Nutrition

While the causes of age-related macular degeneration (AMD) are not fully understood, scientists believe factors responsible include age, genetics, smoking, exposure to sunlight and diet.

Nutritional supplements

There has been a lot of research into whether nutritional supplements can make up for the lack of lutein, zeaxanthin and other antioxidants in people's diets.

Two large studies, Age-Related Eye Disease Study AREDS1 and AREDS2, suggested that certain nutritional supplements can slow down the progression of AMD by about 25%. AREDS2 in 2013 tested a modified version of the AREDS1 formula.

The AREDS2 formula:
Vitamin C 500mg
Vitamin E 400 IU
Copper 2mg
Lutein 10mg
Zeaxanthin 2mg
Zinc 25mg

Overall the new formula did not seem to reduce the progression of AMD any more than the original. However, some people taking the new formula did show a greater benefit.

Studies suggest that you may benefit from an AREDS2 supplement if:

• Your eye care professional has told you that you have many medium-sized drusen* or one or more large drusen in one or both eyes (you may have large drusen and still have good vision).
• You have wet AMD in one eye but good vision and dry AMD in the other.
• You have a diet low in fresh green leafy vegetables and fruit.

There is no evidence that a supplement will be beneficial if:

• You have been told you have early signs of AMD in one or both eyes (your eye care professional may say that you have several small drusen or a few medium-sized drusen in one or both eyes).
• You have advanced AMD in both eyes.
• You have active wet macular degeneration.

*Drusen are made up of cellular waste materials that collect under the retina. These white or yellow deposits are a common early sign of AMD. The AREDS2 supplements are not available on prescription.

Talk to your GP before taking supplements or making major changes to your diet, especially if you take other medications. People who take warfarin, for example, may need to avoid high doses of omega-3 as it thins the blood. Vitamins E and K may also interact with medicines like warfarin and aspirin.

As lutein and zeaxanthin are fat soluble they may be more easily absorbed when taken as oil capsules rather than tablets.

Some scientists believe that another macular carotenoid, meso-zeaxanthin, is also important for macular health. It is made by the body from lutein. It was not tested in the AREDS trials and not all scientists agree on its significance. More research is needed in this area.

Eating a healthy diet including at least five portions of fruit and vegetables a day is considered important for all aspects of health.

Not all supplements have sound clinical research to support their claims. Beware of any which claim to 'cure' macular degeneration.

While we believe that taking supplements containing lutein may be beneficial to eye health, we do not endorse any brand.

Smoking

You should not take any supplement with beta carotene (vitamin A) if you smoke or have smoked as evidence suggests it increases the risk of lung cancer.

Smoking increases the production of the damaging free radicals. People who smoke are up to four times more likely to develop AMD than those who don't, regardless of genetic risk.

Speak to your GP about stopping smoking.