Can you read this line of type without the aid of eyeglasses? How about the headline above? If you answered yes … congratulations! But what if you answered no? Sadly, more and more Americans are experiencing some degree of vision impairment. But this alarming trend need not continue. Modern science has discovered the link between nutrition and eye health—the link that could prevent eye disease in some people and arrest it in others.
What can you do to protect your vision?
Studies have shown that the early detection and treatment of eye disease, before it causes major vision loss, is the best way to control the disease. So, if you fall into one of the high-risk groups for any of the age-related diseases we are about to discuss, please make sure to have your eyes examined thoroughly every two years by an eye care professional and protect your eyes with nutrients that science has proven support eye health.
Before we discuss these nutrients, a little background information … According to the National Eye Institute, at least half of all cases of blindness can be prevented.1 But the number of people in the U.S. who suffer from visual impairment continues to grow at an alarming rate.
Near-sightedness, far-sightedness, and astigmatism are common symptoms of living in the twentieth century. And as we age, many of us face more serious eye problems. Cataracts, the leading cause of blindness in the world, affects nearly 20.5 million Americans; 2.2 million have been diagnosed with glaucoma, and another 2 million are unaware they have it; and more than 1.6 million Americans over 60 have advanced macular degeneration, the most common cause of blindness and visual impairment in Americans over 60.2
The top two causes of serious visual impairment
Cataracts are the leading cause of decreased vision in adults older than 65 and is the most common surgical procedure for elderly Americans, costing Medicare about $3.5 billion per year. But you can get an “age-related” cataract when you’re in your 40s or 50s, although most likely it will be small and not rob you of your vision. Only 15 percent of people are affected with cataracts by age 55, but this figure jumps to 50 percent by age 75, and 90 percent by age 85. It’s important to note, however, that cataracts worsen over time … so it’s never too late—or early—to try to prevent them and/or treat them!3
What is a cataract?
A cataract is an opaque spot on the lens of the eye that you can’t see through. The lens lies behind the iris and the pupil, and works like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye’s focus, which allows you to see things clearly, up close and far away.
The lens is made of mostly water and protein. But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see. 4
The haze can vary in size, density, and location, which means its effect on your vision will also vary. At first, many people experience an overall reduction in their vision; they may need more light to read by, or may have difficulty reading street signs while driving. A cataract can also affect depth perception, which is particularly dangerous for the elderly who are more prone to falling.5
Common symptoms of cataracts include:
- Cloudy, fuzzy, foggy, or filmy vision
- Changes in the way you see colors
- Problems driving at night because headlights seem too bright
- Problems with glare from lamps or the sun
- Frequent changes in your eyeglass prescription
- Double vision
- Better near vision (temporarily in farsighted people only)
- Note: These symptoms also can be signs of other eye problems.
What causes cataracts?
Researchers suspect there are several causes:
- free radicals—natural by-products of metabolism—are highly reactive chemicals that cause oxidation, which in turn causes aging
- physical injury to the vertebrae or neck, or any stress which reduces eye movement and increases muscle tension
- toxins, pharmaceutical drugs, and smoking
- diabetes (high levels of sugar in the blood contribute to cataract formation, so it’s not surprising that diabetics are three to four times more likely to have cataracts)
- the protein in the lens changes from the wear and tear it takes over the years, and hardens and loses its ability to focus 6 7
What nutrients help prevent and treat cataracts?
- N-acetyl-carnosine eye drops
- Taurine, vitamin E, vitamin A, carotenoids, grape seed extract, green tea extract, ginkgo biloba extract, lutein, zeaxanthin, lycopene, vinpocetine
Age-related Macular Degeneration (AMD) is most common in people over 50, but can appear as early as age 40. As life expectancy increases, the disease is becoming a significant problem with thousands of people being diagnosed each year. Millions of American seniors experience blurred or distorted vision from macular degeneration, which can put an end to activities such as reading and driving. In fact, age-related macular degeneration affects one in three people over the age of 75 and is the leading cause of irreversible blindness among adults.
