Ozone Therapy for Eyes: Macular Degeneration, Glaucoma, and Vision Health

Ozone therapy for eye diseases is one of the more surprising applications of medical ozone, and the early clinical data, particularly for age-related macular degeneration, is more compelling than you might expect. But this is a field where the distinction between systemic ozone therapy and direct eye exposure is critical to understand.

Important Clarification: Systemic, Not Topical

Before going further, one point needs to be absolutely clear: ozone therapy for eye diseases does not involve putting ozone in or on the eyes. Ozone gas is toxic to exposed tissue and would damage the cornea and conjunctiva.

Instead, ozone is administered systemically, typically through major autohemotherapy (MAH), where blood is drawn, mixed with ozone, and reinfused intravenously. The therapeutic effects on the eyes come through improved blood circulation, enhanced oxygen delivery, and systemic antioxidant activation.

This is an important distinction because environmental ozone exposure (air pollution) is actually associated with increased risk of eye diseases. A 2025 study published in The Innovation found that medium and high levels of environmental ozone exposure increased the risk of developing AMD by 28% and 2-fold respectively (Chen et al., 2025). Medical ozone therapy works differently because it is administered in controlled doses that trigger beneficial adaptive responses.

Ozone Therapy for Age-Related Macular Degeneration

The strongest evidence for ozone therapy in eye diseases comes from studies on dry age-related macular degeneration (AMD), the leading cause of vision loss in people over 50.

The Siena Studies

Two clinical studies performed at the University of Siena, involving a total of 217 patients, evaluated ozone therapy for dry AMD. The results were published in multiple journals and showed that ozone therapy:

• Stopped the progression of dry AMD in treated patients
• Improved visual acuity (measured by standard eye charts)
• Improved patient well-being and quality of life
• Was safe with excellent patient compliance

The researchers noted that while ozone therapy may not completely restore visual acuity, it offered meaningful protection against the natural course of AMD and improved functional vision (Copello et al., 2012. DOI: 10.4081/ozone.2012.e3).

The Cuban Experience

Dr. Silvia Menendez from the National Center for Scientific Research in Cuba reported on a larger cohort. In a study of 200 patients with various eye conditions, 69 to 72% experienced visual acuity improvement, and patients had their visual field expanded between 59 to 76%. Dr. Menendez treated thousands of patients with eye conditions including macular degeneration, glaucoma, and retinitis pigmentosa over her career.

“Ozone therapy can stop the progression of dry age-related macular degeneration while improving visual acuity and patient well-being. Although it may not completely improve visual acuity, this approach offers protection against the natural course of AMD.”

A Randomized Controlled Trial

A randomized controlled clinical study evaluated the effects of major autohemotherapy (MAH) in the treatment of dry AMD. The study compared ozone-treated patients to controls and found statistically significant improvements in visual function in the ozone group (Copello et al., 2012. DOI: 10.4081/ozone.2012.e3).

How Ozone May Help Eye Diseases

The proposed mechanisms for ozone’s effects on the eyes are centered on vascular and metabolic improvements:

Improved retinal blood flow. The retina has one of the highest metabolic rates of any tissue in the body. AMD, glaucoma, and diabetic retinopathy all involve compromised retinal blood flow. Ozone therapy improves erythrocyte flexibility (the ability of red blood cells to squeeze through small capillaries), increases 2,3-DPG levels (enhancing oxygen release from hemoglobin), and promotes vasodilation.

Enhanced oxygen delivery. The retina is exquisitely sensitive to oxygen deprivation. By improving oxygen transport and release, ozone therapy may help maintain retinal cell viability in conditions where blood supply is compromised.

Antioxidant protection. Oxidative stress is a major factor in AMD and other degenerative eye diseases. Ozone therapy activates the Nrf2 pathway, upregulating endogenous antioxidant enzymes (SOD, catalase, glutathione peroxidase) that protect retinal cells from oxidative damage (Re et al., 2014. DOI: 10.1155/2014/547242).

Anti-inflammatory effects. Chronic low-grade inflammation (inflammaging) contributes to AMD progression. Ozone’s anti-inflammatory properties, particularly NF-kB suppression, may help slow this process.

Eye Conditions Where Ozone Has Been Explored

Condition	Evidence Level	Key Findings	Notes
Dry AMD	Moderate (RCT + cohort studies)	Slowed progression, improved acuity	Best-studied indication
Wet AMD	None	Not studied; anti-VEGF is standard	Ozone not appropriate for wet AMD
Glaucoma	Very limited (clinical reports)	Possible IOP reduction, optic nerve support	Theoretical rationale is sound
Retinitis pigmentosa	Very limited (clinical reports)	Some visual field improvement reported	Cuban clinical experience
Diabetic retinopathy	Minimal (preclinical)	Improved retinal vascular function	Needs clinical studies

The Dry AMD Focus

It is important to emphasize that only the dry form of AMD has been studied with ozone therapy. Dry AMD accounts for about 80 to 90% of AMD cases and is characterized by the gradual breakdown of light-sensitive cells in the macula and the retinal pigment epithelium.

