Supplements should not be overlooked for eye health.

Knowing which nutrients can help improve eye health is essential for the prevention of future eye problems. Retailers should keep up to date on the latest research to better help their customers and to make their supplement section a little easier on the eyes.

Common Conditions
Age-Related Problems. The Age-Related Eye Disease Study (AREDS) was a major clinical trial with 3,640 enrolled subjects. This landmark 2001 study provided evidence that nutritional intervention in the form of supplements (a formula including vitamins C, E, beta-carotene, zinc and copper) could delay the progression of age-related macular degeneration (AMD). The study concluded that taking an antioxidant vitamin or mineral supplement reduced the risk of advanced AMD progression by about 25% and showed a 19% reduction in visual acuity loss in some subjects.

However, a 2008 study by The Wilmer Eye Institute of Johns Hopkins University School of Medicine found that consumer knowledge about the eye health-nutrition link may be less than adequate. The study surveyed 332 individuals who identified themselves as having AMD. Out of these, 228 were considered candidates that would benefit from the AREDS formula, but only 140 patients (61%) in this group were using the correct formula as recommended. They found that almost 50% of the candidates did not correctly answer questions on the relevance of vitamin/mineral supplements to their eye condition and how their vision might benefit.

Headed by Susan B. Bressler, M.D., the research team emphasized that improved patient education is vital for consumers to utilize the potential of supplementation. Retailers can help customers understand the link between nutrition and eye health through literature or an in-store seminar.

Being aware of the latest research is essential for helping consumers as effectively as possible. AREDS2, a follow-up to the original trial, began in June 2008 and includes 4,000 patients at high risk for AMD. It will focus on the protective effects lutein (10 mg/day), zeaxanthin (2 mg/day) and omega-3 fatty acids (1 g/day) against AMD, as well as the link between nutrition and macular pigment optical density, cataract development and visual function.

There may be a nutritional link to other eye diseases as well. Glaucoma is a group of eye disorders leading to progressive damage to the optic nerve, and is characterized by loss of nerve tissue resulting in loss of vision. Experts say that essential fatty acids and certain antioxidants may be beneficial for those with glaucoma (like bilberry or extracts of the French maritime pine bark).

There is evidence that some nutritional deficiencies in addition to UV exposure can lead to cataracts, a cloudy or opaque area in the normally clear lens of the eye. According to the American Optometric Association, these conditions may be prevented or slowed with a diet rich in lutein, zeaxanthin, vitamin C, vitamin E, zinc and essential fatty acids, by food or supplementation.

Dry Eye. There are two main causes of dry eye: decreased secretion of tears by the lacrimal (tear-producing) glands and loss of tears due to excess evaporation. Both can lead to eye discomfort, often described as feelings of dryness, burning, a sandy/gritty sensation, or itchiness. Visual fatigue, sensitivity to light and blurred vision are also characteristic of dry eye. Sjögren’s syndrome, a chronic autoimmune disease in which a person’s white blood cells attack their moisture-producing glands, is an example of a condition leading to chronic dry eyes. Today, as many as four million Americans are living with this disease (1).

There is mounting evidence that essential fatty acid supplementation (orally) can help ease the symptoms of dry eye and Sjögren’s syndrome. A 2005 study found that a higher ratio of omega-6 to omega-3 fatty acid consumption was associated with a significantly increased risk of dry eye syndrome (>15:1 versus <4:1) (2), although a specific number for the most beneficial ratio of omegas is still under debate.

Other helpful remedies for dry eyes include natural teardrops, which may include calendula, eyebright and Kali muriaticum.

Also, vitamin A is required for the production of mucin from the glands to the eyelids, to help tear film spread across the eyelids for moisture and protection (3).

Blepharitis and conjunctivitis. Blepharitis is an infection of the eyelash follicles, usually due to bacteria overgrowth. While it is recommended to see a healthcare professional, those with this infection can gently cleanse their eye with regular or salt water, and place warm compresses over the eye to ease discomfort. An eyelid massage with clean hands is also an option. Conjunctivitis, more commonly known as pink eye, is an inflammation or infection of the conjunctiva, the outermost layer of the eye. Causes can be viral, bacterial or allergic. Depending on the cause, this condition can be very contagious and early diagnosis and treatment are essential to preventing its spread. Warm or cold compresses can be used to ease discomfort and any swelling before seeing a healthcare professional.

General Eye Health
For regular maintenance of healthy eyes, the following are some supplements that can be helpful:
The B vitamins have a range of uses: riboflavin (B2) imbalance can cause light sensitivity; niacin (B3) can reduce high cholesterol, which can result in retinal swelling; vitamin B12 helps maintain the myelin sheath surrounding the optic nerve; some research indicates that folic acid can help prevent cataracts (3).

Lutein and zeaxanthin are yellow plant pigments that accumulate at the back of the eyes and act as internal UV filters. Lutein has also been shown to help those with night blindness.

Vitamin C is an essential antioxidant crucial to the health of many eye tissues, such as boosting glutathione (an antioxidant) levels, maintaining capillary strength and promoting collagen production. It has been shown in many studies to reduce the risk of cataracts (3).

Calcium and magnesium play a symbiotic role in eye health including relaxing smooth eye muscles and relieving ocular migraines. Magnesium is crucial to preventing calcifications in eye tissue. Also, magnesium is required for the conversion of omega-3 fatty acids into DHA, which is transported to the retina to line photoreceptors. Since DHA is very sensitive to damage from light, antioxidants such as vitamin E can help fend off the toxic byproducts from this lipid peroxidation (3).

Zinc can help those with alopecia, the loss of hair from eyebrows and eyelashes, which are important for eye protection from debris. It also plays a vital role in bringing vitamin A from the liver to the retina in order to produce melanin, a protective pigment in the eyes (4).

Astaxanthin has been shown in recent studies to help with eye fatigue. WF

1. Sjögren’s Syndrome Foundation,, accessed Sept. 8, 2009.
2. B. Miljanoviç B, et al., “Relation between Dietary n-3 and n-6 Fatty Acids and Clinically Diagnosed Dry Eye Syndrome in Women,” Am J Clinical Nutrition, 82(4), 887-893 (2005).
3. B. Sardi, User’s Guide to Eye Health Supplements (Basic Health Publications, Inc., North Bergen, 2003).
4. American Optometric Association,, accessed Sept. 21, 2009.
5. “The Reduction of Eye Fatigue Improves Vision in Older Subjects,“ Reuters, Aug. 5, 2009.

Published in WholeFoods Magazine, Nov. 2009