News Article
News Article
This is a curated transcript from the MyEyes Webinar held on September 10th, 2025, titled:
“Managing Eye Pressure & Stress: Proactive Glaucoma Care.”
During the event, glaucoma specialists answered dozens of live questions from patients and caregivers. This Q&A captures those insights, organized by theme for more straightforward navigation. Personal identifiers and names have been removed, but the educational value remains fully intact.
“Every patient is different — that’s where personalized medicine comes in. Flattening the pressure curve is important, but understanding your unique pattern matters most.”
— Dr. Barbara M. Wirostko, MD, FARVO, Moran’s Resident Research Director and Adjunct Professor of Ophthalmology and Biomedical Engineering
Topics covered include:
This is not a substitute for medical care. Use it as a reference and discussion tool when working with your eye care provider.
This section covers key medical questions related to glaucoma, including sleep apnea, dry eye, eye pressure fluctuations, and optic nerve health. The answers clarify how various conditions and risk factors can influence disease progression.
Q: How does sleep apnea affect glaucoma?
A: There is a substantial body of evidence linking sleep apnea to increased glaucoma risk and progression. If glaucoma is worsening, it’s worth getting evaluated for sleep apnea.
Q: How does night “dry eye” affect intraocular pressure (IOP)?
A: Dry eye doesn’t directly impact IOP, but it’s common in people with glaucoma, especially those using eye drops with preservatives like benzalkonium chloride.
Q: Do any of the vitamins increase blood pressure?
A: No. The vitamins discussed in the session are generally associated with lowering blood pressure.
Q: How does Miebo (perfluorohexyloctane) compare to Refresh for dry eye?
A: This question is best discussed with a comprehensive eye care provider or optometrist.
Q: Is the Home 2 IOP device accurate when used with contact lenses?
A: The device hasn’t been formally tested with contacts. Wearing lenses may affect accuracy. For best results, remove contacts before taking readings.
Q: My eye pressures were very erratic the first week I used MyEyes. Should I repeat the testing?
A: IOP tends to fluctuate, especially in the early morning hours. Weekly variability is common, which is why ongoing monitoring can be helpful.
Q: What IOP variation is considered acceptable? My blood pressure rises from 10–12 to 15–18 in the morning.
A: The goal is to keep the IOP curve as flat as possible, but acceptable ranges vary by patient. Speak with your doctor — personalized care is key.
Q: What’s the maximum IOP range glaucoma patients should aim to manage?
A: It depends on optic nerve health. In general, the more advanced the glaucoma, the tighter the IOP range should be. Discuss specifics with your ophthalmologist.
Q: I read that perfusion to the eyes increases at night. Is this true?
A: No. Studies show optic nerve perfusion actually decreases at night.
Q: Why is IOP the primary focus for glaucoma treatment, rather than vascular or other factors?
A: All major clinical trials have shown that lowering IOP slows glaucoma progression. IOP is also the only modifiable risk factor with FDA-approved treatments.
Q: Can glaucoma be reversed?
A: Generally, no. Vision lost due to optic nerve damage can’t be restored. Treatment focuses on slowing or stabilizing progression.
Questions here focus on specific types of glaucoma — such as pigmentary and pseudo-exfoliation — and surgical options like SLT and canaloplasty. Responses emphasize the importance of individualized treatment planning.
Q: Should people with pigment dispersion glaucoma avoid running?
A: Aerobic exercise lowers glaucoma risk, but in pigmentary glaucoma, it may trigger IOP spikes. Portable tonometry can help track IOP after exercise.
Q: Can I exercise after getting stents implanted for glaucoma?
A: Post-operative activity restrictions vary. Always consult your eye surgeon.
Q: What are the benefits of canaloplasty for pseudo-exfoliation glaucoma?
A: Depends on individual case factors. Best discussed directly with your ophthalmologist.
Q: Any special recommendations for pseudo-exfoliation glaucoma?
A: This type often shows greater IOP fluctuation, sometimes with spikes into the high 20s.
Q: Best surgery for pseudo-exfoliation glaucoma and cataracts?
A: Case-dependent. XFG can be more challenging, so personalized surgical planning is essential.
Q: Why won’t my doctor repeat SLT (Selective Laser Trabeculoplasty)?
A: SLT can lose effectiveness over time, but it may still work if repeated. This decision is best made in consultation with your care team.
Eye health doesn’t exist in isolation. These questions explore how systemic health issues, medications, and chronic conditions may intersect with glaucoma management.
Q: Are insulin eye drops effective for optic nerve regeneration?
A: Still experimental. There are challenges with preparation, and no FDA approval has been obtained yet.
Q: Can chronic arm pain affect the optic nerve?
A: No direct link, but discuss any systemic issues with your doctor if you’re concerned.
Q: What helps reduce retinal inflammation besides prednisone?
A: That’s a treatment discussion for your retina specialist.
Q: I have recurring scar tissue after surgeries. Is there anything that can help?
A: Anti-scarring protocols do exist, but must be tailored by your surgeon.
Q: Swelling near my dad’s parotid gland seems linked to vision loss. Could oxalates be involved?
A: A particular and complex case — consult with relevant medical specialists.
