In case you missed it, see here for the first installment of our recap from Bausch + Lomb’s first-ever Consumer Summit.
We’re picking up where we left off with our coverage on B+L’s first-ever consumer health-focused meeting by taking a closer look at how lifestyle choices—including the growing role of nutritional suppplementation—can support eye health.
And who will we hear from?
The following insights were shared by:
- Amanda S. Legge, OD
- Julie Poteet, OD, MS, CNS, FOWNS
- Kaleb Abbott, OD, MS, FAAO
- Jeffry Gerson, OD, FAAO
Let’s take it from the top.
While the correlation between nutrition and overall health is well established, the link connecting nutrition to ocular health is just as paramount
Some stats: Poor dietary habits are the second highest risk factor for death and disability, accounting for one in every five deaths.
As such, lifestyle changes (and nutrition) play critical roles in the onset (and prevention) of diseases such as age-related macular degeneration (AMD), glaucoma, dry eye disease (DED), and myopia.
Talk about this more.
As Amanda S. Legge, OD, noted, this nutritional impact can be seen on the ocular surface.
Such factors include macro- and micronutrients (vitamins), food intolerances or restrictions, the gut microbiome, dietary supplements, additives, and hydration (most commonly linked to tear osmolarity in dry eye).
- Also important: The role of nutraceuticals (products derived from food sources that combine nutrients and pharmaceuticals to provide health benefits in addition to their normal nutritional values).
- As a type of micronutrient, these can be formulated as tablets, capsules, powders, liquids, or bars.
Let’s talk micronutrients and antioxidants.
Significant evidence has highlighted the benefits of Vitamins A, B12, C, and D in decreasing the signs of DED.
On the antioxidant spectrum: Micronutrients such as lutein and zeaxanthin—naturally present in the retina and lens—have shown significant benefits in protecting the eye form:
- Oxidative stress
- Inflammation
- Apoptosis
- Mitochondrial dysfunction
These advantages also extend to dietary supplements containing micronutrients, for which clinical research has shown a reduction in the signs and symptoms of dry eye.
When should clinicians be introducing these to their patients?
The earlier and more proactive the intervention, the better, according to Julie Poteet, OD, following her lecture on nutrition and eye health.
- “We have tools in our armamentarium to intervene at a time where real change and trajectory can be influenced,” she said.
While eyecare providers (ECPs) may argue time constraints as a major challenge preventing them from discussing nutrition and eye health with patients, Dr. Poteet noted that the subject can easily be worked into their current workflow.
She also recommends keeping it simple for patients. Watch below.
Now, to a few specific examples of dietary supplements …
Kaleb Abbott, OD, who presented alongside Dr. Poteet on nutrition and ocular health, noted one product already available: Blink NutriTears.
What it is: Introduced to the U.S. market in 2024, this is a daily nutritional supplement formulated with a proprietary blend of ingredients—categorizing it as a "nutraceutical," but more on that in a moment—designed to target dry eye symptoms.
- Among them: Lutein, zeaxanthin isomers, curcumin, and Vitamin D3.
- See here for a closer look at how each addresses the root cause of dry eye (and promotes healthy tear production).
Dr. Abbott noted that patients—as well as ECPs—are guilty of viewing eyes as a separate entity from the body.
- “What they need to realize is that the eye is intricately connected to the body, so any systemic inflammation will then cause ocular inflammation,” he said. “So when I'm explaining to patients the problems with systemic health spilling over to eye health and things like DED, I emphasize that it’s all fundamentally intertwined."
Any specific patients who may benefit from that supplement?
Indeed. In fact, Dr.Abbott identified GLP-1 users as prone to having key nutritional deficiencies in such micronutrients as those offered in NutriTears.
And before you ask about clinical data: Check out our coverage on the statistically significant outcomes from a randomized safety and efficacy trial supporting the supplement.
Circle back to this nutraceutical component.
For that topic of conversation, Jeffry Gerson, OD, FAAO, dove deeper into the role these products play in managing another ocular disease: AMD.
- “When it comes to macular degeneration, the first thing to realize is just how prevalent it is,” he said. “We should have about three times as many AMD patients in our practices as glaucoma.”
As one of the most common ocular diseases in the United States—impacting ~17% of adults >40 years compared with 3x the prevalence of glaucoma—AMD also accounts for 15 to 20% of global blindness.
- Further: An estimated 25% of all AMD cases are believed to be undiagnosed.
As such, Dr. Gerson echoed Dr. Poteet’s sentiments on adopting a proactive approach to managing this disease—with patient education on lifestyle changes such as diet (including supplementation) and exercise at the forefront.
So what nutraceutical is currently used to treat this disease?
That would be AREDS2 supplementation, which has been clinically shown to reduce the risk of progression in intermediate-to-advanced AMD.
About this: As a second-generation version of the original AREDS formulation (encompassing Vitamins A, C, E, zinc, and copper), AREDS2 is formulated with:
- Lutein
- Zeaxanthin
- Vitamins C and E
- Zinc
- Copper
Hold up: Can we get a refresh on AREDS?
