Vitamins and ocular health: a perspective on nutritional influence in vision disorders
Medical hypothesis, discovery & innovation in optometry,
Vol. 7 No. 2 (2026),
24 July 2026
,
Page 94-102
https://doi.org/10.51329/mehdioptometry250
Abstract
Background: Vitamins are essential for ocular health, and their deficiencies are associated with xerophthalmia, age-related macular degeneration (AMD), cataracts, glaucoma, diabetic retinopathy (DR), dry eye disease (DED), keratoconus, and optic neuropathies. Beyond preventing nutritional deficiency disorders, vitamins contribute to phototransduction, antioxidant defense, immune regulation, and maintenance of retinal, corneal, and optic nerve function. This narrative review summarizes current evidence on the role of individual vitamins in ocular health, highlights clinical findings, and identifies research gaps.Methods: A targeted search of PubMed/MEDLINE and Google Scholar was conducted for English-language studies published between 2000 and 2025. Keywords included “vitamins”, “ocular health”, “eye disease”, “antioxidants”, “retina”, “cornea”, and “nutritional deficiency”. Relevant clinical trials, observational studies, reviews, and guidelines were included. Non-English-language studies and unrelated nutritional research were excluded.
Results: Vitamin A is crucial for phototransduction and epithelial integrity; deficiency leads to night blindness, xerophthalmia, and corneal disease. B-complex vitamins, particularly B1, B2, B6, B12, and folate, are associated with neuro-ophthalmic function, retinal vascular health, and homocysteine metabolism. Vitamin C, a potent antioxidant, protects against oxidative damage in the lens and retina and promotes corneal wound healing. Vitamin D demonstrates emerging therapeutic potential in DED, glaucoma, DR, keratoconus, and AMD through its anti-inflammatory, antioxidant, neuroprotective, and anti-angiogenic properties. Vitamin E contributes to retinal protection and slowing progression of AMD through its antioxidant activity. Additional evidence supports the complementary role of lutein, zeaxanthin, omega-3 fatty acids, and zinc in maintaining retinal integrity and ocular surface health. Deficiencies, malabsorption syndromes, aging, and poor dietary habits contribute significantly to ocular morbidities linked with hypovitaminosis.
Conclusions: Adequate intake of vitamins and selected micronutrients is essential for ocular surface maintenance, retinal function, optic nerve health, and protection against oxidative stress-related diseases. Nutritional assessment and targeted supplementation, particularly in high-risk populations, may help prevent or delay the onset and progression of major eye diseases. Further large-scale randomized controlled trials are warranted to establish evidence-based therapeutic guidelines and optimal supplementation strategies.
References
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3. Pereira A, Adekunle RD, Zaman M, Wan MJ. Association Between Vitamin Deficiencies and Ophthalmological Conditions. Clin Ophthalmol. 2023 Jul 19;17:2045-2062. doi: 10.2147/OPTH.S401262. PMID: 37489231; PMCID: PMC10363387.
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5. Ramdas WD, Schouten JSAG, Webers CAB. The Effect of Vitamins on Glaucoma: A Systematic Review and Meta-Analysis. Nutrients. 2018 Mar 16;10(3):359. doi: 10.3390/nu10030359. PMID: 29547516; PMCID: PMC5872777.
6. Loskutova E, O'Brien C, Loskutov I, Loughman J. Nutritional supplementation in the treatment of glaucoma: A systematic review. Surv Ophthalmol. 2019 Mar-Apr;64(2):195-216. doi: 10.1016/j.survophthal.2018.09.005. Epub 2018 Oct 6. PMID: 30296451.
7. Grover AK, Samson SE. Antioxidants and vision health: facts and fiction. Mol Cell Biochem. 2014 Mar;388(1-2):173-83. doi: 10.1007/s11010-013-1908-z. Epub 2013 Dec 6. PMID: 24311110.
