The eye health of the U.S. population has progressively worsened over the years. The number of people experiencing visual impairment or blindness from age-related eye diseases is expected to reach over 8 million by 2050, according to the National Eye Institute.

Despite these figures, few people are being proactive. Research by Allconnect found the average person spends 7 hours in front of an internet-connected screen per day, which is more than 40% of the average person’s waking hours. The World Health Organization reports that at least 1 billion people globally have a vision impairment that either could have been prevented, or is yet to be addressed.

Market Opportunity

The eye health supplement market is valued at about $2.22 billion, according to Research and Markets. It’s a small portion of the estimated $67 billion dietary supplements market, but the firm projects it will experience a healthy CAGR of 6.72% to reach 3.28 billion by 2029.

Eye health supplements often feature various combinations of antioxidants, carotenoids, and botanicals that have been shown to preserve eye health via a variety of mechanisms.

Compared to 5-10 years ago, the market today is characterized by more innovative product and delivery formats, and better scientific substantiation behind ingredients, said Akhil Bajaj, divisional vice president of marketing for the vision and cognitive health category at OmniActive Health Technologies. “Advances in technology and ingredient delivery systems have also improved bioavailability, making products easier to work with.”

“The market is moving beyond the mostly generic products of the past to address specific modern-day challenges such as blue light exposure and dietary deficiencies while embracing sustainability, clean labels, and enhanced bioavailability,” said Leslie Gallo, president of Artemis International. It’s also important to create products that are more consumer-friendly, like chews, stick packs, and gummies, “combined with technological advances to make ingredients and finished products more bioavailable and effective.”

According to Jeffrey R. Anshel, OD, FAAO, optometrist, founder of the Ocular Wellness and Nutrition Society (OWNS), and partner with Unibar, the aging population continues to drive most of the growth in this category. “Age-related macular degeneration is the most common cause of blindness among people 50 and older. With the global population of those 60 years and older set to double by 2050, this macro-level trend won’t be slowing down any time soon,” he said.

Historically, eye health ingredients have been introduced to consumers through their inclusion in multivitamins. “Ten years ago, most eye health supplement brands leveraged a multivitamin innovation strategy. While multivitamins still account for 47% of the eye health supplement market, [standalone] ingredients driving the overall market growth include lutein, combination herbs, and specialty carotenoids like capsanthin,” Anshel said. 

Plenty of innovation has happened since the Age-Related Eye Disease (AREDS and AREDS2) studies by the National Eye Institute, which found that a formulation of lutein, zeaxanthin, vitamins C and E, copper, and zinc was able to slow down the progression of age-related macular degeneration (AMD), a condition characterized by death of the retinal cells in the macula which impacts an estimated 19.8 million Americans aged 40 and older.^1-2

While AREDS2 sought to establish the gold standard for eye health supplementation, advances are leading to more targeted formulations, said Elizabeth Tarshish, PhD, head of product and scientific strategy at Lycored. 

“Compared to products from 5 or 10 years ago, today’s supplements often incorporate higher concentrations of clinically validated ingredients, such as those from the AREDS2 formula, and are tailored for specific needs, including protection from blue light which has become a great concern.”

Novel botanicals, fatty acids, and other specialty ingredients are showing some promise for a host of eye complaints aside from AMD, including dry eye, visual acuity, the eye-brain connection, and other measures of eye health.

The nutrition industry would benefit by keeping tabs on what’s occurring more broadly in the eye care world, noted Melanie Bush, vice president of science and research at Artemis International.

“In recent years, the vision health category has been leaning hard on the tech trends of artificial intelligence and personalized medicine to refine patient diagnoses and treatments, and design and conduct cutting-edge research. Recent clinical trials have focused on rehabilitation for people with vision impairments. There is also ongoing research to further substantiate both the short- and long-term effects of excessive digital device usage on vision in children and adolescents.”

Blue Light Exposure and Cognition

People are spending all hours of the day staring at screens. Anshel said the impact that excessive screen time has specifically on AMD has been “overblown by the optical industry,” as one would need to spend 15 hours in front of a screen to get the blue light equivalent of an hour in sunlight. However, the evidence of its detriment to sleep quality is compelling, he said. 

