About Dr Brian Ang

Citicoline as a Natural Glaucoma Treatment

Have you heard of citicoline as a natural glaucoma treatment? Before we discuss citicoline, let’s find out a bit more about glaucoma first.

What is glaucoma and why is it important?

Glaucoma is a condition where there is progressive damage to the optic nerve, usually related to high pressure in the eye. This causes visual field loss and if untreated, eventual blindness.

Glaucoma is the second commonest cause of blindness worldwide, and affects at least 2% of the population. More than 60 million people are affected globally. The scary thing is that most people do not notice any glaucoma symptoms until a lot of glaucoma damage has already occurred.

It is widely accepted that the retinal ganglion cells of the optic nerve become permanently and irreversibly damaged from glaucoma. It is this damage to the ganglion cells that eventually leads to blindness.

The conventional thinking is that any vision lost from the optic nerve damage cannot be recovered, hence the focus on monitoring and early glaucoma treatment. The idea to pick up early signs of glaucoma damage before any significant sight loss and glaucoma symptoms develop.

What is citicoline?

Citicoline (also known as cytidine 5′-diphosphocholine) is a compound that is naturally found in our brain. It provides the important building blocks (cytidine and choline) to create phosphatidylcholine (a type of phospholipid in the cell membrane).

Phospholipids make up approximately 30% of brain tissue, and are critical for the metabolism and functioning of our brain nerve cells. Citicoline enhances communication between nerve cells, protects neural structures, and supports healthy brain activity and energy.

Due to this ability to protect nerve cells, citicoline has been studied extensively as an additional treatment in a wide range of neurological conditions. The effects are particularly beneficial for stroke and dementia.

Oral citicoline is tolerated very well, and has minimal or absent side effects, with virtually no toxicity. As a result, it has been authorized as a food supplement in the United States and in the European Union. The Italian Ministry of Health has approved citicoline as a supplement for special medicinal purposes in glaucoma patients.

Cognizin is a patented, clinically-tested form of ultra-pure citicoline. It is the Cognizin form of citicoline that has mainly been researched for its benefits as a form of glaucoma treatment.

Below is a selection of highly-rated Cognizin citicoline supplements that are available for purchase through Amazon:

How does citicoline work as a natural glaucoma treatment? Can citicoline protect the optic nerve?

Citicoline was first investigated as a form of natural glaucoma treatment in 1989, as an injection into the muscle.

Intramuscular citicoline 1 g daily for 10 days was able to improve visual fields in glaucoma patients with well-controlled eye pressures. The effects lasted for at least 3 months, and were maintained with repeat treatment. In fact, the improvement in visual fields persisted for over 10 years with repeated cycles every 6 months.

Now intramuscular injections are quite painful, so I don’t think I’ll be recommending intramuscular injections of citicoline to my patients.

I don’t fancy having citicoline injections either. Are there other forms of citicoline that I can take for my glaucoma?

Fortunately, citicoline is also available as eye drops and also as an oral supplement.

In a randomized clinical trial conducted in Italy, 80 patients with progressing glaucoma despite eye pressure control of 18 mmHg or less were randomized to either citicoline 2% eye drops (Omk-1) or placebo eye drops 3 times daily, used concurrently with existing glaucoma treatments.

At 3 years in those using citicoline 2% eye drops, visual field progression (especially in the central 10 degrees) was significantly slowed compared to those using placebo eye drops. Citicoline eye drops did not cause any significant side effect in the study.

Although the trial had a relatively small sample size, the results strongly suggested a benefit of citicoline eye drops in slowing glaucoma disease progression.

See Related:  Eye drops to reduce eye pressure in glaucoma

How about oral citicoline? Is oral citicoline also effective as a natural glaucoma treatment?

Oral citicoline is well absorbed by the gut and has been shown to be as effective as intramuscular injection for glaucoma, albeit at a higher daily dose (1,600 mg oral vs. 1,000 mg intramuscular injection).

Even at a smaller dose of 500 mg daily, oral citicoline (in the form of a solution) was able to significantly slow down progression of glaucoma when taken over a period of 2 years.

Another clinical trial compared glaucoma patients who took 500 mg oral solution of citicoline daily and those who did not (this was in addition to their usual glaucoma treatments). After 12 to 18 months, the group that took 500 mg oral citicoline daily had better visual fields and nerve thickness measurements. Not only that, the citicoline group also demonstrated less worsening of glaucoma compared to the control group.

Finally, a fixed combination of oral citicoline 500 mg with homotaurine 50 mg and vitamin E 12 mg (Neuprozin) has been shown to improve contrast sensitivity and quality of life in glaucoma patients over the short-term.

Among all the glaucoma supplements, my opinion is that citicoline, along with ginkgo biloba has shown the most promising and impressive results so far in terms of slowing down visual field loss.

See Related: Ginkgo biloba as a natural glaucoma treatment

Are there side effects and risks from citicoline?

Citicoline is safe and very well-tolerated. There does not appear to be any significant adverse effects or drug interactions when taken both as an oral supplement or as eye drops.

The most common possible side effects include tummy upset, diarrhea, and nausea.

See Related: Natural glaucoma vitamins for your optic nerve 

I have glaucoma. Should I take citicoline anyway?

Given that citicoline has an excellent safety profile and very promising results for glaucoma, I am very comfortable suggesting citicoline as a natural glaucoma treatment to my patients.

Citicoline is probably most beneficial for those in whom their glaucoma is getting worse despite the eye pressures being well-controlled medically or with laser.

As far as I am aware, citicoline 2% eye drops (Omk-1) is only available in Italy at present. Oral citicoline is more widely available and can easily be purchased in-store or online from Amazon or iHerb.

If you wish to take citicoline as a natural glaucoma treatment to prevent and reduce your risk of glaucoma blindness, below are highly-rated and recommended supplements that are available for you to purchase through Amazon:

Are there any other alternative natural remedies for glaucoma?

Yes! Citicoline is a great natural glaucoma treatment. But there are other widely available natural supplements that can be used to complement your existing glaucoma treatment.

It is worth repeating that if you are considering any of the natural glaucoma supplements and remedies, please make sure to discuss with your eye specialist and family doctor first to avoid adverse drug interactions and unwanted side effects. .

See Related: 

The seven best natural glaucoma remedies

The six best glaucoma supplements for your optic nerve 

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