8. Akhtar S, Ahmed A, Randhawa MA, Atukorala S, Arlappa N, Ismail T, Ali Z. Prevalence of vitamin A deficiency in South Asia: causes, outcomes, and possible remedies. J Health Popul Nutr. 2013 Dec;31(4):413-23. doi: 10.3329/jhpn.v31i4.19975. PMID: 24592582; PMCID: PMC3905635.
9. Roda M, di Geronimo N, Pellegrini M, Schiavi C. Nutritional Optic Neuropathies: State of the Art and Emerging Evidences. Nutrients. 2020 Aug 31;12(9):2653. doi: 10.3390/nu12092653. PMID: 32878163; PMCID: PMC7551088.
10. Payne JF, Ray R, Watson DG, Delille C, Rimler E, Cleveland J, Lynn MJ, Tangpricha V, Srivastava SK. Vitamin D insufficiency in diabetic retinopathy. Endocr Pract. 2012 Mar-Apr;18(2):185-93. doi: 10.4158/EP11147.OR. PMID: 21940279; PMCID: PMC4706181.
11. Satyanarayana A, Balakrishna N, Pitla S, Reddy PY, Mudili S, Lopamudra P, Suryanarayana P, Viswanath K, Ayyagari R, Reddy GB. Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia. PLoS One. 2011;6(11):e26747. doi: 10.1371/journal.pone.0026747. Epub 2011 Nov 1. PMID: 22069468; PMCID: PMC3206053.
12. Ho JI, Ng EY, Chiew Y, Koay YY, Chuar PF, Phang SCW, Ahmad B, Kadir KA. The effects of vitamin E on non-proliferative diabetic retinopathy in type 2 diabetes mellitus: Are they sustainable with 12?months of therapy. SAGE Open Med. 2022 May 26;10:20503121221095324. doi: 10.1177/20503121221095324. PMID: 35652036; PMCID: PMC9150238.
13. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology. 2010 Jun;117(6):1163-8. doi: 10.1016/j.ophtha.2009.10.043. Epub 2010 Feb 13. PMID: 20153900; PMCID: PMC2881167.
14. Rochtchina E, Wang JJ, Flood VM, Mitchell P. Elevated serum homocysteine, low serum vitamin B12, folate, and age-related macular degeneration: the Blue Mountains Eye Study. Am J Ophthalmol. 2007 Feb;143(2):344-6. doi: 10.1016/j.ajo.2006.08.032. Epub 2006 Sep 29. PMID: 17258528.
15. Medori MC, Naureen Z, Dhuli K, Placidi G, Falsini B, Bertelli M. Dietary supplements in retinal diseases, glaucoma, and other ocular conditions. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E189-E199. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2760. PMID: 36479474; PMCID: PMC9710404.
16. Agte V, Tarwadi K. The importance of nutrition in the prevention of ocular disease with special reference to cataract. Ophthalmic Res. 2010;44(3):166-72. doi: 10.1159/000316477. Epub 2010 Sep 9. PMID: 20829640.
17. Pellegrini M, Senni C, Bernabei F, Cicero AFG, Vagge A, Maestri A, Scorcia V, Giannaccare G. The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases. Nutrients. 2020 Mar 30;12(4):952. doi: 10.3390/nu12040952. PMID: 32235501; PMCID: PMC7230622.
18. Liu Z, Hu Y, Wang Y, Xu B, Zhao J, Yu Z. Relationship between high dose intake of vitamin B12 and glaucoma: Evidence from NHANES 2005-2008 among United States adults. Front Nutr. 2023 Apr 17;10:1130032. doi: 10.3389/fnut.2023.1130032. PMID: 37139451; PMCID: PMC10149911.
19. Mrugacz M, Pie?czykowska K, Bryl A. The Role of Vitamin D3 in Ocular Diseases. Nutrients. 2024 Jun 14;16(12):1878. doi: 10.3390/nu16121878. PMID: 38931233; PMCID: PMC11206323.