It appears that some people are particularly vulnerable to blue light interfering with their sleep patterns, such as those with a history of insomnia, bipolar disorder, delayed sleep phase syndrome, or ADHD.³

“The research into blue light exposure is growing but is not yet conclusive in several areas … Furthermore, the research is complicated by varying screen usage patterns, differing blue light intensities across devices, and other lifestyle factors,” said Rafal Pietruszynski, CEO of Greenvit.

Working conditions/workstation setup can be strongly conducive to eye strain, also known as computer vision syndrome (CVS), Anshel noted. Symptoms range from eye pain or fatigue to headaches, dry eyes, blurred vision, and neck and back aches. A recent survey by CooperVision found nearly seven in 10 respondents reported they experience symptoms related to digital eye strain, yet, most (60%) haven’t discussed symptoms with an eye care professional.

Taking frequent breaks from digital devices, at recommended 20-minute intervals, is “easier said than done,” said Anshel. “The ongoing prevalence of computer vision syndrome within our communities is driving nutrient research for conditions such as dry eye, eye strain, and intraocular pressure.”

Excess screen time has implications for cognitive health that vary across age groups, said Tarshish. “For children and adolescents, there are concerns about effects on attention and working memory, while young adults may experience impacts on domain-specific working memory and anxiety levels.”

Tarshish noted that during the COVID-19 pandemic, children’s screen time increased by an average of 4.38 hours per day, which was associated with both digital eye strain and potential cognitive impacts. A review in Child and Adolescent Psychiatry and Mental Health found that screen time and mood disorders were positively correlated, particularly in young adults, demonstrating a potential eye-brain connection.⁴

Excessive screen time also appears to hurt working memory in people of all ages, and cognitive, linguistic, and social-emotional growth in children, according to recent studies, Bajaj noted. “While the current body of research is robust in establishing the risks, more work is needed to explore long-term impacts and optimal intervention strategies. There needs to be a greater understanding of the interplay between eye and brain health, particularly regarding lifelong cognitive function,” such as attention, memory, and emotional wellbeing, he said. This is especially true regarding how early-life interventions may affect vision and cognition later in life.^5-6

While more research is needed to evaluate the secondary outcomes of blue light exposure aside from macular degeneration, lutein and zeaxanthin have remained of key interest, said Tarshish. “These carotenoids, found naturally in the macula, have shown promise in filtering blue light and protecting eye health.” The associated eye health benefits of lutein and zeaxanthin may have a part to play in enhancing cognition, though the exact reason for this link hasn’t been determined.

The B.L.U.E. study, a clinical trial on OmniActive’s Lutemax 2020, a combination of lutein and zeaxanthin isomers, found the blue light reduction benefits of these two carotenoids were associated with better measures of memory and focus in cognitive assessments.⁷

The World of Carotenoids

Other carotenoids aside from lutein and zeaxanthin may also exhibit both standalone and synergistic effects.

Tarshish noted that Lycored has been investigating the tomato-based carotenoid lycopene, found in its flagship Lycomato formulation, and has found that adding lycopene to a formula can help protect lutein from oxidation, enhancing its ability to reach the eye and have an effect. “Lycomato also contains beta-carotene which, when ingested, converts into provitamin A, an essential nutrient for maintaining healthy vision.”

Capsanthin, a carotenoid found in peppers, is garnering interest for its potential role in the more immediate effects of digital eye strain. According to animal studies, a branded Capsanthin ingredient called Capsiclear may have a role in mitigating dry eye symptoms, tear regeneration, and intraocular pressure, Anshel noted.^8-9

Astaxanthin’s unique antioxidant properties, along with its potential synergistic effects with lutein and zeaxanthin, make it another ingredient to watch in this space, said Bajaj.^10-11

Botanicals

Several botanical ingredients are being researched for their potential roles in alleviating some eye health conditions that are more common in younger adults, with polyphenol-rich extracts showing strong promise.

Pietruszynski noted that Greenvit’s Oculoxin, a blend of standardized bilberry, aronia, and honeysuckle extracts, is currently being tested in a 6-week randomized, double-blind, crossover intervention study to determine its potential in a range of eye health conditions. The composition contains different fractions of polyphenols and iridoids optimized to support vision and will be tested to determine potential effects on visual acuity, contrast perception, conjunctival hydration, vascular flow, field of vision, and more in a population of people with computer-related eye strain and developing presbyopia (a condition that affects the ability to focus on close objects).

A previous study on the ingredient found that, in people with presbyopia, supplementation was associated with improvements in near vision for 92.3% of participants during the second phase of supplementation. Additionally, 80% experienced enhanced conjunctival hydration.

