Our experiences of life are inexorably linked to the health of our eyes and supplements could well be the key to sustaining it. From the exhilaration of the first time, we see our parents, to moments of tears welling up in grief, our eyes trace a million sensory pathways to our mind. As we age, our eyesight starts to fade and our lives make the transition from colorful vibrancy to monochromatic monotony.
So is there anything we do to prevent or at least delay the poor vision that seems to be inevitable in old age? A balanced diet with an ample amount of green leafy vegetables, orange-yellow fruits and vegetables, a good amount of protein, nuts, and dairy products provides our body with plenty of nutrition. Isn’t that enough to sustain our eye health as well? Do we really need to take eye-vitamins or other specific eye health supplements?
In accordance with the premise of eye health being central to human well being, this article attempts to shed light on the pros and cons of supplements aiding eye health. First, let’s see what are the common eye health and vision problems before moving on to what scientific evidence says about nutritional supplements for helping such cases.
Common Eye Problems
Visual impairment is of national and global health concern and it results in a negative impact on physical and mental health. Individuals who are visually impaired are particularly at a greater risk of accidents, chronic health conditions, social withdrawal, depression, and mortality. As the number of the aging population is increasing all over the world, visual impairment and blindness are increasing as well.
Approximately 12 million people who are 40 years or above have vision impairment in the United States. This includes 1 million who are blind, 8 million who developed vision impairment due to uncorrected refractive error and 3 million who have vision impairment after correction.
The leading causes of vision impairment all over the world are:
- Uncorrected refractive errors
- Age-related macular degeneration
- Diabetic retinopathy
- Corneal opacity
Some variations can be seen in the causes of visual impairment in developed and developing countries. Vision impairment because of cataracts is higher in low and middle-income countries whereas diabetic retinopathy, glaucoma, and age-related macular degeneration are more common in high-income countries.
Age-Related Macular Degeneration (AMD)
Age-related macular degeneration is a condition in which there is damage to the macula of the retina that causes blurred or no vision. Even though it is not complete blindness, losing the central vision does make life difficult as it becomes hard to recognize faces, read, drive and go about freely with our normal activity.
AMD occurs mostly in old people. Smoking, high blood pressure, and genetic factors do have a key role in its progression. Antioxidant vitamins and minerals do not show any effect in its prevention, but the nutritional supplements do slow down the progression of this disease from early AMD to late AMD.
Our eyes have a natural clear lens. The clouding of this lens decreases our vision and is known as a cataract.
Cataract mainly develops as we age or have an eye injury that changes the tissues that make up the eye lens. Even though cataracts are not curable they are treatable. They include monitoring and change in lifestyle.
The ultimate solution is surgery to remove the diseased lens. More than half of the Americans, aged 80 or more have developed a cataract or have undergone cataract surgery. More than 25 million Americans suffer from cataracts.
Scientific Evidence: The Effect of Supplements on Eye Health
Over the years, a number of claims have been made that some particular nutrients help maintain eye function. They insulate us from the harmful light and help in reducing the development of age-related degenerative diseases.
Studies have shown that people who have a certain form of AMD which is age-related macular degeneration, may gain from a proper mix of vitamins and minerals. These nutritional supplements may slow down the degeneration process.
Age-related Eye Disease Study (AREDS)
AREDS or Age-Related Eye Disease Study is a National Institute of Health clinical trial where more than 5000 people were enrolled with AMD.
In October 2001, when it ended, AREDS indicated that five years of supplementation with high doses of antioxidant vitamins, zinc, and copper reduced the risk of developing advanced AMD in 30 percent of individuals who took the supplements and had moderate to advanced dry or wet AMD.
The AREDS formulation included:
- 500 milligrams (mg) of Vitamin C
- 15 mg of beta-carotene ( for nonsmokers only)
- 400 IU of Vitamin E
- 80 mg of zinc as zinc oxide
- 2 mg of copper as cupric oxide ( so as to be able to avoid anemia caused by a high dose of zinc )
Age-Related Eye Disease Study 2 (AREDS 2)
In 2013, the result of a follow-up study was published. It was known as the Age-related Eye Disease Study 2 or AREDS2. Some very important changes were made. The beta-carotene was substituted by the nutrients lutein and zeaxanthin as beta carotene was linked to the increased risk of lung cancer in smokers.
