If you have been told you have ocular hypertension, meaning higher than normal eye pressure without signs of glaucoma yet, you may have seen headlines this month about vitamin B3 and glaucoma prevention. A study published in JAMA Ophthalmology found that patients taking a form of vitamin B3 called nicotinamide were significantly less likely to develop glaucoma than those who were not. Here is a clear look at what the research found, how strong the evidence really is, and what it means for your own eye care.
What the Study Looked At
Researchers reviewed electronic health records from 67 health care organizations across the country, covering two decades of patient data. They identified patients diagnosed with ocular hypertension, elevated eye pressure without an existing glaucoma diagnosis, who had not yet started glaucoma drops or laser treatment. Using statistical matching, they compared nearly 1,500 patients who were taking nicotinamide to a similar group who were not, then tracked both groups for an average of almost four years.
This type of study is called a retrospective cohort study. It looks back at existing medical records rather than assigning treatment in a controlled experiment, which is an important distinction covered below.
What the Researchers Found
Among patients taking nicotinamide, glaucoma developed in about 3.5% of cases, compared to 9% of patients who were not taking it. Patients on nicotinamide were also less likely to need pressure-lowering eye drops or laser treatment during the study period. In statistical terms, nicotinamide use was associated with roughly a two-thirds reduction in the relative risk of a glaucoma diagnosis.
Those are meaningful numbers, and they are consistent with earlier laboratory research suggesting that nicotinamide may help support the energy production of retinal cells, potentially making them more resilient to the stress caused by elevated eye pressure.
What the Study Does Not Prove
This is the part that matters most for patients considering whether to act on this news.
Because this was an observational study of existing health records rather than a randomized controlled trial, it can show an association between nicotinamide and lower glaucoma risk, but it cannot prove that nicotinamide caused that lower risk. People who choose to take a vitamin supplement may also be more likely to exercise, eat well, keep regular medical appointments, or take other steps that independently support eye health. The study’s own authors were careful to describe their findings as reason for further investigation, not as a treatment recommendation, and called for prospective clinical trials to confirm whether nicotinamide truly changes the course of the disease.
It is also worth knowing that high doses of niacin-related supplements have been associated with side effects in some studies, including effects on the liver, so more is not automatically better or safer.
What This Means for You
If you have ocular hypertension or a family history of glaucoma, this research is genuinely encouraging and worth discussing at your next visit. But it is not a reason to start high-dose supplementation on your own, replace any prescribed drops or monitoring, or assume a supplement can substitute for regular eye pressure checks.
Glaucoma is a progressive condition that often has no early symptoms, which is exactly why regular monitoring matters so much for anyone with elevated eye pressure or other risk factors. The best next step is a conversation with your eye doctor about your individual risk factors, your current eye pressure trends, and whether a supplement like nicotinamide makes sense as part of your broader care plan.
Talk to Our Team
Our physicians stay current on emerging glaucoma research so we can help you make informed decisions about your eye health. If you have ocular hypertension, a family history of glaucoma, or simply have questions about this study, we would like to see you.
Source: Muayad J, Sallam AB, De Francesco T, De Moraes CG, Ahmed IIK. Nicotinamide Supplementation and Primary Open-Angle Glaucoma in Patients With Ocular Hypertension. JAMA Ophthalmology. Published online July 9, 2026.
About the Author: Dr. Heather Dealy
Dr. Dealy is a board-certified ophthalmic surgeon specializing in cataract and glaucoma care. She earned her BA from Bucknell University and her MD from Thomas Jefferson Medical College. After completing her internship at Yale and residency at SUNY Upstate, she completed a glaucoma fellowship at the Scheie Eye Institute, University of Pennsylvania. Practicing in Wilmington, Delaware since 2004, she joined Promise in Sight in 2020 to provide humanitarian eye care in Central America. She is a member of several ophthalmology societies and enjoys racquet sports, gardening, traveling, and reading.
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