Blackcurrant has also shown promise in eye health studies, noted Bush. A recent clinical study, which is still pending publication, found that Artemis International’s CurrantCraft Blackcurrant extract was associated with significant improvements in a variety of symptoms of screen-related eye fatigue.

Plenty of recently developed eye health supplements feature botanical ingredients. Garden of Life, for instance, launched a line of herbal gummies that includes an eye health formula containing sunflower and safflower oil, lutein, zeaxanthin, marigold flower, blackcurrant, bilberry, and B. subtilis DE111 probiotics.

BulletProof’s Eye Armor softgels feature a formulation of lutein, zeaxanthin, astaxanthin, and bilberry.

NOW Foods’ Eye Moisturize capsules feature a unique formulation of Maquibright, an anthocyanin-rich maqui berry extract, along with extracts of cayenne pepper, acai, turmeric, and grape seed, to support healthy tear production and eye strain.

Fatty Acids

The brain and eye are highly enriched with omega-3 fatty acids, which help these organs develop during late fetal and early neonatal life. Omega-3s may have a part to play in maintaining eye health later in life, too.

According to a recent review in Antioxidants, while the evidence on EPA and DHA is mixed, high-dose DHA supplements in the triglyceride form appear helpful for eye conditions where oxidative stress is involved. DHA may also prevent apoptosis, or programmed cell death, in the retina, per a review in the Journal of Nutrition and Metabolism.^12-13

Omega-3 specialists are already leaning into the emerging science in this area. Nordic Naturals, for instance, recently launched a vision support product that combines a DHA-heavy blend of omega-3 fatty acids in the triglyceride form, with FloraGLO lutein and zeaxanthin.

Wiley’s Finest also launched Bold Vision, a formulation combining its fish oil with lutein, omega-7 fatty acids, anthocyanins from bilberry, astaxanthin from algae, zinc, and vitamin E.

New Research Directions

Gallo noted that eye health is interconnected with other aspects of wellness, including the gut microbiome, cognitive function, inflammation, and diabetes-related retinopathy, all of which “offers significant prospects for targeted product development. These health issues and their impact on vision warrant more research on their relationships and provide a path for the industry to respond by developing dual-benefit formulations.”^14-16

Recent studies also suggest that dietary patterns and nutrients have the potential to prevent age-related cataracts, Tarshish noted. A 2023 review laid the groundwork in creating stronger dietary recommendations for people with developing cataracts, or those vulnerable to them.¹⁷

Personalization and precision nutrition still represent a major white space in the eye health segment, where most formulations are marketed toward a general audience. “The industry could make significant strides in developing more effective and targeted interventions for maintaining eye health throughout life,” said Tarshish. 

Air pollution has been recognized as an important factor in studies on skin health. Similarly, exposure to high concentrations of particulate matter appears to have an adverse effect on the surface of the eye, noted Pietruzynski. “An interesting study from the University of Colorado’s Anschutz Medical Campus found that clinical visits by people with ocular surface conditions more than doubled when exposed to ambient particulates from air pollution; there were 114,313 visits to ophthalmologists for ocular surface irritation and eye allergies, and daily counts were 2.2 times higher than average when particulate matter was very high. The study also found that conjunctivitis was the second-most common reason for eye health visits … Supplementation may be found to provide some value if studied more intently.”¹⁸

Anshel noted there is likely a great deal of unexplored territory regarding genetic predispositions to eye conditions, and the potential for nutrigenomic studies to identify early interventions. “While many think there is a ‘gene’ for a particular health issue, scientists know that our environment can influence the expression of genes that manifest as an ailment,” he said.

With commonplace LED headlights in cars, driving in the dark has become a common pain point. But some have it worse than others, due to nyctalopia, or “night blindness,” which makes it difficult to see in the dark and adjust to sudden changes from bright light to darkness, said Pietruszynski. Vitamin A supplementation for this condition “may be a fertile forthcoming area” for research, he said.

Formulating for Kids

Children’s eye health formulations have been a bit of an afterthought, until more recently. It takes up to 2 years after birth for eyesight to fully develop, and even longer for eyes to reach their adult size and for the visual system to fully mature. New research is demonstrating that classical eye health nutrients like lutein, zeaxanthin, and other antioxidants can help support eyesight during the developmental stages.