“In fact, age-related macular degeneration affects one in three people over the age of 75 and is the leading cause of irreversible blindness among adults.”
What is the macula?
The macula—about the size of a pencil eraser—is a tiny, yellowish area near the center of the retina that allows you to clearly distinguish fine detail.
What is macular degeneration?
Macular degeneration is the slow deterioration of the cells in the macula, which affects your central vision; the vision you use for reading, writing, driving, and identifying faces. In some people, AMD advances so slowly that it will have little effect on their vision as they age. But in others, the disease progresses faster and may lead to a loss of vision in one or both eyes.
Common symptoms of AMD include:
- Normally straight objects appear bent or wavy
- A dark, bland, or blurry spot appears in the center of your vision
- When you cover one eye, the object you’re looking at changes size or color
What causes macular degeneration?
There are two kinds, the dry type and the wet type: 90 percent of people have the dry type, in which small, yellow spots called drusen form underneath the macula. Scientists are still not sure what causes dry AMD. Studies suggest that an area of the retina becomes diseased, leading to the slow breakdown of the light-sensing cells in the macula and a gradual loss of central vision. Dry macular degeneration can progress to the second, more severe type called wet macular degeneration.
Although only 10 percent of all people with AMD have the wet type, it accounts for 90 percent of all blindness from the disease. As dry AMD worsens, new blood vessels may begin to grow and cause “wet” AMD. These new blood vessels tend to be very fragile, and they often leak blood and fluid under the macula, which further deteriorates the macula, causing rapid and severe vision loss.8
Are you at risk for Cataracts and Macular Degeneration?
- Age is a high risk factor
- Extensive exposure to UV radiation or infrared light
- Medications such as steroids, various injuries, and disease
- Vitamin, mineral, and protein imbalances 9
- Age is the greatest risk factor. Everyone develops AMD somewhat. In normal individuals, the macula begins to deteriorate from youth through 30. Deterioration accelerates after 50 and by the age of 75, the incidence of AMD increases to 30%
- People with drusen (yellow spots) on the retina are at risk
- People with AMD in one eye are at high risk for AMD in the other eye (within four years of developing it in one eye, 23 percent develop it in the other eye)
- People with the dry form of AMD are at risk for developing the wet form
- Light-eyed people
- Women tend to be at greater risk for AMD than men
- Smoking increases the risk of AMD
- Genetics—those with immediate family members who have AMD are at a higher risk of developing the disease
- People with atherosclerosis and hypertension
- Nutritional deficiencies 10
What nutrients help protect and heal AMD?
- beta carotene
- vitamin E
- gingko biloba extract
Proper nutrition and dietary supplements make a world of difference
The good news is that cataracts, macular degeneration, and other vision problems can often be prevented, stopped, or slowed down with appropriate diet, supplements, and lifestyle changes.
And if you think you get all the nutrients you need through your diet, and/or multivitamin, think again. There are very specific nutrients proven to support eye health that you may be missing because you’re not eating enough of the foods that contain them … or which may not be included in your daily vitamin regime. It’s impossible to fit every proven nutrient in one supplement, and it’s difficult to obtain all the carotenoids and other nutrients we need through our food.
“According to Anshel, even though the brain and visual system make up only 2 percent of our body weight, they use up to 25 percent of our nutritional intake.”
In addition, “Our eyes are very complex organs and require an extremely high proportion of nutrients to maintain their proper function,” writes Jeffrey R. Anshel, O.D., in Smart Medicine for your Eyes (Avery, 1999). According to Anshel, even though the brain and visual system make up only 2 percent of our body weight, they use up to 25 percent of our nutritional intake. Thus, it’s easy to see (no pun intended) that if one’s nutrient levels are deficient, the strength and elasticity of eye tissues may be compromised, which may result in poor vision and other problems.
