Vitamin A
Vitamin A is essential for enabling our eyes to see at night, as it plays a role in producing certain pigments for the retina. If there is not enough vitamin A in the diet, it could lead to night blindness.
Deficiency of vitamin A in the U.S. is rare, according to Dr. Bernstein. Good dietary sources of vitamin A’s precursor beta-carotene include many colorful fruits and vegetables, he adds.
Carotenoids are what give yellow, orange and red fruits and vegetables their color, and some can be converted by the body into vitamin A. Vitamin A is also found in most multivitamins.
Vitamins C and E
These vitamins may help protect cells in the eye and promote healthy blood vessels for overall eye health. “Both vitamins E and C are antioxidant vitamins, and components in the AREDS vitamin combination recommended for certain patients with age-related macular degeneration,” says Dr. West.
The AREDS and AREDS 2 study supplement mentioned previously, which includes 500 milligrams of vitamin C and 400 International Units of vitamin E, among a combination of four other nutrients, was found to reduce the risk of progression from intermediate to advanced AMD by about 25%, and risk of vision loss by roughly 19%.
People who have macular degeneration or who are at risk of macular degeneration due to a family history of the condition should see an ophthalmologist for an eye examination to determine if they should be taking this supplement, adds Dr. West.
Eating diets high in foods that have vitamin C and E, such as fruits, vegetables, nuts and seeds may also help protect against cataracts and AMD. Because the supplemental form of these vitamins does not have an effect on cataracts, additional study is needed.
Riboflavin (Vitamin B2)
Riboflavin is needed to help produce glutathione, an important antioxidant found throughout our body that accumulates in the eye, says Dr. Layman. Increasing riboflavin intake has been linked to protection against cataract progression, he says.
Riboflavin is also useful for management of corneal abnormalities, adds Dr. Abugo.
Fortified breakfast cereal, yogurt, meat, nuts, cheese, eggs and mushrooms have riboflavin. Most multivitamins also contain riboflavin, and deficiency is not a concern in the U.S.
B Vitamins (B6, B9, B12)
B vitamins may reduce the risk of vascular problems affecting the retina as well as macular degeneration and uveitis, a common cause of blindness, according to Dr. Layman. The retina is a layer of cells at the back of the eye that plays a critical role in sending signals to the brain so we can see.
However, more research is needed when it comes to the role of B vitamins in eye disease, cautions Dr. Bernstein.
B vitamins are found in a range of foods from eggs to animal meats, fish to dark leafy greens, and in chickpeas, rice and bananas. Multivitamins also often have B vitamins. Deficiency is rare except for the case of vitamin B12 in older adults or people who struggle with B12 absorption, says Dr. Abugo.
Omega-3 Fatty Acids
The retina of the eye is where anti-inflammatory omega-3 fatty acids are found. “They are essential to maintain normal structure and function of the photoreceptor cells in the retina,” explains Dr. Bernstein. They may also reduce inflammation and support tear production as well as management of dry eye disease.
In fact, omega-3 fatty acid supplementation could prevent symptoms of dry eye, according to a review of studies published in Cornea.
However, Dr. West cautions that one of the most high-quality studies to-date on supplementation of omega-3 fatty acids for dry eye disease, called the DREAM study, has not confirmed these results, and suggests more research may be needed.
Still, a Mediterranean-style diet, which includes many food sources of omega-3 fatty acids, is linked to improved dry eye parameters as well as less risk for AMD, according to studies in Nutrients.
Good sources of omega-3’s include cold water fish like salmon or herring, and Dr. Bernstein encourages his patients to have at least two servings of these fish a week.
Lutein and Zeaxanthin
“Lutein and zeaxanthin are antioxidants that are found in the retina and may protect the eye from damage caused by blue light and ultraviolet light,” says Dr. West. These natural compounds work like internal sunglasses inside the eye that protect them from damaging light, adds Dr. Layman.
The AREDS 2 study found that including 10 milligrams of lutein and 2 milligrams of zeaxanthin daily, along with other nutrients, was a safe and effective alternative for the use of beta-carotene in the original AREDS study for reducing AMD progression, according to a 10-year follow-up study in JAMA Ophthalmology.
Foods rich in lutein and zeaxanthin include green, leafy vegetables, such as spinach, broccoli and kale and bright foods like corn and tangerines.
A review in Advances in Nutrition suggests lutein and zeaxanthin from dietary sources is generally important for maintaining eye health, but to determine how much and how long these compounds need to be eaten for clinical benefit, more research is needed.
