Daily guided meditation and mindfulness training was able to reduce IOP and stress levels in patients with ocular hypertension. Photo: Patrick Malleret on Unsplash.

Holistic treatment methods are often sought after by patients and physicians who wish to steer clear of the potential adverse effects and financial burden of ocular medications. In a new study, researchers identified a treatment for patients with ocular hypertension that fits both of those criteria, as well as alleviates the mental stress that can accompany using medication and having the condition. The potential panacea? Mindfulness-based stress reduction.

“Mindfulness is a type of meditation in which one focuses on being intensely aware of what he/she is sensing and feeling at the moment and is aimed at balancing mental and emotional well-being,” the study authors explained. “Mindfulness meditation has been shown to be beneficial in decreasing IOP, reducing stress, improving regulation of the autonomic nervous system, increasing optic disc perfusion, reducing inflammatory stress markers and consequently improving mental, physical and social well-being.”

The study involved 60 patients with ocular hypertension, which is defined as IOP above 21mm Hg in the absence of optic nerve, retinal nerve fiber layer and visual field abnormalities. The participants were divided equally among two groups. Group one underwent six weeks of daily hour-long sessions of mindfulness-based stress reduction involving breathing exercises and meditation techniques led by a yoga instructor. The other 30 patients in group two were waitlisted and followed. After the six weeks, change in IOP was compared between the two groups as the primary outcome, and secondary outcomes included the effect on serum cortisol level, diurnal variation of IOP, vessel density and vessel perfusion on OCT-A and quality of life (QOL).

There was a significant decrease in IOP noted in patients in group one (23.1mm Hg to 19.2mm Hg) compared with group two (22.6mm Hg to 22.4mm Hg). The researchers also observed that the diurnal fluctuation of IOP decreased more in group one (4.9mm Hg to 2.7mm Hg) compared with group two (4.5mm Hg to 4.3mm Hg). In addition, group one showed a significant improvement in vessel perfusion, vessel density and flux index on OCT-A compared with group two.

The researchers also assessed QOL in patients at day zero and six weeks using the WHOQOL BREF questionnaire and found that patients in group one showed an improved QOL compared with patients in group two who hadn’t yet undergone meditation therapy.

Serum cortisol levels were also measured in patients using blood samples taken at baseline and six weeks. Perhaps not surprisingly, patients in group one demonstrated significantly decreased cortisol levels after daily mindfulness therapy.

“These results suggest that mindfulness meditation can be considered as a potential treatment option in the management of ocular hypertension,” the authors concluded.

Dada T, Mondal S, Midha N, et al. Effect of mindfulness-based stress reduction on IOP in patients with ocular hypertension: a randomized control trial. Am J Ophthalmol. January 20, 2022. [Epub ahead of print].