20. Latib F, Zafendi MAI, Mohd Lazaldin MA. The use of vitamin E in ocular health: Bridging omics approaches with Tocopherol and Tocotrienol in the management of glaucoma. Food Chem (Oxf). 2024 Sep 24;9:100224. doi: 10.1016/j.fochms.2024.100224. PMID: 39415777; PMCID: PMC11481750.
21. Beer K, Singh A, Ravi SC, Gupta AK, Kumar A, Sharma MM. A comprehensive review on the role of Vitamin A on human health and nutrition. Journal of Environmental Biology. 2024 Nov 1;45(6):645-53. doi: 10.22438/jeb/45/6/MRN-5339.
22. Ata F, Bilal ABI, Javed S, Chaudhry HS, Sharma R, Malik RF, et al. Optic neuropathy as a presenting feature of vitamin B-12 deficiency: A systematic review of literature and a case report. Ann Med Surg (Lond). 2020 Dec;60:316-322. doi: 10.1016/j.amsu.2020.11.010. PMID: 33204422; PMCID: PMC7653199.
23. Bartolomeo N, Pederzolli M, Palombella S, Fonteyne P, Suanno G, Tilaro G, de Pretis S, Borgo F, Bertuzzi F, Senni C, De Micheli M, Bandello F, Ferrari G. The Effects of Vitamin D on Keratoconus Progression. Am J Ophthalmol. 2025 Aug;276:235-251. doi: 10.1016/j.ajo.2025.04.009. Epub 2025 Apr 15. PMID: 40245974.
24. Das Gupta S, Shakeel T, Dhawan A, Kakkar A. Effect of vitamin B12 deficiency anemia on peripapillary retinal nerve fiber layer. Int J Ophthalmol. 2021 Sep 18;14(9):1424-1429. doi: 10.18240/ijo.2021.09.20. PMID: 34540621; PMCID: PMC8403844.
25. McCusker MM, Durrani K, Payette MJ, Suchecki J. An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract. Clin Dermatol. 2016 Mar-Apr;34(2):276-85. doi: 10.1016/j.clindermatol.2015.11.009. Epub 2015 Nov 22. PMID: 26903189.
26. Fekri S, Soheilian M, Roozdar S, Abtahi SH, Nouri H. The effect of vitamin D supplementation on the outcome of treatment with bevacizumab in diabetic macular edema: a randomized clinical trial. Int Ophthalmol. 2022 Nov;42(11):3345-3356. doi: 10.1007/s10792-022-02333-2. Epub 2022 May 11. PMID: 35543853; PMCID: PMC9093557.
27. Lu L, Lu Q, Chen W, Li J, Li C, Zheng Z. Vitamin D3 Protects against Diabetic Retinopathy by Inhibiting High-Glucose-Induced Activation of the ROS/TXNIP/NLRP3 Inflammasome Pathway. J Diabetes Res. 2018 Feb 22;2018:8193523. doi: 10.1155/2018/8193523. PMID: 29682582; PMCID: PMC5842685.
28. Valle MS, Russo C, Malaguarnera L. Protective role of vitamin D against oxidative stress in diabetic retinopathy. Diabetes Metab Res Rev. 2021 Nov;37(8):e3447. doi: 10.1002/dmrr.3447. Epub 2021 Mar 24. PMID: 33760363.
29. Roberts JE, Dennison J. The Photobiology of Lutein and Zeaxanthin in the Eye. J Ophthalmol. 2015;2015:687173. doi: 10.1155/2015/687173. Epub 2015 Dec 20. PMID: 26798505; PMCID: PMC4698938.
30. Scripsema NK, Hu DN, Rosen RB. Lutein, Zeaxanthin, and meso-Zeaxanthin in the Clinical Management of Eye Disease. J Ophthalmol. 2015;2015:865179. doi: 10.1155/2015/865179. Epub 2015 Dec 24. PMID: 26819755; PMCID: PMC4706936.
