Glaucoma
Supplements studied for glaucoma.
Overview
Among ten supplements tracked for glaucoma (22 studies), Citicoline carries the most developed evidence (medium effect size, high evidence, very high trust, WA 72; 7 studies). Early research in open-angle glaucoma suggests oral or injectable citicoline may improve visual responses without lowering eye pressure, and longer use may slow vision loss in some patients.
Ginkgo (WA 36), Bilberry (WA 48), Vitamin A (WA 48), and Alpha-Lipoic Acid (WA 44) sit in a lower band with mostly low-to-medium evidence ratings. Ginkgo shows mixed results across studies. Bilberry, often combined with maritime pine bark, may lower eye pressure in small trials. Dietary vitamin A may be linked to lower glaucoma risk, but supplement effects are unknown. Alpha-lipoic acid has only been studied in combination products.
Overall, supplement evidence for glaucoma remains limited and inconsistent. The heatmap and individual evidence reviews below summarize each supplement.
Relevant supplements
Relevant supplements sorted by DEX Score.
| Citicoline | ★★★★★ | Medium |
| Vitamin A | ★★★★★ | Low |
| Bilberry | ★★★★★ | Low |
| Zeaxanthin | ★★★★★ | Low |
| Panax Ginseng | ★★★★★ | Low |
| Lutein | ★★★★★ | Low |
| Alpha-Lipoic Acid | ★★★★★ | Low |
| Ginkgo | ★★★★★ | Very Low / None |
| Cocoa | ★★★★★ | Very Low / None |
| Vitamin B3 (Niacin) | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
10 supplements for , and rated at least stars. All purchase bands. No minimum star filter.
CiticolineView supplement →
Consider purchase·★★★★★
How we scored this▸
- Some early research in people with open-angle glaucoma shows that taking citicoline by mouth or injection may help improve visual responses but does not lower eye pressure.
- Taking citicoline 1600 mg daily for two months improved brain responses to visual signals.
- Longer use of a citicoline supplement (500 mg daily for periods over 2 years) slowed the loss of vision in some patients.
- Injections of citicoline also helped improve visual signals.
- Eye drops containing citicoline used three times a day for three years reduced loss of nerve fibers in the eye and slowed vision loss in people with well-controlled eye pressure.
- Taking citicoline combined with other nutrients slightly improved contrast vision and quality of life, but it is unclear if this is due to citicoline alone.
- More research is needed.
Browse 7 studies
Systematic reviewEfficacy of citicoline as a supplement in glaucoma patients: A systematic review2023n=424
A systematic review of 10 glaucoma studies (424 patients) found insufficient evidence that citicoline slows progression of intraocular pressure, visual field loss, or retinal nerve fiber thinning.
- Effect
- No Benefit
- Population
- Glaucoma patients
- Participants
- 424
- Ages
- 18–65
RCTCan Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebo-controlled Clinical Trial2020n=80
In 80 glaucoma patients over 3 years on IOP-lowering therapy, citicoline eye drops slowed visual field and retinal nerve fiber layer loss versus placebo.
- Effect
- Benefit
- Duration
- 3 years
- Population
- Glaucoma patients
- Participants
- 80
ObservationalEffects of Citicoline, Homotaurine, and Vitamin E on Contrast Sensitivity and Visual-Related Quality of Life in Patients with Primary Open-Angle Glaucoma: A Preliminary Study2020n=36
In primary open-angle glaucoma patients over 4 months, a citicoline-homotaurine-vitamin E combination improved contrast sensitivity and quality of life versus topical therapy alone.
- Effect
- Benefit
- Duration
- 4 months
- Dose
- 500 mg citicoline + 50 mg homotaurine + 12 mg vitamin E/day
- Population
- Glaucoma patients
- Participants
- 36
- Ages
- 18+
RCTCiticoline oral solution in glaucoma: is there a role in slowing disease progression?2013
In 41 progressing glaucoma patients over 2 years, oral citicoline slowed mean visual field progression from -1.1 to -0.15 dB/year despite controlled intraocular pressure.
- Effect
- Benefit
- Duration
- 2 years
- Population
- Glaucoma patients
Evidence of the neuroprotective role of citicoline in glaucoma patients2008
In glaucoma patients over two 60-day courses, oral or intramuscular citicoline 1,000–1,600 mg/day improved pattern electroretinogram and visual evoked potential responses, with partial regression after washout.
- Effect
- Benefit
- Dose
- 600 mg/day
- Population
- Glaucoma patients
RCTOral citicoline treatment improves visual pathway function in glaucoma2003
In 21 glaucoma patients, two 2-week courses of oral citicoline 1 g/day improved visual evoked potential latency and amplitude in 62% of eyes.
- Effect
- Benefit
- Dose
- 1 g/day
- Population
- Glaucoma patients
RCTCytidine-5'-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma1999n=25
In 25 glaucoma patients over 60 days, intramuscular citicoline 1,000 mg/day improved visual evoked potentials and pattern electroretinograms versus placebo.
