drop to protect your vision. Get off the couch!

Exercises which you should avoid are anything in which you are upside down or your head is below your heart during the exercise. For example, head stands or down-facing dog pose in yoga cause your eye pressure to be twice or three times higher than normal. While there has been no study to show that yoga leads to worsening of glaucoma, there are plenty of other yoga poses to decrease your stress level. In fact, our research group is studying whether practicing yoga and meditation could lower eye pressure. Holding your breath while exerting yourself (called the Valsalva maneuver, like straining on the toilet) is also a time when your eye pressure goes sky high. So, if you lift weights for exercise, which is generally a good idea to maintain bone density, make it low weights with more repetitions of lifting, rather than heavy weights that make you grunt. A similar breath-holding problem applies to those playing the larger wind musical instruments like the French horn. One study suggested that there was a greater chance of glaucoma in symphonic wind players. If you play a brass instrument, it makes sense to have frequent checks of pressure, optic nerve head, and visual field.

Your Mom may have told you not to read so much or you’d ruin your eyes. Mom was right about a lot of things and here she was only half right. Persons between the ages of eight and 15 develop more near-sightedness from close eye work if they have some inherent tendency to it. But, for the adult glaucoma patient, there is no reason to think that using the eyes is harmful. Read away. You can rot your brain by watching reality TV, but it won’t hurt your glaucoma.