Clinical White Paper – Clinical Nutrition and Supplements for Myopia, Blue Light Eye Strain, and Eye Health

Devan Patel, PharmD; Jill Barat, PharmD

In this day and age, almost all of us are on our devices and looking at our screens for extended periods of time. Whether your work involves computer usage, you are a video gamer, student, or just a lover of your device, most of us spend a little too much time looking at our screens. As such, you may experience the negative effects of blue light, which over time can damage our eyes, contributing to conditions such as eye strain and myopia.

In order to best support the health of our eyes, we must use a holistic approach. Eye health doesn’t just involve glasses, contact lenses, surgery, and medication – it also requires adequate support from your diet, supplements, and lifestyle habits. In this white paper, we will highlight common eye health problems and potential evidence-based nutrition, supplements, and lifestyle choices that can improve eye health.

Understanding the Role of Nutrition in Eye Health

While many eye issues are genetic, not all eye conditions are completely out of your control. There are several preventative measures you can take to protect your eyes, one such tool being proper nutrition. Several vitamins, minerals, and nutrients are great for our eyes. For example, foods containing zinc, vitamin C, vitamin E, lutein, omega-3 fatty acids, and zeaxanthin may help lower your risk of eye diseases like cataracts, glaucoma, and age-related macular degeneration (AMD). Additionally, following specific diets may benefit eye health, such as the:

• Mediterranean diet. Research indicates that a seafood and plant-based diet like the Mediterranean diet can lower your risk of AMD and heart disease. This meal plan emphasizes leafy vegetables, fruits, tree nuts, seafood, healthy fats, and whole grains.

• Low-glycemic index diets. People with diabetes may take advantage of a low-glycemic diet, which means prioritizing foods that have a low-glycemic index. This involves opting for foods like oatmeal, brown rice, and whole grain bread over things like overly processed sweetened cereals, white rice, or white bread.

• AREDS2 formula. The Age-Related Eye Diseases Study (AREDS) evaluated what nutrients were best for slowing AMD progression. Based on the study results, many experts would recommend the AREDS2 formula, which includes vitamin C (500 mg), vitamin E (400 IU), lutein (10 mg), zeaxanthin (2 mg), copper oxide (2 mg), and zinc oxide (80 mg), for individuals with AMD.

Although proper nutrition might improve symptoms or slow the progression of eye disease, it is not an end-all-be-all treatment. Nutrition should supplement any eye disease treatments that a healthcare provider has already prescribed. Additionally, it’s important to not start or use any supplements without first consulting your doctor (1).

Normal Healthy Eye Function

In order to best support your eyes, you should know the signs and symptoms of both healthy eye function and eye problems. 

Basic signs of normal eye function include:

Good Vision

Lubricated Eyes

White Sclera

Some signs that may indicate eye problems or visual disturbances include:

Blurred Vision

Redness

Burning or stinging sensation

Eye Pain

Swollen or puffy eyes

A dark spot in the central vision

Flashes or Floaters

Crusty Eyelids

If you are experiencing any of these, it is important to consult a healthcare provider to rule out any problems. These symptoms may indicate an underlying condition or infection.

Eye Health Goals Throughout Life

Sometimes aging brings about changes to eyesight and eye health. For example:

• The risk of impaired vision and blindness becomes greater with age, specifically in those over 65 years old.

• Blindness or impaired vision impacts as many as 3.3 million people over the age of 40 in the US, which accounts for every 1 in 28 people.

• The development of Age-Related Macular Degeneration (AMD) correlates with increased age, specifically after the age of 60, and is most prevalent in Caucasian individuals.

• Cataracts or clouding of the natural lens in the eye is another condition that worsens over time.  With the aging population, this is a condition that will affect everyone at some point.

While people often think of declining eye health as something unavoidable with aging, this may not necessarily be true for everyone. Though age certainly correlates with the development of eye conditions and eyesight changes, there may be ways to help preserve healthy eyesight and eye function well into your later years of life. 

These include:

• Eating a healthy diet. As previously mentioned, certain vitamins and foods may provide a protective effect against eye and vision issues. Some supplements can help to increase your intake of known eye super-nutrients, which we will discuss later.

• Regular eye checkups. Regularly consulting with an eye specialist can help identify and treat eye conditions early to prevent long-term complications. The frequency at which you go to the eye doctor will depend on your age and eye health.

• Regular exercise. High blood sugar levels are a hallmark of diabetes, which can lead to diabetic retinopathy, a condition that can damage the vessels in the eyes. Thankfully, exercise and a healthy diet can help prevent diabetes and improve blood sugar control, which can in turn lower your risk of developing complications like retinal disease and subsequent eye damage.

• Eye protection. Wearing sunglasses with a special tint can protect your eyes from UVA and UVB rays. Certain eyeglasses and contact lenses can also protect your eyes from blue light, which you can wear when looking at screens for an extended period.

