Science: Various Natural Compounds of Interest In Supporting Healthy Intraocular Pressure
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david 4.2k
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This post gathers short scientific summaries and comments for the following natural compounds in regard to their effects on intraocular pressure. Other potentially beneficial effects of these natural compounds are not discussed herein.

  • Cannabinoids (CBD, CBG, CBN, THC)
  • Palmitoylethanolamide (PEA)
  • Omega-3
  • Forskolin
  • Rutin and Forskolin Combination
  • Hesperidin
  • Flavonoids
  • Baicalein
  • Resveratrol
  • Melatonin
  • Saffron
  • Mirtogenol
  • Green Tea
  • Mushrooms (Cordyceps, etc.)
  • Vitamin C
  • O-methylascorbate (a circulating Vitamin C metabolite)
  • Astragalus
  • Cherry Extract
  • Persimmon Leaf Extract (Diospyros kaki)
  • Vitamin D
  • Vitamin B-6
  • A-C Carbamide
  • L-Arginine
  • L-Taurine
  • Fennel
  • Capsanthin
  • Black currants
  • Some quite interesting anecdotal evidence for "Chinese Forbidden Black Rice"

Cannabinoids (CBD, CBG, CBN, THC)

Cannabis Use For Glaucoma And Associated Pain - PubMed

Cannabis plants have been used as therapeutic agents for many centuries, as early as the fourth century AD. More recently, cannabis’ primary psychoactive component delta(9)-tetrahydrocannabinol (THC) and its major non-psychoactive ingredient cannabidiol (CBD) have been used for the treatment of sleep disorders, pain, skin disorders, and lowering of intraocular pressure (IOP).

NOTE: THC (as well as CBG) have been shown to reduce IOP. CBD, on the other hand, has been shown to increase IOP in one study (described below).

Intraocular pressure, ocular toxicity and neurotoxicity after administration of cannabinol (CBN) or cannabigerol (CBG) | Ask FitEyes

Summary of major points from the scientific publication:

  • Marijuana, delta-9-tetrahydrocannabinol (THC) and cannabinol (CBN) produced both ocular toxicity and neurotoxicity.

  • Cannabigerol (CBG) completely lacked these toxicities.

  • Cannabigerol (CBG) caused a significant reduction in intraocular pressure with consistent administration, and the magnitude of pressure reduction was greater than cannabinol (CBN).

A comparison of the ocular and central effects of delta 9-tetrahydrocannabinol and cannabigerol - PubMed

Neither delta 9-THC nor cannabigerol altered the rate of formation of aqueous humor. On the other hand, both cannabinoids produced a two-to three-fold increase in aqueous outflow facility. These results suggest that cannabigerol and related cannabinoids may have therapeutic potential for the treatment of glaucoma.

Summary: THC and CBG both produce a similar IOP reduction, which is achieved by a two-to three-fold increase in aqueous outflow facility without any alteration in the rate of aqueous humor formation. Aqueous humor nourishes the anterior segment of the eye with nutrients and oxygen (it is like a clear blood in this regard), so maintaining its formation and increasing the outflow to manage intraocular pressure is very positive.

Pharmacological Aspects and Biological Effects of Cannabigerol and Its Synthetic Derivatives - PubMed

Cannabigerol (CBG) is a cannabinoid from the plant Cannabis sativa that lacks psychotomimetic effects.

Pre-clinical findings show that CBG reduces intraocular pressure, possesses antioxidant, anti-inflammatory, and anti-tumoral activities, and has anti-anxiety, neuroprotective, dermatological, and appetite-stimulating effects. Several findings suggest that research on CBG deserves to be deepened, as it could be used, alone or in association, for novel therapeutic approaches for several disorders.

Nonpsychotropic cannabinoids, abnormal cannabidiol and canabigerol-dimethyl heptyl, act at novel cannabinoid receptors to reduce intraocular pressure - PubMed

Summary: this article is potentially interesting for future directions in the application of cannabinoids for intraocular pressure management.