31. Murray IJ, Makridaki M, van der Veen RL, Carden D, Parry NR, Berendschot TT. Lutein supplementation over a one-year period in early AMD might have a mild beneficial effect on visual acuity: the CLEAR study. Invest Ophthalmol Vis Sci. 2013 Mar 11;54(3):1781-8. doi: 10.1167/iovs.12-10715. PMID: 23385792.
32. Jue Z, Xu Z, Yuen VL, Chan ODS, Yam JC. Association between vitamin D level and cataract: A systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2025 Jan;263(1):147-156. doi: 10.1007/s00417-024-06592-w. Epub 2024 Aug 23. PMID: 39179900; PMCID: PMC11807021.
33. Audo I, Darjatmoko SR, Schlamp CL, Lokken JM, Lindstrom MJ, Albert DM, Nickells RW. Vitamin D analogues increase p53, p21, and apoptosis in a xenograft model of human retinoblastoma. Invest Ophthalmol Vis Sci. 2003 Oct;44(10):4192-9. doi: 10.1167/iovs.02-1198. PMID: 14507860.
34. Dry Eye Assessment and Management Study Research Group; Asbell PA, Maguire MG, Pistilli M, Ying GS, Szczotka-Flynn LB, Hardten DR, Lin MC, Shtein RM. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 May 3;378(18):1681-1690. doi: 10.1056/NEJMoa1709691. Epub 2018 Apr 13. PMID: 29652551; PMCID: PMC5952353.
35. Jo YJ, Lee JS. Effects of dietary high dose DHA omega-3 supplement in dry eye with meibomian gland dysfunction. Int J Ophthalmol. 2021 Nov 18;14(11):1700-1706. doi: 10.18240/ijo.2021.11.08. PMID: 34804859; PMCID: PMC8569578.
36. Georgiou M, Prokopiou E. Diabetic retinopathy and the role of Omega-3 PUFAs: A narrative review. Exp Eye Res. 2023 Jun;231:109494. doi: 10.1016/j.exer.2023.109494. Epub 2023 May 5. PMID: 37149278.
37. Weiskopf D, Weinberger B, Grubeck-Loebenstein B. The aging of the immune system. Transpl Int. 2009 Nov;22(11):1041-50. doi: 10.1111/j.1432-2277.2009.00927.x. Epub 2009 Jul 16. PMID: 19624493.
38. Maywald M, Rink L. Zinc homeostasis and immunosenescence. J Trace Elem Med Biol. 2015 Jan;29:24-30. doi: 10.1016/j.jtemb.2014.06.003. Epub 2014 Jun 13. PMID: 25022332.
39. Gilbert R, Peto T, Lengyel I, Emri E. Zinc Nutrition and Inflammation in the Aging Retina. Mol Nutr Food Res. 2019 Aug;63(15):e1801049. doi: 10.1002/mnfr.201801049. Epub 2019 Jun 27. PMID: 31148351.
2. Liu H, Prokosch V. Energy Metabolism in the Inner Retina in Health and Glaucoma. Int J Mol Sci. 2021 Apr 1;22(7):3689. doi: 10.3390/ijms22073689. PMID: 33916246; PMCID: PMC8036449.
3. Pereira A, Adekunle RD, Zaman M, Wan MJ. Association Between Vitamin Deficiencies and Ophthalmological Conditions. Clin Ophthalmol. 2023 Jul 19;17:2045-2062. doi: 10.2147/OPTH.S401262. PMID: 37489231; PMCID: PMC10363387.
4. Banerjee M, Chawla R, Kumar A. Antioxidant supplements in age-related macular degeneration: are they actually beneficial? Ther Adv Ophthalmol. 2021 Aug 27;13:25158414211030418. doi: 10.1177/25158414211030418. PMID: 34471798; PMCID: PMC8404659.