Eye Conditions That Can Negatively Affect Eye Health and Function

There are several different types of eye conditions that can impact the health and wellness of your eyes. It is important to be aware of these and know their signs and symptoms so that you can promptly seek medical advice and attention. Below is a brief description of some of the most commonly diagnosed eye problems. 

Myopia (nearsightedness)

Myopia, commonly known as “nearsightedness” occurs when your eye shape causes light to focus in front of the retina as opposed to on the retina itself. This happens when the eye develops too long or the cornea is abnormally shaped. As a result, people with myopia can experience the following symptoms:

• Difficulty seeing far away

• Having to squint to see far away

• Eye strain

Some people with mild myopia may not notice any symptoms. Thus, it is important to get regular check-ups with the eye doctor to evaluate your vision.

Myopia can begin at an early age and get progressively worse until individuals reach their second or third decade of life. Research shows that more time spent outdoors can lower a child’s risk for nearsightedness, but experts are unclear as to why.

The typical treatment for myopia is glasses or contact lenses to improve eyesight. Some individuals may also be eligible for surgery, which can alter the cornea’s shape to improve light focus (4).

Hyperopia (farsightedness)

Hyperopia, referred to as “farsightedness” happens when the eye fails to bend light correctly. When this happens, individuals can see far away, but up-close objects tend to be blurry. As such, farsighted people may experience:

• Trouble with activities requiring close-up vision, such as reading

• Squinting

• Eye strain

• Headaches

Just like myopia, individuals can treat hyperopia with glasses or contacts. Refractive surgery can also be used to improve vision. Refractive laser surgery, like LASIK, reshapes the cornea with a laser (5).

Eye Strain

Eye strain is common, and many people experience it. Eye strain can happen due to prolonged screen time or decreased blinking. Blinking is important because it helps to distribute and replenish the lubrication of your eye, thus directly impacting your vision. When this doesn’t happen, you may experience eye strain.  Signs and symptoms of eyestrain include:

• Blurred vision

• Aching or tired eyelids

• Watery, irritated, or red eyes

• Headache

• Trouble keeping your eyes open

• Muscle spasms in the eyelid or eye

The list above is general and can also be indicative of other eye conditions. Therefore, if you experience any of these, it is best to consult an eye care professional to ensure nothing serious is going on.

Treatment of eyestrain first involves preventative measures. Minimizing screen time, taking breaks, lubricating eyes, and minimizing glare can all help prevent eye strain. If you experience eye strain, you may consider using artificial tears, resting your eyes, or changing your work environment (6).

Blue Light Damage

Blue light refers to a type of light that vibrates in the 380 to 500 nanometer range, which is the type of light with the highest energy and shortest wavelength. Blue light exposure can come from natural sources like the sun or artificial sources like our digital devices. Blue light damage can cause symptoms of eye strain like headaches, neck and shoulder pain, and blurred vision as well as difficulty sleeping.

Prolonged exposure to blue light can lead to conditions such as eye strain, AMD, cataracts, and increased risk of eye cancer. Thus, it is important to manage blue light exposure in a healthy way. You can use some of the same methods that you would use to combat eye strain.

Ways to reduce blue light exposure include:

• Wearing blue light glasses

• Taking breaks to look at something far away

• Minimizing glare and lighting

• Taking supplements for eye health (7)

Age-Related Macular Degeneration

Age-related macular degeneration, or AMD, is an eye condition caused by aging. With increased age, the macula, which is the part of the eye involved in sharp, straight-ahead vision, becomes damaged. As a result, AMD is the main cause of vision loss in older adults. Symptoms of AMD will depend on which stage of AMD you have. These stages include:

• Early dry AMD: This type of AMD does not cause symptoms.

• Intermediate dry AMD: Some people at this stage still won’t have symptoms. However, some individuals may experience central vision blurriness or difficulty seeing in low lighting.

• Late AMD (dry or wet type): In this stage, symptoms include straight lines appearing crooked or wavy. Additionally, there may be a blurry area in the center of one’s vision, which can get bigger with time. AMD in this stage can also make color less bright (8).

Glaucoma

Glaucoma is an eye disease that occurs when the optic nerve is damaged, causing vision difficulties. There are several things that can cause glaucoma, one of the major ones being elevated eye pressure. When the eye’s drainage system is abnormal, fluid builds up and increases pressure in the eye, which in turn damages the optic nerve.

Glaucoma is both chronic and progressive, meaning once vision is gone it cannot be restored. There are several types of glaucoma, some of which include:

• Open-angle glaucoma: This is the most common glaucoma type, which is characterized by a damaged filter in the eye’s drainage canals.

• Angle-closure glaucoma: This form of glaucoma happens when a narrow or closed angle between the cornea and iris blocks the drainage canals.

