Eye Supplements (Ocuvite)

Claims, Benefits: Ocuvite can prevent age-related macular degeneration (AMD) and other eye problems.

Bottom Line: In people with AMD, Ocuvite helps prevent blindness from the disease. Should not be taken by others, since high levels of zinc can have adverse effects. No evidence that Ocuvite or other supplements will prevent AMD or any other eye disease. There is evidence that a healthy diet can helps.

Full Article, Wellness Letter, December 2005:

A Feast for the Eyes: Nutrition for Good Vision

There’s no sure way as yet to prevent the eye disorders that often come with age, but nutrition is certainly an important part of the puzzle. It’s well known that malnutrition harms vision: a shortage of vitamin A, for example, causes night blindness and other problems. Vitamin deficiencies can also cause eye disorders such as cataracts in lab animals. Several other nutrients help protect vision. For example, carrots really are good for your eyes because they are a rich source of beta carotene. This and two other carotenoids, lutein and zeaxanthin, are antioxidant pigments found in many plant foods. Lutein and zeaxanthin are also found in the retina of the healthy eye, specifically in the macula (the central part of the retina), where they act as a shield against blue light (a harmful component of sunlight) and may help protect against damage from ultraviolet radiation. Zinc is also found in healthy retinal tissue.

Nearly half of us will eventually develop cataracts, a clouding of the lens that can result in blindness, but now is easily and permanently corrected with outpatient surgery. Less common but also less treatable is age-related macular degeneration (AMD). Characterized by distortions in vision, blind spots, and a loss of central vision, this is the leading cause of blindness among older people in developed countries: more than one-fourth of those over 75 show some signs of this disorder. No one knows what causes it, though it may be related to ultraviolet damage. But certain nutrients appear to play a role in preventing AMD—or at least delaying it—and in slowing its progression after diagnosis.

Good news for people with AMD . . .

As we reported in 2002, research has shown that a supplement called Ocuvite PreserVision—made by Bausch & Lomb and containing vitamin C and E, beta carotene, zinc, and other nutrients—can slow the progression of AMD in people already diagnosed with the disorder. Another version of the supplement, Ocuvite Lutein, contains other carotenoids, too. The research was solid, and many eye doctors have been recommending the supplements (or similar and often less expensive products). Follow-up studies have confirmed that the supplements, when taken as prescribed, can play a role in saving vision in people with AMD.

. . . and for those whose eyes are still healthy?

But can these or other supplements, or food itself, preserve vision in healthy people and prevent AMD and/or cataracts from ever developing? There is some evidence that a healthy diet helps, but none that supplements do. Based on the most recent studies, including a comprehensive review in Archives of Ophthalmology, here are the supplements most often promoted for eye health, along with what the evidence shows:

Vitamin C and E, selenium, beta carotene, and other antioxidant supplements: High doses of antioxidants have been extensively studied as a means of preventing or delaying cataracts and AMD. But these supplements have never been shown to be beneficial for healthy eyes. Moreover, high doses of beta carotene increase the risk of cancer in smokers.

Zinc: This mineral is essential to good vision and may protect eye tissue from the damaging effects of light or from inflammation, but supplemental zinc has never been found to be beneficial to healthy eyes. In addition, high doses (more than 50 milligrams daily, as in the supplements currently advised for people with AMD) may cause hair loss and increase the risk of invasive prostate cancer, among other side effects. Get zinc from your diet (see below).

Lutein and zeaxanthin: In pill form, these two carotenoids may benefit people who already have AMD, but not those with healthy eyes.
Herbal supplements, such as bilberry: You’ll find a large variety of these in drugstores and health-food stores in the “eye supplement” section. The herbs are often combined with high doses of vitamins. Bilberries, which are similar to blueberries, contain carotenoids and other pigments (anthocyanins) touted to improve night vision. Despite the claims, there’s no evidence that any herb can protect your eyes.

Multivitamin/minerals: There’s a study underway in Italy on multivitamins and cataracts, and some evidence already suggests that people who take a daily multi have a lower risk of cataracts. There is no proof that a multi will protect against AMD. Still, it’s a good idea for most people (those over 60, women of childbearing age, those not eating a healthy diet) to take a daily multi. Multis supply a safe level of zinc. Just be sure the multi does not contain more than 5,000 IU of vitamin A, and that at least 40% of this vitamin comes from beta carotene. Higher doses of vitamin A are now known to contribute to osteoporosis (thinning bones).

Eyes, heart, diet

There’s no proof that a healthy diet can protect against eye disorders, but it’s a good bet. Some researchers now think that the dietary habits that contribute to heart health—and that may also help protect against some cancers—also contribute to eye health. Here are the basics:

Emphasize fruits, vegetables, and whole grains. In particular, leafy greens such as kale, spinach, arugula, and chard may protect against cataracts. Blueberries, blackberries, beets, broccoli, and carrots are also excellent choices. Whenever possible, eat colorful foods—deep green, orange, yellow, purple, red, blue. These contain the highest levels of carotenoids and other healthy pigments. Whole grains are rich in vitamins and minerals.

Follow a low-fat diet, but choose healthy fats from fish and nuts, which may benefit the retina. High-fat diets have been linked to progression of AMD in those diagnosed with it. There is preliminary evidence that the omega-3 fats in fish may benefit eyes.

Focus on zinc, which is plentiful in foods. Meats (select lean cuts), seafood (especially oysters), and liver are the richest sources. Brewer’s yeast, milk and other dairy products (choose nonfat or low-fat), beans, wheat germ, and whole grains also supply some zinc.

Other tips: Smoking is harmful to eyes—so if you smoke, let this be your motivation to quit. Stay out of smoky environments. Be sure you get regular eye exams—once every three to five years starting at age 39, more often as you get older, depending on your state of health and on professional advice.

UC Berkeley Wellness Letter, December 2005