Effects of dietary and lifestyle recommendations on patients with glaucoma: A randomized controlled pilot trial

Introduction: Several studies have shown intra-ocular pressure (IOP) reductions following lifestyle and behavior changes in primary open-angled glaucoma (POAG) in the short term. Our aim in this study was to examine the potential of such interventions as an adjunct treatment and assess their cumulative short-term effect on IOP and illness perception in patients with POAG. Methods: In this randomized, parallel-arm, single blind controlled trial, POAG patients were randomized in a 1:1 ratio to either a treatment group which received instructions on dietary and lifestyle changes in addition to their standard therapy or to a control group which continued their standard therapy. Recommendations were selected to include those previously reported to reduce IOP; including: Saffron spice supplementation, high fiber diet, avoidance of caffeine, aerobic exercise, head elevation during sleep and others. Illness perception was assessed using the Brief IPQ questionnaire. Results: 22 participants were enrolled, 3 were lost to follow-up and 19 entered analysis. Mean age was 69 +/- 12 and 12 (63%) were female. Concerns about the illness, symptoms, and feelings of control were significantly improved in the treatment group compared with controls (all P < 0.05). Mean IOP reduced in the treatment group by 1.0 +/- 3.1 mmHg (17.5 +/- 4.3-16.5 +/- 4.7) and by 0.7 +/- 4.1 mmHg in the controls (16.8 +/- 4.7-16.1 +/- 6.2) with no significant difference between them (P = 0.866). Conclusions: Dietary and lifestyle changes may improve illness perception and patient well-being, however they do not appear to affect IOP in the short term among patients with POAG.