Exploring neuroprotection with glaucoma subspecialist, Dr Aaron Wong
Summary of our 27 August 2025 Patient Education Seminar
If you’re living with glaucoma, you’ve likely heard a lot about eye pressure. For years, that’s been the main focus of treatment.
But as Dr Aaron Wong explained in our August Patient Education Seminar, there’s more to protecting your vision than pressure alone. It’s called neuroprotection — and it’s an exciting area that could one day give you another layer of defence for your sight.
Glaucoma treatment today: All about pressure
Every current glaucoma treatment works by lowering the pressure inside your eye. This is commonly referred to as intraocular pressure, or IOP. Lowering this pressure helps protect the nerve cells that carry messages from your eyes to your brain (retinal ganglion cells).
But here’s the challenge: even when pressure is under control, some people still lose vision. That’s why researchers are looking for ways to help these nerve cells stay healthy and strong.
That’s where neuroprotection comes in.
What neuroprotection means for you
Neuroprotection focuses on keeping your eye’s nerve cells alive and working, even when they’re under stress. This research has been building for years, and scientists are making steady progress.
Dr Wong shared that while there’s no proven neuroprotective treatment yet, studies show promising signs of what might help in the future.
What researchers are studying
Nicotinamide (vitamin B3)
You might already know Vitamin B3 for its skin or energy benefits, but in the eye, it could do even more. A specific form of it, called nicotinamide, helps your retinal cells produce energy by boosting a molecule called NAD.
Animal studies show it can protect against pressure-related cell damage. And in a small Australian study in 2020, people took high doses of nicotinamide for three months. A a result, they saw about a 15% improvement in retinal cell function.
A larger, two-year study is now underway and will finish in 2027. Researchers hope it will confirm if the benefits last long term.
But before you reach for supplements, here’s what Dr Wong wants you to know: The doses used in studies are much higher than typical over-the-counter vitamins (sometimes up to six tablets a day). While nicotinamide is available without a prescription, very high doses can affect your liver.
If you’re interested, talk to your eye specialist first. Some people may safely take smaller doses (around 500mg once or twice daily), but medical advice is essential.
Other neuroprotective research
Memantine: Originally used to treat Alzheimer’s disease. Early research looked promising, but a five-year glaucoma trial found no clear benefit.
Ginkgo Biloba: This herbal supplement is known for its antioxidant effects and blood flow support. Two small studies showed mixed results, and it can interfere with other medications. It’s not currently recommended for glaucoma.
CNTF Implant: A small implant that slowly releases protective growth factors into the eye. Early U.S. trials are showing potential benefits, but it’s still being studied.
Gene Therapy: Used overseas for some inherited eye diseases and now being researched for glaucoma too. The goal is to strengthen nerve cells or lower pressure by adjusting how certain genes work. Some of this research is happening here in Aotearoa.
Where to from here?
Dr Wong put it simply:
There’s a lot of hope, and we want to give you that hope, without the hype.
Neuroprotection won’t replace your drops, laser, or surgery yet, but it’s helping experts think differently about how to protect your sight. And the best part? This research is happening close to home.
Auckland Eye will soon launch a new glaucoma research study. If you’d like to learn more or take part, keep an eye on their website for updates.
The final takeaway
You’re already doing the most important thing by managing your eye pressure, that’s still the gold standard for protecting your vision. But research into neuroprotection shows that one day, there may be even more ways to keep your sight safe.
At Glaucoma NZ, we’ll continue sharing the latest findings, so you can make informed decisions and stay confident in your care.
Because when it comes to glaucoma, every bit of progress matters, and so do you.