Many people with glaucoma do not experience any symptoms until they start to lose their vision. This usually starts with the development of blind spots in the peripheral vision.

Acute-closure glaucoma, however, can produce symptoms prior to vision loss. Some of the signs of acute-closure glaucoma include:

• Narrowed or blurred vision

• Eye pain

• Seeing halos around lights

• Vomiting

• Nausea

• Headache

There is no cure for glaucoma, but early intervention can help manage the condition. Medication, surgery, laser surgery, and cataract surgery are all options. However, in the absence of treatment, glaucoma can lead to permanent blindness (9).

Diabetic Retinopathy

Diabetic retinopathy is an eye condition that is the result of uncontrolled diabetes. With uncontrolled diabetes, your blood sugar levels remain too high for extended periods of time, which causes damage to the retina. The retina is responsible for detecting light and sending signals to the brain via the optic nerve.

You may not have symptoms of diabetic retinopathy in the beginning. Sometimes, individuals will experience vision changes like difficulty reading or seeing things far away. When diabetic retinopathy progresses, the retina becomes damaged. As a result, you may experience eye floaters, dark spots, and scarring in the eye tissues.

Preventing diabetic retinopathy is paramount, meaning that you should manage your diabetes and blood sugar as best as you can to lower your risk. If you’ve already developed diabetic retinopathy, treatments like injections, laser therapy, or surgery might improve the condition (10).

Cataracts

A cataract occurs due to the breakdown and clumping of the protein in your eye lens. As a result, the lens becomes cloudy, which can ultimately affect eyesight. There are several different types of cataracts, including age-related, congenital, secondary, and traumatic cataracts. Typical symptoms include:

• Blurry vision

• Difficulty seeing at night

• Lights causing a halo

• Double vision

• Nearsightedness

• Faded colors

We don’t fully understand why all cataracts happen, but experts hypothesize that factors such as smoking, diabetes, alcohol use, nutritional deficiencies, steroid use, UV exposure, and certain medications may contribute to the development of cataracts.

In the beginning stages of cataracts, treatment may involve eyeglasses or simply using stronger lighting to help you see better. If cataracts progress, surgery is usually the only effective form of treatment (11).

Eye Floaters

Eye floaters refer to small dots, specks, circles, or lines that occur in your line of vision. While they may appear like they are in front of your eye, they are actually caused by things inside of your eye. Floaters are small clumps of cells or gel within the eye that cast shadows, causing you to see things that appear to be “floating” in your vision.

Floaters can happen with age. As you get older, the vitreous fluid, which is the gel in between the retina and lens, can reduce and thicken, causing posterior vitreous detachment. This increases your risk of floaters. However, floaters can also occur without posterior vitreous detachment. 

People at increased risk of floaters include those that:

• Have nearsightedness

• Have had a prior surgery to treat cataracts

• Have had swelling/inflammation within the eye

Floaters are not usually serious, but you should still get them checked out if you experience them. Some floaters can mean that you have a detached or torn retina, which is serious and requires intervention. Otherwise, you can treat floaters with surgery, but this isn’t usually needed or recommended (12).

Dry Eye

A common eye condition is dry eye, which occurs when your eyes don’t produce enough tears to stay lubricated. As a result, you may experience eye discomfort and trouble seeing. Common symptoms include:

• Red eyes

• A scratchy sensation

• Light sensitivity

• Burning or stinging of the eyes

• Blurry vision

Typically, your body contains glands that produce tears to moisten the eyes. If you experience dry eye, this could mean that your eye glands don’t produce enough tears or your tears don’t make your eyes wet enough.

Dry eye can happen to everyone, but it’s more common in people over the age of 50, those wearing contact lenses, females, those with certain autoimmune disorders (e.g., lupus), or those deficient in vitamin A.

Thankfully, dry eye is usually manageable with over-the-counter eye drops, prescription medications, tear duct plugs, optimizing eyelid hygiene, and lifestyle changes (13).

Shortcomings in Current Eye Treatment Options

As mentioned, there are several treatment options available for different eye problems, and what option is best for you will depend on the condition itself and your personal preferences. Unfortunately, many of the treatment options available mostly focus on managing symptoms or delaying the progression of the eye disease instead of getting to the root cause. Common treatments include things like glasses, contacts, medications, and surgery. While these interventions can be very effective, they have some inherent limitations.

We often overlook the importance of nutrition in supporting eye health. Research supports the benefits of nutrients such as lutein, zeaxanthin, omega-3 fatty acids, vitamin C, and vitamin E in improving the wellness of our eyes. However, providers rarely emphasize the importance of dietary choices, supplementation, and lifestyle changes in treating and preventing eye disease.

To make the greatest impact on your eye health, a combination of traditional treatments (e.g., glasses, medication, surgery) with nutrition is best. Doing so will enhance your overall treatment regimen, preventing the progression of poor eyesight.

