Cataracts

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

Most people, if they 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 create what scientists call oxidative damage. Oxidative damage to the lens of the eye appears to cause cataracts in animals² and people.³

Nutritional supplements that may be helpful: People with low blood levels of antioxidants and those who eat few antioxidant-rich fruits and vegetables are 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 is linked to a lower risk of developing cataracts.¹¹ ¹² Healthy people are more likely to take vitamin C and vitamin E supplements than those with cataracts¹³ and people who supplement with vitamin C develop far fewer cataracts.¹⁴ ¹⁵

Vitamin E supplements also protect against cataracts in animals¹⁶ and people.¹⁷ Many people take 400 IU of vitamin E per day as prevention.

Some studies find that eating more foods rich in beta-carotene or supplementing with vitamin A lowers the risk of cataracts.¹⁸ It is still not clear whether beta-carotene per se protects the eye or if the beta-carotene is found in foods that contain other protective factors. People who eat a lot of spinach, which is high in lutein, a nutrient similar to beta-carotene, appear to be at low risk for cataracts.¹⁹

Vitamin B2 and vitamin B3 are needed to protect glutathione, an important antioxidant in the eye. Vitamin B2 deficiency is linked to cataracts.²⁰ ²¹ Older people taking 3 mg of vitamin B2 and 40 mg of vitamin B3 per day may be partly protected against cataracts.²²

The flavonoid quercetin may also help by blocking sorbitol accumulation in the eye.²³ This may be especially helpful for those with diabetes.

Are there any side effects or interactions? (Refer to the individual supplement for complete information.) Some individuals develop diarrhea after as little as a few thousand milligrams of vitamin C per day, while others are not bothered by ten times this amount. However, high levels of vitamin C can deplete the body of copper,²⁴ an essential nutrient. It is prudent to ensure adequate copper intake at higher intakes of vitamin C (copper is found in many multi-vitamin/mineral supplements).

One form of vitamin B3, called niacinamide or nicotinamide, is almost always safe to take, although rare liver problems have occurred at doses in excess of 1,000 mg per day. Another form of vitamin B3, called niacin or nicotinic acid, at doses as low as 50-100 mg may cause flushing, headache, and stomachache in some people. However, very high doses (above 1 gram) of this form of vitamin B3 can also cause a variety of serious health problems.

Herbs that may be helpful: Bilberry, a close relative of blueberry, are high in the bioflavonoid complex anthocyanosides²⁵. 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 make it useful for reducing the risk of cataracts.²⁶ ²⁷

Many people take a 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 complete information.) In recommended amounts, there are no known side effects with bilberry extract. Bilberry does not interact with commonly prescribed drugs, and there are no known contraindications to its use during pregnancy or lactation.

Nutritional Supplements

Herbs

Homeopathic Remedies

Vitamin C

Vitamin E

Vitamin A/Beta-Carotene

Lutein

B-Complex
(B2, B3)

Quercetin

Bilberry

No homeopathy commonly used for this condition

1. 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.
2. 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.
3. Palmquist B, Phillipson B, Barr P. Nuclear cataract and myopia during hyperbaric oxygen therapy. Br J Ophthalmol 1984;68: 113-7.
4. 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-5S.
5. Knekt P, Heliovaara M, Rissanen A, et al. Serum antioxidant vitamins and risk of cataract. BMJ 1992;305:1392-4.
6. 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;10:751-9.
7. Reddy VN. Glutathione and its function in the lens—An overview. Exp Eye Res 1990;150:771-8.
8. Packer JE, Slater TF, Willson RL. Direct observation of a free radical interaction between vitamin E and vitamin C. Nature 1979;278:737-8.
9. Taylor A. Cataract: relationship between nutrition and oxidation. J Am Coll Nutr 1993;12:138-46 (review).
10. 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;10:751-9.
11. 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-5S.
12. Jacques PF, Chylack LT, McGandy RB, Hartz SC. Antioxidant status in persons with and without senile cataract. Arch Ophthalmol 1988;106:337-40.
13. Robertson J McD, Donner AP, Trevithick JR. Vitamin E intake and risk of cataracts in humans. Ann NY Acad Sci 1989;570:372-82.
14. 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.

15. Hankinson Se, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335-9.
16. 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;16:32-8.
17. 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.
18. Hankinson Se, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335-9.
19. Hankinson Se, Stampfer MJ, Seddon JM, et al. Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335-9.
20. Bhat KS. Nutritional status of thiamine, riboflavin and pyridoxine in cataract patients. Nutr Rep Internat 1987;36:685-92.
21. Prchal JT, Conrad ME, Skalka HW. Association of presenile cataracts with heterozygosity for galactosaemic states and with riboflavin deficiency. Lancet 1978; i:12-3.
22. Sperduto RD, Hu TS, Milton RC, et al. The Linxian cataract studies. Arch Ophthalmol 1993;111:1246-53.
23. Varma SD et al. Diabetic cataracts and flavonoids. Science 1977;195:205.
24. Sandstead HH: Copper Bioavailability and Requirements. Am J Nutr 1982;35:809 (review).
25. 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.
26. 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.
27. Bravetti G. Preventive medical treatment of senile cataract with vitamin E and anthocyanosides: clinical evaluation. Ann Ottamol Clin Ocul 1989;115:109.