Eleven important nutrients for healthy eyes
- Palm Oil Carotenoids (alpha and beta carotene)
- Grape Seed Extract
- Ginkgo Biloba Extract
- Green Tea Extract
- Gamma tocopherol and vitamin E
Lutein and zeaxanthin: nature’s colorful antioxidants
Lutein and zeaxanthin are antioxidants in the carotenoid family—a group of naturally occurring, fat-soluble pigments found in plants—that play a key role in the health of our eyes. Carotenoids are the red, orange, and yellow plant pigments that give fruits and vegetables their vivid colors. All fruits and vegetables contain varying concentrations of carotenoids. But their colors are often covered up by green chlorophyll contained in the plant.
Lutein is found in spinach, kale, collard greens, romaine lettuce, leeks, peas, egg yolks, tomatoes, carrots, marigold flowers, and fruits. Zeaxanthin is found in corn, kale, mustard greens, spinach, egg yolk, orange peppers, collard greens, goji berry fruit, green algae spirulina and other types of commercially produced algae.
Lutein and zeaxanthin accumulate in the macula; the prominent, bright yellow spot in the center of the retina that allows you to clearly distinguish fine detail.
Powerful vision protectors
Of the 600 carotenoids found in nature, zeaxanthin and lutein are concentrated in the macula.11 The concentration of zeaxanthin in the center of the macula is about 85 times greater than its concentration in the periphery. Consequently, many researchers believe zeaxanthin and lutein may be a potent protectant against macular degeneration,12 13 14 15 16 17 and may retard aging of the lens and prevent cataracts from forming.18 19 Lutein is also dispersed throughout the entire retina and acts as a filter to protect the macula from potentially damaging forms of light. In fact, one study has shown that 60 year olds with normal levels of zeaxanthin and lutein in their retinas exhibit the visual sensitivity of 20 year olds!20
Lutein and zeaxanthin supplementation diminishes eye health risks
While a deficiency has not been identified, people who eat more lutein and zeaxanthin containing foods are at lower risk of macular degeneration21 and cataracts.22 23 24 Zeaxanthin has also been shown to offer potent protection from light-induced retinal damage.25
Research shows, however, that most people don’t come close to eating the amount of fruits and vegetables needed to meet recommended daily dosage levels, and a poor diet can dramatically lower the amounts of these vital compounds in our bodies. That’s why supplementation with lutein and zeaxanthin is so important!
Unfortunately, while lutein has become a household word since its introduction as a dietary supplement, most products contain only lutein and NO zeaxanthin. Lutein is important for eye health, but that’s not the whole story. Zeaxanthin is more highly concentrated than lutein, in the most light-sensitive center of the macula. It is also a more powerful protector from light damage than lutein. Because zeaxanthin has emerged as a vital protective eye carotenoid, and high doses of lutein may actually impair zeaxanthin uptake into the eyes, a well-designed eye supplement should contain lutein AND significant amounts of zeaxanthin.
Recent epidemiological studies have suggested that the consumption of tomatoes and tomato-based food products reduce the risk of prostate cancer in humans. This protective effect has been attributed to carotenoids, which are one of the major classes of phytochemicals in this fruit. The most abundant carotenoid in tomato is lycopene, followed by phytoene, phytofluene, zeta-carotene, gamma-carotene, beta-carotene, neurosporene, and lutein. Studies have shown that people with a low dietary intake of lycopene have twice the risk of macular degeneration.26
Lycopene and other carotenoids, including beta-carotene, may also play an important role in the prevention of age-related macular degeneration, cataracts, and other blinding disorders. In one study, lycopene and a wide range of dietary carotenoids were detected in high concentrations in ciliary body and retinal pigment epithelium, which leads researchers to believe that lycopene and other carotenoids, like lutein and zeaxanthin, may play a role in the prevention of age-related macular degeneration, cataracts, and other blinding disorders.27
A red-orange carotenoid found in algae, astaxanthin accumulates in the tissues of salmon, trout and shrimp, and other pink seafood giving these fish their pink hue. It’s closely related to carotenoids such as lutein and zeaxanthin. Unfortunately, most people consume very little of this powerful antioxidant carotenoid because it is not found in vegetables.
