The latest studies reflect a category increasingly shaped by a heads-down generation of consumers of all ages spending more hours on phones, laptops and tablets, and researchers responding with work on high screen exposure, dry eye concerns, earlier intervention and nutrients that may support not only the retina and ocular surface but also visual performance, cognition and long-term resilience.
Across the round-up, carotenoids lutein, zeaxanthin and related compounds consistently appear in research on macular pigment, blue light filtering, pediatric development and potential eye-brain benefits, but the science is also widening to include omega-3s, citicoline, B vitamins, botanicals and microbiome-targeted approaches that conceptualize a gut-retina axis. These are united by common mechanisms such as oxidative stress control, inflammation modulation, mitochondrial support and neuroprotection.
While eye health supplement research and launches are being viewed through a broader lens—from condition-specific interventions toward a more preventive, personalized, whole-system approach, the evidence still calls for larger, longer, better-controlled trials to determine how best to address the nutritional demands of aging and modern life.
Review explores protective effects of carotenoids on eye health
A review published in Nutrients examined the growing body of evidence of the potential role of carotenoids—including lutein, zeaxanthin, meso-zeaxanthin, β-carotene, lycopene and astaxanthin—in protecting eye health.
Researchers from the Medical University of Lublin in Poland reviewed experimental, clinical and epidemiological research on how these compounds may support the retina, optic nerve, lens and ocular surface, with particular attention to conditions such as age-related macular degeneration, diabetic retinopathy, glaucoma, cataracts, dry eye disease and pediatric vision concerns.
The review found that carotenoids appear to act through several overlapping mechanisms, including antioxidant, anti-inflammatory and neuroprotective pathways. Lutein, zeaxanthin and meso-zeaxanthin were highlighted as especially relevant because they selectively accumulate in the macula, where they help filter blue light, neutralize reactive oxygen species and support macular pigment density.
While much of the mechanistic evidence still comes from cell and animal studies, the strongest clinical evidence was linked to age-related macular degeneration, where higher intake or supplementation with lutein and zeaxanthin has been associated with improved macular pigment measures and a potential slowing of disease progression in some groups.
“However, their effects depend on many factors, such as interactions with other dietary components, genetic factors and the stage of the disease,” the researchers wrote. “Despite the increasing number of studies confirming the beneficial effects of carotenoids on eye health, there remains a need for high-quality clinical trials to definitively establish their therapeutic efficacy, optimal doses and long-term safety.”
Study finds lutein and zeaxanthin boost eye pigment and some cognitive measures in teens
Researchers affiliated with Clinical Research Australia investigated whether daily supplementation with lutein and zeaxanthin could improve eye and cognitive outcomes in teenagers.
The randomized, double-blind, placebo-controlled trial recruited 82 adolescents between the ages of 13 to 18 years with high screen use and low fruit and vegetable intake and assigned them to receive either lutein (10 mg) plus zeaxanthin (2 mg) per day or a sunflower oil placebo for six months. The main outcome was macular pigment optical density, a marker of lutein and zeaxanthin concentration in the eye, while secondary outcomes included cognitive performance, self-reported attention and sleep.
Compared with placebo, supplementation significantly increased macular pigment optical density in both eyes and improved performance on tests of attention and processing speed but did not significantly improve visual reasoning, nonverbal memory, gaming performance, self-reported attention or sleep.
“This is the first published study to demonstrate that supplementation with LZ in teenagers for 6 months can increase MPOD and some aspects of cognitive performance,” the researchers wrote in the journal Nutrition Research. “Further research on teenagers with impairments in cognitive performance and sleep quality will be important to extend the results of this study.”
Carotenoids linked to children’s eye and cognitive development
In a scoping review published in the journal Nutrients, researchers from the College of Optometry at Western University of Health Sciences in California examined the evidence on carotenoids—particularly lutein, zeaxanthin and β-carotene—and their potential role in children’s visual and cognitive development.
Studies reviewed included 40 human studies through January 2026 covering infants, children, lactating mothers, human milk, infant formula, dietary intake, supplementation and biomarkers such as serum carotenoids, skin carotenoid scores and macular pigment optical density.
The review found that carotenoids are present in meaningful amounts in the developing eye and brain, with lutein and zeaxanthin concentrated in the retina and lutein also prominent in brain regions linked to visual processing.
Across the reviewed studies, higher carotenoid exposure—through maternal status, breastfeeding, diet or supplementation—was associated with several markers of visual and cognitive function, including macular pigment levels, retinal maturation, recognition memory, psychomotor outcomes, receptive vocabulary, executive function and some academic measures. Human milk appeared to provide carotenoids in a more bioavailable form than many fortified formulas, although formula fortification did raise infant plasma carotenoid levels in some studies.