Ways to Help Support Myopia Through Nutrition, Supplements, and Lifestyle Choices

Knowing there are ways to support our eye health naturally, let’s discuss how we can treat myopia through a combination of nutrition, supplements, and lifestyle habits.

Nutrition

The food you intake can greatly benefit your eyesight if you incorporate the right nutrients. Foods rich in vitamins C, A, E, and zinc, as well as fatty acids, lutein, and zeaxanthin, can be used for overall eye health. Here’s where you can find these nutrients:

• Lutein and zeaxanthin – green leafy vegetables such as kale and spinach

• Vitamin E – almonds, sunflower seeds, and avocados  

• Vitamin C – kiwi, berries, greens, and guava

• Vitamin A – liver, egg yolks, cod liver oil, grass-fed butter

• Zinc – grass-fed beef, lamb, chickpeas, pumpkin seeds

• Omega-3 fatty acids – sardines, walnuts, salmon, trout, flaxseeds (14)

Lifestyle habits

There are many lifestyle changes you can make to lower your risk of myopia. These include:

• Spending time outside: Some research suggests that being outside and in the sun lowers children’s risk of developing myopia. However, don’t forget the sunglasses and hats. Excessive UV light exposure can also harm the eyes.

• Quit or reduce smoking and drinking: Smoking and drinking are not good for your overall health, and that includes your eyesight. These activities can increase inflammation and the risk of cataract development along with a host of other detrimental effects.

• Exercise: Physical activity is a proven way to increase blood circulation and minimize inflammation, which can do wonders for the health of your eyes.

• Minimize eye strain: Try to cut back on how often you use your phone, computer, and other devices that expose you to blue light or require your eyes to focus (14). 

Supplements

While it would be certainly nice to get all the necessary nutrients you need through your diet, this doesn’t always happen. If you feel you aren’t getting enough of these eye-friendly nutrients in your diet, you can incorporate supplements to increase your intake. For example, lutein and zeaxanthin are two ingredients commonly present in many eye supplements. As always, consult your doctor before starting any new supplement.

What Is Blue Light Strain and What Are the Sources of Blue Light?

We’ve touched a bit already on blue light – but let’s dive a bit more into where we find blue light and what can happen with prolonged exposure.

Common sources of blue light:

• Sunlight

• Device screens, such as computer monitors, smartphones, and tablet screens

• CFL (compact fluorescent light) bulbs

• Fluorescent light

• Flat-screen LED televisions

• LED light

Most blue light passes through the cornea and lens to the retina. With extended exposure to blue light, we can experience something known as blue light strain. This causes symptoms such as dry eyes, fatigue, irritation, headaches, and difficulty focusing. Blue light can also cause further damage, prematurely aging the eyes and sometimes leading to AMD (14).

Ways to Help Support Blue Light Strain Through Nutrition, Supplements, and Lifestyle Choices

We manage many eye conditions with a combination of glasses, contact lenses, medication, or surgery. However, there are other ways to boost your eye health that can be combined with these. Specifically, when it comes to blue light strain, you may want to also include a combination of supplements and a change in lifestyle choices.

Nutrition and supplements

Nutrition and supplements are great tools to help combat eye strain from blue light. Lutein and zeaxanthin supplementation, for example, have some research that shows they may help with eye strain. A study evaluated 48 college students viewing screens for at least six hours daily after taking lutein and zeaxanthin for six months. At the end of the study, symptoms of eye strain, eye fatigue, and headache improved (15).

Lifestyle habits

Here are some lifestyle tips for minimizing eye strain due to blue light:

• Reduce screen time: If your screen time is several hours a day and you are experiencing eye strain, it may be time to set some limits. Reducing the frequency and time in which you look at your digital devices can do wonders to relieve eye strain due to blue light.

• Filters: Certain filters are available for your digital devices that can help to minimize the amount of blue light that reaches your eyes.

• Glasses: Several glasses are designed specifically to prevent eye strain due to blue light. 

• Intraocular lens (IOL): With cataract surgery, the surgeon replaces the cloudy lens with an IOL. An IOL provides the eye with protection against ultraviolet light and blue light (14).

How Does Gaming and Prolonged Device Usage Affect Eyesight?

Some of us love to play video games, while others have to sit at a computer for work eight hours a day. Regardless of how you spend your screen time, prolonged device usage can have some negative effects. 

The negative effects of prolonged screen time can include:

• Eye strain. Staring at a screen for long periods can lead to eye discomfort, headaches, blurry vision, dry eyes, and neck and shoulder pain.

• Myopia. Looking at screens close-up for prolonged periods of time can increase your risk of myopia, specifically in children and adolescents.

• Dry eyes. When we look at screens for a long time, we tend to forget to blink. Blinking is important for lubricating the eyes, so when we blink less, our eyes get dried out.

