Study Supports Incorporating Exercise into Glaucoma Treatment

Multiple studies have identified a link between the severity of visual field loss and taking fewer steps per day or spending less time on physical activity. Photo: Getty Images. While intraocular pressure is the primary risk factor for glaucoma, there are a number of lifestyle modifications that may affect the development and progression of disease. Changes such as getting more exercise are gaining traction among glaucoma patients and their eye care providers, as physical activity is known to lead to general health benefits. Though its precise impact on glaucoma progression isn’t fully understood yet, a recently published study in the Journal of Glaucoma reported slower rates of visual field loss in patients who exercised more.The study included 131 eyes of 80 primary open-angle glaucoma patients with a mean follow-up of 4.9 years. Patients had a median baseline visual field mean deviation of -3.5. The researchers assessed self-reported physical activity levels using the physical activity index; energy expenditure in metabolic equivalents of task (MET)-minutes; and walking pace. In the cohort, 33.8% of participants self-reported as inactive, 15% as moderately inactive, 13.8% as moderately active and 37.5% as active.In the univariable analysis, the researchers found that slower visual field mean deviation loss was associated with active physical activity index category (0.3 dB/year) and higher physical activity amount (0.14 dB/year per 1,000 MET-minutes). They found no significant associations between the rate of visual field mean deviation loss and baseline visual field mean deviation or walking pace. The multivariable analysis, which included glaucoma severity and other covariates, demonstrated an association between slower visual field mean deviation loss and higher amounts of physical activity (0.15 dB/year per 1,000 MET-minutes).“Physical activity is hypothesized to have neuroprotective effects on retinal ganglion cells,” the researchers explained in their Journal of Glaucoma paper, adding that aerobic exercise has been found to temporarily reduce intraocular pressure while high-intensity resistance exercise and weightlifting can temporarily increase pressure. “Physical activity levels might mitigate the risk of glaucoma by indirectly preventing the development of metabolic disorders such as diabetes, which are often linked to increased intraocular pressure.”“As this observation is derived from a cohort receiving long-term glaucoma management, it may indicate the presence of an additional factor beneficial for glaucoma control that can be achieved through lifestyle modifications,” they concluded. Further studies are needed to confirm this association. Click here for the journal source.  Seo J, Nishida T, Moghimi S, et al. Impact of physical activity levels on visual field progression in individuals with glaucoma. J Glaucoma 2025. [Epub ahead of print].