Current glaucoma research appears focused upon providing neuroprotection to retinal ganglion cells. This approach may benefit those displaying normal tension but still experiencing progressive visual field loss. Recommendations to reduce IOP are also included. Glaucoma represents a serious eye condition, requiring monitored supervision by a qualified ophthalmologist. Best results might be obtained by working with a complementary physician who employs the best of orthodox and alternative wisdom.

Some of the following suggestions replicate the same mechanism and should be structured to individual needs.

The Life Extension Mix, 9 tablets or 14 capsules daily, provides a storehouse of nutrients, including magnesium, zinc, chromium, selenium, vitamin A, thiamine, vitamin C, bioflavonoids, grape seed-skin extract, vitamin E, and bilberry that could benefit ocular health. Some individuals may wish to emphasize additional amounts of the most beneficial of these herbs and nutrients, regarding glaucoma management.

Use vitamin C crystals or a powdered from of vitamin C, buffered with magnesium. (This type is added to a liquid and is considered highly absorbable). The buffered form of vitamin C is easier on the stomach when large amounts of ascorbate are ingested. The magnesium will tend to act as a calcium channel blocker and temper a sympathetic nervous response. The vitamin C may assist in lowering IOP and establishing healthy collagen. Some individuals will realize benefit from as little as 2 grams of vitamin C daily; others will need as much as 35 grams daily. Some practitioners use 500 mg of vitamin C per kilogram (2.2 pounds) of body weight, a dose that must gradually be reached. Vitamin C should be spaced throughout the day, allowing a continuous supply of ascorbate. (See Appendix B).

Grape seed-skin extract, rich in proanthocyanidins, increases the effectiveness of vitamin C. Together they support healthy collagen and defend against free radicals. A therapeutic dose of proanthocyanidins is considered to be 150 to 300 mg daily. Usually this dose can be reduced after a month's saturation.

Select bilberry by evaluating its anthocyanosides content. (This is calculated by the percentage of anthocyanadin present, typically 25%.) The dosage for bilberry, the "eye herb" is between 40 to 80 mg, three times daily.

Select Coleus forskohlii standardized to contain 18% forskolin. Use 50 mg (9 mg of forskolin 2 to 3 times a day) to assist in lowering IOP. CAUTION: Do not use C. forskohlii if prostate cancer is apparent. During C. forskohlii usage, monitor blood pressure, being alert for hypotension.

Individuals with healthy liver function may use between 25,000 to 50,000 IU daily of vitamin A. (Some research indicates the emulsified form of vitamin A is less stressful on the liver). Vitamin A from all supplemental sources should be calculated into the daily total, being watchful as to the cumulative amounts. While toxicity is not usually associated with low doses, one should acquaint themselves with the symptoms of vitamin A toxicity. (See Appendix A.) Pregnant women should use vitamin A only after careful consultation with their physician. The benefits of vitamin A include decreased dry, itchy, inflamed eyeballs and an increase in visual purple, a substance needed for night vision.

Aminoguanidine (300 mg daily) has shown neuroprotective benefits. Aminoguanidine reduces nitric oxide, protecting against oxygen deprivation and decreasing the death of the retinal ganglion cells. Limited clinical experience involving aminoguanidine suggests it should be used under the supervision of a physician. For a directory of offshore suppliers offering aminoguanidine to Americans for personal use, write to the International Society for Free Choice, 9 Dubnov Street, 64368 Tel Aviv, Israel.

Vitamin B12, methylcobalamin, is the choice of many wishing to delay the death of neurons observed in the aging process. (Normally, the Life Extension Foundation considers the dose for protection to be about 1 mg daily). Sublingual methylcobalamin supplementation is considered therapeutic, for central and peripheral neurological damage, at dosages of 5 mg dispensed 1 to 8 times a day. Do not eat the tablet as one would candy. Let the B12 dissolve slowly under the tongue. This form of vitamin B12 appears an alternative to weekly B12 shots and may be quite useful in the prevention of neurotoxicity.

Acetyl-L-carnitine is an important adjuvant in neuropharmacology. A dosage of 3000 mg daily may be used. With most supplements, including acetyl-L-carnitine, gradual introduction of the supplement is advisable, allowing the body to adjust to the actions of the substance.

Alpha-lipoic acid has attained favorable attention in the treatment of glaucoma. It appears to improve ocular hypertension and visual function. Current glaucoma research considers a daily dose of 150 mg adequate for glaucoma treatment. NOTE: Much larger dosages are used in diabetes and AIDS (300 to 600 mg daily) without significant side effects. (This information is included to illustrate the safety parameters of alpha-lipoic acid). Possible side effects include skin rash and hypoglycemia. Lipoic acid can worsen a B1 deficiency. Chronic usage of lipoic acid can interfere with biotin utilization.

Hydergine's mechanism of efficacy appears similar to C. forskohlii. Hydergine reduces hypoxia and free radical damage. A dosage of 3 to 20 mg daily is considered appropriate.

Attempts to reduce stress are valuable to the glaucoma patient. External stress begets internal stress, both of which equate to physical disruption. Unpleasant interactions with others, temperature extremes, and fatigue are not desirable for anyone, especially individuals with glaucoma.

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