Omega-3-fatty-acids were added to determine whether the formulation was more effective in reducing the risk of advanced AMD and cataract.
While omega-3-fatty-acids had no effect on the formulation, the combination formulation of lutein and zeaxanthin reduced the risk of disease progression by 19 percent and vision loss by 25 percent.
Even though in patients with early AMD the supplement did not slow down the progression of the disease to intermediate AMD.
The AREDS2 formulation now includes:
- 500 mg of Vitamin C
- 400 IU of Vitamin E
- 80 mg zinc as zinc oxide
- 2 mg copper as cupric oxide
- 10 mg lutein
- 2 mg zeaxanthin
The Recommended Supplements for Dry AMD and AREDS Vitamins
Studies have shown that regular consumption of nutritional supplements along with a balanced diet that is full of fruits and vegetables which provide an ample amount of vitamins and minerals might help people with early to intermediate AMD.
Presently, the AREDS and AREDS2 formulas are the only treatment that has been proven to be effective for intermediate to severe dry AMD. These have become popular amongst the consumers because of the dosages recommended by AREDS and AREDS2.
The Vitamin E and zinc dosage that is recommended is much higher than those of multivitamin supplements in the market and also higher than the bioavailability of these nutrients through a balanced diet.
Green leafy vegetables and orange-yellow fruits are specifically good for eye health. Whether the food is sufficient or the supplement is needed or the amount of supplement that is needed is enough should be determined by your ophthalmologist on the basis of your eye health.
Ultimately, the combination of a healthy diet and supplementing with necessary eye-vitamins ensures you do get adequate amounts of all the nutrients you need to sustain and improve your eye health. Rather than just relying on diet or supplement alone, combining both offers you a better chance at beating all possible deficiencies that affect eye health and this also provides your eyes with all the resources needed for repair and maintenance. The most essential nutrients needed for eye health are given below.
7 Nutritional Supplements that Boost Eye Health
1. Vitamin A
Vitamin A is a fat-soluble vitamin that plays a very important role in our body. Along with other vitamins and minerals, it is defined as an essential micronutrient. This means our body can not manufacture it and we need to provide it through our diet.
Vitamin A are of two different types. The first is preformed Vitamin A that is found as ‘retinol’ which is the active Vitamin A and is directly used by the body. Good food sources of retinol Vitamin A are whole milk, cheese, chicken liver and beef.
The second is provitamin A that is found in plant-based products like fruits, vegetables and grains. The most common type of provitamin A that is found in food is carotenoids.. The carotenoids are converted to retinol by the body after the food is digested by the body. Good food sources of it are colorful fruits and vegetables like kale, carrots, sweet potatoes, spinach and cantaloupes. The most prevalent and effective provitamin A carotenoid is beta-carotene. It is important that all food products containing high amounts of vitamin A should not be overcooked as this can destroy the vitamin or reduce its content.
Vitamin A plays a very important role in vision. It maintains the cornea keeping it clean. It is also a component of rhodopsin, which is a protein in our eyes that allows us with vision in low light.
Studies have shown that Vitamin A eye drops are effective for the treatment of dry eyes. Vitamin A eye drops have also been shown effectively treating a specific eye inflammation called superior limbic keratoconjunctivitis.
Vitamin A deficiency is rare. Mainly in developed countries where diet has a high amount of animal products. If unaddressed, it can cause a condition called xerophthalmia.
Xerophthalmia is an eye disease which begins with night blindness. If the deficiency continues, our tear ducts and eye can dry out. Finally, the cornea softens and results in blindness which is irreversible. Vitamin A deficiency can also damage the retina that also can contribute to blindness.
Even though Vitamin A or its precursor beta-carotene has not been included in AREDS2 formulation, still this vitamin consumed via nutrient-rich food is very essential.
