Visual impairments are a widespread issue in the United States, affecting over 3.4 million individuals aged 40 and above who suffer from blindness or diminished sight. Estimates point to approximately 21 million Americans experiencing visual difficulties and as many as 80 million having eye conditions that can lead to blindness. Some of the main culprits behind vision loss in older adults are age-related macular degeneration (AMD), glaucoma, cataracts, and diabetic retinopathy. While procedures like surgery are standard treatments for these conditions, many people also explore the use of nutritional supplements to either ward off these disorders or manage their progression.

What the Science Says

Age-Related Macular Degeneration

AMD is a primary cause of vision deterioration in adults over 50. This disease affects the macula, the region in the eye responsible for seeing things straight ahead with clarity. While there are no proven treatments for early-stage AMD, conventional therapy can help delay more serious vision loss in later stages. The Age-Related Eye Disease Study (AREDS), conducted in 2001 with nearly 4,800 participants, examined the impact of supplement use on AMD progression. In 2013, AREDS2 followed up on this research, enrolling over 4,000 patients between the ages of 50 and 85 to test revised supplement formulas.

• The initial AREDS study showed that high levels of vitamins C and E, beta-carotene, zinc, and copper could slow the condition’s development. However, other studies at the time indicated that beta-carotene supplements increased lung cancer risk among smokers.

• AREDS2 aimed to refine the original formula by testing the removal of beta-carotene, lowering zinc content, and adding fish-derived omega-3 fatty acids along with dietary pigments like lutein and zeaxanthin. Smokers were not given beta-carotene due to cancer concerns, but some non- and former smokers received it.

• Omega-3 fats, as included in AREDS2, didn't increase supplement effectiveness.

• Lowering zinc levels had no effect on the formula’s ability to slow AMD.

• Those receiving beta-carotene had a greater chance of getting lung cancer—most of these cases were in previous smokers. In contrast, lutein and zeaxanthin carried no added cancer risk.

• Over a decade, lutein and zeaxanthin were found to be more beneficial than beta-carotene for reducing advanced AMD progression risk.

• A 2015 review involving two randomized trials with about 2,343 participants found that omega-3 supplementation for up to five years did not reduce progression to late-stage AMD nor did it prevent significant vision decline.

• Research in the U.S., Europe, and Australia highlighted that a Mediterranean-style diet, rich in fruits and vegetables and low in red meat, was associated with reduced rates of advanced AMD. Such dietary patterns, however, showed mixed results for early AMD.

Cataracts

A cataract is characterized by a cloudy lens, leading to dimmed or blurred vision. If the problem worsens enough to disrupt everyday life, surgery to remove and replace the lens is typically successful.

• In a 2015 study with more than 11,000 male participants, results showed that taking selenium or vitamin E daily over time did not significantly affect cataract development.

• A Swedish study from 2014 involving about 30,600 women suggested that higher antioxidant intake through food may decrease cataract risk.

• However, a 2012 analysis incorporating nine clinical trials and nearly 117,300 individuals found that supplementing with vitamins C, E, or beta-carotene offered no benefit in preventing or slowing cataract growth.

• AREDS2 results confirmed that its modified supplement blends didn’t prevent the need for cataract surgery, though people with low dietary intake of lutein and zeaxanthin might have experienced some protection.

Diabetic Retinopathy

This diabetes-related eye condition damages retinal blood vessels, leading to blurred or impaired vision.

• A review in 2011 concluded that there is no strong evidence supporting any dietary supplements for improving diabetic retinopathy symptoms.

Glaucoma

Glaucoma affects the optic nerve, often resulting in the gradual loss of peripheral vision. Early detection and medical treatment are crucial. Currently, there is limited proof that high-dose vitamins, special diets, acupuncture, or similar approaches help with glaucoma management.

Side Effects and Risks

• Always consult your eye care provider before starting any supplement regimen, especially if managing an eye disease. Alternative methods should not replace established medical treatments.

• Supplement use—especially combinations containing antioxidants and zinc—may be suggested for certain AMD patients, but not for those with early-stage symptoms. Speak to your provider to determine what’s appropriate for your condition.

• Beta-carotene, found in the first AREDS formula but removed in AREDS2, may increase the chance of lung cancer in smokers and those exposed to materials like asbestos.

• Improper or excessive use of dietary supplements can be harmful and may interact with medications. Caution is advised.

For More Information

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