By Karen L. Kier, Pharmacist on behalf of the ONU Healthwise Team 

Art Garfunkel recorded the song Bright Eyes for the movie Watership Down released in 1978. Art Garfunkel started his solo career after a break from Paul Simon in 1970. The famous duo of Simon & Garfunkel met in elementary school in New York before starting their musical careers. Simon & Garfunkel were inducted into the Rock & Roll Hall of Fame in 1990. Garfunkel had a very accomplished solo career and was named by Rolling Stone magazine as one of the top 100 greatest singers of all time. 

Age may play a role in diminishing our bright eyes. Are there therapies available to reduce this aging?

Several supplements including antioxidants have been studied to help with the most common eye diseases with aging include cataracts, retinopathy with diabetes, glaucoma, and age-related macular degeneration (AMD). 

Macular degeneration or AMD is the leading cause of vision loss in older adults primarily over the age of 60 years. The macula is part of the retina of the eye and AMD causes a loss of vision in the central portion of the eye. This makes it difficult to do tasks such as read and drive.

There are two types of AMD known as wet and dry. Early stages often have no noticeable symptoms with the more significant changes occurring in the later stages. The late stage is referred to as geographic atrophy (GA). Eye exams are essential for detecting the disease before the late stages occur. 

The most common type is dry AMD, which usually progresses slowly and can occur in one eye or both eyes. With age, the macula thins and clumps of protein known as drusen deposit in the retina of the eye blocking vision. Known risk factors for dry AMD are smoking, pollution, and a family history of AMD. 

Studies have evaluated the use of AREDS2 supplements for eye health. The 2 important antioxidants in the AREDS2 products are lutein and zeaxanthin. Make sure your supplement contains both ingredients or ask your pharmacist for advice. Some eye health products may only contain lutein and not provide the essential zeaxanthin component. The newer AREDS2 supplements have removed the beta-carotene ingredient. Beta-carotene is the vivid orange, yellow, or red coloring in many vegetables the body converts to vitamin A. The reason this was removed from the AREDS2 products is due to research showing an increased risk of lung cancer in those who smoked. 

Another antioxidant for eye health, which is often overlooked is alpha-lipoic acid (ALA). Alpha-lipoic acid helps to neutralize damage from free radicals in the lenses of the eyes. Alpha-lipoic acid can help with damage from overexposure to light and pollution. The supplement is often known more for nerve pain than eye health.

A 2020 study completed in Spain showed the benefit of an ALA supplement combined with docosahexaenoic acid (DHA) for six months in patients with glaucoma. The ocular surface of the eye improved and a stabilization of glaucoma was noted. An important note is the product used for the study contained lutein and zeaxanthin. 

Other studies have shown low dose ALA at 300mg per day for 3 months improved light sensitivity in patients with diabetic retinopathy. Studies have shown doses of 300mg to 600mg per day have the best benefit with the least amount of side effects. Some researchers used doses as high as 1200 mg per day. The major side effects seem to be related to the gastrointestinal tract. 

The studies published in the medical literature have differing conclusions when managing patients with AMD. A 2016 study demonstrated an improvement in vision quality of life measures with ALA versus placebo in AMD. This improvement was related to contrast sensitivity when individuals were treated with 200 mg daily for 3 months. A 2020 study evaluating 1200 mg per day of ALA did not show a benefit over placebo in AMD, but showed a high level of gastrointestinal side effects. 

ALA in doses of 200 mg to 600 mg per day over several months may provide some additional eye benefits and improved quality of life with minimal side effects. The ability for ALA to have a major impact on AMD requires further research. 

ALA supplements are available over the counter for eye health, but the better medical evidence is with products such as AREDS2 with lutein and zeaxanthin. There are some eye supplements on the market that provide lutein, zeaxanthin, and ALA in one supplement. Another option would be to include foods high in ALA in your diet such as spinach, tomatoes, broccoli, potatoes, yams, carrots, beets, rice bran, and red meats. 

Talk to your pharmacist about supplements for bright eyes!