Study: Physical Activity, Mindfulness, Optimized Sleep Can Play Major Role in Glaucoma

Lifestyle modifications—including targeted nutritional strategies, regular aerobic exercise, stress-reduction practices, optimized sleep hygiene and smoking cessation—can meaningfully augment traditional glaucoma therapies. Photo: Getty Images. Click image to enlarge. While lowering intraocular pressure (IOP) remains the only proven way to slow or halt disease progression in glaucoma patients, several studies suggest that lifestyle changes may have a positive impact on outcomes as well. In a recent literature review, researchers from India explored the potential role of lifestyle modifications in the prevention and management of the condition, particularly as complementary strategies alongside traditional IOP-lowering treatments. They found that physical activity and exercise, mindfulness, relaxation, optimized sleep hygiene and quitting smoking can meaningfully augment traditional glaucoma therapies. Their paper was published in World Journal of Methodology.The effects of various lifestyle factors—including diet, physical activity, yoga practices, sleep posture and the use of nutritional supplements—on the development and progression of glaucoma were examined.Physical activity emerged as one of the most consistently beneficial lifestyle components. Acute aerobic exercise (30 minutes of moderate treadmill walking) transiently lowered IOP by up to 3.5mm Hg. “Importantly, a 12-month supervised aerobic program yielded a sustained 1.5mm Hg IOP reduction and slowed RNFL thinning by nearly 45% compared to controls, suggesting durable structural protection,” the authors wrote in their paper. “Mechanistically, exercise augments optic nerve head perfusion, elevates endogenous neurotrophins such as BDNF and attenuates oxidative stress—factors implicated in glaucoma pathogenesis.” Incorporating regular moderate-intensity aerobic exercise into glaucoma management plans, not only helps to control IOP, but also for its broader neuroprotective and cardiovascular benefits.Mindfulness-based stress reduction and sleep optimization demonstrated promising adjunctive benefits. Two randomized clinical trials of mindfulness-based stress reduction reported 1.8mm Hg to 2.3mm Hg IOP reductions alongside 20% to 30% decreases in anxiety scores, improvements in vision-related quality of life and downregulation of the stress biomarkers cortisol, interleukin-6 and tumor necrosis factor-alpha. “These findings underscore the role of the hypothalamic-pituitary-adrenal axis and inflammatory mediators in modulating IOP and retinal ganglion cell vulnerability,” the authors explained in their study. “In sleep apnea cohorts, CPAP therapy correlated with 10% slower visual field deterioration over one year, suggesting nocturnal oxygenation influences optic nerve resilience.”Previous studies have reported that smoking cessation reduced the rate of visual field decline, a fact confirmed in these findings, as it was associated with a 15% slower rate of retinal nerve fiber layer thinning—implicating tobacco-induced vascular compromise and oxidative injury in glaucoma progression.The additive benefits of these lifestyle modifications may be clinically meaningful in addition to established IOP-lowering medications, lasers and surgery, the authors concluded in their paper. “A sustained 1mm Hg to 3mm Hg IOP reduction can reduce the risk of glaucoma progression by 10% to 20%, similar to an additional topical agent. Moreover, non-IOP-mediated neuroprotective effects—through enhanced perfusion, neurotrophin induction and inflammation control—address pathophysiologic pathways not targeted by current therapies.” The authors added that lifestyle interventions also improve cardiovascular health, reduce comorbidities and enhance overall quality of life, a particularly salient consideration given the high prevalence of mood disorders and treatment burden in glaucoma patients.Click here for the journal source. Aggarwal S, Morya AK, Kaur R, et al. Role of lifestyle modifications in glaucoma: a systematic review. World J Methodol. March 20, 2026. [Epub ahead of print.]  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.