Cannabinol modulates neuroprotection and intraocular pressure: A potential multi-target therapeutic intervention for glaucoma - PubMed

Conclusion: CBN promotes neuroprotection, abrogates changes in ECM protein, and normalizes the IOP levels in the eye. Therefore, our observations in the present study indicate a therapeutic potential for CBN in the treatment of glaucoma.

Δ9-Tetrahydrocannabinol and Cannabidiol Differentially Regulate Intraocular Pressure - PubMed

Conclusions: We conclude that THC lowers IOP by activating two receptors-CB1 and GPR18-but in a sex-dependent manner. CBD, contrary to expectation, has two opposing effects on IOP and can interfere with the effects of THC.

Summary: our experience indicates that oral CBD can raise IOP and it can cancel the beneficial effects of CBG.

However, there is some evidence that a special formulation of CBD could potentially be used to reduce ocular surface inflammation without raising IOP.

Palmitoylethanolamide (PEA)

Palmitoylethanolamide is found naturally in foods such as egg yolks, peanuts and alfalfa. It is made by the human body. It is not a cannabinoid. Palmitoylethanolamide may be one of the most important natural compounds for glaucoma.

Palmitoylethanolamide (PEA), has been found to be naturally occurring in all tissues of the human body so far examined. The eyes of glaucoma patients have significantly decreased levels of palmitoylethanolamide, especially the ciliary body, an important tissue in the regulation of intraocular pressure (IOP). Multiple studies suggest that PEA may have a protective role in glaucoma, particularly with respect to the regulation of intraocular pressure and reduction of neuroinflammation.

Ocular hypotensive effect of oral palmitoyl-ethanolamide: a clinical trial - PubMed

Conclusions: Systemic administration of PEA reduces IOP in patients with glaucoma and ocular hypertension. PEA could be a valuable tool for the treatment of glaucoma

PEA has been discussed on Ask FitEyes in several topics so far:

Palmitoylethanolamide (PEA) -- Natural Products: Evidence for Neuroprotection to Be Exploited in Glaucoma | Ask FitEyes

PEA effectiveness in reducing IOP | Ask FitEyes

The topic above includes some feedback from users.

There are other reports in the email discussion archive, such as this one:

[FitEyes Discussion 47726] Report: PEAmium significantly reduces IOP - All - FitEyes Discussion

Speaking to this issue, I have been using only one dose of PEA daily for three months and my last two readings at my doctor’s office a week apart were both as much as 3-5 points lower than the average readings over the past decade.

Omega-3

Common omega-3s include EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), found in seafood (fish and shellfish), and ALA (alpha-linolenic acid) found in plants.

Oral Omega-3 Supplementation Lowers Intraocular Pressure in Normotensive Adults | Ask FitEyes

Conclusions: Oral omega-3 supplementation for 3 months significantly reduced IOP in normotensive adults. To our knowledge, this is the first study to report that omega-3 fatty acids lower IOP in humans.

A dietary combination of omega-3 and omega-6 polyunsaturated fatty acids is more efficient than single supplementations in the prevention of retinal damage induced by elevation of intraocular pressure in rats - PubMed

Conclusions: This study demonstrates that a 6-month supplementation with a combination of omega-3 and omega-6 PUFAs is more effective than single supplementations, since the EPA + DHA + GLA dietary combination prevented retinal cell structure and decreased glial cell activation induced by the elevation of IOP in rats.

Dietary omega 3 fatty acids decrease intraocular pressure with age by increasing aqueous outflow - PubMed

Conclusions: Increasing dietary omega-3 reduces IOP with age because of increased outflow facility, likely resulting from an increase in docosanoids. This indicates that dietary manipulation may provide a modifiable factor for IOP regulation.

Glaucoma and Antioxidants: Review and Update - PMC

Nguyen et al. [16] measured intraocular pressure and aqueous humour outflow in rats given an omega 3-deficient diet, and found increased IOP and reduced outflow, compared with rats with normal dietary omega 3 fatty acids. Schnebelen et al.

The following study is interesting:

Omega-3 Fatty Acids Improve Vision In Glaucoma | FitEyes.com

... the positive clinical improvements obtained in this pilot study [are] striking, and they demonstrate the value of high doses of EPA and DHA for neuroinflammation and neurodegeneration in glaucoma patients.