“This review shows emerging evidence on the benefits of carotenoids in children, primarily from cross-sectional studies and longitudinal cohort studies,” they wrote. “We found a paucity of carotenoid intervention and controlled trials for direct carotenoid exposure and its relative effect on neurocognitive function and visual milestone development during early life.”
Saffron blend may protect retinal cells from oxidative stress
Writing in the International Journal of Molecular Sciences, researchers from Italy investigated whether saffron extract could protect retinal pigment epithelial cells from oxidative damage and whether combining saffron with elderberry and melilotus extracts would provide stronger protective effects.
The study used ARPE-19 retinal pigment epithelial cells and exposed them to hydrogen peroxide to mimic oxidative stress, a process implicated in retinal degenerative diseases such as age-related macular degeneration and diabetic retinopathy. Cells were pretreated with saffron alone (Affroneye, Pharmactive) or with a saffron–elderberry–melilotus mix (adding Eldosamb, Anklam Extrakt and Melilotus officinalis, Nutraceutica srl) before oxidative injury was induced. All compounds were gifted by Italian firm VISUfarma.
Although further studies are needed to confirm results in real-world settings, findings indicated that both saffron alone and the combined botanical mix improved cell survival and reduced oxidative stress, but the mix showed broader effects.
In particular, the saffron–elderberry–melilotus combination activated the NRF2 antioxidant pathway, increased SOD2 expression, improved the glutathione redox balance and was more effective than saffron alone at reducing caspase-1 activity, a marker linked to inflammasome-driven inflammation.
Probiotic vesicles and their lipids may help shield retinal cells from blue light damage
A cell study published in the Journal of Food and Drug Analysis supports the emerging gut-eye axis concept and suggests probiotic-derived vesicles as a potential strategy for protecting human retinal pigment epithelial cells from blue light-induced injury.
For this exploratory work, researchers in Taiwan tested extracellular vesicles from eight Bifidobacterium longum strains in ARPE-19 retinal cells exposed to blue light, a stressor associated with oxidative damage and retinal cell death.
The strongest protective effect was observed with extracellular vesicles from the BLMR22 strain. These vesicles reduced blue light-induced cell death in a concentration-dependent manner and helped limit oxidative stress in the retinal cells.
Further analysis showed that the vesicles were nanoscale particles with a lipid profile dominated by triacylglycerols, cholesteryl esters and free fatty acids, including fatty acids like those found in retinal cell membranes. The researchers suggest this lipid composition may help the vesicles enter retinal cells and exert protective effects.
Transcriptomic analysis indicated that the vesicles may support retinal cell survival by regulating PI3K and mTOR signaling pathways, which are linked to cell survival under oxidative stress.
Eye-health supplement use common in Poland despite low nutrition knowledge
A nationwide cross-sectional survey examined how 1,090 adults in Poland to explore the relationship between diet, lifestyle and eye health, and how often they use eye-health supplements.
Data showed a notable gap between supplement use and nutrition knowledge, with only 10.2% of respondents describing their knowledge of diet and lifestyle effects on eye health as good, while 27.9% reported using eye-health supplements in the past year. Supplement use was most often driven by personal preventive decisions, ophthalmologist recommendations or symptoms such as dry eyes and eye fatigue. The most reported ingredients were antioxidant vitamins, omega-3 fatty acids, zinc and lutein or zeaxanthin.
Several groups were more likely to use supplements, including occupationally active adults, people wearing glasses or contact lenses and those with a doctor-diagnosed eye condition. Higher levels of knowledge were more frequently observed among women and individuals living in urban areas.
“The findings suggest that dietary supplement use is associated with multiple factors beyond self-reported knowledge on diet and eye health,” the researchers wrote in the journal Frontiers in Nutrition. “These findings highlight the need for improved public education on nutrition and eye health, as well as a stronger role of healthcare professionals in guiding appropriate, evidence-based supplement use.”
Could omega-3 supplementation lower glaucoma risk in dry eye patients?
Researchers in Taiwan who conducted a multinational retrospective cohort study associated omega-3 fatty acid supplementation with lower risks of ocular hypertension and several glaucoma subtypes.
Using deidentified electronic health records from the TriNetX Global Collaborative Network, covering more than 160 healthcare institutions across 21 countries, the study compared patients prescribed omega-3 fatty acids with matched controls who had never received omega-3 prescriptions. After propensity score matching for demographics, smoking, comorbidities and corticosteroid use, the analysis included 14,168 participants followed for up to five years.