- Effect
- Benefit
- Duration
- 120 days
- Dose
- 1000 mg/day
- Population
- Glaucoma patients
- Participants
- 25
BilberryView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Small studies suggest that taking bilberry extract together with maritime pine bark extract may help lower eye pressure and improve blood flow in people with glaucoma or high eye pressure.
- One study found that a supplement with these ingredients lowered eye pressure by almost 9% after 4 weeks in patients with open-angle glaucoma.
- Another study showed that taking a similar product twice a day for 6 months lowered eye pressure and improved blood flow compared to no treatment.
- There is also some evidence that bilberry anthocyanins might improve vision in patients with normal-tension glaucoma after long-term use.
- However, it is not clear if bilberry alone causes these benefits, and more research is needed.
Browse 3 studies
Effects of French maritime pine bark/bilberry fruit extracts on intraocular pressure for primary open-angle glaucoma2021n=18
A 4-week supplementation in Japanese patients with Primary open‑angle glaucoma (POAG) taking standard glaucoma medications, using a tablet with 40 mg French maritime pine bark extract + 90 mg bilberry fruit extract, resulted in a mean intraocular pressure (IOP) reduction of ~8.7% (from 17.2 to 15.7 mmHg) and ~5.7% morning IOP reduction during the intervention.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 40 mg
- Population
- Adults
- Participants
- 18
- Ages
- 20–70
RCTGinkgo biloba extract and bilberry anthocyanins improve visual function in patients with normal tension glaucoma2012n=132
A retrospective analysis of 332 normal-tension glaucoma patients found anthocyanin and ginkgo biloba supplementation over ~24 months improved visual acuity and visual field mean deviation versus no supplementation.
- Effect
- Benefit
- Duration
- ~24 months
- Population
- Women
- Participants
- 132
Clinical trialEffects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects2008n=20
In 38 adults with ocular hypertension, 2–3 months of Mirtogenol (bilberry plus pine bark, 240 mg/day) lowered IOP from 25.2 to ~22 mmHg and improved ocular blood flow versus untreated controls.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 240 mg/day
- Population
- Pregnant women
- Participants
- 20
- Avg age
- 44.8±6.5
Vitamin AView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Studies show that eating more vitamin A in the diet may lower the chance of developing glaucoma by about one-third to two-fifths.
- It’s not yet known if taking vitamin A supplements helps prevent glaucoma.
Browse 2 studies·2 meta-analyses
Systematic reviewSmoking, dietary factors and major age-related eye disorders: an umbrella review of systematic reviews and meta-analyses2022
An umbrella review found smoking and dietary factors including carotenoids have varying evidence strength for cataract, glaucoma, AMD, and diabetic retinopathy.
MetaVitamin intake and glaucoma risk: A systematic review and meta-analysis2022n=262,189
A meta-analysis of 8 studies (262,189 patients) found high vitamin A intake (OR 0.63) and vitamin B intake (OR 0.71) were associated with lower glaucoma prevalence.
- Effect
- Benefit
- Population
- Adults
- Participants
- 262,189
Alpha-Lipoic AcidView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Alpha-lipoic acid has only been studied together with other ingredients, so its effect alone is unknown.
- One study in adults with open-angle glaucoma showed that taking a supplement combining alpha-lipoic acid and other nutrients daily for 6 months did not lower eye pressure.
Browse 1 study
RCTEffect of an oral supplementation with a formula containing R-lipoic acid in glaucoma patients2020n=15
In 30 glaucoma and control subjects given an antioxidant supplement with R-lipoic acid for 6 months, plasma antioxidant status rose and malondialdehyde fell in the POAG group, with improved Schirmer test and dry-eye symptoms.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 30 g/day
- Population
- Adults
- Participants
- 15
LuteinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with open-angle glaucoma, taking a supplement with lutein, zeaxanthin, and meso-zeaxanthin daily for 18 months increased protective pigment in the eye but did not improve vision.
- Some improvement in glare-related vision was seen, which may help with daily activities.
Browse 1 study
RCTMacular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma: A Randomized Controlled Trial2021n=62
In 62 open-angle glaucoma patients, 18 months of 10 mg lutein, 2 mg zeaxanthin, and 10 mg meso-zeaxanthin significantly increased macular pigment volume versus placebo, with mesopic contrast sensitivity gains at 18 months.
- Effect
- Benefit
- Duration
- 18 months
- Dose
- 10 mg
- Population
- Adults with open-angle glaucoma
- Participants
- 62
- Ages
- 18+
Panax GinsengView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if taking Panax ginseng helps people with glaucoma.
- One small study showed that taking ginseng multiple times daily for four weeks improved dry eyes, vision during the day, and eye pain.
- Some patients with early or moderate glaucoma also had better night vision.
- More research is needed to confirm these results.