Forskolin

Forskolin is an active ingredient in Coleus forskohlii, an herb in the Mint family that is traditionally used in Ayurvedic medicine. It grows in tropical regions of Asia such as Nepal, India, and Thailand.

Natural Products: Evidence for Neuroprotection to Be Exploited in Glaucoma - PMC

Forskolin has been shown to be effective in lowering IOP in rabbits, monkeys [242,243,244], and humans [242,243,244,245,246]. In an open label pilot study enrolling 16 POAG patients, supplementation with forskolin, rutin, and vitamins B1 and B2 potentiated the hypotonizing effects of pharmacological treatments [247]. Similarly, in a randomized controlled trial (97 subjects), oral administration of forskolin and rutin was associated with a better control and a further reduction of IOP in POAG patients poorly responsive to multitherapy treatment [248].

More recently, Mutolo and colleagues (2016) reported a reduction of IOP values and an improvement of PERG amplitude in POAG patients under IOP-lowering medications and treated with a combination of forskolin, homotaurine, carnosine, and folic acid [249].

Rutin and Forskolin Combination

Rutin is a plant pigment found in certain fruits and vegetables. Buckwheat is a well-known source of rutin.

Oral administration of an association of forskolin, rutin and vitamins B1 and B2 potentiates the hypotonising effects of pharmacological treatments in POAG patients - PubMed

Conclusions: These data show for the fi rst time that forskolin and rutin given through the oral route appear to reach the ocular district, where they can act in synergy with topical pharmacological treatments, and contribute to the control of intraocular pressure.

Oral administration of forskolin and rutin contributes to intraocular pressure control in primary open angle glaucoma patients under maximum tolerated medical therapy - PubMed

Conclusions: Forskolin and rutin given as oral treatment appear to contribute to a better control and a further small reduction of IOP in patients who were poorly responsive to multitherapy treatment.

Hesperidin

Hesperidin is a natural bioflavonoid, a type of plant pigment found primarily in citrus fruit. Oranges, grapefruit, lemon, and tangerines all contain hesperidin.

Anti-glaucoma potential of hesperidin in experimental glaucoma induced rats - PubMed

Hesperidin treatment significantly reduced the increased intraocular pressure (IOP) level in dextrose induced ocular hypertension than saline treated rats. The effect of hesperidin was comparable to the positive control acetazolamide. Similarly, hesperidin treatment significantly reduced the IOP level in prednisolone acetate induced ocular hypertension than saline treated rats.

Flavonoids

Flavonoids are a diverse group of yellow-colored nutrients found in almost all fruits and vegetables as well as in grains, flowers, tea and wine. Flavonoids are the largest group of phytonutrients, with more than 6,000 types identified so far.

Natural Products: Evidence for Neuroprotection to Be Exploited in Glaucoma - PMC

High concentrations of flavonoids are present in fruits and vegetables but also in red wine and chocolate [207]. These compounds have been shown to exert antioxidant and anti-inflammatory effects in different pathological states, including cancer, cardiovascular diseases, and neurodegenerative disorders [208].

Clinical data analyzed in systematic reviews suggest that flavonoid intake can help in maintaining or restoring the visual field in patients with OHT or glaucoma, although no significant effects were observed on IOP values [209,210].

Dietary intake of flavonoids has been reported to reduce the risk of cataract and AMD in other studies.

Baicalein

Baicalein is a natural flavonoid that has potent anti-inflammatory, anti-oxidative, and anti-apoptotic properties. It has been used in the clinical treatment of cancers, inflammation, and cardiovascular diseases and it is considered to be safe. It has also shown protective effects against ischemia-induced neurodegeneration in pre-clinical models.

Baicalein affects multiple biochemical pathways that are strongly implicated in the pathogenesis of many ocular diseases, such as cataract, glaucoma, AMD and diabetic retinopathy. Here I am focusing only its effects on intraocular pressure.

Baicalein has been demonstrated to regulate fluid secretion, cell contraction, and extracellular matrix (ECM) homeostasis in various cell types, raising the possibility that it may regulate outflow resistance in human trabecular meshwork cells and thus lead to a reduction in intraocular pressure.

