The NP-10 System™: Rethinking Glaucoma Support Through Proactive Care

You've just been told you have glaucoma, or are at risk of having it. The word lands quietly, but heavily. You're handed a prescription for eye drops to reduce eye pressure and told to come back in six months.

It's a familiar scene — and for many, it feels like the beginning of a slow yet inevitable decline in vision.

But what if that moment could mark the start of something more proactive?

Glaucoma is often described as the "silent thief of sight." It's a chronic, progressive condition that affects over 80 million people worldwide. And while lowering eye pressure remains the cornerstone of treatment, it's not the whole story. In fact, around 30-40% of those with glaucoma continue to lose vision despite textbook-perfect pressure control.

As an eye surgeon, I've seen this firsthand. It's led me to ask a deeper question: what else is driving this disease?

The answer lies in the optic nerve, and more specifically, in the health of the retinal ganglion cells that make up that nerve. Their key role is to transmit visual information (what you see) from the eye for processing (how you perceive what you see) by the brain. 

The retinal ganglion cells and optic nerve use a lot of energy, and this makes them highly vulnerable to stress and damage. So while eye pressure is a key risk factor, glaucoma isn't only a pressure problem. It's a neurodegenerative condition. And like other diseases that affect the nervous system, it's shaped by a complex web of biological factors.

That understanding became the foundation for a broader philosophy I call Proactive Glaucoma Care, which encompasses a neuroprotective framework I spent over two years developing: the NP-10 System™.

The Story Behind NP-10

The NP-10 System™ wasn't developed in a lab or boardroom. It began as a deeply personal project.

My father was diagnosed with normal tension glaucoma, a form of glaucoma that progresses even when eye pressure is within normal limits. It's notoriously difficult to manage, and it raises important questions about what else drives optic nerve damage.

Faced with this challenge, I began researching the broader biology of glaucoma: mitochondrial health, vascular integrity, oxidative stress, and more. What emerged was a systems-based model that looked beyond pressure and toward neuroprotection.

That model became NP-10.

So what started as a mission to help my father has since evolved into a framework that goes beyond eye drops and features neuroprotection as a key pillar of holistic glaucoma support.

The NP-10 System™: A Neuroprotective Framework

The NP-10 (Neuroprotection 10) System™ is an evidence-based framework that identifies and targets the ten key biocellular pathways and mechanisms that contribute to glaucoma progression. These are grouped into four core areas:

Core Area #1. Pressure & Stress

• Eye Pressure: Still the main risk factor, but not the only one.
• Psychological Stress: Chronic stress increases eye pressure and may influence disease progression through vascular and inflammatory mechanisms.

Core Area #2. Cellular Health

• Mitochondrial Dysfunction: Impairs energy production in retinal ganglion cells.
• Glucose Metabolism Disturbances: Can lead to glycation and oxidative damage.
• Oxidative Stress: Damages DNA, proteins, and lipids in optic nerve cells.
• Chronic Inflammation: Sustained immune activation harms neural tissues.

Core Area #3. Vascular Integrity

• Vascular Dysregulation: Poor blood flow to the optic nerve contributes to cell death.
• Elevated Homocysteine & Endothelial Dysfunction: Linked to vascular stiffness and reduced perfusion.

Core Area #4. Functional Support

• Axonal Transport Failure: Disrupts communication between eye and brain.
• Macular Pigment Deficiency: Reduces antioxidant protection in the macula.

Each pathway represents a potential point of intervention; not just through medication, but through nutrition, lifestyle, and targeted neuroprotective support.

One of the most accessible and effective ways to address these pathways is through nutrition. Certain micronutrients — including botanical antioxidants, B vitamins, and mitochondrial cofactors — have shown promise in supporting retinal ganglion cell health in clinical studies. 

While research is ongoing, the rationale is clear: if we can protect against oxidative stress, improve mitochondrial function, support vascular integrity and support optic nerve resilience, alongside reducing eye pressure, then this gives us the best chance of slowing glaucoma progression and preserving long-term vision.

Protocols like Nutravision are designed with this in mind. It's a curated nutritional supplement strategy that aligns with the NP-10 System™ to help reduce risk and stabilise glaucoma progression. Our pilot study found that in those with consistently well-controlled eye pressures at 15 mmHg or less, 81% showed improvement in their visual field test parameters after taking Nutravision for 5.7 months*.

In the case example above, a 67-year-old female (who already had cataract surgery and glaucoma stent implantation previously) recovered some of her visual sensitivity (red circle) after taking Nutravision consistently for 6 months. 

But Nutravision or NP-10 is not a standalone solution. It's part of a broader philosophy — one that encourages people to take an active role in their eye care, understand the biology of their condition, and explore evidence-informed ways to support their vision.

(*Note: The clinical data and case example shown do not constitute randomised clinical trial evidence or treatment recommendations. Individual results to supplements vary and you should always consult with your healthcare professional first before use. Supplements must not replace your existing prescribed treatments.)

What You Can Do

For those living with glaucoma, the NP-10 System™ offers a comprehensive roadmap for glaucoma neuroprotection. It's not a replacement for conventional treatment, but a complement to it. Here are a few practical steps that you can consider:

• Talk to your eye specialist about neuroprotection and whether nutritional support might be appropriate.
• Move regularly — even light aerobic activity can support ocular perfusion.
• Manage stress through mindfulness, therapy, or breathing techniques.
• Prioritise sleep — aim for consistency and deep rest.
• Explore targeted nutrition — ideally under the guidance of a clinician familiar with glaucoma neuroprotection.

Looking Ahead

Glaucoma care is evolving. We're moving beyond a single metric — eye pressure — and toward a systems-based understanding of optic nerve health. The NP-10 System™ is part of that evolution as part of Proactive Glaucoma Care.

This isn't a trend. It's a shift in mindset. A way of thinking differently about a condition that affects millions, and a way of giving people more agency in how they manage glaucoma.

Because glaucoma isn't only about the eye or eye pressure. It's about the health of the optic nerve. And the optic nerve deserves more than pressure control — it deserves effective neuroprotection.