Omega-3 use was linked to significantly lower risks across several glaucoma-related outcomes. Compared with controls, patients prescribed omega-3 had a lower risk of total glaucoma, ocular hypertension, primary open-angle glaucoma, normal-tension glaucoma, primary angle-closure glaucoma and first-line glaucoma medication use. The association was particularly consistent for ocular hypertension and primary open-angle glaucoma and remained evident in several subgroup and sensitivity analyses, including after excluding cases diagnosed shortly after treatment initiation.
The study suggested that omega-3 fatty acids may help reduce glaucoma risk through mechanisms such as lowering intraocular pressure, supporting ocular blood flow, protecting retinal ganglion cells and reducing oxidative stress and inflammation.
“The consistency with findings from prior trials and biologic plausibility proposed by animal studies suggests that omega-3 intake may complement existing glaucoma preventive strategies,” the researchers wrote. “Randomized controlled studies are required to confirm causality and define optimal dosing.”
Citicoline shows promise as a neuroprotective supplement in ophthalmology
Researchers at Izmir City Hospital in Turkey reviewed published evidence on the use of citicoline in ophthalmology, linking the compound to potentially beneficial effects in several eye conditions.
In amblyopia, studies reported improvements in visual acuity, contrast sensitivity and visual evoked potential measures, particularly when citicoline was used alongside standard treatments such as patching or Bangerter filters. In glaucoma, earlier studies suggested that intramuscular or oral citicoline may improve electrophysiologic markers, visual field sensitivity or visual pathway function, although effects often appeared to diminish after treatment stopped and improve again with retreatment. The review also identified evidence suggesting possible benefit in non-arteritic ischemic optic neuropathy, where citicoline’s neuroprotective properties may support visual recovery or stabilization.
The researchers suggested that citicoline may act through several mechanisms, including supporting phosphatidylcholine synthesis, stabilizing neuronal and mitochondrial membranes, modulating dopamine and other neurotransmitters, reducing phospholipase A2 activity and helping protect retinal ganglion cells and visual pathways.
“Although its use as a supplement in glaucoma treatment is increasingly common today, larger, long-term, and more comprehensive studies are needed,” they wrote in Beyoglu Eye Journal. “Depending on its use, citicoline can be regarded both as a pharmaceutical agent and a dietary supplement. Further studies are needed to explore its potential benefits in both ophthalmic and non-ophthalmic diseases.”
Microbiome research may reshape how eye diseases are understood and treated
Emerging evidence suggests that the microbes living in the gut, mouth and ocular surface may influence inflammation, immune regulation and disease pathways across several major ophthalmic conditions.
A review published in Advances in Therapy examined how ocular and extraocular microbial communities, along with microbial metabolites such as short-chain fatty acids, may contribute to dry eye disease, glaucoma, uveitis, age-related macular degeneration and diabetic retinopathy.
“Clarifying the probable role of the microbiome in ocular diseases would not only offer valuable insights into pathogenesis but could also enable the development of novel therapeutic approaches,” the international team of researchers wrote. “As yet, microbial-based therapeutic applications in ophthalmology are limited. Nevertheless, recently emerging strategies utilizing probiotics and prebiotics, or even fecal transplantation to regulate microbiome composition, offer promising research avenues for developing future innovative therapies for ocular diseases.
Rather than presenting the microbiome as a single cause of eye disease, the review highlighted several possible routes of influence. Gut dysbiosis, for example, may promote systemic low-grade inflammation, alter immune-cell behavior, affect retinal and optic nerve vulnerability, and change the circulating levels of metabolites that help regulate inflammation and tissue stress. The researchers also discussed evidence linking microbial imbalance with ocular surface disease, glaucoma-related neuroinflammation, non-infectious uveitis, AMD-related angiogenesis and complement activity, and inflammatory pathways involved in diabetic retinopathy.
Review explores vitamins for dry eye, evidence limited
A systematic review published in Ophthalmic and Physiological Optics suggests the evidence for using vitamins to treat dry eye disease is still too thin to guide firm clinical recommendations.
The review focused on vitamins A, B12, C and D, examining whether these nutrients improved objective signs such as tear production, tear film break-up time, corneal staining and lid hyperemia, as well as patient-reported symptoms measured by tools such as the ocular surface disease index and visual analogue pain scale.
