Optometric Management presents Nutritional Insights for Clinical Practice, a monthly e-newsletter focusing on the latest developments and valuable information on the importance of ocular nutrition for the optometrist. A variety of guest editors are featured.

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May 2022

New Study Proves Effectiveness of a Non-Surgical, Dietary Supplement for “Eye Floaters”

John M. Nolan, PhD

The transparent vitreous body, which occupies about 80% of the eye’s volume, is laden with numerous enzymatic and non-enzymatic antioxidants that could protect the eye from oxidative stress and disease. Aging is associated with degeneration of vitreous structure, as well as a reduction in its antioxidant capacity. A growing body of evidence suggests these age-related changes may be the precursor of numerous oxidative stress-induced vitreo-retinopathies, including vision degrading myodesopsia (vitreous eye floaters), the clinically significant entoptic phenomena that can result from advanced vitreous degeneration.1
Vitreous degeneration commences early in life: 12.5% of the vitreous gel is liquified by age 18. After increasing during growth and development, the volume of the gel remains stable until about the fifth decade when it begins to decrease in parallel with an increase in liquid vitreous. These changes, coupled with the aforementioned decrease in antioxidant capacity, can lead to significant vitreous degeneration. Perceptually, this degeneration manifests as hair-like, fly-like, grey, linear images like cobwebs, primarily within the central visual field, which are commonly known as “vitreous floaters.” Although many eye care practitioners consider this condition to simply be a nuisance, vitreous floaters can cause significant disturbance in vision and impairment of contrast sensitivity for patients.2
Recent works by Nolan et al at the Nutrition Research Centre Ireland (NRCI) have demonstrated a clear link between vitreous antioxidants, vitreous degeneration, visual function and vision-related quality of life.1-3 Indeed, a new study published in Translational Vision Science and Technology (TVST), an ARVO journal, has revealed that targeted nutrition can significantly reduce vitreous floaters and their associated discomforts, as well as visual disturbance. This study reports the outcomes of the Floater Intervention Study (FLIES). The FLIES trial is the first double-blind, placebo-controlled clinical trial in patients with primary floaters that demonstrated reduction in floater suffering and improvements in both visual function and vision-related quality of life in the active group compared to placebo (Figure 1). Patients followed a 6-month dietary intervention with a formulation consisting of 125 mg l-lysine, 40 mg vitamin C, 26.3 mg Vitis vinifera extract, 5 mg zinc, and 100 mg Citrus aurantium (a product commercially available in North America as Vitreous Health). Notably, these improvements were confirmed by the decrease in vitreous opacity areas in the active group. This targeted dietary intervention should be considered to support patients with symptomatic vitreous degeneration, who are presenting and suffering with vitreous floaters.
Figure 1
Figure 1. Within 6 months, 67% of patients recognized improvements in their symptoms. On average, the active intervention achieved a 22% decrease in floater area, 46% decrease in visual discomfort, 9% improvement in contrast sensitivity, and 47% improvement in daily visual experience.

The FLIES trial was sponsored by Waterford Institute of Technology and ebiga-VISION GmbH through a WIT Co-Fund PhD scholarship (WD_2007_43).
  1. Ankamah E, Sebag J, Ng E, Nolan JM. Vitreous antioxidants, degeneration, and vitreo-retinopathy: exploring the links. Antioxidants. 2020;9(1):7. doi:10.3390/antiox9010007
  2. Ankamah E, Green-Gomez M, Roche W, et al. Impact of symptomatic vitreous degeneration on photopic and mesopic contrast thresholds. Clin Exp Optom. 2021:1-8. doi:10.1080/08164622.2021.1981116
  3. Ankamah E, Green-Gomez M, Roche W, et al. Dietary intervention with a targeted micronutrient formulation reduces the visual discomfort associated with vitreous degeneration. Transl Vis Sci Technol. 2021;10(12):19. doi:10.1167/tvst.10.12.19
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