Cataracts develop when damage to the protein of the lens of the eye clouds the lens and impairs vision.

Most people who live long enough will develop cataracts.1 Cataracts are more likely to occur in those who smoke, have diabetes, or are exposed to excessive sunlight. All of these factors lead to oxidative damage. Oxidative damage to the lens of the eye appears to cause cataracts in animals 2 and people.3

It is unlikely that any nutritional supplements of herbs can reverse existing cataracts, although no research has explored this possibility.

Nutritional supplements that may be helpful: People with low blood levels of antioxidants and those who eat few antioxidant-rich fruits and vegetables have been reported to be at high risk for cataracts.4,5

The major antioxidants in the lens of the eye are vitamin C6 and glutathione (an antioxidant enzyme).7 Vitamin C is needed to activate vitamin E,8 which in turn activates glutathione. Both nutrients are important for healthy vision.

Vitamin C levels in the eye decrease with age;9 however, supplementing with vitamin C prevents this decrease10 and has been linked to a lower risk of developing cataracts.11,12 Healthy people have been reported to be more likely to take vitamin C and vitamin E supplements than those with cataracts in some 13 but not all studies.14 Nonetheless, because people who supplement with vitamin C have developed far fewer cataracts in some research,15,16 nutritionally oriented doctors often recommend 500–1,000 mg of vitamin C supplementation as part of a cataract prevention program. The difference between successful and unsuccessful trials may be tied to the length of time people actually supplement vitamin C. In one trial, people taking vitamin C for at least ten years showed a dramatic reduction in cataract risk, but those taking vitamin C for less than ten years showed no evidence of protection at all.17

Low blood levels of vitamin E have been linked to 3.7 times the risk of forming cataracts compared with people in the highest 20% of blood vitamin E levels.18 Vitamin E supplements have been reported to protect against cataracts in animals19 and people20 though the evidence remains inconsistent.21 In one trial, people who took vitamin E supplements had less than half the risk of developing cataracts compared with others in the five-year study.22 Nutritionally oriented doctors typically recommend 400 IU of vitamin E per day as prevention. Smaller amounts (approximately 50 IU per day) have been proven in double blind research to provide no protection.23

Some studies have reported that eating more foods rich in beta-carotene or supplementing with vitamin A lowers the risk of cataracts.24 Synthetic beta-carotene supplementation has not been found to reduce the risk of cataract formation.25 It remains unclear whether natural beta-carotene from food or supplements would protect the eye or whether beta-carotene in food is merely a marker for other protective factors in fruit and vegetables high in betacarotene.

People who eat a lot of spinach, which is high in lutein, a nutrient similar to beta-carotene, have been reported to be at low risk for cataracts.26 Both lutein and beta-carotene offer the promise of protection because they are antioxidants. It’s quite possible, however, that lutein is more important than beta-carotene because lutein is found in the lens of the eye while beta-carotene is not.27

Vitamin B2 and vitamin B3 are needed to protect glutathione, an important antioxidant in the eye. Vitamin B2 deficiency has been linked to cataracts.28,29 Older people taking 3 mg of vitamin B2 and 40 mg of vitamin B3 per day were partly protected against cataracts in a Chinese trial.30 Most researchers in the field do not believe that higher amounts would be helpful, and it remains unclear whether these vitamins would help protect people in societies that eat higher levels of B vitamins than the Chinese, whose intake appears to be low.

The flavonoid quercetin may also help by blocking sorbitol accumulation in the eye.31 This may be especially helpful for people with diabetes, though no clinical trials have yet explored whether quercetin actually prevents diabetic cataracts.

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful: Bilberry, a close relative of blueberry, is high in the bioflavonoid complex anthocyanosides.32 Anthocyanosides protect both the lens and the retina from oxidative damage. This bioflavonoid also helps with adaptation to bright light and improves night vision. The potent antioxidant activity of anthocyanosides appears to make bilberry useful for reducing the risk of cataracts.33,34

Doctors well versed in the use of herbs sometimes recommend 240–480 mg per day of bilberry extract, capsules, or tablets standardized to contain 25% anthocyanosides.

Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions.

References:

  • Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study: I. Outline and major prevalence findings. Am J Epidemiol 1977;106:17–32.
  • Schocket SS, Esterson J, Bradford B, et al. induction of cataracts in mice by exposure to oxygen. Isr J Med Sci 1972;8:1596–1601.
  • Palmquist B, Phillipson B, Barr P. Nuclear cataract and myopia during hyperbaric oxygen therapy. Br J Ophthalmol 1984;68: 113–17.
  • Jacques PF, Chylack LT.Jr. Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 1991;53:352S–55S.
  • Knekt P, Heliovaara M, Rissanen A, et al. Serum antioxidant vitamins and risk of cataract. BMJ 1992;305:1392–94.
  • Taylor A, Jacques PF, Nadler D, et al. Relationship in humans between ascorbic acid consumption and levels of total and reduce ascorbic acid in lens, aqueous humor, and plasma. Curr Eye Res 1991;10:751–59.
  • Reddy VN. Glutathione and its function in the lens—An overview. Exp Eye Res 1990;150:771–78.
  • Packer JE, Slater TF, Wilson RL. Direct observation of a free radical interaction between vitamin E and vitamin C. Nature 1979;278:737–38.
  • Taylor A. Cataract: relationship between nutrition and oxidation. J Am Coll Nutr 1993;12:138–46 [review].
  • Taylor A, Jacques PF, Nadler D, et al. Relationship in humans between ascorbic acid consumption and levels of total and reduced ascorbic acid in lens, aqueous humor, and plasma. Curr Eye Res 1991;10:751–59.
  • Jacques PF, Chylack LT Jr. Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 1991;53:352S–55S.
  • Jacques PF, Chylack LT, McGandy RB, Hartz SC. Antioxidant status in persons with and without senile cataract. Arch Ophthalmol 1988;106:337–40.
  • Robertson JMD, Donner AP, Trevithick JR. Vitamin E intake and risk of cataracts in humans. Ann NY Acad Sci 1989;570:372–82.
  • Seddon JM, Christen WG, Manson JE, et al. The use of vitamin supplements and the risk of cataract among US male physicians. Am J Public Health 1994;84:788–92.
  • Robertson J McD, Donner AP, Trevithick JR. A possible role for vitamins C and E in cataract prevention. Am J Clin Nutr 1991;53:346S–51S.
  • Hankinson SE, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335–39.
  • Jacques PF, Taylor A, Hankinson SE, et al. Long-term vitamin C supplement use and prevalence of early age-related lens opacities. Am J Clin Nutr 1997;66:911–16.
  • Rouhiainen P, Rouhiainen H, Salonen JT. Association between low plasma vitamin E concentration and progression of early cortical lens opacities. Am J Epidemiol 1996;144:496–500.
  • Trevithick JR, Creighton MO, et al. Modelling cortical cataractogenesis: 2. In vitro effects on the lens of agents preventing glucose- and sorbitol-induced cataracts. Can J Ophthalmol 1981;16:32–38.
  • Robertson J McD, Donner AP, Trevithick JR. A possible role for vitamins C and E in cataract prevention. Am J Clin Nutr 1991;53:346S–51S.
  • Seddon JM, Christen WG, Manson JE, et al. The use of vitamin supplements and the risk of cataract among US male physicians. Am J Public Health 1994;84:788–92.
  • Leske MC, Chylack LT Jr, He Q, et al. Antioxidant vitamins and nuclear opacities. The Longitudinal Study of Cataract. Ophthalmology 1998;105:831–36.
  • Teikari JM, Virtamo J, Rautalahti M, et al. Long-term supplementation with alpha-tocopherol and beta-carotene and age-related cataract. Acta Ophthalmol Scand 1997;75:634–40.
  • Hankinson SE, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335–39.
  • Teikari JM, Virtamo J, Rautalahti M, et al. Long-term supplementation with alpha-tocopherol and beta-carotene and age-related cataract. Acta Ophthalmol Scand 1997;75:634–40.
  • Hankinson SE, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335–39.
  • Yeum K-J, Taylor A, Tang G, Russell RM. Measurement of carotenoids, retinoids, and tocopherols in human lenses. Ophthalmol Vis Sci 1995;36:2756–61.
  • Bhat KS. Nutritional status of thiamine, riboflavin and pyridoxine in cataract patients. Nutr Rep Internat 1987;36:685–92.
  • Prchal JT, Conrad ME, Skalka HW. Association of presenile cataracts with heterozygosity for galactosaemic states and with riboflavin deficiency. Lancet 1978; i:12–13.
  • Sperduto RD, Hu TS, Milton RC, et al. The Linxian cataract studies. Arch Ophthalmol 1993;111:1246–53.
  • Varma SD et al. Diabetic cataracts and flavonoids. Science 1977;195:205.
  • van Acker SA, van den Berg DJ, Tromp MN, et al. Structural aspects of antioxidant activity of flavonoids. Free Rad Biol Med1996; 20:331–42.
  • Salvayre R, Braquet P, et al. Comparison of the scavenger effect of bilberry anthocyanosides with various flavonoids. Proceed Intl Bioflavonoids Symposium, Munich, 1981, 437–42.
  • Bravetti G. Preventive medical treatment of senile cataract with vitamin E and anthocyanosides: clinical evaluation. Ann Ottamol Clin Ocul 1989;115:109.

The information contained in this article is for information and education purposes only and is not medical advice. Do not use this information as an alternative to obtaining medical advice from your physician or other professional healthcare provider. Always consult with your physician or other professional healthcare provider about any medical conditions you are experiencing. If you are experiencing a medical emergency, contact your local emergency services for help.

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