Vision & Eye Health

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Vision & Eye Health

Vision is an important part of everyday life, influencing how we learn, communicate, work, play and interact with the world. Its immeasurable value is also something that many of us take for granted, yet if we live long enough, visual impairment or blindness is likely. The good news is that common eye disorders can be prevented, stopped or dramatically slowed with nutrition and lifestyle interventions.
The eyes are particularly vulnerable to the effects of aging with degenerative changes often beginning in middle age. If you think you are experiencing changes in your vision, an eye examination is the best way to know exactly what the changes are so you can take appropriate action.

Age-related Macular Degeneration

Age-related macular degeneration (AMD) is the leading cause of vision loss in Canadians 50 and over. By 75 years of age, 80% of us will be affected by it. AMD causes damage to the macula, the central part of the retina that is responsible for seeing fine details such as reading print and seeing faces. AMD takes two forms, wet and dry. Approximately 90% of AMD cases are dry. The remaining 10% are the wet, more advanced form that causes about 90% of serious vision loss. AMD is painless and variable: it may worsen slowly or rapidly. Watch for any of the following symptoms.

  • Blurred central vision – the most common AMD symptom
  • Straight lines appearing wavy
  • Difficulty seeing details, like faces or words on a page
  • Dark or blank spots blocking your central vision
  • Problems seeing colours correctly
  • Trouble seeing things in the distance

Conventional treatment for dry AMD focuses on monitoring or slowing the progression of the disease. The US National Eye Institute’s Age-Related Disease Studies I and II (AREDS), found that specific doses of certain vitamins for people with intermediate dry AMD lowered the risk of the disease progressing to the advanced form where vision loss cannot be prevented. We will discuss these vitamins and supplements in the Therapeutic Supplements section below.

Treatment for wet AMD also focuses on slowing vision loss and in some cases, restoring it. Such treatment may include intraocular (anti-VEGF) injections where drugs are injected into the eye to stop the growth of abnormal blood vessels. Many of these drugs show promising results and some may even improve vision. Photodynamic therapy is another treatment where a light-activated drug is injected into the body and a non-thermal laser is used inside the eye to activate the drug and seal leaking blood vessels without damaging the retina. The least common therapy is laser photocoagulation therapy where a thermal laser is used in specific areas of the retina to stop the growth of the abnormal blood vessels, but it can cause damage to the retina.
A comprehensive treatment plan for AMD also includes dietary changes and supplemental nutrients. Please see the Nutritional Guidelines, Therapeutic Supplements and Lifestyle Recommendations sections, below.

Diabetic Retinopathy

Diabetes is the single largest cause of blindness in Canada. People with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma. But it is the effect of blood sugar and insulin on the retina of the eye that is the main threat to vision. This threat does not wait to happen until after diabetes is diagnosed; it starts happening even in the early stages of “pre-diabetes” when most people are unaware of their blood sugar challenges.

Elevated insulin and glucose levels in the blood cause damage to the blood vessels in the eye, causing them to swell and leak in the retina. New blood vessels may also grow causing further damage. There are four stages in diabetic retinopathy, ranging from mild to severe. In the first three stages vision loss may not be detected but as it progresses there may be dark spots and blurred, distorted or double vision that can be accompanied by large “floaters” – specks, dots, lines or cobwebs that move across your field of vision and are most noticeable when looking at a white wall or clear sky. These floaters may not be a sign of retinopathy but should be checked.

Conventional treatment for diabetic retinopathy includes “Scatter” laser treatment (pan-retinal photocoagulation) which works to shrink abnormal blood vessels before they begin to bleed. “Focal” laser treatment can also be done to stabilize vision. If blood has leaked into the centre of the eye, surgical Vitrectomy is performed and the vitreous gel is removed from the eye. Intraocular (anti-VEGF) injections often used to treat Age-related Macular Degeneration are also being used for diabetic retinopathy.
Perhaps more urgently than for other eye diseases, a comprehensive treatment plan for diabetic retinopathy also includes dietary changes and supplemental nutrients. Please see the Nutritional Guidelines, Therapeutic Supplements and Lifestyle Recommendations sections, below.


A cataract is a condition in which the eye’s normally clear lens becomes cloudy, allowing less light to reach the retina and blurring vision. Cataracts are painless and can take years to develop before they affect sight. As the cataract develops, a person may have more sensitivity to bright light, experience glare and haloes around lights, have blurred or double vision, and need frequent prescription changes for their eyeglasses or contact lenses. Once cataracts interfere with everyday activities, the very common and safe surgery is generally recommended.

A comprehensive treatment plan for cataracts also includes dietary changes and supplemental nutrients. Please see the Nutritional Guidelines, Therapeutic Supplements and Lifestyle Recommendations sections, below.


