Research Points to Major Reduction in Risk for a Leading Cause of Blindness
For years, vitamins have been studied for their potential to prevent disease rather than simply treat it after it develops. A new study published in JAMA Ophthalmology adds to that growing body of evidence, suggesting that one form of vitamin B3 may dramatically reduce the risk of developing glaucoma by as much as 66% in people already at high risk for the disease.
The findings are especially significant because glaucoma remains one of the world’s leading causes of irreversible blindness. While current treatments can slow the disease, there is still no cure. Researchers believe this latest study could point toward a new preventive strategy that works alongside traditional therapies rather than replacing them.
What Is Glaucoma?
Glaucoma is a group of eye diseases that damage the optic nerve, the structure responsible for carrying visual information from the eye to the brain. As the optic nerve deteriorates, permanent vision loss can occur.
An estimated 95 million people worldwide are affected by glaucoma, including roughly 4.22 million Americans. It is the second leading cause of blindness around the globe.
One of the greatest challenges is that glaucoma often develops silently. Many patients experience no noticeable symptoms until significant vision has already been lost. According to the Glaucoma Research Foundation, nearly half of people living with glaucoma do not know they have the disease because it frequently progresses without warning signs. By the time vision changes become obvious, the damage cannot be reversed.
Current Treatment Challenges
Doctors currently focus on lowering pressure inside the eye, known as intraocular pressure, to slow damage to the optic nerve. This can involve prescription eye drops, medications, laser procedures, or surgery.
Although these treatments can slow disease progression, they do not cure glaucoma or restore vision that has already been lost. That reality has motivated researchers to search for therapies that may actually protect the optic nerve before permanent damage occurs.
Researchers have also explored whether nutrients including omega-3 fatty acids, dietary nitrates, vitamins A and C, and vitamin B compounds might help reduce glaucoma risk.
The Vitamin B3 Claim
The latest research focuses on nicotinamide, a form of vitamin B3.
Scientists investigated whether nicotinamide supplementation could reduce the likelihood of developing primary open-angle glaucoma, the most common form of the disease. Their findings suggest that people with ocular hypertension, or elevated pressure inside the eye, experienced a substantially lower risk of developing glaucoma when taking nicotinamide supplements.
How the Research Was Conducted
Researchers analyzed electronic medical records from 67 healthcare organizations across the United States.
The study included nearly 2,900 people diagnosed with ocular hypertension who had not yet developed glaucoma. Approximately half of the participants received nicotinamide supplementation, while the remaining participants served as a comparison group.
The participants were followed for an average of 3.7 years, allowing researchers to compare how often glaucoma developed in each group.
The Results
The numbers were striking.
Researchers reported that participants taking nicotinamide experienced:
- A 66% lower risk of developing primary open-angle glaucoma.
- A 43% reduction in the need for prescription medications to lower eye pressure.
- A 62% reduction in the need for laser trabeculoplasty surgery used to treat glaucoma.
During the follow-up period, only 51 participants receiving nicotinamide developed glaucoma compared with 132 participants in the control group.
What This Means for Patients
If future studies confirm these findings, vitamin B3 could become an important tool for patients who are at elevated risk of glaucoma, particularly those diagnosed with ocular hypertension.
Dr. Benjamin Bert, a board-certified ophthalmologist who was not involved in the study, believes therapies that safely reduce glaucoma risk could make an important difference.
“A treatment that allows our bodies to continue to function the way that they are supposed to, as is the hypothesis with vitamin B3, then that would be especially beneficial,” Bert said. “Glaucoma can be a difficult disease to control, so it is important that research continues to look at it from many different aspects to help continue to develop new treatments.”
Dr. Ariana Levin of NYU Grossman School of Medicine also emphasized the importance of prevention, noting that glaucoma causes permanent damage that cannot be reversed once it occurs. She said preventing disease before optic nerve injury develops remains one of the most important goals in glaucoma research.
Experts Urge Caution
Despite the encouraging findings, researchers and physicians stress that nicotinamide is not currently an approved treatment for glaucoma.
The American Academy of Ophthalmology and the American Glaucoma Society have warned that high doses above 3 grams per day may cause liver damage and should not be taken outside carefully monitored clinical trials.
Dr. Bert advises patients to consult their physicians before beginning any supplement regimen because vitamins can interact with medications and, at high doses, may require liver function monitoring.
A Growing Case for Vitamins
While additional clinical trials will be needed to determine the safest and most effective dosage of vitamin B3, the study contributes to a growing body of research suggesting that nutritional interventions may play a meaningful role in disease prevention.
Researchers have already investigated several nutrients for their potential protective effects against glaucoma. The new findings surrounding vitamin B3 strengthen the broader idea that vitamins may do more than prevent nutritional deficiencies. In some cases, they may help preserve normal biological function and reduce the risk of serious chronic diseases before irreversible damage occurs.
For millions of people at risk of glaucoma, that possibility offers hope that one day prevention may become just as important as treatment.
