For decades, the most effective way to treat glaucoma has been to lower intraocular pressure. One of the most widely used medications for this purpose is latanoprost, a drug developed from research led by Columbia University scientist Laszlo Bito, PhD. Approved in 1996, latanoprost remains a first-line treatment for reducing intraocular pressure and protecting the optic nerve.

While this and other medications that lower eye pressure have helped preserve the vision of millions of people, researchers continue to search for additional ways to protect the optic nerve, especially in patients whose glaucoma continues to progress even when eye pressures appear  well controlled.

One promising area of research focuses on whether certain nutrient supplements, specifically vitamin B3  (nicotinamide) and pyruvate, may help protect the cells in the eye that are damaged by glaucoma.*

IMPORTANT: Researchers are studying whether vitamin B3 and pyruvate could help protect the optic nerve, but these supplements are still experimental, have been used in very large doses, and are not a substitute for standard glaucoma care.

Why Researchers Are Studying Vitamin B3 and Pyruvate

Simon John, PhD, a glaucoma researcher at Columbia University, has been studying how glaucoma affects the health of retinal ganglion cells, the nerve cells that carry visual information from the eye to the brain.

In early experiments with mice that were prone to developing glaucoma, researchers discovered that mitochondria, the energy-producing structures inside cells, were not functioning properly in these retinal cells.

They also found that levels of NAD, a molecule important for cellular energy and mitochondrial health, declined as the animals aged.

Vitamin B3 (also called nicotinamide) plays an important role because it helps the body produce NAD. When researchers gave mice vitamin B3 supplements, NAD levels increased, and many fewer animals developed glaucoma.

The researchers also observed protective effects from pyruvate, another molecule involved in cellular energy production.

When vitamin B3 and pyruvate were used together, the protective effects appeared even stronger.

This approach, sometimes called metabolic neuroprotection, aims to make nerve cells more resilient so they can better withstand the stresses associated with glaucoma and aging.

Could This Approach Work in Humans?

Early studies suggest the idea may hold promise.

In a small clinical trial involving 21 patients with glaucoma, researchers tested vitamin B3 and pyruvate supplementation in people who already had moderate visual field loss in at least one eye.

Over several months, participants showed improvements in visual function, encouraging researchers to explore the treatment further.

Since then, three independent clinical trials have reported positive findings, and additional longer-term studies are now underway around the world.

These trials are trying to determine:

• Whether the benefits last over time
• How effective the treatment may be for different types of glaucoma
• What doses are safest for patients

Why Supplements Alone Are Not Enough

Despite the promising research, experts caution that vitamin supplements are not currently a replacement for standard glaucoma treatments.

Lowering eye pressure remains the most proven way to slow glaucoma progression.

Dr. John believes metabolic approaches like vitamin B3 and pyruvate may eventually complement existing treatments, rather than replace them.

Another challenge is dosage. The most effective doses seen in animal studies are not considered safe for people, and even the higher doses used in human trials often require monitoring with blood tests.

Because of this, researchers are continuing to study ways to develop safer combinations of metabolic treatments.

Patients should always speak with their eye doctor before starting any supplement regimen.

The Bottom Line for Patients

Vitamin B3 and pyruvate are being studied as potential ways to support the health of retinal cells and slow glaucoma damage.

However, these supplements and their appropriate dosage are still being researched and are not currently approved as a standard treatment for glaucoma.

If you are living with glaucoma, the most important steps remain:

• Regular eye exams
• Following your prescribed treatment plan
• Talking with your doctor about any supplements you are considering

As research continues, new approaches may eventually help doctors protect the optic nerve in ways that go beyond lowering eye pressure alone.

*Columbia University Irving Medical Center (January 29, 2026). “Can Nutrient Supplements Prevent Glaucoma?” columbia.edu

Medically reviewed by Alan Robin, MD. Dr. Robin is a leading glaucoma specialist and researcher. He serves as an Associate Professor of Ophthalmology at Johns Hopkins University and has contributed extensively to the development of modern glaucoma treatments. Dr. Robin has authored more than 260 peer-reviewed publications and is widely recognized for his impact on patient care and global eye health.

The information provided by The Glaucoma Community is for educational purposes only and does not replace professional medical advice. Always talk with your healthcare provider before making changes to your treatment or care. The Glaucoma Community does not endorse specific treatments, providers, or products.