Elevations and large fluctuations in eye fluid pressure are risk factors for glaucoma, a disease that results in optic nerve damage and blindness. Experts disagree on when it is best to monitor eye fluid pressure and when it is best to initiate medical treatment.

While pharmacological treatments reduce glaucoma risk, they can be expensive and cause unwanted side effects. In addition, knowing one is at risk for glaucoma can increase stress which can further elevate eye fluid pressure and decrease quality of life. 

Dada et al. [American Journal of Ophthalmology] investigated whether mindfulness meditation could reduce eye fluid pressure and fluid pressure fluctuations, thus delaying or reducing the need for pharmaceutical treatment. Normal eye fluid pressure is ≤ 20 mm Hg, and every 1 mm Hg decrease in pressure results in a 10% decrease in glaucoma risk.

The researchers randomly assigned 60 patients attending a New Delhi glaucoma clinic with eye fluid pressure elevations of 21-30 mm Hg (average age = 52 years) to mindfulness meditation or a wait-list control group. The mindfulness group included two one-hour trainings in breath-focused mindfulness meditation and 60-minutes  of daily practice  at home for 6 weeks.

Study personnel called participants on a weekly basis to encourage continued practice and insure correct technique. Participants completed assessments at baseline and six weeks after baseline (or after intervention) on measures of eye fluid pressure (taken every 3 hours across  a 15-hour interval), optic disc blood vessel density and perfusion, a single 8:00 AM blood serum cortisol, and self-reported quality-of-life.

The results showed the mindfulness group had a significantly greater reduction in eye fluid pressure (-3.9 mm Hg) than controls (-0.18 mm Hg). The mindfulness group also showed significant reductions in diurnal pressure fluctuation (-2.14 mm Hg) while controls did not (-0.20 mm Hg).

Average optic disc blood vessel density and perfusion improved more for mindfulness than control participants. The mindfulness group also reported a significantly greater improvement in quality of life than controls.

Lastly, mindfulness practitioners saw a significantly greater decrease in morning serum cortisol (-2.54 μg/dl) than controls (+0.38 μg/dl). Serum cortisol reductions were correlated with decreased eye fluid pressure (r=-.73), reduced diurnal fluctuation in pressure (r=-.56), and improved quality of life (r=.62).

The study shows mindfulness mediation training can reduce clinically-evaluated risk factors for developing glaucoma. The reported average drop in eye fluid pressure for mindfulness participants reflects a 39% decrease in risk for glaucoma progression.

It is unclear how long this improvement persists, and how much daily meditation practice is needed to maintain it. The study is limited by its lack of published information on the extent of home practice compliance and the absence of an active control.

Reference:

Dada, T., Mondal, S., Midha, N., Mahalingam, K., Sihota, R., Gupta, S., Angmo, D., & Yadav, R. K. (2022). Effect of mindfulness-based stress reduction on IOP in patients with ocular hypertension: A randomized control trial. American Journal of Ophthalmology. 

Link to study