Ways That Gamers and Computer Users Can Help Support Eye Health Through Nutrition, Supplements, and Lifestyle Choices

If you tend to look at screens for prolonged periods of time, such as with gamers or computer users, many of the aforementioned tips still ring true. 

Things that may help include:

• Taking frequent breaks

• Using the 20-20-20 rule, which involves looking at something 20 feet away for 20 seconds every 20 minutes

• Keeping a distance between your eyes and the screen

• Blinking more

• Using blue light glasses or filters

• Minimizing effects of glare

How Can Poor Nutrition or Malnutrition Contribute to Declining Eye Health or Eye Disease?

Did you know that being a picky eater can lead to vision loss? It’s true – which is why supporting your eyes with a proper diet is paramount. 

In this day and age, dietary deficiencies aren’t as common because of the easy access we have to nutritious food. However, certain conditions like chronic alcoholism, having gastrointestinal surgery, having an eating disorder, or having an unbalanced diet can lead to deficiencies. These deficiencies, in turn, can cause eye problems.

One notable case of dietary deficiency involves a teenage boy who was a particularly picky eater. His diet consisted strictly of white bread, chips, French fries, and processed pork, leading to a B12 deficiency, high zinc levels, low levels of vitamin D, low levels of copper and selenium, decreased bone density, and serious optic neuropathy. Ultimately, the child ended up losing his vision (16).

While this certainly is an extreme example, it is a cautionary tale.  Poor nutrition can negatively affect even general eye health. For example, an overly fatty or high-cholesterol diet can cause vessel plaques. These plaques slow the blood flow through the small vessels in the eyes, limiting circulation to the eyes and causing a decline in eye function.

Another instance of poor nutrition and eyesight involves diabetic retinopathy. Diabetes is characterized by high blood sugar levels, which can be exacerbated by overconsuming sugars and carbohydrates. With diabetic retinopathy, a complication of diabetes, excess glucose in the bloodstream damages small vessels in the eye, leading to vision loss.

How Vitamin and Mineral Deficiencies Can Lead to Eye Health Decline

It’s no secret that certain vitamins and minerals may support the health of our eyes, but the reverse is also true. Deficiencies in certain vitamins and minerals, such as zinc, selenium, and vitamins A, B1, B12, C, and D can be linked to eye health problems. 

For just a few examples:

• Zinc deficiencies: Zinc is a trace mineral essential to humans. Zinc deficiency has become increasingly more prevalent with the increase in popularity of plant-based diets and bariatric surgeries. Although uncommon, zinc deficiency can lead to nutritional optic neuropathy, which can cause profound vision loss (17).

• Selenium deficiencies: Selenium is another mineral that we’ll discuss in detail later. Deficiencies in selenium are linked to eye issues, particularly thyroid eye disease. Several studies have shown that low selenium levels correlate with the incidence of thyroid eye disease (18).

Fundamental Nutrients to Support Eye Health

We’ve touched on some of the vitamins, minerals, and nutrients important to eye health, but let’s dive a bit deeper into the benefits of each one.

Vitamin A

Vitamin A is a vitamin essential to maintaining good vision. When it comes to eyesight, the eye must produce specific pigments in order for the retina to function properly. Vitamin A contributes to pigment products, so when it is deficient, you may have difficulty seeing at night. Additionally, vitamin A also helps lubricate the eyes, particularly the cornea.

Vitamin A deficiency is serious, and it is the leading cause of preventable blindness in children globally. Experts estimate that as many as 500,000 children become blind yearly due to a deficiency in vitamin A. Thus, getting your vitamin A via leafy greens, eggs, and orange-hued fruits and vegetables is imperative (19). 

If obtaining vitamin A solely through diet is challenging, dietary supplements are an ideal addition to close gaps in nutrition and support eye health. The type of vitamin A supplement selected is also important. Most supplements contain vitamin A in the form of retinyl acetate, retinyl palmitate, or beta-carotene. Beta-carotene is the provitamin for vitamin A, meaning that it is transformed into vitamin A once inside the body.

Most multivitamins contain some type and amount of vitamin A. There are also supplements focused only on vitamin A that you can purchase. One patented vitamin A formulation is called EVTene™. EVTene™ is innovative because it is extracted directly from palm fruit oil, and is a natural mixed-carotene complex. Palm fruit extract is beneficial since it has the highest ratio of alpha-carotene to other carotenoids as compared to other plant extracts. It doesn’t just contain beta-carotene, but the whole range of related compounds existing naturally in the palm fruit. EVTene™ contains alpha-carotene, beta-carotene, gamma-carotene, and lycopene, as well as small amounts of other plant-based carotenoids. EVTene™ is found as the vitamin A supplement element inside of the Eyemazing eye vitamin.

