Peripheral (side) vision is the first to be affected and, as the disease progresses, some daily activities such as driving, reading, and playing sports may become challenging. When diagnosed early, people with glaucoma can slow or prevent their vision loss1. There are several effective medical and surgical treatments available to help preserve vision.
Glaucoma is often called the ‘sneak thief’ of eyesight. This is because it slowly robs a person of their vision without any obvious symptoms. While there is little evidence as to whether it’s possible to prevent glaucoma, there may be certain lifestyle factors that can work to manage your risk of developing the condition.
Routine eye testing for glaucoma prevention
Glaucoma can occur at any age but is more common in older people. Acute angle-closure glaucoma is considered a medical emergency and requires immediate attention. This is when the drainage in the eye suddenly becomes blocked, which can cause a sharp increase in intraocular pressure.
Chronic open-angle glaucoma, on the other hand, is a slowly progressive condition. It often occurs without any symptoms or warning signs, however, early diagnosis and treatment can help to preserve vision. As changes are gradual, the affected person may lose some vision before they are even aware of the problem1.
Eye tests are the best way to detect glaucoma. They are quick and painless, and regular testing allows for early detection and treatment. This can prevent vision from worsening and becoming severely affected. The NHS recommends having a routine eye test with a local optician at least every two years, but people who have a family history of glaucoma may be advised to undergo more frequent testing. Subtle changes in the eyes within early-stage glaucoma are usually picked up on routine eye examinations before there are any obvious symptoms. If glaucoma is suspected, further tests are performed before a definitive diagnosis is made2.
Exercise and glaucoma prevention: what does the research say?
Glaucoma is a complex eye condition, and it’s important to take any recommendations for prevention via lifestyle change with a pinch of salt - unless they come from your doctor. In terms of exercise, there are no activities that have been proven to reduce the risk of glaucoma. However, the consensus is that certain types of exercise can lower eye pressure, which is the leading modifiable risk factor for glaucoma. Also, regular physical activity has an indirect benefit because it helps control glaucoma risk factors such as high blood pressure and diabetes.
Studies have shown that people who meet the recommended guidelines for physical activity have a significantly lower risk of developing glaucoma3. The NHS recommends that every adult should participate in 150 minutes of moderate cardiovascular exercise and two or more days of strength training every week to stay healthy4.
What types of exercise can help prevent glaucoma?
In terms of glaucoma prevention, aerobic exercises (cardio) may be beneficial5. This includes activities such as brisk walking, running, cycling, and dancing. These dynamic forms of exercise lead to a reduction in intraocular pressure. Researchers have measured intraocular pressure (IOP) before and after exercise and found it to be significantly lower after activities such as walking and running. Also, the degree of reduction in IOP was found to be directly proportional to the intensity of the exercise6.
Exactly how exercise may work to improve eye pressure is poorly understood. Some explanations for the lower IOP and other protective effects of exercise include:
- Dehydration leading to reduced aqueous humour production (this is the fluid that creates the pressure inside the eye)6
- Stimulation of nerves causing expansion of the drainage network in the eye7
- Improved blood flow to the retina and optic nerve8
Experts warn that while exercise may be beneficial in reducing the risk of glaucoma, it cannot be a replacement for regular visits to the optometrist8.
What types of exercise can increase eye pressure?
Certain activities are known to cause an increase in eye pressure. For example, a Valsalva manoeuvre (attempting forced exhalation with the mouth closed and the nose pinched shut) increases intraocular pressure6. Similarly, IOP can rise significantly during intense physical exercise with abdominal muscle and respiratory effort. For example, in one study, eye pressure was found to be elevated during bench presses, and more so when the breath was held9. Heavy weightlifting activities have also been reported to cause other adverse eye incidents such as retinal detachment and conjunctival/retinal haemorrhage6.
Other types of exercise you should approach with caution include:
- Certain yoga postures — an inverted headstand causes facial congestion and increased IOP6
- Swimming — the prone (face down) body position in most strokes and the use of some styles of swimming goggles may increase IOP6
These caveats do not mean that everybody should stop lifting weights, swimming, or participating in yoga. Always consult a healthcare professional before starting an exercise regimen and be sure to start slowly and monitor your progress. Also, people susceptible to glaucoma and people with a family history of this disease should speak to their eye doctor about specific types of exercises that may not be advised for them.
- Mayo Clinic. (no date). Glaucoma. [Online]. Available at: https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839 NHS. (no date). Glaucoma Diagnosis. [Online]. Available at: https://www.nhs.uk/conditions/glaucoma/diagnosis/ [Accessed 29 August 2019].
- Meier, NF, Lee, D, Sui, X, Blair, SN. Medicine & Science in Sports & Exercise: November 2018 - Volume 50 - Issue 11 - p 2253–2258. [Online]. Available at: https://journals.lww.com/acsm-msse/Citation/2018/11000/Physical_Activity,_Cardiorespiratory_Fitness,_and.9.aspx [Accessed 29 August 2019].
- NHS. (no date). Physical Activity Guidelines for Adults. [Online]. Available at: https://www.nhs.uk/live-well/exercise/ [Accessed 29 August 2019].
- American Optometric Association Clinical Eye Care. (no date). Physical Activity May Lessen Glaucoma Risk. [Online]. Available at: https://www.aoa.org/news/clinical-eye-care/glaucoma-and-exercise [Accessed 29 August 2019].
- McMonnies CW. Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk?. J Optom. 2016;9(3):139–147. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911456/ [Accessed 29 August 2019].
- Xiaoqin Yan; Mu Li; Yinwei Song; Jingmin Guo; Yin Zhao; Wei Chen; Hong Zhang. Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4733-4739. [Online]. Available at: https://iovs.arvojournals.org/article.aspx?articleid=2552280 [Accessed 29 August 2019].
- Glaucoma Research Foundation. (no date). Can Exercise Lower Eye Pressure? [Online]. Available at: https://www.glaucoma.org/q-a/can-exercise-lower-eye-pressure.php [Accessed 29 August 2019].
- Geraldo Magela Vieira, MD; Hildeamo Bonifácio Oliveira, MSD; Daniel Tavares de Andrade, MSD; et alMartim Bottaro, PhD; Robert Ritch, MD. Intraocular pressure variation during weight lifting. Arch Ophthalmol. 2006;124(9):1251-1254. [Online]. Available at: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/815228 [Accessed 29 August 2019].