5. Ramdas WD, Schouten JSAG, Webers CAB. The Effect of Vitamins on Glaucoma: A Systematic Review and Meta-Analysis. Nutrients. 2018 Mar 16;10(3):359. doi: 10.3390/nu10030359. PMID: 29547516; PMCID: PMC5872777.
6. Loskutova E, O'Brien C, Loskutov I, Loughman J. Nutritional supplementation in the treatment of glaucoma: A systematic review. Surv Ophthalmol. 2019 Mar-Apr;64(2):195-216. doi: 10.1016/j.survophthal.2018.09.005. Epub 2018 Oct 6. PMID: 30296451.
7. Grover AK, Samson SE. Antioxidants and vision health: facts and fiction. Mol Cell Biochem. 2014 Mar;388(1-2):173-83. doi: 10.1007/s11010-013-1908-z. Epub 2013 Dec 6. PMID: 24311110.
8. Akhtar S, Ahmed A, Randhawa MA, Atukorala S, Arlappa N, Ismail T, Ali Z. Prevalence of vitamin A deficiency in South Asia: causes, outcomes, and possible remedies. J Health Popul Nutr. 2013 Dec;31(4):413-23. doi: 10.3329/jhpn.v31i4.19975. PMID: 24592582; PMCID: PMC3905635.
9. Roda M, di Geronimo N, Pellegrini M, Schiavi C. Nutritional Optic Neuropathies: State of the Art and Emerging Evidences. Nutrients. 2020 Aug 31;12(9):2653. doi: 10.3390/nu12092653. PMID: 32878163; PMCID: PMC7551088.
10. Payne JF, Ray R, Watson DG, Delille C, Rimler E, Cleveland J, Lynn MJ, Tangpricha V, Srivastava SK. Vitamin D insufficiency in diabetic retinopathy. Endocr Pract. 2012 Mar-Apr;18(2):185-93. doi: 10.4158/EP11147.OR. PMID: 21940279; PMCID: PMC4706181.
11. Satyanarayana A, Balakrishna N, Pitla S, Reddy PY, Mudili S, Lopamudra P, Suryanarayana P, Viswanath K, Ayyagari R, Reddy GB. Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia. PLoS One. 2011;6(11):e26747. doi: 10.1371/journal.pone.0026747. Epub 2011 Nov 1. PMID: 22069468; PMCID: PMC3206053.
12. Ho JI, Ng EY, Chiew Y, Koay YY, Chuar PF, Phang SCW, Ahmad B, Kadir KA. The effects of vitamin E on non-proliferative diabetic retinopathy in type 2 diabetes mellitus: Are they sustainable with 12?months of therapy. SAGE Open Med. 2022 May 26;10:20503121221095324. doi: 10.1177/20503121221095324. PMID: 35652036; PMCID: PMC9150238.
13. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology. 2010 Jun;117(6):1163-8. doi: 10.1016/j.ophtha.2009.10.043. Epub 2010 Feb 13. PMID: 20153900; PMCID: PMC2881167.
14. Rochtchina E, Wang JJ, Flood VM, Mitchell P. Elevated serum homocysteine, low serum vitamin B12, folate, and age-related macular degeneration: the Blue Mountains Eye Study. Am J Ophthalmol. 2007 Feb;143(2):344-6. doi: 10.1016/j.ajo.2006.08.032. Epub 2006 Sep 29. PMID: 17258528.
15. Medori MC, Naureen Z, Dhuli K, Placidi G, Falsini B, Bertelli M. Dietary supplements in retinal diseases, glaucoma, and other ocular conditions. J Prev Med Hyg. 2022 Oct 17;63(2 Suppl 3):E189-E199. doi: 10.15167/2421-4248/jpmh2022.63.2S3.2760. PMID: 36479474; PMCID: PMC9710404.
16. Agte V, Tarwadi K. The importance of nutrition in the prevention of ocular disease with special reference to cataract. Ophthalmic Res. 2010;44(3):166-72. doi: 10.1159/000316477. Epub 2010 Sep 9. PMID: 20829640.
