Back-to-school season may seem more challenging than ever this year. Whether our children will be learning in school, virtually or a hybrid of both, one of the most important, yet often overlooked necessities for learning is eye health. Healthy vision is critical to a child’s success in school, physical development and overall wellbeing. With increased demands of screen time, due to social distancing, and the increased exposure to blue light, it has become necessary to focus on ways to support children’s vision.
Necessary Nutrients for Eye Health
Essential to maintaining excellent vision in children are the nutrients that support eye health, and this can be ensured through the proper intake of foods and supplements that provide these nutrients. The most important nutrients for eye health include the macular carotenoids (lutein, zeaxanthin, and meso-zeaxanthin); vitamins A, C and E; zinc; selenium; anthocyanins; and omega-3 fatty acids.
The Macular Carotenoids
Nature has provided our eyes with internal antioxidants and blue light protection – three pigments called lutein, zeaxanthin and meso-zeaxanthin. Collectively referred to as the “macular carotenoids,” these three pigments are found in high concentrations within the macula, or central retina. These pigments act as a frontline defense by filtering high-energy blue light and protecting against the effects of prolonged screen time. Out of all three pigments, meso-zeaxanthin is the most potent of the macular carotenoids because of its powerful antioxidant capability. Essentially, the three macular carotenoids are our innate blue blockers.
Because we cannot make these protective pigments that our eyes need, we must get them from diet or from supplementation.
Lutein and zeaxanthin come from plants that are found abundantly in dark green, leafy vegetables (such as spinach, kale, collard greens, and romaine lettuce); yellow and orange bell peppers; cilantro; and parsley. Egg yolk and corn are also rich in lutein and zeaxanthin, and a rich source of zeaxanthin is the spice, paprika. Unfortunately, unlike lutein and zeaxanthin, meso-zeaxanthin is not readily found in high quantities in foods.
Obtaining enough amounts of the macular carotenoids from diet alone can be challenging, especially for children. According to The Centers for Disease Control and Prevention, only 9% of America’s youth eats the recommended amount of fruits and 2% eat the recommended amounts of vegetables each day. The lack of sufficient dietary intake in children may be even more concerning when it comes to protecting against blue light because, as evidence suggests, their eyes are still developing and, therefore, may be more susceptible to it than adult eyes.
Recommended intake and clinical research indicate the optimum levels of lutein are at least 6-20 mg/day and of zeaxanthin are 1-4 mg/day. 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, because it is found in only trace quantities in food, may be missing altogether. Thus, many people are deficient in these important eye health nutrients. To make up for the gap, supplementation provides an easy way to protect children’s eyes against blue light exposure.
There are a wide variety of eye health supplements available on the market and each has a different formulation, making it difficult to choose. Many only contain two out of the three pigments – often lacking meso-zeaxanthin. In doing research for my book on prevention of macular degeneration through proper nutrition and healthy lifestyle choices, I’ve reviewed more than 40 of the top eye health supplements. I carefully looked at ingredients, dosing, formulation and bioavailability. In my research, I identified an ingredient called Lutemax 2020, which provides all three of these macular carotenoids: lutein, zeaxanthin and meso-zeaxanthin. The ingredient is a natural extract of marigold flowers and provides all three nutrients in the same 5:1 ratio as is found naturally in the diet.
In addition, Lutemax 2020 has strong science to back its benefits for vision and sleep. Multiple clinical studies support the role of Lutemax 2020 in increasing the macular carotenoid pigments in the retina, supporting healthy vision during prolonged digital device use, improving visual performance and sleep quality. In a landmark, double-blind, placebo-controlled trial, supplementing with Lutemax 2020 reduced eye fatigue and eyestrain resulting from prolonged digital device use.
Lutemax 2020 can be found in a variety of blue light and vision supplements including gummy supplements, which are great for children and adults (just look for Lutemax 2020 on the ingredient label).
Vitamins to support eye health
Vitamin A: is critical both for healthy retinal function and also to maintain the health of the surface layers of the eye, the cornea and the conjunctiva. Vitamin A deficiency may lead to night blindness as well as xerophthalmia, or severe dryness of the ocular surface, and is the leading cause of preventable blindness in young children in developing nations. Vitamin A may be found in a variety of animal products (liver, fatty fish, eggs), vegetables (sweet potato, winter squash, kale, collards) and fruits (mango, cantaloupe).
Vitamin C: is a powerful antioxidant that helps with collagen synthesis. Collagen is an important building block for many structures of the eye, including the cornea, sclera, uvea, choroid and vitreous. Excellent dietary sources of vitamin C include fruits, such as kiwi, lemons, kiwi, oranges, papaya, and strawberries, as well as vegetables like kale, mustard spinach, Brussels sprouts and broccoli.
Vitamin E: is a potent antioxidant for eye health, helping to maintain the clarity of the lens and fight against oxidative damage in the retina. Dietary sources of vitamin E include a variety of nuts and seeds, such as almonds, pine nuts, sunflower seeds and hazelnuts. Oils such as wheat germ, avocado and hazelnut are wonderful sources of vitamin E. Fish, such as Atlantic salmon and rainbow trout, are also rich in vitamin E. Finally, avocados, sweet peppers and mangoes are also good dietary sources.
Zinc: is a crucial mineral necessary to maintain vision. Zinc is found in high concentrations in the macula, the center of the retina responsible for high resolution vision. Zinc works along with vitamin A in the visual cycle in the retina. Dietary sources of zinc include oysters, beef, baked beans and cashews.
Selenium: is a trace mineral also necessary for eyesight. Selenium functions not only as an antioxidant, but it also helps with absorption of vitamin E. Plant-based sources of selenium include Brazil nuts, frozen spinach and baked beans. Animal sources include tuna, halibut, turkey and beef.
Anthocyanins: are in the class of flavonoid polyphenols, nutrients which come from plants and are powerful antioxidants. Anthocyanins give certain fruits and vegetables their bright colors, and they are commonly red, blue or purple. Fruits such as berries, red grapes, pomegranate, cherries and black plums are rich in anthocyanins. Vegetables high in anthocyanins include red cabbage, red onions, eggplant (within the peel), purple sweet potatoes and purple carrots. Make sure children eat 1-2 servings per day of anthocyanin-rich foods.
Omega-3 Fatty Acids: Children need an adequate intake of omega-3 fatty acids to support their vision health as well as cognition. The vision-promoting omega-3s, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may be found in fish oil. Good sources for children include wild salmon, sardines, and anchovies. Plant-based sources of omega-3 include chia seeds, Brussels sprouts, algal oil, walnuts and flax seeds.
To help with digital eye strain, supporting the innate blue blockers within our children’s eyes through proper nutrition and supplementation is paramount. Additional ways to combat digital eye strain include frequent breaks, lubrication of the eye, blue blocking glasses and screen filter apps.
The amount of time school-aged children spend outdoors in natural light may have some impact on whether they develop myopia. Recent research suggests that spending time outdoors may lower the risk of nearsightedness in children. While outdoors however, it is important to protect children’s eyes from potentially damaging UV rays. Sunglasses with 100% UV-A and UV-B blocking filters as well as hats are best while outdoors, especially on bright, sunny days.
Finally, if a vision problem is suspected in a child, an eye screening with an ophthalmologist or another professional who is properly trained to assess vision in school-aged children is the best course of action. The more proactive we can be about our children’s eye health, the better opportunities we can give them to reach their full visual potential of 20/20 in the year of 2020 and beyond.
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. 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. Banik is 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.