B Vitamins

B vitamins are important to eye health, particularly in preventing AMD. This is because high homocysteine levels are associated with AMD, and B vitamins (e.g., B6, folate, and B12) are key to regulating homocysteine levels in the body.  Homocysteine is an amino acid that facilitates protein synthesis.  B vitamins are also important to the creation, repair, and replication of DNA.

One study evaluated older adults over an eight-year period for the incidence of AMD based on their B vitamin intake. Findings indicated that:

• Individuals with normal folate levels had a 51% lower risk of AMD

• Individuals with high vitamin B5 and B6 intake had a 28% lower risk of AMD (20)

Vitamin C

You can find vitamin C in the lens of the eye, functioning almost like a “sunscreen” to protect the lens from UV light and oxidative damage. Unfortunately, vitamin C levels in the lens decline with age, contributing to the development of cataracts. Thus, vitamin C supplementation can help prevent cataracts, with supplements delaying cataract onset post-vitrectomy in as many as 80 percent of patients within two years, according to research (21).

Vitamin D

Vitamin D is a fat-soluble vitamin that is key to many biological functions, including the immune system, inflammation response, neuromuscular function, cell growth, endothelial cells, and more. We mostly get vitamin D through our skin’s exposure to the sun, but it is also in some foods, and can be taken in supplement form.

Recent research has highlighted the importance of vitamin D for healthy eyesight. Key highlights from studies include findings that:

• Vitamin D supplementation may help dry eye syndrome that doesn’t respond to conventional treatment

• Vitamin D improves corneal epithelial barrier function

• Vitamin D lowers inflammation and improves visual acuity in the eyes of older adults

• Oral supplementation with vitamin D can affect vitamin D metabolite concentrations in the tear fluid and vitreous and aqueous humor (22)

Vitamin E

Vitamin E is a nutrient that affects the physiology and survival of our cells via several different pathways. Its mechanism at a molecular level supports the uptake, transport, metabolism, and cellular action, provides antioxidant properties, and has a neuroprotective effect on the retina. Consequently, research indicates that taking vitamin E can benefit people who suffer from moderate to severe AMD (23). 

Selenium

Oxidative stress refers to a state in which there are too many free radicals in the body compared to antioxidants. As a result, free radicals can damage your cells. Oxidative stress is an important component of several ocular diseases such as cataracts, diabetic retinopathy, and AMD.

Selenium is a substance that can potentially mitigate the effects of oxidative stress. It contains selenoproteins, which increase antioxidant enzymes and thus counteract the effects of reactive oxygen species (ROS). As a result, selenium can help to prevent the progression of eye conditions (24).

Zinc

As mentioned before, zinc is a trace mineral that serves important biological functions in our bodies. It supports several metabolic and cellular processes, specifically those linked to vision. When we don’t get enough zinc through our food intake, the retina and retinal pigment epithelium become dysfunctional. Individuals with low zinc levels may, as a result, experience vision loss, low sensitivity to contrast, and several other symptoms (17).

Omega-3 Fatty Acids

We consider omega-3 fatty acids to be “essential”, as our bodies cannot make them. Thus, we must get omega-3 fatty acids from our diet. Omega-3s may be beneficial for certain ocular conditions, including AMD and dry eye disease (DED). Here’s how:

• Docosahexaenoic acid (DHA), a long-chain omega-3 fatty acid, is important to the retina’s structure and function

• Animal models have shown that diets with plenty of polyunsaturated fat intake can improve the retina’s response to inflammatory and oxidative damage

• Epidemiologic studies demonstrate a correlation between omega-3 intake and a decreased risk of AMD

Because of the widespread benefits of omega-3 fatty acids in eye health, almost 80 percent of optometrists regularly recommend that patients increase their consumption of omega-3s (25).

Lutein and zeaxanthin

Plants, bacteria, and algae produce carotenoids, which are essential to preventing disease and overall health. Two such carotenoids include lutein and zeaxanthin, which you can find in green leafy vegetables and egg yolks, among other foods. These substances are found in and support the health of the macula of your eye, which is where your eye processes things in front of your vision. Making sure that you are taking in enough lutein and zeaxanthin can be protective against macular degeneration and also protect your eyes from blue light exposure damage, meaning they are a great option to support your eye health (26,27).

One study looked into high-dose lutein and zeaxanthin supplements to see how well they can increase the macular pigment ocular density (MPOD) of the eye. The study found significantly increased MPOD values in the eye by week 8, and this increase continued until the end of the study at week 16 (40). This is important because higher levels of macular pigment in the eye help to act as a blue light filter and reduce damage to the retina. There may also be a role in these pigments acting as antioxidants and reducing the free radicals in the eye. People with age-related macular degeneration also show lower levels of these macular pigments as compared to healthy eyes. This suggests that keeping the macular pigment levels higher using lutein and zeaxanthin may help prevent or slow the progression of macular degeneration.