Many attendees asked about vitamin protocols, dosing, safety, and emerging research on supplements like nicotinamide, citicoline, and pyruvate. This section summarizes those insights.
Q: What’s a safe dose of Vitamin B3 (nicotinamide)?
A: Around 500 mg daily is reasonable for long-term use. Clinical trials have tested 2,000–3,000 mg.
Q: Can nicotinamide cause liver damage?
A: Rare, but possible at high doses. One case of abnormal liver function was reported at 1,000 mg/day.
Q: Is there a single pill that combines all the recommended vitamins?
A: Yes.
Q: Is pyruvate easy to get?
A: Yes. Found in apples, red wine, cheese, dark ale, and supplement form (e.g., calcium pyruvate).
Q: What’s wrong with niacin?
A: It’s not the form studied for glaucoma. Nicotinamide is preferred and better tolerated.
Q: Niacinamide vs. nicotinamide — are they the same?
A: Yes.
Q: Are EyePromise vitamins good?
A: Hard to say without detailed ingredient analysis. Discuss with your ophthalmologist.
Q: Thoughts on citicoline?
A: Supports choline levels and brain health. Found in beef liver and eggs. Talk to your doctor before supplementing.
Q: How to order a vitamin stack if US orders are paused?
A: Contact the provider directly for updates.
This section addresses non-mainstream and experimental treatments — from red light therapy and microcurrent to homeopathy and psilocybin. Where data is lacking, experts note that further research is needed.
Q: Any evidence for red light therapy?
A: Still experimental in glaucoma. More data needed.
Q: Are European electrical pulse treatments effective?
A: Research on neurostimulation is ongoing. Refer to academic literature.
Q: Any benefits of microcurrent or homeopathy for glaucoma?
A: No scientific evidence supports homeopathy. Microcurrent remains investigational.
Q: What about psilocybin and glaucoma?
A: No clinical data support its use for eye health.
Q: Does the 2025 Ginkgo Biloba review change your stance?
A: Ginkgo may help circulation and is well-studied for normal-tension glaucoma. Can act as a blood thinner — consult your physician.
Sleep, posture, and daily routines can all impact glaucoma. These questions explore practical strategies to support stable IOP and optic nerve health through improved sleep quality and small behavioral changes.
Q: Is sleeping on a wedge helpful?
A: Slight elevation may reduce IOP, but good sleep quality matters more.
Q: Can glaucoma damage occur during sleep?
A: Possibly, depending on sleep posture, apnea, and blood pressure. Discuss strategies with your doctor.
Physical activity is often a point of confusion. This section explores which exercises are helpful, which may pose risks, and how patients can monitor IOP responses to physical exertion.
Q: Concerns with weightlifting, alcohol, caffeine, scuba diving?
A:
Q: Can lifestyle changes restore visual field loss?
A: Rarely. The goal is to preserve vision, not regain it — though minor improvements may occur in some cases.
Q: Is tilting my bed by 7% okay?
A: If you sleep well, it’s fine.
Q: Are slender, active women at higher risk for glaucoma?
A: Some studies suggest higher rates of normal-tension glaucoma among women with lower BMI, possibly due to post-menopausal hormonal changes.
Q: Exercises to avoid?
A: Avoid inverted positions (e.g., downward dog, headstands) where the head is below the heart.
Q: How to lower eye pressure during sleep?
A: Use overnight treatments, avoid face-down positions, elevate the head, and support optic nerve health through lifestyle.
Q: Is running bad for glaucoma?
A: Generally, no aerobic exercise is beneficial. Exceptions exist for pigmentary glaucoma.
From caffeine to chocolate to raw honey — this section breaks down how everyday dietary choices might influence eye pressure and long-term risk factors.
Q: How do alcohol and caffeine affect glaucoma?
A:
Q: What about chocolate?
A: Dark chocolate (70%+) contains beneficial flavonoids, but also sugar and caffeine. Consume in moderation.
Q: Is raw honey a better sugar substitute?
A: It’s natural, but it still affects blood sugar. Use in moderation.
For those wanting to go deeper into the science, this section explains how to interpret medical research and how clinical insights are formed from both evidence and experience.
Q: Are your studies publicly available?
A: Yes. Clinical recommendations are typically based on robust, randomized controlled trials. Clinical experience also plays a role in patient care decisions.
Glaucoma care is highly personal. Monitoring your own IOP at home, understanding lifestyle impacts, and working closely with your doctor are the best ways to stay ahead of progression.
Want to learn more? Watch the full webinar replay here.
Take the necessary steps with at-home monitoring using an approved eye pressure meter like the iCare HOME2. You can rent the tonometer for $249 during the initial week. Subsequent weeks cost $149.
The content published on the MyEyes blog is intended for educational purposes only and should not be construed as medical advice, diagnosis, treatment, or glaucoma management. MyEyes makes no medical recommendations and advises readers to seek guidance from their physician or qualified eyecare professional regarding individual circumstances, as each case may vary.
Our mission is to make it easier to get home tonometers into hands of the people who need it. In this way, IOP data collected at home at various time points during the day and or night can help to direct an individual patients’ doctors to provide the ideal treatment for that patient’s tailored need.
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