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Editors Selection IGR 15-4

Miscellaneous: Effect of Exercise on IOP

Comment by Jonathan Crowston on:

103912 Effects of regular exercise on intraocular pressure, Yeak Dieu Siang J; Mohamed MNAB; Mohd Ramli NB et al., European Journal of Ophthalmology, 2022; 32: 2265-2273

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The ability for exercise to lower IOP in the short-term is well established. Less good evidence exists surrounding the effect of exercise on IOP over the longer term. Siang and colleagues from the University of Malaya conducted a prospective non-randomized study in 45-healthy (non-glaucoma) volunteers who were entering a 6-week exercise program, consisting of aerobic activities and weight training, three days a week. Change in IOP over the follow-up period was measured with i-Care and Goldman tonometry. The intervention group was compared to a separate cohort of age- and sex-matched volunteers, who did not enter an exercise program, but continued their habitual exercise routines.

The major finding was that individuals enrolled in the exercise program saw a reduction in average IOP of −2.18 ± 2.25 mmHg (p < 0.001) at the end of the 6-week period. In contrast no IOP change was seen in the 'sedentary' group. These data suggest that regular exercise can lower IOP by clinically meaningful levels. It is to be noted that these were individuals without glaucoma and further study should be conducted to determine whether glaucoma patients see similar pressure lowering. The concomitant use of IOP lowering medications in such a study would make study design somewhat more complicated. Other points worth noting were that there were significant differences in baseline CCT, systolic BP, heart rate and BMI between intervention and control group.

Exercise and other lifestyle interventions such as diet are garnering increasing interest, not only in ophthalmology, but across medicine and accumulating evidence is demonstrating their ability to confer many health benefits. The impact of regular exercise on IOP regulation as well as RGC health and glaucoma prevalence also appear promising but more quality clinical studies in glaucoma cohorts are still needed.

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