James C Tsai – [email protected] Update 25 contact Glaucoma

agent with possible blood flow effects. One study showed a short-term visual field improvement in patients with normal GLAUCOMA AND LIFESTYLE tension glaucoma taking ginkgo. For other antioxidants, there does not appear to Growing demand from patients to know more about be any effect on the risk of open angle glaucoma,” he said. possible role of lifestyle factors in glaucoma Dr Tsai also stressed the role of by Dermot McGrath in Paris the cardiovascular system, which is heavily lifestyle influenced, in glaucoma development and progression. “We know that there may be potential hile the main emphasis in The relationship between diet and vascular risk factors in glaucoma and one of current glaucoma research glaucoma is quite complex, said Dr Tsai, “Aerobic exercise the proposed ideas is that influencing ocular is focused on finding although at least one published paper has circulation may be beneficial for the disease more efficacious and safer does seem to be suggested that the ratio of omega-3 fats process. In certain patients there appears treatments for the disease, lifestyle-related to omega-6 polyunsaturated fats might W to be abnormal auto-regulatory responses risk factors should not be overlooked in helpful in reducing be important. This study reported that a to changes in ocular perfusion pressure in helping to combat glaucoma onset and diet favouring omega-6 fats, which include play,” he said. progression, according to a presentation at intraocular pressure” corn, sunflower and safflower oils, relative Studies such as the Barbados Eye the 2011 World Glaucoma Congress. to omega-3 fats in flaxseed, canola and soy Study have reported that lower systolic James C Tsai MD, chairman and Robert contrast, several studies have noted that oils was associated with a reduced risk of blood pressure and lower ocular systolic, R Young, professor of ophthalmology and aerobic exercise has been shown to reduce primary open angle glaucoma. diastolic and mean perfusion pressures visual science at Yale University School IOP. Alcohol consumption, while not having There is also some evidence to support were all associated with an increased of Medicine in New Haven, Connecticut, a proven effect on the risk of open angle the idea of dietary approaches influencing risk of developing glaucoma, said Dr US, said that while a lot more research was glaucoma, has been shown to lower IOP vascular regulation and blood flow to the Tsai. Another landmark study, the Early needed to understand this complex disease, levels, said Dr Tsai. eye, said Dr Tsai. Manifest Glaucoma Trial, showed that there is growing evidence that certain He noted that in discussing the potential “Antioxidants such as those found in lower ocular systolic perfusion pressure lifestyle modifications might be beneficial benefits of exercise for glaucoma, most of the ginkgo biloba, and polyphenolic flavenoids and cardiovascular history in patients for glaucoma. “Aerobic exercise does seem to studies in the literature have been carried out found in tea, coffee and red wine may with higher baseline IOPs, as well as lower be helpful in reducing intraocular pressure. in patients without glaucoma. reduce the extent of mitochondrial systolic blood pressure in patients with I also tell my patients to limit their cigarette “In non-smoking and healthy volunteers, oxidative stress. In terms of supplements, lower baseline IOPs, were associated with smoking since this action will improve their exercise increases heart rate, systolic blood ginkgo biloba in particular has been increased progression of glaucoma. general health as well as perhaps enhance pressure and ocular perfusion pressure but studied as a potential neuroprotective their ocular perfusion pressure. A diet it also decreases IOP and diastolic blood rich in antioxidants and low in fat content pressure. In physically active college-aged may also be beneficial. In addition, there is students, dynamic resistance exercises lowers some evidence that limiting caffeine intake, IOP as well. There have also been papers avoiding head-down positions and drinking looking at healthy subjects where there red wine may help in preventing or slowing was a link shown between beta 2 receptor down glaucoma,” he said. polymorphism and IOP lowering with Dr Tsai said that he has personally noticed dynamic exercise. And just this year, there Invites Ophthalmologist from Europe to join a growing demand from his patients to learn was a paper published in a population of more about the possible role and effects of myopic and emmetropic young adults that our team in state of the art facility in Dubai lifestyle factors in glaucoma. showed that dynamic exercise does in fact “There is increasing interest in exploring reduce IOP,” he said. complementary and alternative treatments, Cigarette smoking has also been targeted Founded in 1955, MAGRABI Hospitals & Centers is the Leading Eye Care and patients are viewing these non- for its potentially deleterious impact on Provider in the Middle East and is seeking an accomplished Consultant traditional therapies as possible supplements ocular health, said Dr Tsai. Ophthalmologist for its state-of-the art facility in Dubai, UAE to their conventional medical and/or surgical “We know that cigarette smoking seems therapy. More importantly, patients want to have broad deleterious effects across the greater control over their disease and they are entire health spectrum. There are over 4,000 bioactive substances in cigarettes so it is constantly asking what they can do to alter Current Vacancy their lifestyle habits for a positive/beneficial difficult to isolate out the effects of every effect on their disease,” he said. one of these bioactive substances. But we Position: Cornea & Refractive, Cataract Consultant know that there appears to be both acute Moreover, shedding light on the link Eligibility: Minimum 3 Yearsʼ Experience, FRCS or Equivalent. between lifestyle and glaucoma may have and chronic IOP elevation with smoking,” . important implications for public health he said. Attractive Tax Free salary according to qualifi cations and experience Dr Tsai added that there have been some . strategies and possibly provide insights into Medical Insurance the causes of the disease, said Dr Tsai. reports linking smoking with increased . blood flow to the brain. “There is a possible Free Accommodation Reviewing the scientific literature on . reduction in the levels of apoptosis; Family Status lifestyle and glaucoma, Dr Tsai stated that . some studies had pointed out the negative however, smoking has been linked to Continued Medical Education Benefi ts . effects of yoga and head-down activities on macular degeneration and cataracts. It is Paid Annual Leave IOP levels. Similarly, wearing tight neckties important to stress that when adjusted and playing high resistance wind instruments for IOP level, there does not appear to be Please send your CVʼs to email: [email protected] have been implicated in raising IOP, as an increased risk of glaucoma linked with have caffeine consumption and stress. By cigarette smoking at this time,” he said.

EUROTIMES | Volume 17 | Issue 2