Carotenoids are nutrients which are widely distributed in foods, especially fruits and vegetables. They appear to have antioxidant properties. Lutein is one of the carotenoid and has anti-inflammatory properties. Lutein has several beneficial effects on eye health.
Lutein is known to improve or prevent age-related macular diseases and even cataracts. Studies have reported that lutein also has positive effects in different clinical conditions. Lutein is one of the two major carotenoids that is found as a color pigment in the human eye. It functions as a light filter protecting the tissues in the eye from damage through sunlight.
Foods rich in lutein include egg yolk, spinach, kale, broccoli, corn, kiwi, orange pepper, orange juice, grapes, squash, and zucchini. Lutein is better absorbed when taken along with high-fat foods. Just make sure to choose healthy fat sources such as olive oil, nuts, seeds, avocado, coconut, etc.
They are deep yellow carotenoid pigments that are present in the retina of our eyes.
Zeaxanthin along with lutein block high energy blue wavelengths of light from reaching the underlying structures in the retina, reducing the risk of light-induced oxidative damage that may lead to AMD. It also maintains and protects healthy cells in the eyes. It is deposited in high quantities in the retina of the eye.
The best natural food sources for zeaxanthin are green leafy vegetables and yellow fruits and vegetables. Amongst them, kale and spinach top the list. Among non-vegetarian food, egg yolk is an excellent source of this nutrient.
Currently, there is no Recommended Dietary Allowance of zeaxanthin, but recent studies show health benefits by consuming 2 mg/day of a zeaxanthin supplement. Epidemiological studies and clinical trials like AREDS2 have brought attention to the functional benefits of these carotenoids , lutein and zeaxanthin, on ocular health.
Zinc is an essential mineral that plays a very important role in the transportation of Vitamin A from the liver to the retina to produce melanin. It is the protective pigment in the eyes. The vascular tissue layer under the retina has a very high concentration of zinc.
Zinc deficiency causes poor night vision and cloudy cataracts. People who are at risk of AMD or at the early stages of AMD may benefit from zinc supplements. As the human body does not produce the required amount of zinc that is required by the body, we need to intake zinc through proper diet, zinc fortified foods and supplements. Red meat, seafood, black-eyed peas, tofu, beans, mixed nuts, and wheat germ contain zinc.
The U.S. Food and Drug Association (FDA) recommends 11 mg/day of zinc for men and 8 mg/day for women. Those who are at risk from AMD, in accordance with AREDS studies have shown that 40-80 mg /day of zinc is beneficial.
As zinc supplements have been seen to interfere with copper absorption, 2mg/day of copper is also recommended.
5. Vitamin B1 (Thiamine)
Amongst the 8 essential B vitamins, vitamin B1 or thiamine is one. It has many important functions in our body. It plays a very important role in muscle, nerve and heart functions, in glucose metabolism and in the conversion of carbohydrates to energy. One of the causes of blurry vision is thiamine deficiency. It causes swelling of the optic nerve resulting in optic neuropathy.
Several studies have connected severe thiamine deficiency to blurry vision and vision loss. It has also been seen that patients have significantly improved after supplementation with thiamine.
As thiamine is not produced by the human body, various thiamine rich foods such as meat, whole grains and nuts need to be consumed to enable our body to function properly.
6. Omega 3-Fatty-Acids
Studies have suggested that omega-3-fatty-acids can help protect the adult eyes from dry eye syndrome and macular degeneration. It also may help the drainage of intraocular fluid properly from the eyes thereby decreasing the risk of high eye pressure and glaucoma.
In a European study that was published in 2008, subjects consuming oily fish at least once per week had half the risk of developing neovascular macular degeneration.
In 2009, a National Eye Institute (NEI) study found that participants who confirmed very high level of omega-3-fatty acids in their diet were 30 percent less likely to develop macular degeneration in a 12-year study.
