Alternative and non-traditional treatments of glaucoma

Glaucoma often exists and progresses at normal or even low intraocular pressure (IOP) levels, on the basis of IOP-independent risk factors. Pressure-independent risk factors have only begun to be explored. Decreased perfusion of the optic nerve head may result from orthostatic hypotension, nocturnal hypotension, atrial fibrillation, migraine, Raynaud's phenomenon, abnormally low intracranial pressure, autoimmune phenomena, and sleep apnea. Hemorheologic abnormalities, such as increased erythrocyte agglutinability, decreased erythrocyte deformability, increased serum viscosity, or increased platelet aggregability, may also play a role. Recent evidence has implicated oxidative stress as playing a significant role in retinal ganglion cell (RGC) damage in glaucoma. Gamma-aminobutyric acid (GABA_A) receptors are expressed on RGCs and may play a role in apoptosis induced by oxidative stress.