Magnesium and Glaucoma: A Systematic Review of Human Evidence

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Magnesium and Glaucoma: What Do Human Studies Show?Glaucoma is a chronic eye disease where the optic nerve is damaged over time, often leading to vision loss if untreated. The most common form is primary open-angle glaucoma (POAG), in which eye pressure tends to be high. A related condition, normal-tension glaucoma (NTG), causes nerve damage even though eye pressure (intraocular pressure, IOP) is not elevated. Researchers have wondered if improving ocular blood flow and nerve health could help slow glaucoma. Magnesium is a mineral that supports blood vessel function and nerve cell health (). This has led scientists to test if glaucoma patients might benefit from more magnesium, either by diet or supplements. This article reviews all human studies on magnesium in glaucoma. Specifically, we look at trials and reports of magnesium levels or supplementation in POAG and NTG. We focus on study design, patient numbers, what dose of magnesium was used, how long patients were treated, and what outcomes were measured: visual field tests (checking side and central vision), OCT scans of nerve fiber thickness (RNFL) or ganglion cell layers (GCC), blood flow measures, and IOP. We also comment on study quality and differences between studies, and point out what’s still unknown.Why Magnesium? The RationaleMagnesium plays roles in blood vessel function and nerve protection. It can relax blood vessels and improve blood flow, partly by altering nitric oxide and endothelin-1 pathways (). In laboratory studies, magnesium also blocks excess calcium signaling that can damage nerve cells. Because glaucoma involves loss of retinal ganglion cells (the nerve cells of the optic nerve), improving blood supply and preventing cell stress might help. For example, in stroke or heart studies, magnesium sometimes improves blood flow and cell survival. Some researchers have found lower magnesium levels in glaucoma patients. One conference report (in eye fluid and tissues) showed much lower Mg in eyes with glaucoma versus controls (). However, those findings need formal publication. In any case, these ideas led to clinical studies testing magnesium in people with glaucoma.What the Clinical Studies FoundOnly a handful of small clinical studies have tested magnesium in glaucoma. We found three main human reports that gave magnesium supplements to glaucoma patients, plus some observational data about magnesium and glaucoma risk.Gaspar et al (1995) – NTG and Peripheral Blood FlowIn 1995, Gaspar and colleagues reported on 10 patients with glaucoma (likely NTG, though the report lists "glaucoma" broadly) (). They gave 243 mg of oral magnesium per day (121.5 mg tablets twice a day) for one month. They used video nailfold capillaroscopy to examine tiny blood vessels in the fingers, as a sign of peripheral circulation. They also tested visual fields. After one month on magnesium, both visual field measures and peripheral blood flow improved (). In other words, patients showed better vision field test scores and more open capillaries in their fingers. This small study did not have a placebo group, and it did not measure eye-related blood flow directly (just finger capillaries). Nevertheless, it suggested short-term benefit of magnesium on blood flow and vision in