One of the key features of astaxanthin is its unique antioxidant functions not shared by other dietary carotenoids, especially in relation to preventing light and UV damage. Astaxanthin has only recently been available as a dietary supplement, and is quite expensive. However, there is good preliminary evidence that it is a very worthwhile addition to our normal array of dietary carotenoids, especially for eye health.
Vitamin A and its precursor beta-carotene
Beta-carotene nourishes the eye’s rod and cone photoreceptors and is related to retina and macular functioning because it provides day, night, and sharp central vision, and may also act as a light filter for the eyes, protecting against photooxidation of the lens.28
Also, the National Eye Institute Age-Related Eye Disease Study found that supplementation with 400 iu of vitamin E, 500 mg vitamin C, 15 mg beta-carotene, and 80 mg zinc oxide slows the progression of macular degeneration by about 25 percent.
Grape seed extract
Grape seed extract contains proanthocyanidins, a powerful class of antioxidants that is very effective at protecting the body from the damaging effects of free radicals.
Although little is known of the effect of proanthocyanidins on cataract formation, a study in which rats were fed grape seed extract showed that the proanthocyanidins and their antioxidant metabolites prevented the progression of cataract formation, when compared to the group that didn’t receive the grape seed extract.31
Ginkgo biloba extract
Ginkgo biloba extract has antioxidant activity, improves arterial blood flow, and enhances cellular metabolism. It also has anti-aging properties, which may prevent degenerative changes in the eye. Several studies have indicated that Ginkgo may have a significant therapeutic value in cases of retinal damage, 32 33 34 and that it can be used successfully and safely to protect the eye from cataracts, macular degeneration, and glaucoma.
According to Robert Ritch, M.D., Chief of Glaucoma Service, Surgeon Director, and Professor at the Department of Ophthalmology, New York Eye and Ear Infirmary, New York Medical College, “Ginkgo biloba extract is freely available and has several biological actions which combine to make it a potentially important agent in the treatment of glaucoma: improvement of central and peripheral blood flow, reduction of vasospasm, reduction of serum viscosity, antioxidant activity, platelet activating factor inhibitory activity, inhibition of apoptosis, and inhibition of excitotoxicity. The effect of Ginkgo biloba extract as a potential antiglaucoma therapy deserves intensive scrutiny.”35
In an experiment with laboratory rats in which cataracts were induced, treatment with Ginkgo biloba extract was found to significantly retard the progression of lens opacification (cloudiness). 36
In a double-blind trial involving 99 patients with dry senile macular degeneration, the visual acuity in the group of patients treated with Ginkgo biloba extract was significantly improved. The results demonstrated the therapeutic efficacy of Ginkgo biloba extract in patients with senile, dry macular degeneration with obvious benefits in every-day life.37
Green tea extract
Green tea extract has been used throughout Asia for thousands of years to promote longevity, improve mental functions, and prevent disease. But it is only within the past twenty years or so that green tea has become a popular healing tonic in the West. As a result of both historical accounts and current research, tea has gone from a simple beverage to a functional food with ample evidence of its health promoting properties.
For instance, we now know, thanks to scientific studies, that antioxidants in green tea help protect against free radical damage, and specifically possesses anti-cataract potential.38 It has also been found to protect against UV radiation.39
Taurine is an amino acid, and an important antioxidant for the regeneration of worn out tissues of the visual system. High amounts of taurine are found in the retina of the eye—especially in the photoreceptor cells—where it protects cells from ultraviolet damage, and is important for the maintenance of vision.40 But taurine decreases with age, and deficiencies of taurine are known to cause retinal lesions and visual deterioration, which can be reversed with dietary taurine supplementation.