17. Pellegrini M, Senni C, Bernabei F, Cicero AFG, Vagge A, Maestri A, Scorcia V, Giannaccare G. The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases. Nutrients. 2020 Mar 30;12(4):952. doi: 10.3390/nu12040952. PMID: 32235501; PMCID: PMC7230622.
18. Liu Z, Hu Y, Wang Y, Xu B, Zhao J, Yu Z. Relationship between high dose intake of vitamin B12 and glaucoma: Evidence from NHANES 2005-2008 among United States adults. Front Nutr. 2023 Apr 17;10:1130032. doi: 10.3389/fnut.2023.1130032. PMID: 37139451; PMCID: PMC10149911.
19. Mrugacz M, Pie?czykowska K, Bryl A. The Role of Vitamin D3 in Ocular Diseases. Nutrients. 2024 Jun 14;16(12):1878. doi: 10.3390/nu16121878. PMID: 38931233; PMCID: PMC11206323.
20. Latib F, Zafendi MAI, Mohd Lazaldin MA. The use of vitamin E in ocular health: Bridging omics approaches with Tocopherol and Tocotrienol in the management of glaucoma. Food Chem (Oxf). 2024 Sep 24;9:100224. doi: 10.1016/j.fochms.2024.100224. PMID: 39415777; PMCID: PMC11481750.
21. Beer K, Singh A, Ravi SC, Gupta AK, Kumar A, Sharma MM. A comprehensive review on the role of Vitamin A on human health and nutrition. Journal of Environmental Biology. 2024 Nov 1;45(6):645-53. doi: 10.22438/jeb/45/6/MRN-5339.
22. Ata F, Bilal ABI, Javed S, Chaudhry HS, Sharma R, Malik RF, et al. Optic neuropathy as a presenting feature of vitamin B-12 deficiency: A systematic review of literature and a case report. Ann Med Surg (Lond). 2020 Dec;60:316-322. doi: 10.1016/j.amsu.2020.11.010. PMID: 33204422; PMCID: PMC7653199.
23. Bartolomeo N, Pederzolli M, Palombella S, Fonteyne P, Suanno G, Tilaro G, de Pretis S, Borgo F, Bertuzzi F, Senni C, De Micheli M, Bandello F, Ferrari G. The Effects of Vitamin D on Keratoconus Progression. Am J Ophthalmol. 2025 Aug;276:235-251. doi: 10.1016/j.ajo.2025.04.009. Epub 2025 Apr 15. PMID: 40245974.
24. Das Gupta S, Shakeel T, Dhawan A, Kakkar A. Effect of vitamin B12 deficiency anemia on peripapillary retinal nerve fiber layer. Int J Ophthalmol. 2021 Sep 18;14(9):1424-1429. doi: 10.18240/ijo.2021.09.20. PMID: 34540621; PMCID: PMC8403844.
25. McCusker MM, Durrani K, Payette MJ, Suchecki J. An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract. Clin Dermatol. 2016 Mar-Apr;34(2):276-85. doi: 10.1016/j.clindermatol.2015.11.009. Epub 2015 Nov 22. PMID: 26903189.
26. Fekri S, Soheilian M, Roozdar S, Abtahi SH, Nouri H. The effect of vitamin D supplementation on the outcome of treatment with bevacizumab in diabetic macular edema: a randomized clinical trial. Int Ophthalmol. 2022 Nov;42(11):3345-3356. doi: 10.1007/s10792-022-02333-2. Epub 2022 May 11. PMID: 35543853; PMCID: PMC9093557.
27. Lu L, Lu Q, Chen W, Li J, Li C, Zheng Z. Vitamin D3 Protects against Diabetic Retinopathy by Inhibiting High-Glucose-Induced Activation of the ROS/TXNIP/NLRP3 Inflammasome Pathway. J Diabetes Res. 2018 Feb 22;2018:8193523. doi: 10.1155/2018/8193523. PMID: 29682582; PMCID: PMC5842685.