Mechanistic Effects of Baicalein on Aqueous Humor Drainage and Intraocular Pressure - PubMed

Summary: This study demonstrated that Baicalein significantly lowered the IOP by about 5 mmHg in living mice. Consistent with that, Baicalein further increased the aqueous humor outflow facility by up to 90% in mouse eyes.

Baicalein was investigated on human trabecular meshwork cells where it was found to modulate cell relaxation and volume regulation, influencing the aqueous humor outflow facility and thereby reducing intraocular pressure.

Resveratrol

Resveratrol is a natural compound found in red grape skin, Japanese knotweed (polygonum cuspidatum), peanuts, blueberries and some other berries.

Topical trans-resveratrol ameliorates steroid-induced anterior and posterior segment changes in rats - PubMed

We observed that treatment with trans-resveratrol results in significant and sustained IOP reduction in SIOH rats.

In conclusion, repeated dose topical application of trans-resveratrol produces sustained IOP lowering effect, which is associated with increased level of aqueous humor MMP-2, normalization of TM and retinal morphology and restoration of retinal redox status.

Co-encapsulated resveratrol and quercetin in chitosan and peg modified chitosan nanoparticles: For efficient intra ocular pressure reduction - PubMed

Natural anti-oxidants resveratrol and quercetin possess the ability to reduce intraocular pressure efficiently. Concurrent administration of resveratrol and quercetin was able to enhance the bioavailability of resveratrol. Present research work describes upsurge of quercetin in resveratrol loaded chitosan nanoparticles (NPs) and polyethylene glycol (PEG) modified chitosan NPs for improved delivery and synergic effects on reducing intraocular pressure for the treatment of glaucoma.

Melatonin

Melatonin is a natural chemical found in plants and animals. It is primarily known as the hormone associated with control of the sleep-wake cycle. It is sold as a dietary supplement in some countries, including the USA. Melatonin is of great interest in glaucoma, beyond just its effects on IOP.

Natural Products: Evidence for Neuroprotection to Be Exploited in Glaucoma - PMC

In addition to its neuroprotective properties, melatonin also shows hypotensive direct effects on IOP. Oral or topical administration of melatonin reduced IOP in rabbits [140,141,142] and monkeys [143]. The topical administration of melatonin decreased IOP in normotensive control and glaucomatous DBA/2J mice via the MT2 receptor [144].

In human normotensive subjects, Samples et al. found that oral melatonin reduced IOP by about 10% [145]. IOP reduction was reported in patients that underwent cataract surgery when treated with melatonin [146]. More recently, a short-term prospective study showed a reduction of IOP value in normotensive subjects taking a melatonin-based supplement [147]. However, the study lacked a placebo group, and the reported IOP reduction was only limited to 1 mmHg. Pescosolido and colleagues (2015), in a pilot study on 10 POAG patients treated with multiple hypotensive topical drugs, reported that oral treatment with agomelatine, a melatonin analogue, was able to significantly further reduce IOP [148].

Saffron

Saffron is a vivid crimson-colored spice derived from the flower of Crocus sativus. It is native to Asia, where it has been used for thousands of years in medicines, perfumes, dyes, and as a delicate and mysterious flavoring for foods and beverages. (The taste is described as mysterious because it seems that everyone experiences it differently.)

The ocular hypotensive effect of saffron extract in primary open angle glaucoma: a pilot study - PubMed

Studies on saffron extract suggest that it may exert a protective effect in patients with glaucoma. Oral consumption of aqueous saffron extract for three weeks was able to reduce intraocular pressure (IOP) in primary open-angle glaucoma [68], from a mean IOP of 12.9 ± 3.7 mmHg to 10.9 ± 3.3 mmHg after three weeks of intervention as compared to the control group (mean baseline IOP of 14.0 ± 2.5 mmHg and 13.5 ± 2.3 mmHg after three weeks).

Mirtogenol

The branded ingredient consists of Mirtoselect®, a registered trademark name for bilberry fruit extract and Pycnogenol, a registered trademark name for pine bark from a tree known as Pinus pinaster.

