0.5 grams of ascorbic acid administered twice daily produced a significant drop in the intraocular pressure of normal eyes.

2 grams of ascorbic acid a day, orally, produced the same significant decrease in glaucomatous eyes.

Of all the disorders afflicting man, blindness causes the most widespread disability.  Aside from the cost in terms of economic loss and the personal expenses of family care and dependency, the annual bill for aid to the blind approaches a billion dollars.  It is estimated that a million people in the United States have visual impairment so severe that they cannot read a newspaper.  Yet, in spite of significant advances in eye research, the incidence of blindness is increasing.  Megascorbic therapy might one day help to reverse this trend.
Structurally, the eye is a spherical camera aimed by exterior muscles.  It has a transparent window in the front (cornea) composed of a special protein and a large optic nerve exiting at the rear.  The interior is divided into two chambers separated by a flexible lens which focuses the image on a thin, biochemically active membrane (retina) which transforms light energy into nerve impulses.  These nerve impulses are gathered into the optic nerve and transmitted to the brain where the color pictures are "seen" and recorded.  As would be expected of an organ of such biochemical activity, the eye was early found normally to contain high levels of ascorbic acid and seemed to have the ability to extract it from the blood and to concentrate it for its many vital functions.
The 1962 paper by Heath (1), with forty references to the literature, reviewed the work on ascorbic acid and the eye.  He cited twelve separate biochemical processes in which ascorbic acid is involved and speculated on the functions of ascorbic acid in the eye and its possible involvement in diabetic retinopathy, detachment of the retina, and maintenance of the proper consistency of the internal fluids of the eye.  It has been known since the early 1930s that ascorbic acid is normally found in the eye at much higher levels than in the blood and in many other tissues.  Heath confirmed this by showing that the ascorbic acid levels in different bovine eye tissues were (in milligram percent) the cornea, 30; corneal epithelium, 47 to 94; lens, 34; retina, 22; and were higher than in the skeletal muscle, 2; heart, 4; kidney, 13; and brain 17′ but were not as high as in the adrenal gland, 97-160; or the pituitary gland, 126.  He states:
Animals which are capable of synthesizing their own ascorbic acid usually have tissue levels approaching saturation.  It would, therefore, seem desirable to ensure that the intake of ascorbic acid by man is sufficiently high for tissue saturation. Lower intakes, although not leading to scurvy, may affect some metabolic processing in which ascorbic acid is involved.
Glaucoma usually appears in middle life and is the second leading cause of blindness in the United States.  High pressure within the afflicted eyeball eventually destroys the nerve cells within the retina and progressive loss of vision results. Glaucoma as present in about 2 percent of the population over forty,and 8 to 10 percent over sixty-five.  It brings creeping blindness to 3,500 Americans a year.
The prevention of glaucoma is achieved by merely maintaining low intraocular pressure during the lifetime of the individual.  The treatment of the disease, once it occurs, is to endeavor to reduce the intraocular pressure to normal levels to prevent further nerve damage.  About a million Americans over forty years of age have glaucoma without knowing it.  Many cases go undetected for years in spite of the availability of a simple, rapid, and painless tonometer test procedure.  Control and prevention of the disease in its early stages is preferable to waiting for the agony of acute glaucoma to strike.
There was a period of intense research activity from 1964 to 1969 on the use of megascorbic levels of ascorbic acid or sodium ascorbate for reducing the intraocular eye pressure.  Linner (2), in 1964 in Sweden, showed that 0.5 grams of ascorbic acid administered twice daily produced a significant drop in the intraocular pressure of normal eyes. He published another paper, in 1969, in which he showed that 2 grams of ascorbic acid a day, orally, produced the same significant decrease in glaucomatous eyes.