28. Valle MS, Russo C, Malaguarnera L. Protective role of vitamin D against oxidative stress in diabetic retinopathy. Diabetes Metab Res Rev. 2021 Nov;37(8):e3447. doi: 10.1002/dmrr.3447. Epub 2021 Mar 24. PMID: 33760363.
29. Roberts JE, Dennison J. The Photobiology of Lutein and Zeaxanthin in the Eye. J Ophthalmol. 2015;2015:687173. doi: 10.1155/2015/687173. Epub 2015 Dec 20. PMID: 26798505; PMCID: PMC4698938.
30. Scripsema NK, Hu DN, Rosen RB. Lutein, Zeaxanthin, and meso-Zeaxanthin in the Clinical Management of Eye Disease. J Ophthalmol. 2015;2015:865179. doi: 10.1155/2015/865179. Epub 2015 Dec 24. PMID: 26819755; PMCID: PMC4706936.
31. Murray IJ, Makridaki M, van der Veen RL, Carden D, Parry NR, Berendschot TT. Lutein supplementation over a one-year period in early AMD might have a mild beneficial effect on visual acuity: the CLEAR study. Invest Ophthalmol Vis Sci. 2013 Mar 11;54(3):1781-8. doi: 10.1167/iovs.12-10715. PMID: 23385792.
32. Jue Z, Xu Z, Yuen VL, Chan ODS, Yam JC. Association between vitamin D level and cataract: A systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2025 Jan;263(1):147-156. doi: 10.1007/s00417-024-06592-w. Epub 2024 Aug 23. PMID: 39179900; PMCID: PMC11807021.
33. Audo I, Darjatmoko SR, Schlamp CL, Lokken JM, Lindstrom MJ, Albert DM, Nickells RW. Vitamin D analogues increase p53, p21, and apoptosis in a xenograft model of human retinoblastoma. Invest Ophthalmol Vis Sci. 2003 Oct;44(10):4192-9. doi: 10.1167/iovs.02-1198. PMID: 14507860.
34. Dry Eye Assessment and Management Study Research Group; Asbell PA, Maguire MG, Pistilli M, Ying GS, Szczotka-Flynn LB, Hardten DR, Lin MC, Shtein RM. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 May 3;378(18):1681-1690. doi: 10.1056/NEJMoa1709691. Epub 2018 Apr 13. PMID: 29652551; PMCID: PMC5952353.
35. Jo YJ, Lee JS. Effects of dietary high dose DHA omega-3 supplement in dry eye with meibomian gland dysfunction. Int J Ophthalmol. 2021 Nov 18;14(11):1700-1706. doi: 10.18240/ijo.2021.11.08. PMID: 34804859; PMCID: PMC8569578.
36. Georgiou M, Prokopiou E. Diabetic retinopathy and the role of Omega-3 PUFAs: A narrative review. Exp Eye Res. 2023 Jun;231:109494. doi: 10.1016/j.exer.2023.109494. Epub 2023 May 5. PMID: 37149278.
37. Weiskopf D, Weinberger B, Grubeck-Loebenstein B. The aging of the immune system. Transpl Int. 2009 Nov;22(11):1041-50. doi: 10.1111/j.1432-2277.2009.00927.x. Epub 2009 Jul 16. PMID: 19624493.
38. Maywald M, Rink L. Zinc homeostasis and immunosenescence. J Trace Elem Med Biol. 2015 Jan;29:24-30. doi: 10.1016/j.jtemb.2014.06.003. Epub 2014 Jun 13. PMID: 25022332.
39. Gilbert R, Peto T, Lengyel I, Emri E. Zinc Nutrition and Inflammation in the Aging Retina. Mol Nutr Food Res. 2019 Aug;63(15):e1801049. doi: 10.1002/mnfr.201801049. Epub 2019 Jun 27. PMID: 31148351.
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