Not long ago, deteriorating eyesight was considered an inevitable side effect of aging. In recent years, however, it has become an issue no longer reserved only for the aging. And as the population seeking relief from failing eyes skews younger, and its causes less tied to Father Time, new solutions are being sought.

“With more consumers at a younger age paying attention to eye issues such as ‘tired’ eyes, visual processing speed (how quickly you can change focus, for one thing), dry eyes and contrast sensitivity (and seeing in darker conditions), consumers are looking to support healthier vision,” said Jason Pellegrini, CEO, Quantum Health.

“With growing awareness of blue light from the sun and digital devices, Kemin has seen more interest in products for eye health at younger ages,” agreed Ceci Snyder, global product manager, Kemin.

That growing awareness Snyder noted can be seen in sales data. According to proprietary data from Nutrition Business Journal, U.S. sales of eye health products have increased from US$572 million in 2014 to $685 million in 2018, a 3.67% compound annual growth rate (CAGR). Sales have especially increased recently, seeing a 7.5% growth from 2017 to 2018.

This new category of consumers means manufacturers must not only continue to develop products for age-related eye conditions, but a whole new set of concerns unique to the digital age. As Brian Appell, marketing manager, OmniActive Health Technologies, pointed out, people are constantly exposed to eye-damaging blue light naturally from the sun. But with the ubiquity of technology and its accompanying blue-light-emitting screens, people are more exposed to it than ever before. A 2016 survey by Common Sense Media reported parents with children between 8 and 18 years old spend, on average, nine hours per day using screen media such as computers, tablets, televisions and video games. A 2019 Nielsen report indicated Americans spend as much as 11 hours per day consuming media, the vast majority of which is spent looking at some kind of screen.

Appell described these short-term consequences of blue light, which he calls “computer vision syndrome,” as “one of the chief complaints among people who spend a lot of time on digital devices and presents as eye strain and fatigue, headache frequency, and dry and/or blurry vision.”

Two promising ingredients—carotenoids lutein and zeaxanthin—may alleviate symptoms related to computer vision syndrome and its symptoms

“Depending on dietary consumption, the concentration of lutein and zeaxanthin in the macula can be astoundingly high,” Pellegrini said.

In one double-blind, placebo-controlled study, 59 young (mean age = 21.7), healthy volunteers were given either 10 mg of lutein and 2 mg of zeaxanthin, 20 mg of lutein and 4 mg of zeaxanthin, or a placebo. At both six- and 12-month visits, macular pigment optical density (MPOD) increased significantly in both supplemental groups versus placebo.1

Pellegrini noted that every eye health formula offered by Quantum Health contains lutein and zeaxanthin.

Kemin, in partnership with its distributor DSM, offers FloraGLO Lutein and ZeaONE Zeaxanthin in combination as OPTISHARP Zeaxanthin. As Snyder explained, “Both ingredients work together for eye performance and protection by absorbing blue light at complementary wavelengths. Lutein and zeaxanthin are found together in the eye, as well as other parts of the body. FloraGLO Lutein and ZeaONE Zeaxanthin support products addressing eye fatigue2,3, blue light protection4, glare recovery5, contrast sensitivity6 and age-related macular degeneration.”7

Appell also noted OmniActive’s flagship eye health ingredient, Lutemax 2020, contains both lutein and zeaxanthin isomers.

While increased screen use is bringing younger consumers into the eye health market, older individuals must also be accounted for. According to the National Eye Institute (NEI), age-related macular degeneration (AMD) is a leading cause of vision loss among people 50 and older. According to NEI, “AMD … can interfere with simple everyday activities, such as the ability to see faces, drive, read, write or do close work, such as cooking or fixing things around the house.”

A 2019 review titled “Nutrients for Prevention of Macular Degeneration and Eye-Related Disease” by Khoo et al. identified promising nutrients in the treatment of AMD. In its conclusion, it noted, “vitamins C and E, as well as selenium, act as antioxidants in reducing the cellular oxidative stress of the retina or macular region of the eye.”8 The same review noted positive findings for zinc supplementation, concluding, “Four human studies also showed that zinc supplementation effectively reduced the risk of AMD and visual loss.”

