This Common Vitamin May Dramatically Lower Glaucoma Risk In People With High Eye Pressure
If you've ever left an eye appointment with a note about high eye pressure, you know the feeling: a little unsettling, a little unclear on what to do next.
High eye pressure (or ocular hypertension) is one of the main risk factors for glaucoma, the leading cause of irreversible blindness worldwide. Usually, the plan is to monitor it, maybe start eye drops, and check back in a few months.
But new research1 points to a common, well-tolerated form of vitamin B3 as a possible tool that hasn't traditionally been part of that conversation.
What is nicotinamide?
Nicotinamide is a form of vitamin B3, the same nutrient found in everyday foods like chicken, tuna, and peanuts.
Scientists have been interested in it for its potential to protect nerve cells, and in recent years, that curiosity has extended to the eyes, specifically, whether it might help shield the optic nerve from the kind of damage that glaucoma causes.
This study is one of the first large-scale, real-world looks at whether that holds true in people with elevated eye pressure.
About the study
Researchers wanted to know whether nicotinamide could help prevent people with ocular hypertension from developing glaucoma, a condition it had shown promise against in earlier lab research, but with limited real-world evidence.
To find out, they analyzed electronic medical records from 67 U.S. healthcare organizations over a 20-year window. They compared 1,460 people with ocular hypertension who had documented nicotinamide use against 1,460 matched patients with no history of nicotinamide or niacin use. Patients were followed for an average of 3.7 years.
Nicotinamide users were far less likely to develop glaucoma
Among people who took nicotinamide, glaucoma was diagnosed in just 3.5% of patients, compared with 9.0% in the control group. The secondary outcomes followed the same pattern: nicotinamide users were less likely to be started on eye-pressure-lowering drops, and less likely to need laser treatment.
In short, people with ocular hypertension who used nicotinamide were not only less likely to be diagnosed with glaucoma; they were also less likely to need escalating treatment along the way.
What to do if you have high eye pressure
Before talking to your doctor, keep in mind:
- Observational design: This study found a strong association between nicotinamide use and lower glaucoma risk, but doesn't prove cause and effect.
- The mechanism is still unknown: This study didn't test why nicotinamide may be protective, so that question remains open.
- Adjunctive, not a replacement: Nicotinamide is meant to complement standard care, not replace eye drops, not regular eye exams, and not anything your eye doctor already has you on.
That said, the cohort was large (nearly 3,000 matched patients), the follow-up averaged 3.7 years, and the results held across both primary and secondary outcomes, similar to other emerging research pointing to unexpected protective factors for eye health. If you have ocular hypertension, it's worth raising with your doctor at your next visit.
The takeaway
Vitamin B3 isn't typically part of the glaucoma conversation, but this large real-world study suggests it may deserve a place in it. For anyone managing high eye pressure, it's a promising and a worthwhile conversation to have with your eye doctor at your next visit.