The active ingredients in Pycnogenol can also be extracted from other sources, including peanut skin, grape seed, and witch hazel bark.

Many FitEyes members use a generic version of Mirtogenol consisting of a bilberry fruit extract and either pine bark extract or grape seed extract, with grape seed extract being more popular (and more efficacious as far as I know).

Green Tea

Green tea is a type of tea that is made from Camellia sinensis leaves and buds that have not undergone the same process which is used to make black teas.

Green tea-a new perspective of glaucoma prevention - PubMed

Conclusion: People who have increased IOP or risk factors for glaucoma development, could benefit from drinking green tea or its concentrated extracts in moderate doses.

Mushrooms

Lowering the Intraocular Pressure in Rats and Rabbits by Cordyceps cicadae Extract and Its Active Compounds - PubMed

[An] extract of Cordyceps cicadae mycelium, a traditional medicinal mushroom, was studied for its potential in lowering IOP in rat and rabbit models. Data showed that Cordyceps cicadae could significantly (60.5%) reduce the IOP induced by microbead occlusion after 56 days of oral administration.

Intraocular pressure-lowering effect of Cordyceps cicadae mycelia extract in a glaucoma rat model - PubMed

Cordyceps cicadae mycelia extract may be beneficial for preventing or treating glaucoma due to its significant IOP-lowering and antioxidant activities.

The Royal King Culinary-Medicinal Mushroom, Pleurotus tuber-regium Sclerotium (Agaricomycetes), a Potential Source of Drug for Interocular Pressure Management - PubMed

This work further confirms P. tuber-regium as a candidate to study for a source of drug that could be useful in IOP management in clinical practice.

Vitamin C

The history of vitamin C and intraocular pressure is quite interesting and controversial.

Natural therapies for ocular disorders, part two: cataracts and glaucoma - PubMed

Vitamin C in high doses has been found to lower IOP via its osmotic effect.

The osmotic effect of vitamin C (or urea or any other osmotic agent) is not a practical solution for managing IOP. However, it is possible that vitamin C could help in other ways, as the next study suggests:

Ascorbic Acid Modulation of Iron Homeostasis and Lysosomal Function in Trabecular Meshwork Cells - PMC

Conclusions: Our results suggest that the reported decrease of Vitamin C levels in plasma and aqueous humor can compromise lysosomal degradation in the outflow pathway cells with aging and contribute to the pathogenesis of glaucoma. Restoration of physiological levels of Vitamin C inside the cells might improve their ability to degrade proteins within the lysosomal compartment and recover tissue function.

Here's an archived FitEyes discussion on Vitamin C and IOP. (One of many.)

[FitEyes Discussion 38806] Eye Pressure Lowering Effect of Vitamin C Purpose - All - FitEyes Discussion (login required)

Here's an interesting study on the topic:

Ascorbic acid metabolites are involved in intraocular pressure control in the general population - PubMed

We show that O-methylascorbate, a circulating Vitamin C metabolite, has a significant IOP-lowering effect.

Astragalus

At least one FitEyes member has reported that the herb Astragalus membranaceus significantly reduced his IOP. That potential is supported by this pre-clinical study.

Astragaloside IV Attenuates Ocular Hypertension in a Mouse Model of TGFβ2 Induced Primary Open Angle Glaucoma - PubMed

Cherry Extract

Application of Cornelian Cherry Iridoid-Polyphenolic Fraction and Loganic Acid to Reduce Intraocular Pressure - PubMed

The influence of loganic acid and the polyphenolic fraction isolated from Cornelian cherry fruit was investigated. We found a strong IOP-hypotensive effect for a 0.7% solution of loganic acid, which could be compared with the widely ophthalmologically used timolol. About a 25% decrease in IOP was observed within the first 3 hours of use. (animal model)

Persimmon Leaf Extract (Diospyros kaki)

The Intraocular Pressure-Lowering Effect of Persimmon leaves ( Diospyros kaki) in a Mouse Model of Glaucoma 2019

We demonstrated that Ethanol Extract of Diospyros kaki reduced elevated intraocular pressure (IOP) in [two] mouse models of glaucoma by measurements with a tonometer. Collectively, our results suggested that [Persimmon Leaf Extract (Diospyros kaki)] could be an effective therapeutic and IOP-lowering agent for preventing and treating retinal degenerative diseases such as glaucoma.