The authors suggested “[m]ore studies should be focused on specific formulas with a combination of these antioxidants for prevention of [AMD’s] early development and the treatment of macular degeneration and other eye-related complications…”

A 2018 study by Rinninella et al. also concluded, “In vitro studies have suggested that AREDS [Age-Related Eye Disease Study] vitamins and zinc supplementation attenuate angiogenesis and endothelial-macrophage interactions, thereby reducing the progression of AMD.”9

Other ingredients in the fight against AMD are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

One comprehensive study by Wu et al. followed 75,889 women from the Nurses’ Health Study and 38,961 men from the Health Professionals Follow-Up Study who were at least 50 years old from 1984 to 2012, and 1986 to 2010. That study concluded “Higher intakes of EPA and DHA may prevent or delay the occurrence of visually significant intermediate AMD.”11

A 2013 study on dry-eye sufferers also found those treated with EPA- and DHA-containing fish oil saw significant improvement in visual analogue scale eye pain score and tear-film break up time score after 12 weeks over placebo, indicating effectiveness in ameliorating dry eye symptoms.11

Another ingredient that has shown promise in the field of eye health, Pellegrini noted, is curcumin, the main curcuminoid of turmeric root.

A 2014 review by Pescosolido et al. concluded, “Most studies demonstrated [curcumin’s] potential therapeutic role and its efficacy in eye relapsing diseases, such as dry eye syndrome, allergic conjunctivitis, anterior uveitis, glaucoma, maculopathy, and ischemic and diabetic retinopathy.”12 The review went on to note, “In light of its angiogenesis-modulating profile and anti-inflammatory properties, curcumin has great potential in the treatment of inflammatory and neovascular proliferative diseases of the retina.”

Knowing the right ingredients to combat failing eyesight is one thing; knowing how to formulate those ingredients into the best possible product is another.

“With all supplements, the consumer is demanding more forms to have more flexibility in consumption,” Pellegrini said. “We focus our current efforts on soft gels, as we have determined this is the best method to deliver a product that has appropriate bioavailability of key ingredients in the right ratios.”

Pellegrini did note that Quantum is looking into other delivery formats, but that no matter the format, its “core focus is efficacy,” he stated.

Pellegrini also made clear than continuing research is the only way to ensure ingredients and formulations stay state-of-the-art.

“I think the key for consumers and retailers here is to continue to learn,” he said. “Many products on the shelf may be based on research that is now not the latest thinking. In a category that is evolving so quickly, finding partners that are continuing to innovate and learning why is very important.”

References:

1. Stringham JM, O'Brien KJ, Stringham NT. “Macular carotenoid supplementation improves disability glare performance and dynamics of photostress recovery.” Eye Vis.   2016;3:30.

2. Yagi A et al. “The effect of lutein supplementation on visual fatigue: a psychophysiological analysis.” Appl Ergon. 2009 Nov;40(6):1047-54

3. Kawabata F and Tsuji T. “Effects of dietary supplementation with a combination of fish oil, bilberry extract, and lutein on subjective symptoms of asthenopia in humans.” Biomed Res. 2011 Dec;32(6):387-93.

4. Hammond BR et al. “A double-blind, placebo-controlled study on the effects of lutein and zeaxanthin on photostress recovery, glare disability, and chromatic contrast.” Invest Ophthalmol Vis Sci. 2014 Dec 2;55(12):8583-9.

5. Stringham JM and Hammond BR. “Macular pigment and visual performance under glare conditions.” Optom Vis Sci. 2008 Apr;85(4):285.

6. Bovier ER and Hammond BR (2015). “A randomized placebo-controlled study on the effects of lutein and zeaxanthin on visual processing speed in young healthy subjects.” Arch Biochem Biophys. 572; 54-57.

7. Chew EY et al. “Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3.” JAMA Ophthalmol. 2014 Feb;132(2):142-9.

8. Khoo et al. “Nutrients for Prevention of Macular Degeneration and Eye-Related Diseases.” Antioxidants. 2019;8:85.

9. Rinninella et al. “The Role of Diet, Micronutrients and the Gut Microbiota in Age-Related Macular Degeneration: New Perspectives from the Gut–Retina Axis.” Nutrients. 2018;10:1677

10. Wu et al. “Dietary Intakes of Eicosapentaenoic Acid and Docosahexaenoic Acid and Risk of Age-Related Macular Degeneration.” Ophthalmology. 2017 May;124(5): 634–643

11. Kawakita et al. “Effects if dietary supplementation with fish oil on dry eye syndrome subjects: randomized controlled trial.” Biomedical Research. 2013 34(5) 215-220

12. Pescosolido N, et al. “Curcumin: therapeutical potential in ophthalmology.” Planta Med. 2014;80(4):249-54