Glaucoma is the second most common cause of vision loss in seniors in Canada. Typically symptoms don’t appear until there is already damage to the optic nerve that is usually associated with an elevated pressure inside the eye (intraocular pressure). The most common type of glaucoma is primary open-angle glaucoma. Another type can also develop without an increase in eye pressure, called low-tension or normal-tension glaucoma. As the disease progresses, symptoms include blurry vision, narrowed side (peripheral) vision, trouble focusing, and sometimes a halo effect around lights.

Once vision is lost from glaucoma, it cannot be restored. However, early detection and treatment can often protect you from severe vision loss. Treatment can include eye drops or pills that help reduce pressure in the eye, several kinds of laser treatments that also decrease eye pressure or compensate for narrow angle glaucoma and finally surgery to help fluid drain from the eye.

A comprehensive treatment plan for glaucoma also includes dietary changes and supplemental nutrients. Please see the Nutritional Guidelines, Therapeutic Supplements and Lifestyle Recommendations sections, below.

Risk Factors for Eye Disease

There are a number of common factors that put you at risk for developing age-related macular degeneration, diabetic retinopathy, cataracts and glaucoma.

  • Age – The older you are, the greater your chance of developing AMD, glaucoma and cataracts. Diabetic retinopathy can happen at any age, but the longer there is insulin and blood sugar imbalance, the greater the risk of damage.
  • Smoking – Second after age, this is the largest risk factor for AMD. If you smoke you are up to 4 times more likely to develop AMD. Smoking is also a preventable risk factor for glaucoma and cataracts. When you have diabetes, smoking increases blood pressure and blood sugar levels, both of which increase the risk of retinopathy.
  • Diabetes – Everyone with either Type I or Type II diabetes is at risk of developing diabetic retinopathy. The risk increases the longer you have diabetes and the more unbalanced your blood sugar. People with diabetes who do not control their blood sugar are almost eight times more likely to develop diabetic retinopathy. Diabetes is also a risk factor for AMD, glaucoma and cataracts.
  • Inadequate diet – Diets high in trans fats, processed grains, and sugars, and low in dark leafy green vegetables and fruit increase the risk of developing AMD, glaucoma, cataracts and diabetic retinopathy. The good news here is that increasing specific nutrients in your diet can help prevent, slow or stop the progression of these diseases (please see the Nutrition Guidelines and Therapeutic Supplements sections, below).
  • Excessive sunlight – Over exposure to the sun’s damaging UV rays increases the risk of cataracts and AMD specifically. Wear sunglasses and a brimmed hat to reduce the ultraviolet rays that damage the retina.
  • Family history – Your risk factor increases if your parents, grandparents, or siblings have AMD, glaucoma, cataracts or diabetes. This is not just a genetic link, but also a link to habits, environment, diet and lifestyle.
  • Eye injury or trauma are risk factors for cataracts and glaucoma.

Nutritional Guidelines

Protecting your vision starts with the food on your plate. Carrots may be the best know food for our eyes and as wonderful and nutritious as they are, there are many other aspects of nutrition that have a profound effect on eye health.

Lower your insulin and blood sugar levels. As your blood sugar and insulin levels rise, blood pressure also rises. This damages the blood vessels in the retina and can increase intraocular pressure. To regulate blood sugar levels, restrict all types of sugar and grains, including breads, pasta, rice, cereal and potatoes.

Avoid trans fat. Trans fat is found in many processes foods and baked goods and can be identified in the ingredients by the terms hydrogenated or partially hydrogenated vegetable oil, or shortening. These fats interfere with omega-3 fats in your body and are linked to all chronic diseases as well as poor eye health.

The greener the better. Eat plenty of dark green leafy vegetables, especially kale and spinach. These are loaded with two specific antioxidants, lutein and zeaxanthin, that protect the eye against damage from things like sunlight, pollution and cigarette smoke. Studies show that people with the highest consumption of carotenoid-rich vegetables, especially ones high in lutein and zeaxanthin, have better vision health.

Cold water fatty fish. The omega-3 fats that keeps your brain and heart healthy also protect your eyes by reducing inflammation. Cold water fish such as sardines, wild salmon, mackerel, sable fish, rainbow trout and mussels are among the best sources of these healthy fats.

Vitamins E and C and sometimes Z. Vitamins E and C work together throughout the body to keep cellular damage at bay and promote overall health. Leave the orange juice for the commercials – it doesn’t contain as much vitamin C when compared to some whole foods and the high sugar content will drive up your blood sugar and insulin. Reach instead for strawberries, kiwi, red peppers and Brussels sprouts. Grab a handful of sunflower seeds or almonds for a snack to help your body get the vitamin E it needs. Z is for zinc, an important mineral antioxidant that works to protect your vision. Oysters are a tremendous source of zinc but don’t forget pumpkin seeds, turkey and chickpeas.

Therapeutic Supplementation

Lutein and Zeaxanthin are carotenoids that filter excess ultraviolet and harmful blue wavelengths of light and act as antioxidants in the eye, helping to protect and maintain healthy cells. Of the 600 carotenoids found in nature (so far), only lutein and zeaxanthin are deposited in high quantities in the retina of the eye. The body does not synthesize the lutein and zeaxanthin it needs on a daily basis so it is important for eye health to get it in your diet (dark green leafy vegetables) and through nutritional supplements.

