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Optometric ManagementClinical: Glaucoma

Exploring the Gut-Glaucoma Connection

The article explores the emerging research on the relationship between gut dysbiosis and glaucoma. It outlines the role of gut microbiota in systemic health, the factors that can lead to an imbalance in this microbiota, and how such an imbalance may contribute to glaucoma. The article also offers provider tips for managing this complex relationship.

Key Points:
  • Gut microbiota, comprising mainly of Proteobacteria, Actinobacteria, Firmicutes, and Bacteroidetes, plays a critical role in immune function and nutrient metabolism.
  • Dysbiosis can occur due to modifiable lifestyle choices like diet and physical activity, as well as nonmodifiable factors like age and genetics.
  • Gut dysbiosis may lead to systemic immune responses and the translocation of microbes to distant sites, including the eye, creating a negative gut-eye axis.
  • Three main factors in the gut-glaucoma axis are systemic bacterial dissemination, neuroinflammation, and obesity.
Additional Points:
  • Treating Helicobacter pylori in glaucoma patients may stabilize/improve VF testing and IOP reduction.
  • Neuroinflammation in the optic nerve is an under-appreciated contributing factor in glaucoma.
  • Obesity can increase intraocular pressure (IOP) by making the blood more viscous, affecting the outflow of aqueous humor from the eye.
  • Understanding the gut-glaucoma axis offers new avenues for both diagnosis and treatment, emphasizing the importance of lifestyle choices in managing this eye condition.
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“Since ‘…we are what we eat and the fact that the microbes are not passive partners in the gut [which] could positively influence human health…,’ will restaurant menus soon include the microbe count and concentration of meal options?”
– Austin Lifferth, OD, FAAO

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