If you are not consuming enough lutein and zeaxanthin daily through your diet, you can look to supplements to help supply these eye-health nutrients for optimal eye wellness. Lutemax 2020 is a clinically studied high-dose, highly bioavailable blue light damage support supplement, which contains both lutein and zeaxanthin. 

Citicoline (CDP Choline)

Citicoline, also referred to as cytidine 5’-diphosphocholine, is a natural substance you can find in your brain. It provides the precursors (choline and cytidine) your body needs to make phosphatidylcholine, which is a key component of your cell membranes and plays a role in eye health, focus, memory, and attention.

Citicoline can be particularly effective when it comes to glaucoma treatment. Studies show that an injection of one gram of citicoline daily for 10 days improved visual fields in individuals with glaucoma. These effects continued for a minimum of three months and greater than 10 years in those receiving repeated doses every six months (28). Other studies in animal models have shown that citicoline injections could delay the progression of myopia (29).

While citicoline injections aren’t always routine, you can find citicoline in eyedrops and as oral supplements. One study found that 2% citicoline eye drops delayed visual field progression, meaning it may be helpful in glaucoma (28). In animal studies, CDP choline eye injections were found to slow the progression of myopia in just 10 days (42). This suggests that optimal choline levels may be helpful in slowing the progression of several common eyesight conditions.

When it comes to brain health, citicoline may have benefits as well. Memory, focus, and increased attention are key benefits of citicoline and can play hand-in-hand with sharp and healthy eyesight for gamers, people working in the tech space, or simply those individuals who work mainly on screens and need optimal eye and brain health to function at their best.

Oral citicoline supplements are sometimes referred to as ‘nootropics’ and are gaining popularity in the gaming and tech space. One patented citicoline supplement is Cognizin® (41). Cognizin® citicoline has been clinically studied in adults and has shown benefits in focus, memory, and attention span. Some eye health supplements including the Eyemazing eye supplement from Zen Nutrients see the parallels and interplay between brain and eye health, and include this innovative Cognizin® ingredient as part of the supplement blend.

Crocin

Crocin is a natural ingredient that you can find in the flower saffron, known for its potential as a supplement for eye health. Research has assessed crocin’s efficacy in addressing several ocular conditions like diabetic retinopathy, glaucoma, and  AMD. 

This research suggests that crocin possesses cytoprotective, anti-inflammatory, antioxidative, and blood-flow-enhancing effects within the retina. As such, some studies indicate that crocin can improve clinical outcomes in conditions such as glaucoma, retinal degeneration, and retinal dystrophy. Thus, certain individuals should consider adding crocin to their supplement routine to protect their vision and treat eye diseases (30). 

For people who don’t suffer from eye disorders but engage in prolonged time in front of screens, including gamers, crocin supplements may be especially appealing. Crocin saffron extracts may function as fast-absorbing antioxidants to help protect eyes against damage from prolonged blue light exposure. Crocin may be anti-inflammatory, neuroprotective, and act as an antioxidant, helping to scavenge free radicals. This may help with uncomfortable eye symptoms from excess blue light exposure and long gaming sessions including eye strain, itchy and red eyes, eye dryness, and headaches (43).

Eyemuse™ (Lacticaseibacillus paracasei KW3110 postbiotic)

Eyemuse is an exciting post-biotic supplement that is currently only available in the U.S. inside of the EyeMazing eye supplement from Zen Nutrients. Eyemuse is the only lactic acid bacteria that shows the potential to reduce the negative effects of blue light by activating immune cells.

As a post-biotic, (not a prebiotic or probiotic), Eyemuse contains L. paracasei, which is a lactic acid bacteria commonly used in dairy products for its benefits in the gut.  It functions as a postbiotic, meaning that it is a dead bacteria that can provide several health advantages when taken orally. Eyemuse contains Lacticaseibacillus paracasei KW3110, which is the only strain to be clinically researched in the realm of eye health (31).

Eyemuse clinical trials have shown potential benefits for overall eye health and wellness. Studies have shown protective effects against eye strain by using Eyemuse supplementation to support a balanced immune response in the eye. Eyemuse was also found to reduce reported eye fatigue, ocular discomfort, and shoulder stiffness in healthy participants in just 8 weeks of use as compared to placebo (31).

Lacticaseibacillus paracasei KW3110 works by decreasing inflammation and activating specific immune cells like M2 macrophages. These macrophages produce anti-inflammatory substances like interleukin-10 (IL-10). Additionally, KW3110 has also shown that it lowers inflammation and photoreceptor degeneration in mice with light-induced retinopathy, suggesting a preventative effect against retinal diseases (32).

Why Eyemuse Is an Exciting Supplement for Eye Health and Wellness

We’ve already gone over some of the benefits of Eyemuse and its main ingredient Lacticaseibacillus paracasei, but let’s delve a bit deeper into its benefits:

• Reverses blue light damage. Because of the anti-inflammatory effects of KW3110, it can help prevent damage to the retinal pigment epithelium (RPE) cells caused by blue light (33).