See here for background on AREDS and AREDS 2, including:
- The similarities and differences in their respective formulations.
- Findings from the Age-Related Eye Disease Studies (AREDS) both formulations are based on.
And in case you missed it: Check out this rundown on how these antioxidants influence AMD progression and offer ocular surface benefits.
Got it. Now, can AREDS2 also be used for early AMD?
Nope—that’s where it falls short. However, as Dr. Gerson noted: B+L is introducing a new version of the AREDS formulation to fill in this gap.
Enter in: AREDS3.
What it is: A next-generation variation of the AREDS formulation with the potential to address early-to-advanced AMD—essentially protecting against all disease stages.
A new formulation?! Tell me about this.
To start: AREDS3 is formulated with the same antioxidant ingredient list as its predecessor formulations (AREDS [but excluding Vitamin A] and AREDS2)—but with a new addition.
- The most notable difference between the AREDS2 and AREDS3 formulations is the addition of a B-vitamin complex.
Why B vitamins, you ask? Because B vitamins are known to enhance oxidative stress protection while simultaneously supporting cellular metabolism and healthy homocysteine levels.
Expand on how this impacts AMD—with supporting research.
In recent years, the role of B vitamins has emerged as a meaningful adjunct (though not a replacement method) for preventing and managing AMD. Check out this analysis for proof.
In fact: Consistent associations have found higher dietary intakes of B vitamins (most notably B6, B9/folate, and B12) to be correlated with:
- A lower risk of AMD development (more on this later)
- Slower progression to advanced AMD (more on this later)
Go on …
And as water-soluble vitamins, various clinical studies over the last 20+ years have found B-vitamins to result in no ocular adverse events—with the exception of at-risk populations such as those with liver and kidney disease as well as neuropathy.
Conversely: A B-vitamin deficiency (such as B12 and B9) has been linked to a higher risk for AMD development.
So with that in mind … which B vitamins are in AREDS3?
Eight in total—B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, B7 (biotin), B9, and B12—targeting five integral aspects of ocular health:
- Target: Mitochondrial dysfunction
- Vitamins: B1, B2 , and B3
- Target: Oxidative stress (OS)
- Vitamins: B1 and B2 for mitigation via antioxidant properties
- Target: Homocysteine homeostasis (a modifiable AMD risk factor)
- Vitamins: B6, B9, and B12 for lowering homocysteine levels to reduce inflammation and OS
- Target: Neurotrophic effects
- Vitamins: B1, B6, and B12 for promoting nerve regeneration
- Target: Retinal protection
- Vitamins: B1, B2, B6, B9, and B12 for impact on retina and choroid (in diabetic retinopathy)
And the supplement itself?
Similar to the prior AREDS and AREDS2 supplements, AREDS3 is formulated as a soft gel with a twice daily (BID) oral dosing—preferably taken with a meal.
As for its development: The supplement is manufactured in FDA-registered facilities in compliance with current Good Manufacturing Practices (cGMP) regulations, ensuring its high quality and safety standards.
Federal standards are critical … but is there clinical data to back its benefits up?
On the AREDS3 supplement specifically? Not quite.
However, as we referenced earlier, multiple clinical datasets have separately evaluated the roles of B vitamins andAREDS2 nutrients on AMD development.
In each of these clinical investigations, Dr. Gerson emphasized that the benefits have been evident, helping to inform the ingredient profile for the AREDS3 formulation.
- For B vitamins: Intake resulted in a 41% and 42% reduced risk of visually significant and early AMD, respectively
- For AREDS2 nutrients: Intake resulted in a 25% risk reduction in moderate-to-advanced AMD and 22% lower risk of wet AMD, per the AREDS and AREDS2 studies, respectively
Sounds like AREDS3 could be a game-changer … now tie this all together.
From over-the-counter (OTC) options for DED to the benefits of nutrition and supplementation for ocular health (including AMD), Dr.Gerson emphasized the biggest takeaway for clinicians to remember: innovation and preventative care.
In regards to the former: “New innovations can really help in clinical practice, whether it be around nutrition in general, macular degeneration, or dry eye—there are new options and things we can do for our patients,” he said.
And the latter?
Dr. Gerson noted that, too often, ECPs are reactive in treating their patients.
“But what if we thought about things differently and we were trying to do things before there was a problem?” he asked.
- “Options like AREDS2 and (soon) AREDS3 are giving us the opportunity to be more proactive with our macular degeneration (and at-risk) patients.”
Lastly … some final words.
Cecelia Koetting, OD, FAAO, program chair for the event, emphasized a few key clinical pearls eyecare providers should keep in mind in their clinical practices: collaboration, the importance of OTC, medication and staying proactive
“We need to work with our patients. We need to help to control the story, narrate the story—and we need to be moving towards the future,” she said. “But the future is not just us. It's being developed and we're developing it with partners like Bausch + Lomb, who are there to help us offer products to take care of our patients, both in a reactionary form but also in a proactive form.”