A surprising result of AREDS2 was that the participants supplementing their diet with 1000 mg of omega-3 fatty acids daily did not show any reduction from the risk of progressive AMD in a 5-year duration study compared to the ones in placebo. A possible explanation was that omega-3-fatty-acids obtained through food are much more effective in reducing the risk of age-related eye diseases than provided from nutrient supplements. Omega-3-fatty-acids may be effective in reducing the risk of dry eyes.
The best source of omega-3-fatty-acid is cold-water fish like sardines, herring, salmon, and tuna. They are also in ample amounts in flaxseeds, flaxseed oil, walnuts, and dark green leafy vegetables.
7. Vitamin C
Smoking, diabetes, steroid use deplete the lens of the eye of Vitamin C. Studies have shown that low Vitamin C in the eye increases the risk of developing cataracts. When consumed in addition to other essential nutrients, Vitamin C can slow down the progression of AMD.
Several studies have linked the intake of Vitamin C with decreased risk of cataracts. Vitamin C promotes healthy gums, teeth, capillaries and also the efficient absorption of iron. All the cells in our body depend on it, especially the eyes, where it is accumulated in the tissues. It supports the health of the blood vessels in the eye.
In one of the studies, women who took Vitamin C for a span of 10 years or more showed a 64 percent reduction in the risk of developing cataracts.
One another study has shown that women taking a daily supplement of VItamin C with a dosage of 364 mg experienced a 57 percent reduction in the risk of cataract. The U.S. The Food and Drug Administration recommends men to take 90 mg per day of Vitamin C and women to take 75 mg / day.
People under stress will need more Vitamin C though. They include smokers, older people, athletes, diabetics, alcoholics, pregnant and breastfeeding mothers and people with chronic diseases. Citrus fruits like oranges, lemons, limes, and grapefruits have a very high quantity of Vitamin C.
10 Tips For Better Eye Health
There are many factors that affect eye health, so there are certain lifestyle changes that can make a big impact on improving your eyesight.
- Eat a balanced diet that ensures all the essential nutrients that are good for eye health and health in general.
- Exercise regularly. It improves the blood circulation that in turn improves oxygen level in the eye and effective removal of toxins.
- Sleep on time. A good night’s rest will ensure well-rested eyes.
- Do not smoke. Smoking increases the free radicals in the body resulting in oxidative stress. It increases the risks of vision problems such as cataracts and macular degeneration.
- Do not stare at bright lights. Wear sunglasses, while outside, to protect your eyes from harmful radiation.
- Wash your hands properly before putting it inside your eyes while wearing contact lenses.
- Prevent dirty and dusty air from entering your eyes.
- Use a humidifier to ensure sufficient moisture in the house.
- Cold compresses with dampened black tea and green tea bags, cold cucumber works wonder to the tired eyes.
- As you cross the age of 60, make sure you get your eyes checked regularly.
The Final Note
In order to connect with our surroundings, sight and vision are the two most important factors. In fact, 80 percent of the things that we perceive comes via our sense of sight. Eyes have the ability to focus on 50 different objects in one second. Eyes can distinguish around 10 million different kinds of colors. 80 percent of our learning comes via the eyes.
As poor vision makes it hard to deal with even basic things like reading, writing, driving, it is very important that we take good care of our eyes. Regular eye checkups can detect eye problems faster and most of them can be cured or taken care of properly before it gets complicated.
It is always better to get your vitamins and minerals through your food rather than rely on supplements alone. Good nutrient-rich food that provides us with sufficient amounts of vitamins and minerals that are good for our eyes should be generously served in your diet. They are mainly Vitamin A, beta-carotene, lutein and zeaxanthin, Vitamin C, Vitamin B1, omega-3-fatty-acids and zinc.
The green leafy vegetables like kale, mustard greens, spinach, orange-yellow vegetables like carrots, orange pepper, fatty fish like salmon, mackerel, herring, do provide nutrients that are good for eye health in accordance with the AREDS and AREDS2 formulation.
In case, the diet is not sufficient enough, nutrient supplements prescribed by your doctor can help you bridge the gap. Consumption in accordance with your needs can be your shield to the eye and ensure your good eye health.