Leading a Healthy Lifestyle
Chat Highlights
February 6, 2002

Norma Devine, Editor

On Wednesday, February 6, 2002, Dr. Rick Wilson, a glaucoma specialist at Wills, and the glaucoma chat group discussed "Leading a Healthy Lifestyle."

Moderator:  Welcome, Dr. Rick.  Our topic tonight is "Leading a Healthy Lifestyle."  

Dr. Rick Wilson:  For starters, I suggest not eating as fast as I just did.  I just finished giving a two-hour lecture.

Moderator:  This is the time of year when New Year's resolutions are already forgotten.  We know that you exercise regularly.  What motivates you?

Dr. Rick Wilson:  When I was 38 years old I had my blood pressure checked for the first time in years.  It was 145/105 mm Hg.  I had no history of anything in my family.  I lost 15 pounds,  started swimming four times a week, and cut back on my work.  My blood pressure dropped to normal and has stayed there without meds. That is my motivation to keep exercising. 

P:  How does smoking tobacco affect glaucoma?  Can it raise IOP (intraocular pressure) or cause optic nerve damage through other mechanisms?

Dr. Rick Wilson:  Smoking tobacco does not elevate IOP, but the nicotine is a vasoconstrictor.  The British have shown that smoking slows the blood flow to the posterior part of the eye. Since blood circulation seems to be the second greatest risk factor for glaucoma, anything that impedes circulation is harmful to glaucoma.  I am sure the extent of the harmful effect varies tremendously, but I caution patients to cut their smoking as much as possible or quit if they can.

P:  I assume that the main effect on glaucoma of a healthful life style is better circulation in the vascular system in the eye.  Has there been testing to verify that effect?

Dr. Rick Wilson:  There has been testing to verify the effect of exercise.  Good nutrition and antioxidants have been proven to be helpful in delaying age-related macular degeneration, and I think cataracts, as well.

P:  We have all heard that regular exercise helps lower IOP.  Does it make a difference what kind of exercise, i.e., aerobic, strength training, etc?

P:  I know exercise is important to general health, but how important is it specifically to the health of the eyes?  Does it really affect them?

Dr. Rick Wilson:  There is a mile of blood vessels in every pound of fat.  Excess fat is not healthful.  I don't know how losing weight causes lower eye pressure and lower blood pressure and better blood sugars, but it does.  It also lowers eye pressure if the exercise is aerobic and done for at least 20 minutes, four times a week.  

P:  I heard that smoking is a risk factor for cataracts, too.  It that true?  

Dr. Rick Wilson:  Yes, that is true.  And glaucoma is a definite risk factor for cataracts, but not the other way around.  

P:  Does really cold air hurt the eyes or glaucoma at all?

Dr. Rick Wilson:  It can cause dry and "wind-burned" eyes that become very irritable.  But cold air does not seriously harm the eyes unless the cold is severe and causes frostbite.

P:  Would aerobic exercise lower pressure when it is already too low (hypotony)?

Dr. Rick Wilson:  Usually not, since it improves muscular tone and circulation.

P:  How about eating nutritious food?  Is there such a thing as too much?  For example, are more than four oranges and/or grapefruit a day too much?

Dr. Rick Wilson:  It is much harder to overdose on vitamins exclusively from food, although my mother did it.  To her, if a certain amount was good, then much more would be better.  She got a juicer and started drinking the juice of a bag of carrots a day.  The next time I saw her, she was orange colored.  Four oranges and a grapefruit sounds okay to me.

P:  When I am in a restaurant that has a smoking area, even if it is isolated, my eyes burn and sting.  Aside from the obvious discomfort, is the smoke harmful?

Dr. Rick Wilson:  No, but it points usually to dry eyes.  Perhaps taking along some artificial tears and using them every 10 to 15 minutes would help.

P:  How about high altitudes?  I go skiing several weeks a year at altitudes that range from 9,000 to 12,000 feet.   Would the lower oxygen cause a problem with eyes even though I am exercising very hard?

Dr. Rick Wilson:  High altitudes can decrease oxygen saturation in the blood and can cause hemorrhages in the retina.  It might be beneficial to have an Eye MD check your retinas when you return from a trip to anywhere, especially at the high end of the range you mentioned.  It is not clear whether there would be any effect on glaucoma.

P:  Can you give us a brand name for antioxidants that might be helpful for the eyes?

Dr. Rick Wilson:  I hesitate to mention brand-name vitamins on the web site.  Vitamin E, C, the B vitamins and zinc are multivitamins that are thought to be helpful to the retina and possibly glaucoma.  A good multivitamin (I use a generic) with a little added E and C are a poor man's antioxidant combination.

P:  There was a basket of ICaps samples containing lutein in the eye doctor's office the other day.  Is that something recommended, or does a good diet provide enough of those nutrients?  

Dr. Rick Wilson:  All vitamins just include what the present research knows about. It changes all the time,  and I am sure we are missing many micronutrients that we don't know about.  The absolute best antioxidants at this point are spinach, kale, and broccoli.

P:  Can lack of nutrition affect glaucoma? What about caffeine?  

Dr. Rick Wilson:  Possibly, but the malnutrition would probably have to be significant.  There is no evidence that caffeine affects glaucoma.  Patients who are subject to pressure rises with too much liquid intake shouldn't be drinking over four cups an hour.

P:  What's the best way to cook kale and broccoli?  

Dr. Rick Wilson:  The best way to cook the vegetables is in their own juices with some seasonings in a microwave oven.  I am not a cook so can't give you recipes.  The more water that washes away the nutrients, the fewer nutrients you get.  

P:  Thank you so much, Dr. Rick.   I hate spinach, kale and broccoli, but I'll try.

P:  How about broccoli or spinach quiche?

Dr. Rick Wilson:  Works for me.  

Moderator:  How about chocolate?

Dr. Rick Wilson:  Chocolate is the Vitamin C that I mentioned earlier.  Sleeping brings down IOP, exercise brings down IOP.  Dehydration brings down IOP, but is not compatible with life.

P:  I am convinced that golf is good for the eyes. Besides the exercise (if you walk fast and carry your bag), there's the constant refocusing of the eyes, close and near, in the air, in the trees, etc.  I need to persuade my wife of that.

P:  I need to get more sleep!

Dr. Rick Wilson:  Night all.  Have a very healthful week with a lot of  kale, broccoli and spinach. 

End of highlights for February 6, 2002.

On February 13, Dr. Wilson discussed "Lasers for Glaucoma" in the Chat room. Click here for highlights of that meeting.

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