Cold therapy for primary open-angle glaucoma
Evidence review
Overview
No study of cold-water immersion in glaucoma was found. In a Russian randomized study of 74 patients with stage I-II primary open-angle glaucoma, 14 sessions of whole-body cryotherapy (cold air at -166 to -184 F) added to medication, diet and eye exercises were followed by a 4-6 mm Hg fall in intraocular pressure versus 2-3 mm Hg with basic therapy alone. Intraocular pressure rose briefly by about 5 mm Hg just after the first session. The report is a short congress abstract without between-group statistics, and WBC findings cannot be assumed to apply to water immersion.
Key findings
- No cold-water immersion study in glaucoma identified.
- WBC randomized study, n=74 stage I-II POAG: intraocular pressure fell 4-6 mm Hg with 14 cryotherapy sessions added to basic therapy vs 2-3 mm Hg with basic therapy alone (Lyadov 2014).
- Visual-field light sensitivity improved in 67% of the cryotherapy group (Lyadov 2014).
- Intraocular pressure rose by 5.4 +/- 1.3 mm Hg 1-2 minutes after the first session, then fell by 3.2 +/- 0.8 mm Hg at 40-60 minutes (Lyadov 2014).
Every study we reviewed
1 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 2 studies on glaucoma, across all heat and cold therapies, including case reports and older work not graded here.
Use of whole-body air cryotherapy in the combined treatment of patients with primary open-angle glaucoma
Lyadov MV et al. Fizioterapiya, Bal'neologiya i Reabilitatsiya. 2014. Not in PubMed: sourceRussian publication; title and summary translated by SaunaLMN. Original title: Применение общей воздушной криотерапии в комплексном лечении пациентов с первичной открытоугольной глаукомой
- Who
- Patients aged 42-67 (mean 56.7) with stage I-II primary open-angle glaucoma, disease duration 6-14 years, Moscow outpatient clinic
- What
- WHOLE-BODY CRYOTHERAPY (two-stage cold-air chamber: pre-chamber -76 to -94 F for 30-45 s, then 1.5-3 min at -166 to -184 F), 14 sessions every other day, added to basic therapy (potassium-rich diet, glaucoma medication, eye exercises) (n=36) vs basic therapy alone (n=38)
- Protocol
- -166 to -184 °F · 1.5-3 min · 3-4/wk · 4 wk
- Measured
- Intraocular pressure (tonometry), visual-field light sensitivity (computer perimetry), ophthalmoscopy
- Result
- By the end of the course intraocular pressure fell by 4-6 mm Hg with cryotherapy vs 2-3 mm Hg with basic therapy alone (reported as significant in the cryotherapy group only); light sensitivity improved in 67% and the authors report fewer optic-disc surface hemorrhages in 32% of the cryotherapy group; no significant ophthalmoscopic change in controls. Intraocular pressure rose by 5.4 +/- 1.3 mm Hg 1-2 minutes after the first session and fell by 3.2 +/- 0.8 mm Hg 40-60 minutes later
- Limitations
- Two-page congress abstract; randomization method not described; ranges rather than means with SD and no between-group test reported; unblinded; single centre; Russian-language (translated by us); WBC, not cold-water immersion
Protocols used in the studies
Whole-body cryotherapy in a two-stage cold-air chamber: 30-45 seconds at -76 to -94 F (-60 to -70 C), then 1.5-3 minutes at -166 to -184 F (-110 to -120 C), 14 sessions every other day, alongside glaucoma medication, diet and eye exercises. No cold-water immersion protocol has been tested.
What is still unknown
Whether cold-water immersion affects intraocular pressure or glaucoma progression; full publication and replication of the cryotherapy study with between-group statistics; the clinical significance of the transient pressure rise in advanced glaucoma.
Safety
Cautions for cold therapy in this condition
- Intraocular pressure rose by 5.4 +/- 1.3 mm Hg 1-2 minutes after the first cryotherapy session before falling below baseline 40-60 minutes later; no adverse reactions were recorded during sessions (Lyadov 2014).
- Cold exposure acutely raises blood pressure (Radtke 2016, PMID 26152773).
- Whole-body cryotherapy contraindications and adverse events (16 documented across case reports and RCTs) are specific to cold-air chambers and do not transfer directly to cold-water immersion (Legrand 2023, PMID 37770960). See general cold safety entry.
For clinicians
Suggested rationale
A small randomized study reported a larger fall in intraocular pressure when whole-body cryotherapy was added to standard glaucoma treatment (Lyadov 2014), but it is a short congress abstract without between-group statistics, concerns a cold-air chamber rather than cold-water immersion, and noted a transient pressure rise after the first session; cold therapy is not established as glaucoma treatment.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: H40.11, H40.10. Examples only; the clinician assigns the code.
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