Did you know that there are three nutrients that are fundamental to visual health? Why are they so important?
The top three nutrients for your eyes (and brain) are lutein, zeaxanthin, and mesozeaxanthin. Lutein, zeaxanthin and mesozeaxanthin are primarily found in the macula, that center part of the retina essential for detailed vision. They are found, not only in the macula, but in all of the retina, in the lenses, and in the aqueous humor. People with macular degeneration, other retinal diseases, and cataracts are deficient in these nutrients.
They are of the phytonutrient carotenoid category, the antioxidants that give fruits and vegetables their color: green in spinach and kale, orange in cantaloupes and oranges, and red in tomatoes.
Protecting the Retina
What does this threesome do for our eyes?
The retina contains photoreceptor cells that are the initial stage of processing light and ultimately the images we see. The fovea in the center of the retina gives us our most detailed vision. Photoreceptor cells consist of rods and cones. The rods are most active in low light, used for peripheral vision, and are good motion sensors. The cones primarily give us our day vision, including color perception and high acuity.
These light-sensitive cells are protected by macular pigment, which filters harmful blue light before it hits your delicate retina. Insufficient levels of lutein, zeaxanthin, and meso-zeaxanthin in the retina are associated with thinner macular pigment1 and increased vulnerability to blue light.
Macular Degeneration
Macular degeneration has many contributing causes – smoking, genetic predisposition, environmental factors – but the presence or absence of carotenoids in the retina is key. Exposure to blue light causes free radical oxidative damage. Carotenoids in macular pigment absorb blue light and act as internal sunglasses.
Lutein and zeaxanthin are two similarly structured carotenoids that make up the macular pigment in the retina and help protect against damaging blue light (visible), as well as acting as powerful antioxidants. Scientists measure the levels of these carotenoids by lighting the macula with a special low-power argon laser and measuring the resulting backscattered light.2
Lutein. Lutein supplementation alone is linked to improved vision in patients with AMD, and lutein coupled with other antioxidants (especially zeaxanthin) shows even better results.3
Zeaxanthin. New technology has made it easier to distinguish between lutein and zeaxanthin levels in the macula. In new research, scientists measuring lutein and zeaxanthin levels in the macula suspect that zeaxanthin may actually be more important than lutein in protecting against macular disease.4 Zeaxanthin is the most concentrated nutrient in the center of the fovea, with 2-1/2 times the levels of lutein.5
Meso-zeaxanthin. Like zeaxanthin, meso-zeaxanthin is concentrated in the fovea at the center of the macula. And like lutein and zeaxanthin, meso-zeaxanthin absorbs blue light. Meso-zeaxanthin is not available through dietary sources, but is formed from lutein. Like lutein and zeaxanthin, meso-zeaxanthin levels are linked to macular pigment thickness, which is, in turn, linked to AMD risk.6.
Cataracts
These carotenoids are also found in the lens of the eyes and in the aqueous humor (located behind the cornea and in front of the lens). Cataracts develop as lens optical density increases. The presence of the carotenoids appears to protect against increased lens optical density.7
Researchers have noted that after cataract surgery, when a clear artificial lens is implanted, that macular pigment density, critical for retinal protection, decreases. For that reason, they suggest that future artificial lenses be yellow tinted to substitute for the loss of carotenoid storage in the natural lens.8
Lutein. Scientists measuring the content of bionutrients in the aqueous humor have discovered that after six weeks of lutein supplementation lutein levels increase with corresponding oxidative damage in the humor. Lutein improves visual function in patients with age-related cataracts9 and decreases the risk of cataracts.10
The lens also contains significant levels of lutein11 which helps protect the lens against oxidative damage.
Zeaxanthin and meso-zeaxanthin. Like lutein, these powerful antioxidants are contained in the lens where they provide antioxidant protection, and blue-light filtering capacity.12
A meta-analysis of studies including more than 40,000 patients determined that lutein and zeaxanthin in the diet are linked to a lower risk of age-related cataracts. This was especially true in dose-related results where every additional 300 micrograms per day of the various nutrients were linked to increased reduced risk, especially of nuclear cataract.13
Computer Eye Strain
Computer eye strain is exacerbated by blue light. These nutrients along with astaxanthin help filter out UV and particularly blue light, that cause accelerated free radical activity in the eyes. The impact of exposure to blue light is particularly relevant due to the excessive ongoing use of smartphones and computers.