Following its B.L.U.E. study, OmniActive supported a study on its children’s formulation, Lutemax Kids. Children between the ages of 5 and 12 experienced improved macular pigment optical density (MPOD), visual processing speed, less eye strain, and global measures of cognitive function.

A study on Kemin’s FloraGlo lutein and zeaxanthin, provided some of the first evidence that mothers who supplement with the two carotenoids are more likely to have children with greater macular carotenoid concentrations.¹⁹

Bush noted that the American Optometric Association considers children’s eyes, which are not yet fully developed, to be at greater risk of blue light damage, as they absorb less short-wavelength light than adults’ eyes. “However, since children’s heavy screen use is only a relatively new problem, the long-term consequences of blue light exposure are not well understood, and future research is needed.”

“Myopia, digital eye strain, and sleep disruption are the driving forces causing parents to look for targeted eye health supplements for kids,” said Anshel. “Additionally, more children are complaining about dry eyes, which is a side effect of excessive display viewing.”

“The rise in children’s screen time, whether for education or entertainment, has driven significant interest by caregivers in eye health supplements,” said Bajaj. “In a recent survey we conducted with parents, children are on digital devices more than 4 hours per day on average. As a result, caregivers are increasingly concerned about children’s digital eye strain, blue light exposure, and the potential long-term impacts on visual and cognitive health.”

Bush noted that ingredients for kids’ supplements need to be suitable for the most palatable delivery formats possible, otherwise, the odds that children will take the product plummet. Additionally, shoppers in the children’s supplement segment are especially sensitive to artificial-sounding ingredients, so sticking to familiar botanicals or vitamins will be more widely accepted. 

Several mainstream brands offer children’s eye health formulations, with examples including: GNC’s Kids Eye Health Formula, featuring vitamin A, bilberry fruit powder, lutein, and zeaxanthin; Nordic Naturals’ Children’s Eye Health gummy chews, featuring lutein, zeaxanthin, EPA, and DHA; and ChildLife Essentials’ Healthy Vision SoftMelt Gummies, featuring vitamin A, bilberry powder extract, lutein, and zeaxanthin.

The Esports Segment

Eye health concerns are a cornerstone of the burgeoning category of supplements designed to support gamers and esports enthusiasts.

Unlike the general population, gamers have more immediate concerns, and product developers are focused on ingredients that support vision acuity and reduced eye strain/fatigue during prolonged screen time, rather than the more chronic issues, said Pietruszynski.

Products in this segment feature especially high doses of lutein and zeaxanthin, at levels that can both filter blue light and offer performance-based benefits like enhanced visual processing speed, Tarshish said. “Innovative delivery formats, such as gummies and powders that can be mixed into energy drinks, are gaining popularity among the gaming community. Some companies are also exploring the integration of eye health supplements with gaming peripherals, such as blue light-filtering glasses, to create comprehensive eye care solutions for gamers. As the esports industry continues to grow, we can expect further tailored product development and increased research into ingredients that specifically benefit gamers’ visual performance and eye health.” 

Some of the performance-based demands that make this consumer audience unique include the need for improved visual acuity, dark adaptation, focusing flexibility, binocular vision, eye tracking, and hand-eye coordination, noted Anshel. “While there is no shortage of ingredient solutions, more direct studies are needed on the various well-known eye health ingredients with the gaming population. At the finished product level, many brands like GFuel, Ghost, and others have done a spectacular job of carving out this niche … as more clinical studies emerge linking eye health to gaming performance, I anticipate major gaming-focused brands will reformulate their products to include dedicated eye health ingredients.”

While this audience is keen on a diverse lineup of ingredients including nootropics and energy boosters, don’t count out the flagship, established carotenoids. “Lutein and zeaxanthin appeal to this audience as they help protect against blue light exposure and improve visual processing speed,” said Bajaj. There are also apparent benefits to psychomotor speed, which is “where cognitive processes translate into physical movements, closely tied with visual processing speed.”

“Gamers suffer the same problems as anyone who uses digital devices for hours on end: eye strain and the unpleasant symptoms that go along with it,” said Bush. General improvements in eye fatigue are part-and-parcel with the sought-after performance benefits that esports supplement consumers are most interested in, and solutions to support eye fatigue are perfectly suitable for serious and recreational gamers, as well as other adults.