The year 1965 saw the beginning of a four-year period when numerous papers reported on the prompt reduction of the intraocular pressure, with no side effects, by the intravenous injection of 20 percent sodium ascorbate solution at doses of about 70 grams per treatment. Virno and coworkers (3) in Rome published five papers in this period, the group from the University of Rome’s Ocular Clinic (4) presented seven papers, one came from Switzerland (5), and one from Finland (5).  Even though two papers were published in American journals in 1966 and 1967 by the Italian workers (3), no papers coming from American authors could be found on this exciting line of research.
Such a research silence on the part of American scientists can only be interpreted as an indication that no work has been carried out in the United States in the past six years in this field.  Yet, during this same time, numerous government bulletins have appeared describing the urgent need for solving the problem of glaucoma and the daily mail is filled with repeated requests for donations to eye research charities.  Where is the money going?  What is being done with the available funds?
Research should be started immediately on population groups near forty years of age and older to determine the long-term effect on the inhibition of glaucoma by means of the continued daily intake of about  3 to 5 grams of ascorbic acid. The use of higher dosages, both orally and intravenously, for the therapy of incipient and advanced glaucoma should be included in the research protocols.  This will help to determine if a simple and harmless ascorbic acid regimen can be worked out which will prevent blindness in our senior citizens.
A Public Health Service government bulletin (6) starts the discussion of cataracts with:
Cataracts are the leading cause of blindness in this country.  They occur when the chemical composition of the crystalline lens changes, making it opaque rather than transparent.  When cataracts form, the only way to restore sight is to remove the afflicted lens.  In the majority of cases, cataracts appear to be part of the aging process.  Uveitis (inflammation of the eye) and physical and chemical injury are other causes.
Let us discuss these authoritative statements individually:
1.         That cataract is now the leading cause of blindness there is no argument — but need it be? The proper long-term use of ascorbic acid may have a profound effect in reducing the incidence of this condition and preventing blindness.
2.         Changes in the chemical composition of the lens makes it opaque — correct, no argument.  But what is the chemical composition of the lens?  It is made from a specially oriented helical protein (7).  Dische and Zil (8), in 1951, start their paper, "The most striking chemical change in the lens during the cataractous process is the decrease in sulfhydryl groups."  Sulfhydryl groups, like ascorbic acid, are strong, normally occurring reducing agents, and are destroyed by oxidative processes. Possibly, the high levels of ascorbic acid found in the normal eye are there to protect against the loss of these sulfhydryl groups by oxidation. Studies in India (9), from 1963 to 1969, where senile cataract is rampant, occurs at an early age, and matures more quickly, show that cataractous eyes have a much lower content of ascorbic acid than normal eyes.  One of these papers (Nema and Srivastava) suggests that the chronically low ascorbic acid content may be responsible for the high incidence of senile cataract.
3.         When cataracts form, the only way to restore sight is to remove the afflicted lens — right and wrong.  This is the opinion of many present-day ophthalmologist. While some research shows that it is possible to slow down the cataractous process, no work could be found which would indicate that the proper use of ascorbic acid has been tried to reverse the cataractous process.
4.         In the majority of cases, cataracts appear to be part of the aging process — right.  But let us do something about this by inhibiting aging (see Chapter 18).
5.         Uveitid and physical and chemical injury are other causes — right.  All these stresses reduce the ascorbic acid levels in the eye. The 1941 paper f Lyle and McLan of the Royal Air Force on corneal inflammations should not be ignored.  They stated:
Treatment by means of ascorbic acid intravenously is of therapeutic value.  The improvement in most cases is almost dramatic.  In most cases there is no reason to believe that a general vitamin C deficiency exists.  It appears, therefore, that the beneficial results are obtained by flooding the bloodstream with excess of ascorbic acid.
This work was confirmed by Summers in 1946. The profound effects of ascorbic acid on the healing of deep corneal ulcers caused Boyd and Campbell, in 1950, to state and recommend, "We therefore suggest that ascorbic acid, in such massive doses as 1.5 grams daily, has a value in therapy apart from its normal role as a vitamin at accepted levels of intake."  The additional work of Campbell and coworkers, in 1950, and Boyd, in 1955, on experimental eye burns, supplies additional confirmation for the need for adequate levels of ascorbic acid in the eye for recovery from heat injury 10).