Vitamin D

1α,25-Dihydroxyvitamin D(3) and its analog, 2-methylene-19-nor-(20S)-1α,25-dihydroxyvitamin D(3) (2MD), suppress intraocular pressure in non-human primates - PubMed

Topical administration of 1α,25-(OH)(2)D(3) or its analog, 2-methylene-19-nor-(20S)-1α,25-dihydroxyvitamin D(3) (2MD), markedly reduces IOP in non-human primates.

However:

Vitamin D and intraocular pressure--results from a case-control and an intervention study - PubMed

Conclusion: This study in healthy participants revealed no associations between serum 25(OH)D levels and IOP, and administration of vitamin D3 to participants with low levels of 25(OH)D did not affect IOP. These results do not support a role of vitamin D in the regulation of IOP.

Vitamin B-6

An old Russian study on patients with glaucoma and early stages of cataract reported that eye instillation of low doses of pyridoxine hydrochloride for 20 days affected vision (with changes in visual acuity and enlargement of visual field) and reduced IOP and Becker’s coefficient.

Source: Ianovskaia, N.P.; Shtol’ko, V.N.; Burlakova, E.B. Effect of low doses of emoxipine and pyridoxine hydrochloride on the status of patients with cataract and glaucoma. Bull. Exp. Biol. Med. 1993, 115, 479–481.

A-C Carbamide by Standard Process

Carbamide is an organic compound commonly known as urea. Urea is the principal nitrogenous waste product of metabolism and is generated from protein breakdown. It is eliminated from the body almost exclusively by the kidneys in urine.

The product A-C Carbamide by Standard Process consists mainly of a proprietary blend of urea and arrowroot.

Feedback from FitEyes members:

I, for one, found no IOP lowering effect from Standard Process AC Carbamide, and it seemed to upset my system.

Oral urea as an osmotic ocular hypotensive agent - PubMed

Intravenous urea has proved to be an effective agent for the reduction of IOP. The present study clearly indicates that urea is effective orally when administered at a dosage of 1.5 grams per kilogram.

NOTE: oral urea is intended as a short term treatment. It is not practical or efficacious for routine daily IOP management. To achieve the published result would likely require consuming nearly an entire bottle of A-C Carbamide per day for a 75-90 kg person -- and that is certainly not recommended.

L-Arginine

The effect of L-arginine on intraocular pressure in the human eye - PubMed

Results: The mean IOP of the L-arginine group was significantly decreased during infusion, but recovered rapidly after infusion. The mean IOP of the control group increased during infusion. The changes in pupillary diameter, refraction, and accommodative amplitude before and after infusion of L-arginine were not significant. L-Arginine significantly elevated the level of nitrite in the aqueous humor compared with the controls.

NOTE: not practical. This study used an intravenous drip-infusion.

L-Taurine

[Effect of the mixture of timoptol and amino acid taurine in the bioregulation of the intraocular pressure in rabbits] - PubMed

Conclusions: The results proved that in the mixture of antiglaucomatic Timoptol and amino acid Taurine a new biologically active substance, the bioregulator is created by interaction. This metabolite as "bioantiglaucomatic" showed several times higher effect on the IOP decrease compared with Timolol or Taurine alone. The showed effect on IOP based on interaction of amino acid mixture with antiglaucomatic is specific and efficacy together with duration changed according the type of amino acid.

Fennel

Fennel (Foeniculum vulgare Mill.) is an aromatic herb in the carrot family commonly grown in vegetable and herb gardens in many parts of the world.

Oculohypotensive effects of foeniculum vulgare in experimental models of glaucoma - PubMed

NOTE: Oculohypotensive means "reducing intraocular pressure."

Conclusions: The aqueous extract of Foeniculum vulgare possesses significant oculohypotensive activity, which was found to be comparable to that of timolol. Further investigations into the mechanism of action, possible toxicity and human clinical trials are warranted before the Foeniculum vulgare finds place in the arsenal of antiglaucoma drugs prescribed by physicians.