There is currently no FDA-approved treatment for dry AMD (the AREDS2 supplement formula is the standard of care but only slows progression modestly). This treatment gap makes the ozone therapy data particularly interesting, because patients with dry AMD have very few options.

Wet AMD, which involves abnormal blood vessel growth under the retina, is treated with anti-VEGF injections (ranibizumab, aflibercept, brolucizumab). Ozone therapy has not been studied for wet AMD and should not be used as an alternative to anti-VEGF treatment.

Ozone and Glaucoma

Glaucoma involves progressive damage to the optic nerve, usually (but not always) associated with elevated intraocular pressure (IOP). The theoretical rationale for ozone in glaucoma includes:

• Improved blood flow to the optic nerve head
• Neuroprotective effects through antioxidant activation
• Possible IOP reduction through improved aqueous humor outflow

Clinical data is limited to reports from practitioners like Dr. Menendez who have used ozone for glaucoma patients. No controlled trials exist. Glaucoma patients should not discontinue standard treatments (IOP-lowering drops, laser, surgery) in favor of ozone therapy.

Treatment Protocol for Eye Conditions

Based on the published studies, the typical protocol for eye conditions involves:

Method: Major autohemotherapy (MAH). Blood is drawn (100 to 200 mL), mixed with ozone (20 to 40 mcg/mL), and reinfused.

Frequency: 2 sessions per week during the initial treatment phase.

Duration: 15 to 20 sessions over 8 to 10 weeks for the initial course.

Maintenance: Monthly sessions to sustain benefits.

Assessment: Visual acuity testing and visual field testing before, during, and after treatment to measure response.

What About Retinal Vascular Reactivity?

A study published in Microvascular Research used optical coherence tomography angiography (OCTA) to assess ozone-induced retinal vascular reactivity. The findings showed that ozone therapy induced measurable changes in retinal blood vessel function, supporting the vascular mechanism theory (2022. DOI: 10.1016/j.mvr.2022.104402).

This is significant because OCTA provides objective, quantifiable evidence of vascular changes rather than relying solely on subjective visual acuity reports.

Limitations and Unknowns

Despite the promising results, several limitations must be acknowledged:

• Most studies come from a small number of research groups (primarily Siena and Cuba)
• Sample sizes are modest (the largest study involved 217 patients)
• Long-term outcomes (5+ years) have not been reported
• The optimal ozone concentration, session frequency, and treatment duration have not been standardized
• No head-to-head comparisons with AREDS2 supplementation exist
• The studies have not been replicated by independent research groups

Practical Considerations

For patients considering ozone therapy for eye conditions:

• Do not discontinue current treatments. Ozone should complement, not replace, standard eye care
• Get baseline testing. Visual acuity, visual field, and OCT imaging before starting ozone therapy will help track any changes
• Find an experienced practitioner. Ozone therapy for eye conditions is a niche application. Look for practitioners who have specific experience with this indication
• Monitor regularly. Continue regular ophthalmologist visits throughout ozone treatment
• Set realistic expectations. The goal is typically to slow or stop progression rather than restore lost vision

The Bottom Line

Ozone therapy for eye diseases is a small but intriguing field. The dry AMD data from Siena and Cuba is more rigorous than many people expect, with a randomized controlled trial showing benefit. The vascular and antioxidant mechanisms make biological sense for a disease driven by poor retinal blood flow and oxidative damage.

But this is still a niche application with limited evidence. Patients with dry AMD who have exhausted conventional options may find ozone therapy worth exploring. For glaucoma, retinitis pigmentosa, and other eye conditions, the evidence is too thin to make even a cautious recommendation.

The field needs larger, multi-center trials. Until those exist, ozone therapy for eye diseases will remain promising but unproven.

References

• Chen, Y. et al. (2025). Ozone exposure and increased risk of age-related macular degeneration: Evidence from nationwide cohort and toxicological studies. The Innovation, 6(3). DOI: 10.1016/j.xinn.2025.100754
• Copello, M. et al. (2012). Visual Improvement Following Ozone Therapy in Dry Age Related Macular Degeneration: A Review. Ozone Therapy, 1(1), e3. DOI: 10.4081/ozone.2012.e3
• Re, L. et al. (2014). Is ozone pre-conditioning effect linked to Nrf2/EpRE activation pathway in vivo? Free Radical Biology and Medicine, 71, 321-327. DOI: 10.1155/2014/547242
• Retinal vascular reactivity study. (2022). Microvascular Research, 144, 104402. DOI: 10.1016/j.mvr.2022.104402