• Improved eye fatigue. One study evaluated how KW3110 affected critical flicker frequency, an indicator of eye fatigue, in individuals taking a KW3110 supplement for eight weeks. The research found that KW3110 decreased critical flicker frequency versus placebo (34).

• Prevents retina damage. As mentioned, KW3110 increases anti-inflammatory cytokines to mitigate degenerative retinal diseases and prevent photoreceptor degeneration (32).

What Is a Postbiotic vs a Probiotic or Prebiotic?

Many people have heard of probiotics and prebiotics, but we don’t tend to hear about postbiotics too frequently. Let’s break down what each of these are and their benefits to our health and wellness:

• Probiotic. Probiotics are living microorganisms that you can find in fermented foods such as kimchi, yogurt, and sauerkraut. Probiotics are important in supporting your gut microbiota, ensuring a healthy balance of good and bad bacteria. Probiotics from your food and some supplements may help to improve the health of your gut and digestion.

• Prebiotic. Prebiotics fuel the effects of probiotics and the beneficial bacteria in your gut. Prebiotics are nutrients that support the growth and development of these beneficial bacteria, allowing microbes to flourish within the gut’s competitive landscape. The main prebiotics are microbiota-accessible carbohydrates (MACs), commonly known as dietary fiber. You can increase your fiber intake by eating more complex carbohydrates such as whole grains, fruits, vegetables, legumes, and other plant materials.

• Postbiotic. Postbiotics are the waste products of probiotic and prebiotic activity, as well as the killed bacterium itself. When the body breaks down fiber, it yields postbiotics like vitamins, amino acids, enzymes, and short-chain fatty acids (SCFAs). These may be incredibly beneficial in lowering your risk of chronic disease, supporting brain and metabolic health, and providing anti-inflammatory effects (35).

Non-Supplement Eye Solutions

Aside from the nutrition and supplement solutions for eye health, there are also several mobile apps that may support the wellness of your eyes, particularly for those with myopia. These can be used in conjunction with proper nutrition and supplements like Eyemuse to optimize eye function. 

Some popular eye support apps include:

Myopia.app

Myopia.app is designed by optometrists and scientists, as a tool to mitigate the effects of myopia across all ages.

With Myopia.app, you can: 

• Create profiles for family members 

• Monitor screen time, ambient light, and the distance of your eyes from the screen 

• Set daily screen time limits 

• Keep your device at a healthy distance from your face (36)

Eyeli

App developers created Eyeli to assist eye care professionals in diagnosing and managing several eye conditions, particularly myopia and binocular vision problems. It includes:

• Comprehensive testing. Using the app, you can assess your visual acuity, color vision, binocular activity, stereo acuity, eye alignment, and fusional reserves.

• Analysis and reporting. The app uses this data to interpret results.

• Visual therapy. Patients can use the app to perform visual therapy exercises from anywhere and at any time, allowing them to get treatment outside of the clinic (37).

Menicon Bloom

Menicon Bloom is an app that specifically targets myopia treatment in children and young 

adults. The app itself allows patients to connect with their eye care provider and relays the tracking and monitoring of your myopia with your doctor. Patients can take surveys about their contact lens treatment, communicate with their doctor, and facilitate myopia management throughout their treatment journey (38). 

Myopia Care Web App

The Myopia Care web application is a great tool that allows you to assess your child’s risk of myopia right at home. With just a questionnaire, it can estimate your risk of myopia, and if needed, connect you with a local eye care professional for further evaluation. Doing so allows for early intervention, helping to improve outcomes for your eyes. Furthermore, the Myopia Care app is updated regularly based on the latest research (39).

Conclusion

While some eye diseases are inevitable, there is a lot we can do to support our eye health, protect ourselves from blue light damage, and potentially delay the progression of existing ocular conditions. To improve outcomes for our eyes, we can integrate traditional medical practices, which include glasses, contact lenses, medication, and surgery, along with natural approaches such as nutrition, supplements, and good lifestyle choices. 

In summary, for optimal eye support and wellness, experts recommend:

• Adequate nutrition: A diet rich in vitamins A, C, D, E, and B vitamins, zinc, omega-3 fatty acids, and selenium can support eye health.

• Supplements: The majority of the population does not obtain enough of these vitamins and nutrients from their diet, thus certain supplements are vital. Eyemuse in particular includes a postbiotic known as Lacticaseibacillus paracasei KW3110, which is clinically validated for alleviating blue light strain, eye fatigue, and as a prophylactic tool against retinal damage.

• Lifestyle habits. One of the simplest, yet most impactful thing we can do for our health is to decrease screen time. This may minimize the damage caused by blue light and increase outdoor time to temper the progression of myopia.

 

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