Supplements for glaucoma: what the research shows
Vitamins and supplements, the evidence so far, and why your treatment plan still comes first
Some nutritional supplements are being studied for their possible ability to support the health of the optic nerve, and many patients ask whether they should take them. So far, no supplement has been proven to treat or prevent glaucoma, and none is a replacement for prescribed drops, laser, or surgery. Some patients choose to add a supplement to their treatment plan after talking with their doctor. At San Antonio Eye & Face Institute, Dr. Relief Jones, III, a glaucoma fellowship-trained ophthalmologist, and Dr. Maria Isabel Triana have reviewed the research on nicotinamide (vitamin B3) and recommend it to patients who are interested in a holistic approach to their care, with some exceptions explained below. Please consult an ophthalmologist before starting any supplement.
Reviewed by Dr. Relief Jones, III, M.D. · Last updated: October 15, 2026
At a glance
| Short answer | No supplement has been proven to treat or prevent glaucoma |
| What is proven | Lowering eye pressure, with drops, laser, or surgery, slows glaucoma |
| Most studied | Nicotinamide (vitamin B3); larger trials are underway |
| Our approach | We recommend nicotinamide to interested patients, except those with a history of cancer, especially breast cancer |
| Also studied | Nicotinamide riboside, citicoline, ginkgo biloba, antioxidants, omega-3s |
| Never | Stop or change your glaucoma treatment because of a supplement |
| Before you start | Talk with an ophthalmologist, and bring a list of what you take |
Why do people consider supplements for glaucoma?
Glaucoma damages the optic nerve, and lowering eye pressure is the only proven way to slow it. But some patients keep losing vision even when their pressure is well controlled, which has led researchers to look for ways to protect the nerve cells directly. Studies suggest that the energy systems inside nerve cells (the mitochondria) and oxidative stress may play a role, and some supplements are being studied for their effect on those pathways. This research is promising for the future, but it’s early, and no supplement has been proven to help in everyday care. Learn about glaucoma
What the research shows
Researchers are still studying these products. This is an overview, not a recommendation, and the evidence may change.
| Supplement | Why it’s studied | What the evidence shows so far | Cautions |
|---|---|---|---|
| Nicotinamide (vitamin B3) | Supports cellular energy (NAD+) in nerve cells | The most studied. A few small, short randomized trials reported improvements in measures of inner retinal function, and one trial combining nicotinamide with pyruvate reported improved visual field test locations. Results on standard visual field measures have been inconsistent, and reviews conclude the evidence isn’t yet enough for routine use. Larger trials are underway. | Studies used doses much higher than ordinary vitamin B3 supplements. Possible side effects include nausea, headaches, and liver changes. Talk with your doctor |
| Nicotinamide riboside (NR) | A related compound that raises NAD+ | Widely marketed, but much less glaucoma-specific human research | Unproven for glaucoma |
| Citicoline | Studied for possible effects on nerve and visual function | Small studies, mixed results, and no proof of benefit | Larger trials are needed |
| Ginkgo biloba | Studied for blood flow and antioxidant effects | A few small studies in normal-tension glaucoma suggested possible benefits, but evidence is limited | Can increase bleeding, especially with blood thinners or before surgery |
| Antioxidant vitamins and minerals (vitamins C and E, others) | Oxidative stress is linked to nerve cell damage | No good evidence they prevent or treat glaucoma. The AREDS2 formula was studied for macular degeneration, not glaucoma | High doses aren’t necessarily safe |
| Omega-3 fatty acids | General nutrition and inflammation | Studies on glaucoma have been inconsistent | Fish oil can increase bleeding at high doses |
| Vitamin B12 and folate | Needed for healthy nerves | Correcting a deficiency is important, but there’s no proof they treat glaucoma otherwise | Check levels with your doctor |
Other products marketed for glaucoma, such as lutein, alpha-lipoic acid, curcumin, and resveratrol, don’t have good human evidence for glaucoma.
A note on the research. Nicotinamide gets the most attention, and larger studies, such as the NAMinG trial in the UK, are testing whether it slows visual field loss over two years. Until those results are in, major eye organizations don’t yet recommend any supplement for glaucoma.