Gamma tocopherol and vitamin E
Gamma tocopherol and vitamin E have been shown to reduce cataract risk by up to 56 percent, whereas a low level increases cataract risk and increases photooxidation.41
Vinpocetine is a derivative of vincamine, which is an extract of the periwinkle plant. Vinpocetine has been shown to improve circulation, particularly the micro-circulation in the eyes leading to improved vision. Vinpocetine has been used to treat acute or chronic ophthalmological diseases of various origin, with visual acuity improving in 70% of the subjects.25 42
- Shoemaker, John. A. Vision Problems in the U.S.:Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America, Prevent Blindness America, published by the National Eye Institute (NEI), a component of National Institutes of Health (NIH), 2002.
- Grossman, Marc, O.D., L.Ac. & Swartwout, Glen, O.D. Natural Eye Care; Keats Publishing, Los Angeles, 1999.
- National Eye Institute http://www.nei.nih.gov/health/cataract/cataract_risk.htm
- Grossman, Marc, O.D., L.Ac. & Swartwout, Glen, O.D. Natural Eye Care; Keats Publishing, Los Angeles, 1999.
- National Eye Institute, http://www.nei.nih.gov/health/cataract/cataract_risk.htm
- Grossman, Marc, O.D., L.Ac. & Swartwout, Glen, O.D. Natural Eye Care; Keats Publishing, Los Angeles, 1999.
- John T. Landrum, Richard A. Bone, Linda L. Moore, and Christina M. Gomez, “Analysis of Zeaxanthin Distribution within Individual Human Retinas”, Methods In Enzymology, 1999, 299: 457-467.
- Bernstein PS, Zhao DY, Wintch SW, Ermakov IV, McClane RW, Gellermann W. Resonance Raman measurement of macular carotenoids in normal subjects and in age-related macular degeneration patients. Ophthalmology 2002 Oct;109(10):1780.
- Snellen EL, Verbeek AL, Van Den Hoogen GW, Cruysberg JR, Hoyng CB. Neovascular age-related macular degeneration and its relationship to antioxidant intake. Acta Ophthalmol Scand 2002 Aug;80(4):368-71.
- Wooten BR, Hammond BR. Macular pigment: influences on visual acuity and visibility. Prog Retin Eye Res 2002 Mar;21(2):225-40.
- Shaban H, Richter C. Biol Chem 2002 Mar-Apr;383(3-4):537-45 A2E and blue light in the retina: the paradigm of age-related macular degeneration. Biol Chem 2002 Mar-Apr;383(3-4):537-45.
- Rock CL, Thornquist MD, Neuhouser ML, Kristal AR, Neumark-Sztainer D, Cooper DA, Patterson RE, Cheskin LJ. Diet and lifestyle correlates of lutein in the blood and diet. Nutr 2002 Mar;132(3):525S-530S.
- Mares-Perlman JA, Millen AE, Ficek TL, Hankinson SE. The body of evidence to support a protective role for lutein and zeaxanthin in delaying chronic disease. Overview. J Nutr 2002 Mar;132(3):518S-524S.
- Berendschot TT, Broekmans WM, Klopping-Ketelaars IA, Kardinaal AF, Van Poppel G, Van Norren D. Lens aging in relation to nutritional determinants and possible risk factors for age-related cataract. Arch Ophthalmol 2002 Dec;120(12):1732-7.
- Hammond BR, et al. Preservation of visual sensitivity of older subjects; association with macular pigment density. Inv Ophthalmol 1996;93:54-8.
- Seddon JM, Ajani UA, Sperduto RD, et al. “Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration.” JAMA 1994;272:1413–20.
- Mares-Perlman et al., “Lutein and Zeaxanthin in the Diet and Serum and Their Relation to Age-Related Maculopathy in the Third National Health and Nutrition Examination Survey,” American Journal of Epidemiology, 2001, Vol. 153, No. 5, pgs. 424-432.
- Brown et al., “A Prospective Study of Carotenoid Intake and Risk of Cataract Extraction in US Men,” American Journal of Clinical Nutrition, 1999, Vol. 70, pgs. 517-524.
- Lyle et al., “Serum Carotenoids and Tocopherols and Incidence of Age-Related Nuclear Cataract,” American Journal of Clinical Nutrition, 1999, Vol. 69, pgs. 272-277.