A FitEyes member with a tonometer reported:

I can report that a fennel eye drop does actually work but, like forskolin eye drops, the effectiveness is not long lasting. Perhaps a 20% reduction but as I say there isn’t much data yet with this data being “murky” due to the other eye drops I use. It takes a while to “kick in” and seems to last around 4-5 hours and is not much use to me overnight which is where I do have problem(s). So this is more out of interest rather than an ongoing experiment.

The other thing is that it dries my eye out quite a bit which takes me back to when I first started using eye drops. So am cautious about this aspect.

Capsanthin

Extraction of capsanthin from Capsicum annum L fruits and its effect on carbomer-induced intraocular pressure in Albino Wistar rats - PubMed

Simplified abstract:

We showed that the oral supplementation of capsanthin from a food source can reduce the intraocular pressure in rats.

NOTE: this study may be biased. I refrained from quoting sections of it because there they contain exaggerated claims.

Capsanthin from Capsicum annum fruits exerts anti-glaucoma, antioxidant, anti-inflammatory activity, and corneal pro-inflammatory cytokine gene expression in a benzalkonium chloride-induced rat dry eye model - PubMed

Oral supplementation of Capsicum annum resulted in a statistically significant decrease in intraocular pressure (IOP) (p < .0001) in rats.

Black currants

Effects of black currant anthocyanins on intraocular pressure in healthy volunteers and patients with glaucoma - PubMed

Conclusions: Our results suggested that oral administration of black currant anthocyanins may induce a beneficial decrease in IOP levels in healthy subjects as well as in patients with glaucoma.

Like a lot of the natural compounds mentioned here, black currants have additional benefits for supporting healthy eyes beyond support for healthy intraocular pressure. For example:

Two-year randomized, placebo-controlled study of black currant anthocyanins on visual field in glaucoma - PubMed

Conclusions: Our results suggest that oral administration of black currant anthocyanins may be a safe and promising supplement for patients with open angle glaucoma in addition to anti-glaucoma medication.

Other Anthocyanins

[ProVens® in the Therapy of Glaucoma and Ocular Hypertension] - PubMed

Conclusion: Intake of a dietary supplement containing proanthocyanins from the bark of the maritime pine tree Pinus pinaster together with a mixture of herbal antioxidants appears to be one of the methods of how to improve the control of intraocular pressure, particularly in patients with ocular hypertension

ProVens contains:

  • 50 mg of extract from maritime pine bark 
  • 100 mg of green tea extract (Epigallocatechin gallate - EGCG)
  • 3 mg of blueberry extract

Recommended adult dose is 1-2 tablets daily

As with Mirtogenol, a generic version of the same ingredients listed above can be used and the results are expected to be identical or even superior.

Therapeutic Effects of Anthocyanins for Vision and Eye Health - PubMed Two-year randomized, placebo-controlled study of black currant anthocyanins on visual field in glaucoma - PubMed

NOTE: the study above makes no mention of intraocular pressure

Chinese Forbidden Black Rice (rich in anthocyanins)

There are no scientific studies on black rice and IOP (as far as I know). But these two case reports are so interesting I can't ignore them.

A case report from FitEyes:

I just thought I'd share something I've observed with my own eye pressure management. Brief background: I'm a glaucoma suspect and use a range of drops to keep my pressure controlled during the day. This tends to work pretty well, but I can have rather substantial spikes when I lie down and sleep as I'm sure many of you have noticed. So my eye pressure can very easily and quickly more than double while lying down -- e.g. I've recorded my eye pressure using my iCare Home 2 at around 14 prior to lying down/sleeping/napping, and measured it immediately upon waking to find it at 33, for instance. 

I've had this pattern for quite a while. However, I've found that consumption of foods relatively rich in anthocyanins seems to result in lower eye pressure -- particularly if these foods are eaten in the evening. For instance, after consuming black rice and black currant every day for around a week, my eye pressure progressively ticks down when I measure upon waking: 27 to 25 to 23 to as low as 20. It does not seem to really impact my eye pressure during the day at least as far as I have noticed, but the impact on my nocturnal / supine pressure seems to be rather significant.