Astaxanthin is also a carotenoid and one of the most powerful antioxidants known. It has the unique ability to cross the blood-brain barrier and the blood-retinal barrier, bringing antioxidant and anti-inflammatory protection to your eyes, brain and central nervous system. This reduces your risk for cataracts and AMD, not to mention heart disease and Alzheimer’s. Astaxanthin is soluble in fats, so it is easily incorporated in to cell membranes and also protects them from oxidative damage.

Benfotiamine is a highly bioavailable form of vitamin B1. Studies show that it supports eye health and is especially effective at preventing the formation of glycated proteins called Advanced Glycation End-Products (AGEs). AGEs are extremely damaging to the eyes and are a leading cause of AMD, cataracts and diabetic retinopathy.

Omega-3 Fatty Acids are critical to the functioning of the body. One of these fats, docosahexaenoic acid (DHA) is found in the highest concentration in the retina. Eicosapentaenoic acid (EPA), another omega-3, is used in the synthesis of DHA. Among other characteristics, omega-3 fatty acids have anti-inflammatory properties and low levels of DHA and EPA have been associated with diabetic retinopathy and AMD as well as dry eye syndrome.

Vitamin D plays a key role in immune regulation and may protect against the aging process. A recent study in mice found that supplementing with vitamin D reduced inflammation and amyloid beta, a risk factor for AMD.
Broad-Spectrum High-Potency Multi-Vitamins play a role in supporting eye health. The antioxidant vitamins A, C and E and the mineral zinc may help with the prevention of AMD. The retina, especially the macula, is an environment of high oxidative stress where there are a lot of free radicals – molecules that damage proteins and DNA within cells. The antioxidants quench the free radicals, preventing cellular damage.

Zwell Lifestyle Recommendations

Quit Smoking. Smoking increases the free radical production throughout your body and puts you at risk for less-than-optimal health in many ways, including the risk of decreased vision. Smoking makes you more likely to get cataracts, glaucoma and AMD. If you have tried to quit before and started again, keep trying. The more times you try to quit, the more likely you are to succeed.

Wear Sunglasses. The right kind of sunglasses with help protect your eyes from the sun’s UV rays. Choose sunglasses that block at least 99% of both UVA and UVB rays. Wrap around lenses help protect your eyes from the side and polarized lenses reduce glare when driving.

Look away from the computer screen. Staring at a computer screen for too long can cause eye strain, blurry vision, dry eyes and trouble focusing at a distance. Taking a break every 20 minutes to stand up and look at something 20 feet away for at least 20 seconds can help with eye strain and focusing. Be sure your glasses or contact lens prescription is adequate for computer use. Position the computer so that your eyes are level with the top of the monitor, allowing you to look slightly down at the screen. Use an anti-glare screen if needed.

Eat whole foods. A diet rich in nutrients from unprocessed foods is foundational for health. Putting the right building blocks into the body in terms of good fats, slow carbohydrates and lean proteins, means the body can repair damaged cells and fight inflammation. Processed foods deplete the body of important vitamins, minerals and antioxidants that are needed for good eye health. Maintaining good blood sugar control reduces the formation of AGEs and helps protect the small blood vessels of the eye from retinopathy. Please see the specific food recommendations for good eye health under the Nutritional Guidelines section.

Drink water. Water is as essential a nutrient to the body as are proteins, fats and carbohydrates. Consuming enough water allows for better flow of nutrients into the cells and facilitates better toxin removal. Being dehydrated forces the body to operate at sub-optimal health.
Exercise. Exercise is one of the best ways to help control blood sugar. When you exercise, insulin sensitivity is increased so your body is better able to use blood sugar. Exercise also lowers blood pressure, helps improve cholesterol and improves blood circulation, right down to the small blood vessels of the eyes.

Connect. Decreased vision can often lead to feelings of isolation and depression. But a diagnosis of AMD, glaucoma, cataracts or diabetic retinopathy does not need to be a life sentence. Use the strategies we have outlined here to manage and even reverse your symptoms. Be active in every way; proactive, interactive and physically active. The end result can be very enjoyable!


The information appearing on this website is for information and education purposes only and is not intended to diagnose, treat, cure or prevent disease or to replace medical advice from a qualified health care practitioner. Statements made have not been evaluated by Health Canada or the U.S. Food and Drug Administration. Be sure to check with a qualified health care practitioner for any contraindications before taking any supplements.


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Hammes HP et al. Benfotiamine blocks three major pathways of hyperglycemic damage and prevents experimental diabetic retinopathy. Nat Med. 2003 Mar;9(3):294-9.
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Neurobiology of Aging January 4, 2012

The eyes are particularly vulnerable to the effects of aging with degenerative changes often beginning in middle age. If you think you are experiencing changes in your vision, an eye examination is the best way to know exactly what the changes are so you can take appropriate action.

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