Glaucoma is a progressive condition that damages the optic nerve, often associated with elevated intraocular pressure (IOP). This pressure results from a buildup of aqueous humor fluid inside the eye. While medical treatments stabilize IOP, managing glaucoma also requires attention to daily habits that can cause temporary pressure spikes. Knowing what to avoid is crucial for protecting vision and slowing the disease’s progression.
Medications and Supplements to Discuss with Your Doctor
Systemic medications have the potential to raise intraocular pressure and should be discussed with your ophthalmologist before use. The most common agents known to cause an IOP spike are corticosteroids. This includes steroid eye drops, inhaled and nasal sprays for allergies or asthma, and oral steroids for inflammatory conditions. These drugs increase resistance to fluid outflow by altering the eye’s drainage system (the trabecular meshwork).
Certain non-ophthalmic medications risk triggering acute angle-closure glaucoma, especially in individuals with narrow drainage angles. This group includes anticholinergic drugs found in over-the-counter cold medicines, anti-nausea treatments, and medications for overactive bladder. These agents dilate the pupil, which can block the eye’s drainage angle and cause a sudden, dangerous pressure rise.
Specific prescription drugs, such as Topiramate (used for migraines and seizures), can cause rapid, secondary angle-closure by building up fluid behind the iris. Inform every healthcare provider, including your dentist or primary care physician, about your glaucoma diagnosis before starting any new prescription or supplement. Never abruptly stop a prescribed medication without consulting the prescribing doctor and your ophthalmologist, as this could have serious health consequences.
Physical Activities and Positions That Increase Eye Pressure
Specific body positions and physical maneuvers can cause a transient increase in intraocular pressure due to changes in blood flow to the head. Any inverted posture where the head is held lower than the heart should be minimized or avoided, especially by individuals with moderate or advanced glaucoma. Common yoga poses like the headstand, shoulder stand, and downward-facing dog can cause a significant rise in IOP (6 to 11 mmHg). This occurs because the inverted position increases episcleral venous pressure, restricting the eye’s fluid drainage.
Activities involving the Valsalva maneuver—forceful exhalation against a closed airway—cause a temporary, sharp spike in eye pressure. This maneuver occurs unknowingly during straining activities, such as heavy weightlifting, pushing, or playing brass wind instruments. While the pressure spike is brief, repeated increases are a concern for the vulnerable optic nerve.
External pressure applied to the neck or eye socket should also be avoided. Tight neckwear, such as a constricted necktie or scarf, impedes venous blood outflow from the head, leading to an increase in IOP. Similarly, tight-fitting swimming goggles or eye protection that presses directly into the orbital socket can cause a temporary rise in eye pressure. These should be replaced with models that have a larger, softer seal.
Dietary and Lifestyle Choices to Moderate
Smoking should be strongly avoided, as its impact goes beyond temporary pressure spikes. Smoking is linked to a reduction in blood flow to the optic nerve, which can compromise the nerve’s health and make it more vulnerable to damage. Heavy smokers face a significantly higher risk for glaucoma progression and visual field deterioration.
While moderate consumption is acceptable, high intake of caffeine can cause a temporary, small increase in intraocular pressure, lasting up to 90 minutes after ingestion. For most patients, a few cups of coffee daily poses no major risk. However, individuals who are highly sensitive may benefit from limiting their daily intake. Moderation is the recommended approach unless a specialist advises complete avoidance.
A rapid, large volume of fluid intake can temporarily affect eye pressure. Drinking a liter of fluid in a short period (under 30 minutes) can cause a transient increase in IOP. This sudden fluid load lowers the blood’s osmotic pressure, affecting the eye’s fluid dynamics. Patients should maintain steady, measured hydration throughout the day, avoiding “chugging” large quantities of liquid.
Although stress does not directly cause glaucoma, chronic, unmanaged stress is detrimental to overall vascular health and may indirectly impact optic nerve resilience. Acute psychological stress can cause temporary fluctuations in eye pressure. Implementing stress management techniques, such as mindfulness or light aerobic exercise, supports stable eye pressure and overall well-being. Drinking alcohol in moderation is generally acceptable, but chronic heavy consumption is associated with poor optic nerve health and increased risk of open-angle glaucoma.