Nutrition Supplements and Vision

Age-Related Eye Disease Study (AREDS) was a study to examine if the daily intake of certain vitamins and minerals could reduce the risk of cataract and AMD. In 2001, the National Eye Institute (NEI) released findings from AREDS. The initial AREDS findings found that pharmacological-level doses of zinc, vitamins C and E, and beta-carotene along with copper may help slow the progression of AMD only in people who were at high risk of developing advanced AMD – those with intermediate AMD in one or both eyes and those with advanced AMD in one eye but not the other. Unfortunately, these nutrients did not lower the risk of cataract development.

The National Eye Institute continued research on the use of nutritional supplements to preserve vision and the results of the follow-up study called AREDS2 were released by the NEI in 2013. This study was used to determine if the AREDS formulation could be improved by adding the antioxidants, lutein and zeaxanthin, or adding omega-3 fatty acids. Previous studies have shown that these antioxidants were associated with a lower risk of developing advanced AMD. The study looked to see if lutein and zeaxanthin are a safer and more effective alternative to beta-carotene since they are from the same family of nutrients as beta-carotene. AREDS2 also examined removing beta-carotene and lowering the dose of zinc to see if it affected the risk of advanced AMD. Beta-carotene has been associated with increased risk of lung cancer in smokers and the zinc level used in the first AREDS was considered by some nutritionists to be too high.

Download a free copy of the Nutrition Supplements and Vision Fact Sheet (pdf)

Original AREDS Formulation

• 500 mg of vitamin C
• 400 international units of vitamin E
• 15 mg beta-carotene
• 80 mg zinc oxide
• 2 mg copper as cupric oxide

Modifications in AREDS2

• Adding lutein and zeaxanthin
• Adding omega-3
• Removing beta-carotene
• Reducing level of zinc

AREDS2 Results:

• The original AREDS formulation reduced the risk of advanced AMD by about 25 percent over a five-year period.
• Adding omega-3 fatty acids or lutein/zeaxanthin to the original AREDS formulation (containing beta-carotene) had no effect.
• The AREDS formulation with the addition of lutein/zeaxanthin and no beta-carotene had a slight reduction in risk of advanced AMD compared to those with beta-carotene.
• For those with very low levels of lutein/zeaxanthin in their diet, adding supplements to the AREDS formulation helped lower their risk of advanced AMD and progression to cataract surgery.
• Removing beta-carotene or lowering zinc produced no significant changes in the effectiveness of the AREDS formulation.

Lifelong good nutrition may lower the risk of some eye diseases. A diet rich in certain dark green vegetables may reduce the risk of AMD. You can also help your general eye health by avoiding smoking, staying active and controlling your blood pressure.

Pharmaceutical companies have developed supplements for vision health based on the results of AREDS and AREDS2. Caution is advised when considering taking supplements. The following points should be kept in mind:

• There is no evidence from this study to suggest that taking nutritional supplements can prevent people who currently do not have vision problems from getting AMD in the future.
• The results are restricted to the supplements evaluated (lutein, zeaxanthin, zinc, vitamins C and E, and beta-carotene).
• If you are like many Americans and take prescription and over-the-counter medications, you must be careful when combining those medications with nutritional supplements. High-dose supplements can interfere and interact with other medications, decreasing the nutrients’ absorption into the body. The high doses of supplements are several times greater than those found in most multi-supplement formulations and may have some risks. Please consult your primary care doctors and/or eye care professionals before beginning the AREDS formulation.
• The AREDS formulation is not a substitute for a multivitamin. While the AREDS formulation includes nutrients for eye health in much higher doses than found in multivitamins, it is lacking in other key nutrients.
• Supplements are not a cure. You should NEVER stop taking your medication or other treatment in favor of taking supplements, without first consulting your doctor.

Prevent Blindness recommends periodic dilated eye exams as the best way to ensure that your vision is healthy and to keep it that way. If you have AMD, or any vision problems, you should visit your eye doctor regularly according to a treatment plan that is appropriate for your condition.