Of the 488 records screened, 13 studies met the eligibility criteria and included a total of 483 participants. Vitamin D dominated the evidence base, accounting for eight studies, followed by three studies of vitamin A and two studies evaluating vitamin B1 combined with mecobalamin. Notably, no eligible studies assessed oral vitamin C as a standalone intervention for dry eye disease, and vitamin B12 had not been studied separately from vitamin B1.
“Although it has been suggested that vitamins A, D and B complex affect ocular surface physiology through roles in immune modulation, neural function and epithelial integrity, these mechanistic considerations are not adequate to support their clinical use in the absence of solid, well-controlled trials,” the researchers from the University of New South Wales concluded.
Botanical extract boosts macular pigment in midlife trial
Six months of supplementation with a standardized Centella asiatica extract (CA-HE50) significantly increased macular pigment optical density in middle-aged adults with low baseline levels, according to a study published in the journal Nutrients.
The double-blind, placebo-controlled trial was designed to test whether a non-carotenoid botanical extract could improve macular pigment status by supporting the retinal antioxidant environment rather than directly supplying lutein, zeaxanthin or related pigments.
The Korean research team randomly assigned 80 men and women between the ages of 45 and 65 to receive either 300 mg per day of CA-HE50 (manufactured by Genencell Co.) or a placebo for 180 days, measuring macular pigment optical density, a non-invasive biomarker linked to the antioxidant status of the macula, at baseline and after 60, 120 and 180 days.
By the end of the study period, CA-HE50 was associated with significantly greater improvements in macular pigment optical density than placebo in the right eye, left eye and the average of both eyes, with between-group differences emerging by Day 120 and persisting through Day 180. A responder analysis also showed that 94.74% of participants receiving CA-HE50 experienced an increase in macular pigment optical density compared with 32.43% of those receiving placebo.
The researchers suggested that the extract’s triterpenoid compounds, including asiaticoside, may help strengthen retinal antioxidant defenses through pathways such as Nrf2 and HO-1 signaling, potentially improving the macular environment without directly adding carotenoid pigments.
“These results indicate that nutritional interventions can enhance macular antioxidant status during midlife, a time when retinal vulnerability starts to increase, even in the absence of obvious ocular disease,” the researchers wrote, recognizing the findings as preliminary.
CE-HE50 launched into the U.S. and European markets in 2025, marketed as Hilmalca and targeting eye and liver health.
Ginger extract and selenium combo for diabetic retinopathy?
A combination of ginger extract and selenium appeared to blunt several biological hallmarks of diabetic retinopathy in a rat model, raising the possibility that antioxidant and anti-inflammatory supplementation could influence early retinal damage pathways.
Researchers from Capital Medical University in Beijing divided 72 adult male Wistar rats into nine groups, including healthy controls, untreated diabetic rats, diabetic rats treated with ginger extract, diabetic rats treated with varying selenium doses, and diabetic rats treated with ginger plus selenium combinations. Type 2 diabetes was induced using a high-fat diet followed by streptozocin injection, and the animals received treatment by gavage for 28 days. Researchers then assessed metabolic markers, oxidative stress, inflammatory cytokines, apoptosis-related genes, TRPM2 and TRPV1 expression, and retinal histology.
“Diabetes induced retinopathy by inducing oxidative damage, inflammation, apoptosis and upregulation of TRPM2 and TRPV1,” the researchers reported in Molecular Vision. “However, treatments with selenium, ginger and their combinations improved diabetic retinopathy by inhibiting oxidative damage, inflammation and apoptosis and downregulating protein and gene expression of TRPM2 and TRPV1.”
They suggested that ginger’s bioactive compounds, including gingerols and shogaols, and selenium’s role in antioxidant enzyme systems may act together to reduce free-radical damage, dampen inflammatory signaling, improve insulin and glucose measures, and downregulate TRPM2 and TRPV1 channels involved in calcium signaling and retinal cell stress.
Human studies will be needed to determine safety, dosing, durability of effect and whether these biological improvements translate into meaningful vision protection.
Bausch + Lomb-funded study examines B vitamins and ocular health
B vitamins may have a broader role in eye health than traditionally recognized, according to a review published by Dove Medical Press that synthesized preclinical, observational and clinical evidence on the links between B vitamins and major eye conditions, including age-related macular degeneration, diabetic retinopathy, glaucoma, cataracts, dry eye disease and other ocular surface disorders.
Conducted by researchers affiliated with Tufts University and leading eye institutes around the world, the review highlights several biological pathways that make B vitamins plausible candidates for ocular-health research.