Browse 1 study
RCTEffect of red ginseng on visual function and vision-related quality of life in patients with glaucoma2021
A crossover trial in glaucoma patients found red ginseng improved daytime contrast sensitivity and ocular pain; nighttime contrast sensitivity improved in early-to-moderate glaucoma.
- Effect
- Benefit
- Population
- Patients with glaucoma
ZeaxanthinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research in people with open-angle glaucoma shows that taking zeaxanthin, lutein, and meso-zeaxanthin daily for 18 months increases the density of pigment in the eye’s macula but does not improve vision compared to not supplementing.
Browse 1 study
RCTMacular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma: A Randomized Controlled Trial2021n=20
In 62 open-angle glaucoma patients, 18 months of 10 mg lutein, 2 mg zeaxanthin, and 10 mg meso-zeaxanthin significantly increased macular pigment volume versus placebo, with mesopic contrast sensitivity gains at 18 months.
- Effect
- Benefit
- Duration
- 18 months
- Dose
- 10 mg
- Population
- Adults with open-angle glaucoma
- Participants
- 20
- Ages
- 18+
GinkgoView supplement →
Do not purchase·★★★★★
How we scored this▸
- It’s not clear if ginkgo helps with glaucoma.
- In one long-term study, people with normal tension glaucoma who took ginkgo (80 mg twice a day) for many years had less vision loss.
- A short study also found possible benefits, but another similar study did not.
- These mixed results may be due to differences in the type of ginkgo used, how long it was taken, and the severity of glaucoma when treatment began.
Browse 4 studies
Clinical trialEffect of ginkgo biloba extract on macula and peripapillary perfusion examined using optical coherence tomography angiography2025
In 34 primary open-angle glaucoma patients, ginkgo biloba extract 240 mg/day for 4 months did not significantly change OCT-A macular or peripapillary perfusion versus matched controls.
- Effect
- No Benefit
- Duration
- 4 months
- Dose
- 120 mg 2×/day
- Population
- Glaucoma patients
RCTEffect of Ginkgo biloba on visual field and contrast sensitivity in Chinese patients with normal tension glaucoma: a randomized, crossover clinical trial2014n=30
In 35 normal tension glaucoma patients, ginkgo biloba 120 mg/day for two 4-week phases significantly improved visual field indices versus placebo in a crossover trial.
- Effect
- No Benefit
- Duration
- 4 weeks
- Dose
- 120 mg/day
- Population
- Glaucoma patients
- Participants
- 30
- Avg age
- ~64
ObservationalEffect of Ginkgo biloba extract on visual field progression in normal tension glaucoma2013n=42
In 42 normal tension glaucoma patients followed 4+ years, ginkgo biloba 160 mg/day slowed visual field mean deviation decline versus pre-treatment progression rates.
- Effect
- Benefit
- Duration
- 4 years
- Dose
- 160 mg/day
- Population
- Glaucoma patients
- Participants
- 42
RCTEffect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma2003n=27
In 27 normal tension glaucoma patients, ginkgo biloba 120 mg/day for 4 weeks significantly improved pre-existing visual field damage versus placebo in a crossover trial.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 120 mg/day
- Population
- ER patients
- Participants
- 27
CocoaView supplement →
Do not purchase·★★★★★
How we scored this▸
- No summary is available.
Browse 1 study
RCTThe short-term effect of flavonoid-rich dark chocolate on retinal vessel diameter in glaucoma patients and age-matched controls2014
In glaucoma patients and controls, dark chocolate improved venous vasodilation 2 hours after intake in controls but not in glaucoma patients.
- Effect
- No Benefit
- Population
- Glaucoma patients
Vitamin B3 (Niacin)View supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not clear if niacin helps prevent or treat glaucoma.
- Some studies found that people who eat more niacin in their diet may have a lower chance of glaucoma, but this link is not consistent when other factors are considered.
- There is no research on whether niacin supplements help with glaucoma.
Browse 1 study
Niacin supplementation impairs exercise performance2021
A study found that 5 mg/kg similarly, habitual caffeine use (p=0.72), habitual aerobic exercise (p=0.08), and habitual resistance exercise (p=0.39) did not significantly affect total work performed.
- Effect
- No Benefit
- Dose
- 5 mg/kg
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Citicoline | ★★★★★72% | 7 | 0 | 32% |
| Ginkgo | ★★★★★36% | 4 | 0 | 18% |
| Bilberry | ★★★★★48% | 3 | 0 | 14% |
| Vitamin A | ★★★★★48% | 2 | 2 | 9% |
| Alpha-Lipoic Acid | ★★★★★44% | 1 | 0 | 5% |
| Cocoa | ★★★★★32% | 1 | 0 | 5% |
| Lutein | ★★★★★44% | 1 | 0 | 5% |
| Panax Ginseng | ★★★★★44% | 1 | 0 | 5% |
| Vitamin B3 (Niacin) | ★★★★★28% | 1 | 0 | 5% |
| Zeaxanthin | ★★★★★44% | 1 | 0 | 5% |