Our approach to nicotinamide
Dr. Jones and Dr. Triana have reviewed the studies on nicotinamide (vitamin B3), and they recommend it to patients who are interested in taking a holistic approach to their care. A few important points:
- It’s an add-on, not a replacement. Nicotinamide doesn’t lower eye pressure, and it doesn’t replace your drops, laser, or surgery.
- The research is still early. Small trials are encouraging, but larger trials are still underway, and we can’t promise it will help your glaucoma.
- It isn’t for everyone. We do not recommend nicotinamide for patients with a history of cancer, especially breast cancer. If you’ve ever had cancer, please tell us, and talk with your oncologist before taking any supplement. It may also not be right if you have liver disease, are pregnant or breastfeeding, or take certain medications.
- We’ll talk it through with you. We discuss whether it’s reasonable for you, how to take it, and how we’ll monitor you.
Safety: what to know before taking a supplement
- Never stop your glaucoma drops, laser, or surgery follow-up because you started a supplement.
- Tell us about every supplement and medication you take, with the doses. Supplements can interact with medicines, including blood thinners and blood pressure medicines.
- Ask before taking high doses. Studies of nicotinamide used doses well above the usual 35 mg daily upper limit for niacin supplements, and high doses can affect the liver.
- Blood pressure matters in glaucoma. Some supplements can lower blood pressure, and very low blood pressure may be harmful to the optic nerve in some patients.
- Surgery. We don’t currently recommend any specific supplements before eye surgery. Tell us about everything you take, since some supplements, such as ginkgo, fish oil, and vitamin E, can increase bleeding, and we’ll tell you if you need to stop any.
- Quality varies. Supplements aren’t regulated like medicines. Look for independent testing (USP, NSF, or ConsumerLab), avoid products that promise to cure or reverse glaucoma, and be skeptical of ads and testimonials.
- Pregnancy, kidney or liver disease, and other conditions can make some supplements unsafe, so ask first.
Nutrition and lifestyle: what may help
There’s more evidence for overall healthy habits than for any single pill. Eating a balanced diet with plenty of vegetables, including leafy greens, is linked to better eye and general health in observational studies, though it’s not a proven glaucoma treatment. Not smoking, staying active with your doctor’s guidance, and managing your blood pressure and diabetes also support your overall health. These habits support, but never replace, your glaucoma treatment.
Marijuana and CBD
Marijuana can lower eye pressure only for a few hours, so it isn’t recommended as a glaucoma treatment, and CBD hasn’t been shown to help and may raise eye pressure in some people. Read more about marijuana and CBD and glaucoma
What actually protects your vision
The most important parts of glaucoma care are:
- Lowering your eye pressure with drops, laser (SLT or MP-CPC), or surgery
- Using your treatment as prescribed
- Keeping your regular exams and testing, so we can catch changes early
If your pressure isn’t controlled, or drops are hard to use, ask us about other options, such as goniotomy, microstents, or glaucoma surgery.
If you’re thinking about a supplement
Bring a list or the bottles of everything you take, and ask:
- Is this supplement reasonable for my type and stage of glaucoma?
- What dose, and for how long?
- Could it interact with my medications or my health conditions?
- Should I have any blood tests?
- Do I need to stop anything before surgery?
- How will we know whether my glaucoma is stable?
Why choose San Antonio Eye & Face Institute
- Glaucoma fellowship-trained care. Dr. Jones completed a clinical glaucoma fellowship at Massachusetts Eye and Ear/Harvard Medical School, and Dr. Triana a research fellowship in glaucoma genetics there.
- Straight answers about what’s proven and what isn’t. We’ll tell you honestly what the research shows.
- A full range of treatment, from drops and lasers to surgery, so your pressure is controlled with proven treatment first.
- Physician-owned, so you see your doctors from your first exam to your last follow-up.
- Se habla español.
Request a Glaucoma Evaluation
Call (210) 485-1488
Frequently asked questions
Can supplements treat glaucoma? No supplement has been proven to treat or prevent glaucoma. Some are being studied for possible effects on the optic nerve, but the only proven way to slow glaucoma is to lower eye pressure with drops, laser, or surgery.