Vitamins B1, B2 and B3 support mitochondrial energy production and may help counter oxidative stress in highly metabolically active tissues such as the retina and optic nerve. Vitamins B6, B9 and B12 help regulate homocysteine, a molecule linked in some studies to vascular injury, inflammation, optic nerve damage and retinal disease. Vitamins B1, B6 and B12 also have neurotropic roles that may support nerve function, while several B vitamins have been investigated for retinal protection in diabetes-related damage.
“The available evidence suggests increased risk of multiple eye diseases, including AMD, diabetic retinopathy, glaucoma, cataracts and DED, with low intake or circulating concentrations of B vitamins,” the researchers concluded.
“Preclinical data and clinical studies indicate that B vitamin supplementation can be beneficial for the prevention of ocular disease development and/or progression. Nonetheless, there is a need to identify optimal dosing regimens based on the clinical context and to evaluate long-term safety and efficacy in clinical trials”
Gut microbiome changes may contribute to age-related macular degeneration
Changes in the gut microbiome may play a role in the development and progression of age-related macular degeneration, according to a review that links aging-related dysbiosis with inflammation, immune disruption and metabolic changes affecting the retina.
The research, published in Ageing Research Reviews, described age-related macular degeneration as a multifactorial disease shaped by aging, genetics, oxidative stress, immune dysfunction, lipid imbalance and chronic inflammation. It focused on the gut-retina axis, outlining how reduced microbial diversity, loss of beneficial commensal organisms, increased gut permeability and enrichment of pro-inflammatory species may fuel systemic low-grade inflammation and retinal injury.
Beneficial species such as Lactobacillus casei, Lactobacillus plantarum, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium longum and Faecalibacterium prausnitzii are presented as supportive of gut homeostasis and retinal protection. In contrast, higher levels of organisms such as Escherichia coli, Prevotella, Desulfovibrio, Enterococcus faecalis and Streptococcus salivarius are discussed as potential contributors to dysbiosis-associated ARMD progression through inflammatory, immune and metabolic pathways.
The researchers, affiliated with institutes in India and Australia, also reviewed possible microbiome-centered strategies for ARMD management, including probiotics, synbiotics, dietary interventions, metabolite-based therapies and fecal microbiota transplantation.
More research needed on supplements for glaucoma care
Researchers affiliated with Royal Victorian Eye and Ear Hospital in Melbourne, Australia assessed evidence for 35 vitamins, minerals and nutraceuticals investigated for glaucoma prevention or treatment.
The review focused on compounds that may support mitochondrial function, cellular energy metabolism, inflammation control, oxidative-stress reduction, optic nerve protection or modest pressure lowering.
“The most compelling evidence exists for nicotinamide, homotaurine, resveratrol and melatonin, whilst emerging compounds like vitamin K1, nicotinamide riboside and novel compounds based on EGCG show promise for future therapeutic development,” the researchers wrote in the European Journal of Ophthalmology. “Despite this, there remains a need for more randomized controlled trials to validate and ensure the safety of supplementation for each. A key challenge for clinical trials focused on neuroprotection is the trial length and sample size required to achieve significance.”
They also noted that because glaucoma is a polygenic, multifactorial disease, there is unlikely to be a one-size-fits-all solution, but that there is a potential that combination therapy targeted to patients with specific genetic risk or with specific dietary deficiencies will be more beneficial than a single supplementation therapy. For many patients, they added, exercise and a healthy and varied diet will be sufficient to prevent the needs of excess supplementation.
What the latest science suggests
• Research expanding beyond traditional claims. The strongest and most repeated evidence thread still centers on lutein and zeaxanthin, but the studies show the category is no longer limited to classic macular health claims.
• Several newer findings are mechanism-led rather than outcome-led. Cell, animal and observational work points to antioxidant, inflammatory, mitochondrial and microbiome pathways that still need clinical confirmation.
• Modern lifestyle factors impacting research targets. Screen-heavy lifestyles are helping shift research toward younger and otherwise healthy populations including teens, children and adults experiencing dry eye, eye fatigue or low macular pigment.
• New ingredients are moving into the category. Citicoline, omega-3s, B vitamins, saffron, Centella asiatica, ginger, selenium and probiotic-derived compounds are broadening the discussion, but the quality of evidence varies widely by nutrient and condition.
• More research is needed. Across conditions, researchers repeatedly caution against treating supplements as standalone therapies without stronger randomized controlled trials.
• Supplements are best positioned for specific support. For brands and practitioners, the most defensible positioning appears to be targeted support for defined needs, risk factors or deficiencies rather than broad promises of vision improvement.