- Hankinson SE, Stampfer MJ, Seddon JM, et al. “Nutrient intake and cataract extraction in women: a prospective study.” Br Med J 1992;305(6849):335–9.
- Thomson LR, et al. Elevated retinal zeaxanthin and prevention of light-induced photoreceptor cell death. Qual Invest Oph Vis Sci 2002 Nov;43(11):3538-49.
- Khachik F, Carvalho L, Bernstein PS, Muir GJ, Zhao DY, Katz NB. Chemistry, distribution, and metabolism of tomato carotenoids and their impact on human health. Exp Biol Med (Maywood) 2002 Nov;227(10):845-51.
- Teikari, J. Prevention of cataract with alpha-tocopherol and beta carotene. Investigative Ophthalmological Visual Science 33 (1992):1307.
- Corbe C, Boissin JP, Siou A. Light vision and chorioretinal circulation. Study of the effect of procyanidalic oligomers. J Fr Ophtalmol 1988;11:453–60.
- Boissin JP, Corbe C, Siou A. Chorioretinal circulation and dazzling; use of procyanidolic oligomers. Bull Soc Ophtalmol Fr 1988;88:173–4, 177–9 [in French].
- Yamakoshi J, Saito M, Kataoka S, Tokutake S. Procyanidin-rich extract from grape seeds prevents cataract formation in hereditary cataractous (ICR/f) rats. J Agric Food Chem 2002 Aug 14;50(17):4983-8.
- Pritz-Hohmeier S, Chao TI, Krenzlin J, Reichenbach A. Effect of in vivo application of the ginkgo biloba extract EGb 761 (Rokan) on the susceptibility of mammalian retinal cells to proteolytic enzymes. Ophthalmic Res 1994;26(2):80-6.
- Baudouin C, Ettaiche M, Imbert F, Droy-Lefaix MT, Gastaud P, Lapalus P. Inhibition of preretinal proliferation by free radical scavengers in an experimental model of tractional retinal detachment. Exp Eye Res 1994 Dec;59(6):697-70.
- Droy-Lefaix MT, Cluzel J, Menerath JM, Bonhomme B, Doly M. Antioxidant effect of a Ginkgo biloba extract (EGb 761) on the retina. Int J Tissue React 1995;17(3):93-100.
- Ritch R., M.D. Potential role for Ginkgo biloba extract in the treatment of glaucoma. Med Hypotheses 2000 Feb;54(2):221-35.
- Thiagarajan G, Chandani S, Harinarayana Rao S, Samuni AM, Chandrasekaran K, Balasubramanian D. Molecular and cellular assessment of ginkgo biloba extract as a possible ophthalmic drug. Exp Eye Res 2002 Oct;75(4):421-30.
- Fies P, Dienel A. [Ginkgo extract in impaired vision–treatment with special extract EGb 761 of impaired vision due to dry senile macular degeneration] [Article in German]Wien Med Wochenschr 2002;152(15-16):423-6.
- Gupta SK, Halder N, Srivastava S, Trivedi D, Joshi S, Varma SD. Green tea (Camellia sinensis) protects against selenite-induced oxidative stress in experimental cataractogenesis. Ophthalmic Res 2002 Jul-Aug;34(4).
- S.K. Katiyar, M.S. Matsui. C.A. Elmets. H. Mukhtar, Polyphenolic antioxidant (-)-epigallocatechin-3-gallate from green tea reduces UVB-induced inflammatory responses and infiltration of leukocytes in human skin. Photochem Photobiol. 69(1999) 148-53.
- Militante JD, Lombardini JB. Taurine: evidence of physiological function in the retina. Nutr Neurosci. 2002 April; 5 (2): 75-90.
- Vegh S, Szikszay E, Bonoczk P, Cserjes Z, Kiss G. Retrospective analysis of the effect of vinpocetine infusion in ophthalmologic disorders. Orv Hetil. 2006 Dec 10;147(49):2361-5.