Physical activity and exercise in primary open-angle glaucoma: a scoping review

Area of Science:

• Ophthalmology
• Exercise Physiology
• Public Health

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness globally.
• While intraocular pressure (IOP) reduction is key, physical activity (PA) and exercise are gaining attention as adjunctive strategies.
• Exercise impacts systemic vascular health, autonomic regulation, and perfusion, potentially influencing glaucoma beyond IOP.

Purpose of the Study:

• To conduct a scoping review of studies investigating the association between PA/exercise and POAG-related outcomes.
• To synthesize evidence on how PA and exercise affect glaucoma incidence, progression, severity, and quality of life.

Main Methods:

• Systematic search of MEDLINE, Embase, and SPORTDiscus databases.
• Included studies of any design examining PA/exercise effects on ophthalmological parameters, systemic vascular markers, or patient-reported outcomes.
• Narrative synthesis of data across clinical domains: incidence, progression, disease severity, and quality of life.

Main Results:

• Eighteen studies (14 observational, 4 RCTs) were included.
• Aerobic exercise showed short-term IOP reduction and increased ocular perfusion pressure.
• Higher habitual PA linked to lower POAG prevalence, incidence, and slower progression, though findings were heterogeneous.

Conclusions:

• Increased PA is associated with better POAG outcomes, possibly via IOP-dependent and systemic vascular mechanisms.
• Causal links are limited; future research needs long-term RCTs with objective PA measures.
• Clarifying exercise's role in glaucoma prevention and management requires further investigation.