Just a few things I've noticed as I've tested this over the past 2-2.5 months:

  • generally not as impactful with supplements I've tried (although this could be a function of supplement quality/purity or timing or the food it's taken with or not)
  • I seem to notice an impact if I eat, for instance, 50-60 grams of black rice; or if I eat around 20-30 grams of black currants; however, it seems black rice has more of a measurable impact. This could be because it's easier to eat more of it or maybe due to an interaction that's occurring?
  • I've tried a very wide range of supplements and eye drops in various dosages, patterns, etc. and have thus far not found anything else that has been able to make my morning eye pressure measurements budge. 
  • I've tested this by first eating black rice/black currant daily in July for around 2 weeks. I then stopped for around 2 weeks. I repeated this pattern twice, and both times there was a dramatic increase in eye pressure (average of 22-23 in the morning vs an average of 30 or a range of 29-33)

I know a lot of you are already familiar with anthocyanins and already take black currant supplements. However, it may be worth considering trying to get these into your diet and potentially considering the impact their consumption can have based on the time of day when consumed? 

And a follow up from someone else:

After reading Patrick's post on black rice (above), I decided to try it myself. The effects on my pressure have been quite amazing. If we can all duplicate this, I think we all need to buy Patrick a drink. First, let me set the stage. My pressures are somewhat unlike any others here. I have my lowest pressures when I get out of bed in the morning, typically in the mid-teens. My pressures rise throughout the morning into early afternoon, frequently reaching 20 in my left eye and up to mid-30s in my right eye. I asked my wife to prepare some black rice for my dinner. The day after my first dinner, I noticed very little change in my pressure. The second night, we had take-out quesadillas that came with queso cheese sauce. I poured some of the queso cheese sauce on top of the black rice. It tasted delicious. The next day the pressures in my right eye did not go above 25. In other words, almost a 10 mm drop. I continued the rice and queso for dinner every night for a week. It was so startling; I could not believe it.

Now, I also had MicroPulse CPC about 8 weeks prior with no effect on IOP. My first thought was perhaps this large drop was due to that delayed response to MP3 and not from the black rice. I went without black rice for three or four days and my peak pressures went back up to the mid-30s. I went back on the black rice with queso sauce, and my pressures went back to the mid-20s. I am really astounded. Now, if anyone wants to try what I'm doing, we are getting the Lotus Foods Forbidden Rice from Whole Foods, or it can also be ordered on Amazon.

I tried the same black rice myself and I seemed to find a small IOP reduction, but it wasn't as dramatic as reported above, and I would have to track my IOP data carefully to determine if the effect was real. However, both of the two individuals above continue to report good results from eating black rice.

dietary-supplements iop:intraocular-pressure • 4.3k views
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This study suggests I need to add Vitamin K1 to this list.

The Effect of Dietary Vitamin K1 Supplementation on Trabecular Meshwork and Retina in a Chronic Ocular Hypertensive Rat Model - PubMed

Conclusions: High Vitamin K1 intake inhibited the loss of retinal ganglion cells during glaucomatous injury. A transient decrease in the IOP was observed in the high Vit K1 group, implying a potential effect of VitK1 on aqueous outflow. Retinal ganglion cells protection by high Vit K1 supplementation may be due to the IOP-lowering effects as well as neuroprotective effect. Further research is required to delineate these processes.

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Two more additions to the list:

Lowering of intraocular pressure by topical application of Daucus carota seed extract in rabbits - PubMed

In normotensive rabbits topical application of Daucus carota seed extract at the concentration of 0.3, 0.6 and 1.2% resulted in mean IOP reduction of 19.33. 23.20 and 25.61% respectively from baseline.

What is Daucus carota - Wikipedia

Daucus carota's common names include wild carrot, European wild carrot, bird's nest, bishop's lace, and Queen Anne's lace.

Intraocular pressure-lowering activity of topical application of Aegle marmelos fruit extract in experimental animal models - PubMed

Conclusion: A. marmelos fruit extract showed significant IOP-lowering activity in experimental animal models.

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