People who are doing moderate to vigorous physical activity may significantly lower their risk of glaucoma, according to research presented at the 121st Annual Meeting of the American Academy of Ophthalmology (AAO). Tseng et al from the University of California, Los Angeles (UCLA) reported a 73% lower incidence of glaucoma among the most physically active study participants, compared with the least active.
The researchers reviewed survey and pedometer readings from the National Health and Nutrition Examination Survey (NHANES), which has tracked the health and nutritional status of over 70 million adults in the United States since the 1960s. For each 10-minute increase in moderate-to-vigorous activity per week, glaucoma risk decreased 25 per cent.(1) This suggests that exercise plays a protective role, where people who exercise at a higher intensity (speed and steps) may decrease their glaucoma risk more, compared to people exercising at a lower intensity.
These results correlate with a study showing reduced self-reported glaucoma incidence with each kilometer (km) per day run and with each incremental increase in speed in a 10-km footrace among 29,854 male runners followed for 7.7 years. (2)
However there are studies which contradict these results. A South Korean study of 11,247 people, showed increased glaucoma prevalence for participants doing high intensity activity versus moderate activity.(3) South Korea does have a high proportion of normal tension glaucoma, where there may be a lower threshold for glaucomatous damage due to exercise-induced changes in eye pressure.
Care should be taken when interpreting these new findings until they are published in a peer reviewed journal. However the emergence of exercise as a potential modifiable risk factor in glaucoma is exciting, because most other risk factors are outside an indiviual's control. Moderate intensity exercise appears to be safe and likely beneficial for most people,(10) including glaucoma patients.
People with glaucoma, especially normal tension glaucoma, or advanced disease, should discuss exercise with their Eye Specialist.
1. Tseng, V., F. Yu, and A.L. Coleman, Exercise Intensity and Risk of Glaucoma in the National Health and Nutrition Examination Survey, in American Academy of Ophthalmology. 2017: New Orleans, USA.
2. Williams, P.T., Relationship of incident glaucoma versus physical activity and fitness in male runners. Med Sci Sports Exerc, 2009. 41(8): p. 1566-72.
3. Lin, S.C., et al., The relation between exercise and glaucoma in a South Korean population-based sample. PLoS One, 2017. 12(2): p. e0171441.
4. Society, A.P.G., Asia Pacific Glaucoma Guidelines. 2016, Kugler Publications: Amsterdam, The Netherlands.
5. Qureshi, I.A., The effects of mild, moderate, and severe exercise on intraocular pressure in glaucoma patients. Jpn J Physiol, 1995. 45(4): p. 561-9.
6. Wylegala, A., The Effects of Physical Exercises on Ocular Physiology: A Review. J Glaucoma, 2016. 25(10): p. e843-e849.
7. Natsis, K., et al., Aerobic exercise and intraocular pressure in normotensive and glaucoma patients. BMC Ophthalmol, 2009. 9: p. 6.
8. McMonnies, C.W., Intraocular pressure and glaucoma: Is physical exercise beneficial or a risk? J Optom, 2016. 9(3): p. 139-47.
9. Susanna, R., Jr., et al., Applications of the water drinking test in glaucoma management. Clin Exp Ophthalmol, 2017. 45(6): p. 625-631.
10. Garber, C.E., et al., American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 2011. 43(7): p. 1334-59.