It’s important that ingredients in this space are versatile for a wide range of the more palatable RTD beverages, powdered drinks, gummies, and other delivery systems that this audience is particularly keen on, said Bajaj.

References

1. The Age-Related Eye Disease Study Research Group (2006). The Age-Related Eye Disease Study (AREDS): Design Implications AREDS Report No. 1. Control Clin Trials. 20(6):573–600. doi: 10.1016/s0197-2456(99)00031-8

2. The Age-Related Eye Disease Study 2 (AREDS2) Research Group (2013). The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial. JAMA. 309(19):2005-2015. doi:10.1001/jama.2013.4997

3. Shechter et al. (2020). Interventions to reduce short-wavelength light exposure at night and their effects on sleep: a systematic review and meta-analysis. Sleep Advances. 4;1(1):zpaa002. doi: 10.1093/sleepadvances/zpaa002.

4. Choi et al. (2023). Screen time in children and youth during the pandemic: A systematic review and meta-analysis. Global Pediatrics. https://doi.org/10.1016/j.gpeds.2023.100080

5. Muacevic, Alder (2024). Screen Time Exposure and Domain-Specific Working Memory in Young Adults. Cureus. 16(5):e60626. doi: 10.7759/cureus.60626

6. Muppalla et al. (2023). Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus. 18;15(6):e40608. doi: 10.7759/cureus.40608

7. Strignham et al. (2017). Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods. 6(7):47. doi: 10.3390/foods6070047.

8. Shanmugham, Subban (2022). Capsanthin from Capsicum annum fruits exerts anti-glaucoma, antioxidant, anti-inflammatory activity, and corneal pro-inflammatory cytokine gene expression in a benzalkonium chloride-induced rat dry eye model. Journal of Food Biochemistry. https://doi.org/10.1111/jfbc.14352

9. Shanmugham, Subban (2021). Extraction of capsanthin from Capsicum annum L fruits and its effect on carbomer-induced intraocular pressure in Albino Wistar rats. Journal of Food Biochemistry. https://doi.org/10.1111/jfbc.13776

10. Giannaccare et al. (2020). Clinical Applications of Astaxanthin in the Treatment of Ocular Diseases: Emerging Insights. Marine Drugs. 18(5):239. doi: 10.3390/md18050239

11. Yoshida et al (2023). Effects of Astaxanthin, Lutein, and Zeaxanthin on Eye–Hand Coordination and Smooth-Pursuit Eye Movement after Visual Display Terminal Operation in Healthy Subjects: A Randomized, Double-Blind Placebo-Controlled Intergroup Trial. Nutrients. 15(6):1459. doi: 10.3390/nu15061459 

12. Lafuente et al (2021). Antioxidant Activity and Neuroprotective Role of Docosahexaenoic Acid (DHA) Supplementation in Eye Diseases That Can Lead to Blindness: A Narrative Review. Antioxidants. 10(3):386. doi: 10.3390/antiox10030386.

13. Querques et al. (2011). Retina and Omega-3. Journal of Nutrition and Metabolism. doi: 10.1155/2011/748361

14. Zysset-Burri et al. (2023). The role of the gut microbiome in eye diseases. Progress in Retinal and Eye Research. https://doi.org/10.1016/j.preteyeres.2022.101117

15. Zheng et al. (2018). Longitudinal Associations Between Visual Impairment and Cognitive Functioning: The Salisbury Eye Evaluation Study. JAMA Ophthalmology. https://doi.org/10.1001/jamaophthalmol.2018.2493

16. Kaur et al (2022). Inflammation and retinal degenerative diseases. Neural Regeneration Research. 18(3):513–518. doi: 10.4103/1673-5374.350192

17. Falkowska et al. (2023). Influence of Diet, Dietary Products and Vitamins on Age-Related Cataract Incidence: A Systematic Review. Nutrients. 15(21):4585. doi: 10.3390/nu15214585

18. Patnaik et al (2024). Association Between Particulate Matter Pollutants and Ophthalmology Visits for Ocular Surface Irritation and Allergy. Clinical Ophthalmology. https://doi.org/10.2147/OPTH.S485199

19. Addo et al (2024). Ocular Effects of Prenatal Carotenoid Supplementation in the Mother and Her Child: The Lutein and Zeaxanthin in Pregnancy (L-ZIP) Randomized Trial – Report Number 2. Ophthalmology. https://www.ophthalmologyscience.org/article/S2666-9145(24)00073-3/fulltext