Lutein14, zeaxanthin, and meso-zeaxanthin help reduce eyestrain, particularly in those with high screen time. 15
A Note on Brain Health
Most biochemicals in the body are blocked from crossing the blood-brain barrier. However, these carotenoids which benefit the visual system do have that ability and can support brain function. See our series on the eye-brain connection.
How to take supplements.
Carotenoid supplements like lutein, zeaxanthin, and mesozeaxanthin are best taken separately from beta-carotene supplements because of competition for absorption. They need fat for good absorption, so take them with food or a small amount of oil.
We Recommend
Advanced Eye & Vision Support Formula (whole food) 60 vcaps – our whole food, organic, non-GMO eye formula with lutein, zeaxanthin, and other great nutrients from whole foods.
Advanced Eye & Vision Support Formula (whole food) 60 vcaps – includes the Advanced Eye and Vision Support Formula and our whole food, organic, non-GMO multivitamin.
Dr. Grossman’s Meso Plus Retinal Support and Computer Eye Strain Formula with Astaxanthin 90 vcaps – contains, lutein, zeaxanthin, mesozeaxanthin, and astaxanthin.
Advanced Eye & Vision Support & Meso Plus Formula with Astaxanthin (3-mo. Combo)
- Ma L, Liu R, Du JH, Liu T, Wu SS, et al. (2016). Lutein, Zeaxanthin and Meso-zeaxanthin Supplementation Associated with Macular Pigment Optical Density. Nutrients. Jul 12;8(7):426. ↩
- Bernstein PS, Zhao DY, Wintch SW, Ermakov IV, McClane RW, et al. (2002). Resonance Raman measurement of macular carotenoids in normal subjects and in age-related macular degeneration patients. Ophthalmology. Oct;109(10):1780-7. ↩
- Richer S, Stiles W, Statkute L, Pulido J, Frankowski J, et al. (2004). Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry. Apr;75(4):216-30. ↩
- Li B, George EW, Rognon GT, Gorusupudi A, Ranganathan A, et al. (2020). Imaging lutein and zeaxanthin in the human retina with confocal resonance Raman microscopy. Proc Natl Acad Sci U S A. Jun 2;117(22):12352-12358. ↩
- Widomska J, SanGiovanni JP, Subczynski WK. (2020). Why is Zeaxanthin the Most Concentrated Xanthophyll in the Central Fovea? Nutrients. May 7;12(5):1333. ↩
- Ibid. Ma. 2016 ↩
- Hammond BR, Wooten BR, Snodderly DM. (1997). Density of the human crystalline lens is related to the macular pigment carotenoids, lutein and zeaxanthin. Optom Vis Sci. Jul;74(7):499-504. ↩
- Obana A, Gohto Y, Asaoka R. (2021). Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation. PLoS One. Mar 25;16(3):e0248506. ↩
- Olmedill B, Granado F, Blanco I, Vaquero M. (2003). Lutein, but not alpha tocopherol, supplementation improves visual function in patients with age-related cataracts: A 2 year double-blind, placebo controlled study. Nutrition. Jan;19(1):21-4. ↩
- Liu XH, Yu RB, Liu R, Hao ZX, Han CC, et al. (2014). Association between lutein and zeaxanthin status and the risk of cataract: a meta-analysis. Nutrients. Jan 22;6(1):452-65. ↩
- Johra FT, Bepari AK, Bristy AT, Reza HM. (2020). A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants (Basel). Oct 26;9(11):1046. ↩
- Ibid. Johra. (2020). ↩
- Ma L, Hao ZX, Liu RR, Yu RB, Shi Q, et al. (2014). A dose-response meta-analysis of dietary lutein and zeaxanthin intake in relation to risk of age-related cataract. Graefes Arch Clin Exp Ophthalmol. Jan;252(1):63-70. ↩
- Yagi A, Fujimoto K, Michihiro B, Goh D, Tsi H. (2009). The effect of lutein supplementation on visual fatigue: A psychophysiological analysis. Appl Ergon. Nov;40(6):1047-54. ↩
- Stringham JM, Stringham NT, O’Brien KJ. (2017). Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods. Jun 29;6(7):47. ↩