The answers to this discussion of cataracts seem to be supplied by ascorbic acid.  Are they not sufficiently suggestive to warrant further research and investigation?
The literature cited in this discussion of cataracts is but a small fraction of the total which has been published on ascorbic acid and  the eye since the early 1930s.  To thoroughly review this voluminous work is beyond the scope of a short monograph.  We have to omit the work done on experimental diabetic cataracts, naphthalene cataracts, and dinitrophenol cataracts.  But before closing this chapter, let us consider only four of the papers on senile cataract.
As long ago as 1939, Muhlmann and corworkers (11), in the Argentine, obtained 90 percent good results in sixty patients with 113 incipient senile cataracts by 2 series of daily injections, for ten days each, of 50 to 100 milligrams of ascorbic acid.  He concluded that the treatment had no contraindications, should be tried in all incipient cases, and is more effective the earlier it is used.
In another 1939 paper, "Vitamin C and the Aging Eye," Bouton (11) of Detroit found "ascorbic acid deficiency can be held partly responsible for impairment of vision associated with senescence of the human eye and that the administration of ascorbic acid by mouth can counteract this process."  He gave 350 milligrams of ascorbic acid a day for four to eight weeks and obtained improvement in vision in 60 percent of the treated group; marked improvement usually set in within the first two weeks of treatment. He believed that cataracts already formed were not affected and the benefits obtained were due to clearing of the other optic media and to some degree to a beneficial effect on the retinal vessels and the head of the optic nerve.  While 350 milligrams of ascorbic acid a day was considered a huge dose in 1939, the administration of multigram daily levels would have obtained even better results.
Atkinson, an ophthalmologist of more than thirty years’ experience, published in 1952, a scholarly paper on the senile cataract (11).  He stated,"…in a larger percentage of cases than most surgeons have realized , cataract is a preventable disease." In 1952 he had over 450 cases of incipient cataract under his treatment which included, among other dietary suggestions, the administration of about 1 gram of ascorbic acid a day.  He noted that untreated incipient cataracts matured in four years or less, some taking only one year,  Of his over 450 patients under prophylaxis, only a limited number matured and went to surgery, whereas formerly nearly all had to submit to surgery.  He states that in a number of his patients the cataracts have remained incipient over a period of eleven years.
The promising leads relating to ascorbic acid cited above, have not been picked up or been the subject of intensive research in an effort to help prevent this annual plague of blindness.  Why?  A search of the government bulletin (6) entitled, "Research Profile — Summary of Progress in Eye Disorders," discussed before, fails to reveal a single mention of ascorbic acid in its 16 pages.  This indicates that no research on the use of ascorbic acid for the prevention of blindness is being conducted at the National Institutes of Health or the National Institute of Neurological Diseases and Blindness.  The same situation probably exists in the research facilities of the many publicly supported charitable foundations for the blind.
Most of the investigators using ascorbic acid in the treatment of eye pathology employed it orally or by injection.  It is also possible to use it as a solution of sodium ascorbate applied topically.  This is especially effective when the topical application is done iontophoretically.  This method uses a harmless mild electric current to force the ascorbate into the eye tissues. As pointed out by Erlanger (12), in 1954, after many years of research, iontophoresis is another neglected principle of therapy which should find much wider use in the treatment of eye diseases.  Topical megascorbic therapy and iontophoresis should be a most valuable combination.
Retinal Detachment
Another area for eye research is in retinal detachments. A 1964 paper by Weber and Wilson (12) showed that the ascorbic acid levels in the subretinal fluid decreased with the length of time of the retinal detachments.  Possibly, individuals on high levels of ascorbic acid would have less chance of suffering retinal detachment. The research on this condition could be combined with the above suggested tests on glaucoma and cataracts to determine whether the prophylactic daily dosage of 3 to 5 grams of ascorbic acid would also reduce the incidence of retinal detachments.

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