Interest in supplements for eye health has steadily increased during the past few years. In fact, in 2018 growth in the category was well above the industry standard at 9%, according to the 2019 Nutrition Business Journal (NBJ) Condition-Specific Report. This trend is attributed to greater awareness and education around the impact of blue light exposure from digital devices on vision health.
 
Now with the COVID-19 pandemic thrust upon consumers globally, adults are spending almost half of their day in front of digital devices while usage has reportedly doubled among children. Many experts feel this trend will remain in place even when this health crisis subsides, which means supporting digital eye health has become more important than ever.
 
Consumers are examining their options to protect against prolonged screen time: blue-blocking glasses and computer shields are gaining popularity and most smartphones can track and set limits on screen time, and offer the ability to use a “night shift” mode.
 
Whether or not these options prove to help protect against blue light exposure, the most important—and effective—strategy is supplementation to provide key nutritional support to the eyes. Consumers are receptive to taking supplements that proactively help their children and family deal with the consequences of a modern digital lifestyle. In fact, as they become more educated on the impact of blue light on the eyes, their intent to purchase almost doubles.
 
Blue Light Exposure: How Much is Too Much?
Blue light makes up some of the highest energy within the spectrum of visible light. Unlike UV-light exposure, which is almost exclusively from the sun, blue light is emitted from a multitude of sources, including sunlight, digital devices (e.g., computers/laptops, smartphones, television screens) and energy-efficient indoor lighting, like compact fluorescent (CFL) bulbs and light-emitting diodes (LEDs).
 
Therefore, compared to UV-light, daily exposure to blue light from both outdoor and indoor sources can be significantly greater. One of the most common complaints associated with prolonged screen time is digital eye strain that manifests as visual fatigue, blurry vision, light sensitivity, increased headache frequency, and neck and shoulder pain. It is estimated that more than half of people experience digital eye strain or vision problems as a direct result of prolonged screen time. Digital eye strain impacts all age groups. Some parents report that their children experience symptoms of digital eye strain after two or more hours of screen time.
 
The Macular Carotenoids: Preferential Protectors Against Blue Light
The most effective way to protect against blue light exposure is by optimizing our intake of three key nutrients—lutein, RR-zeaxanthin (3R,3’R-zeaxanthin), and RS-zeaxanthin (3R,3’S-zeaxanthin], a.k.a. the macular carotenoids. Lutein and the two zeaxanthin isomers are the only carotenoids found in the eye, specifically in the macula—the area of the retina responsible for highest visual acuity and susceptible to the greatest amount of photo-oxidative damage from blue light.
 
The deposition of macular carotenoids in the eye is highly specific: lutein is preferentially deposited in the peripheral macula, whereas RR-zeaxanthin and RS-zeaxanthin are found in the mid-peripheral and central macula, respectively. Out of all three, RS-zeaxanthin is unique because it is the most potent antioxidant that protects the most vulnerable part of the eye—the fovea (the very center of the macula).
 
Increased dietary intake of lutein and zeaxanthin is associated with increased macular pigment optical density (MPOD), the thickness or density of the protective layer of carotenoids in the macula, in healthy adults. This is important because epidemiological studies have reported an inverse association between dietary intake of lutein and zeaxanthin and the risk of developing eye diseases, such as age-related macular degeneration (AMD).
 
Lutein and the zeaxanthin isomers each absorb different wavelengths of blue light and together are more effective at protecting against digital eye strain because they absorb a broader spectrum of high-energy blue light. Oral intake is the only way to build and maintain this protective layer in the eye.
 
The main problem is getting these nutrients from the diet is a lot easier than it sounds. According to the CDC, only 10% of American adults eat the recommended amounts of fruits and vegetables, while only 9% of America’s youth eat the recommended amount of fruits and 2% eat the recommended amounts of vegetables each day. Insufficient dietary intake among children is particularly concerning because their eyes are developing and therefore may be more vulnerable to blue light than adults.
 
Research points to an ideal intake of lutein from 6-20 mg/day and 1-4 mg/day of zeaxanthin. However, most people on a western diet usually get only 1-2 mg of lutein daily and less than 1 mg of zeaxanthin. Meso-zeaxanthin, found in only trace quantities in food, may be missing altogether. Though the body can synthesize RS-zeaxanthin from lutein, this process is considered inefficient. Supplementation with the three macular carotenoids provides an easy way for adults and children to protect their eyes from daily screen time exposure.
 
The B.L.U.E Science
The B.L.U.E. study (an acronym for Blue Light User Exposure) was the first study in young, healthy adults to demonstrate how macular carotenoids support visual function, reduce the symptoms of prolonged screen time, and improve sleep quality. B.L.U.E. was a 6-month double-blind, randomized, placebo-controlled trial in young healthy subjects exposed to 6-hours per day of screen time, who also supplemented with 20 mg lutein and 4 mg zeaxanthin isomers (as Lutemax 2020) or placebo.
 
The results showed that MPOD, indicators of visual performance (contrast sensitivity, disability glare, photostress recovery, and visual processing speed), and symptoms resulting from prolonged blue light exposure significantly improved. Several of the most significant results include:
 

• 26% increase in MPOD
• 29% decrease in eye strain
• 28% decrease in eye fatigue
• 34% decrease in headache frequency
• 20% improvement in sleep quality
• 44% improvement in disability glare
• 33% improvement in photostress recovery

 
The B.L.U.E. study along with prior research on Lutemax 2020 demonstrate a direct link between supplementation with macular carotenoids and their ability to provide a frontline defense against prolonged blue light exposure.
 
The COVID-19 pandemic has accelerated our dependence on digital devices and consumers are starting to connect the dots: about 85% of adults are familiar with the impact of screen time on their eyes and 75% of parents are concerned about the effects of prolonged use of digital devices on their children’s eyes. Paired with the fact that more than 80% of consumers want to learn more about how to take better care of their eyes, there is a growing opportunity to support the new eye health consumer, with effective formulas built around the three macular carotenoids.
 
About the author: Dr. Rudrani Banik, MD, is a board-certified ophthalmologist specializing in an integrative approach to vision health and author of “The Macular Degeneration Prevention Protocol.” She is also a fellowship-trained neuro-ophthalmologist. Dr. Banik is the founder of Envision Health NYC, a concierge practice specializing in eye health, neurological conditions, and migraine headaches. She is Associate Professor of Ophthalmology at Mount Sinai Icahn School of Medicine. Dr. Banik is also a member of the American Board of Ophthalmology’s Exam Development Committee and contributes to setting the standards for board certification. She has committed herself to 13 years of training at some of the finest medical institutions like Brown University and John Hopkins, allowing her to author numerous articles and present at national and international meetings.
 
References
 

1. Condition Specific Report. NBJ 2019
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11. AOA. American Eye-Q Results, 2018