Can supplements replace my glaucoma drops or surgery? No. Supplements are not a replacement for prescribed medications, laser treatment, or surgery, and you should never stop or change your glaucoma treatment because of a supplement. Some patients choose to add a supplement to their treatment plan after talking with their ophthalmologist.
Is there a supplement proven to protect the optic nerve? No. Several supplements are being researched, but major eye organizations say the evidence is not yet strong enough to recommend any supplement for glaucoma. Larger studies are underway.
What is nicotinamide, and does it help glaucoma? Nicotinamide is a form of vitamin B3 that is the most studied supplement in glaucoma. Small, short randomized trials reported improvements in measures of retinal function, but results on standard visual field tests were inconsistent, and larger trials are still underway. The doses studied are far higher than typical vitamin doses, so it should only be taken under a doctor’s guidance.
Who should not take nicotinamide? Dr. Jones and Dr. Triana do not recommend nicotinamide for patients with a history of cancer, especially breast cancer. It may also not be right if you have liver disease, are pregnant or breastfeeding, or take certain medications, so talk with us before starting.
What about nicotinamide riboside? Nicotinamide riboside is a related compound that the body can convert into the same cellular energy molecule, NAD+. It is widely sold as a supplement, but there is less glaucoma-specific human research than for nicotinamide, and it has not been proven to help glaucoma.
Does citicoline help glaucoma? Citicoline has been studied for possible effects on nerve and visual function in glaucoma, but the studies so far are small and mixed, and it has not been proven to help. Larger trials are needed.
Does ginkgo biloba help glaucoma? A few small studies in normal-tension glaucoma suggested possible benefits, but the evidence is limited. Ginkgo can increase the risk of bleeding, especially if you take blood thinners or are having surgery, so check with your doctor before taking it.
Do antioxidant vitamins or the AREDS2 formula help glaucoma? There is no good evidence that antioxidant vitamins such as vitamins C and E prevent or treat glaucoma. The AREDS2 formula was studied for macular degeneration, not glaucoma.
Do omega-3 fatty acids help glaucoma? Studies of omega-3 fatty acids and glaucoma have been inconsistent, and they have not been proven to help. Omega-3s may be part of a healthy diet, but they are not a glaucoma treatment.
Are supplements safe if I have glaucoma? Supplements can interact with medications, affect blood pressure or the liver, and, at high doses, cause side effects. Supplements are also not regulated like medications, so quality varies. Tell your ophthalmologist about every supplement you take before you start.
Do you recommend any supplements before eye surgery? We do not currently recommend any specific supplements before eye surgery. Tell us about everything you take, since some supplements, such as ginkgo, fish oil, and vitamin E, can increase bleeding, and we will tell you if you need to stop any.
How do I choose a quality supplement? Look for products tested by an independent group, such as USP, NSF, or ConsumerLab, be cautious about products that promise to cure or reverse glaucoma, and bring the bottle to your appointment so we can review the ingredients and dose.
What do Dr. Jones and Dr. Triana recommend? They have reviewed the studies on nicotinamide (vitamin B3) and recommend it to patients who are interested in a holistic approach to their care, but not to patients with a history of cancer, especially breast cancer. They ask you to talk with them before starting any supplement, and the most important parts of glaucoma care remain lowering your eye pressure, using your treatment as prescribed, and keeping your regular exams.
What can I do besides taking supplements to protect my vision? Use your drops as prescribed, keep your appointments, ask us about laser or surgery if your pressure is not controlled, do not smoke, manage your blood pressure and diabetes, and ask us which kinds of exercise are right for you.
Are marijuana or CBD helpful for glaucoma? Marijuana lowers eye pressure only for a few hours and is not recommended as a glaucoma treatment, and CBD has not been shown to help and may raise eye pressure in some people. Talk with us before using either.
This page is for general education and isn’t medical advice. Supplements are not approved to treat glaucoma. Never start, stop, or change a medicine or supplement without talking to your doctor. Product names are trademarks of their respective owners.