Dr. Frank Weinstock - Vitamins and the eye

August 21st, 2008

By Frank J. Weinstock, MD, FACS

Boca Raton and Canton, OH

Vitamins are extremely popular and are recommended by many people for almost everything. However, there is often little evidence that they are effective, but there is much evidence about side-effects. Unfortunately many articles are quite adamant about their beneficial effects with little proof. This was discussed in some detail in a recent publication from the Lighthouse in New York.

With the eye Vitamins A, C and E are mentioned along with many leafy vegetables. The feeling is that some eye conditions may be slowed down by some of the vitamins in leafy vegetables. Some individuals feel that if there is a higher concentration of substances such as lutein in the macula, these substances may protect against eye diseases.

Part of our information is derived from the AREDS (Macular Degeneration (AMD) study) several years ago where compounds with a number of substances, including some vitamins, appeared to slow down the progress of dry macular degeneration.

My feeling is that these studies do not really directly relate and are not directly transferable to the general public without eye disease. There is really no definitive evidence that you can prevent cataracts, glaucoma, macular degeneration or other eye diseases with the use of vitamin or other supplements. On the other hand eating leafy vegetables, fruit and other substances high in anti-oxidants, when used in moderations, probably will not do any harm and might actually do some good.

With macular degeneration, diets high in Vitamin C and carotenoids, such as carrots, spinach kale, and citrus fruits may slow dry AMD. The other compound mentioned is lutein that may be found in the macula.

In reference to cataracts, these same substances, along with selenium and folic acid are being linked with a feeling that the cataracts may be slowed down in their progress. It is very difficult to evaluate because most cataracts progress extremely slowly. In my experience, over a limited period of time, 9 out of 10 patients with cataracts don’t require surgery and progress relatively slowly.

Unfortunately high doses of vitamin C may be linked to cancer in smokers and high doses of vitamin E have been associated with increased bleeding- a special concern if you are taking anti-coagulants.

Besides increasing  the vegetables and citrus fruits in your diet, it might also be helpful to cut down on saturated fats and sugars since it apparently is generally a better type of diet.

The other substance which is felt to be dangerous to your eyes, especially macula degeneration is tobacco. For eye health and general health eliminate smoking.

Lutein is present in the area of the macula and is felt to have some effect on dry macular degeneration. It is part of a number of the vitamin supplements.

Omega 3 fish oils are receiving much publicity for treatment of eye diseases. A recent study at the University of Michigan that they may have a role in dry eye, as well as age-related macular degeneration.

Although there is talk about the benefit of the above concepts, the there doesn’t appear to be any evidence that they reverse macular degeneration or any other eye diseases.

Another concept without proof is that certain vitamin supplements eliminate vitreous detachments and floaters. I see patients who tell me that they have taken certain supplements which have totally eliminated their floaters and vitreous detachments- upon examining their eyes I can see that the vitreous detachments and floaters are still present, but not noticed by the patients.

My recommendation is to use a multivitamin which contains lutein since many of us don’t always eat a well balanced diet. This may have a beneficial effect on general health also.

We all want an easy to stay health and avoid illness, but be wary of claims which may sound too good to be true when it comes to nutritional supplements, as well as other easy cures.

When you want to use vitamin or other dietary supplements, check with you physician as to their efficacy and safety since they may be harmful themselves, or may interact negatively with prescription medications.

Dr. Frank Weinstock is a Professor of Ophthalmology- NEOUCOM

Affiliate Clinical Professor at Florida Atlantic University. © 2008 Frank J. Weinstock