Feast your Eyes: Diet and Nutrition for Optimal Eye Health

Pinakin Gunvant Davey ^1* Arunkumar Ranganathan ²

• ¹ Western University of Health Sciences, Pomona, United States
• ² The University of Utah, Salt Lake City, Utah, United States

It is not an exaggeration to say we are having a myopia epidemic (14). Whereas in most countries, emmetropia was normal, we are now having countries like China where myopic refractive error is the norm (14). Obviously, genetics play an important role, but the effects of epigenetics cannot be underestimated, and researchers Xiao et al., have found, using the NHANES data, that cis-β carotene is significantly associated with the risk of myopia and high myopia. The results are indeed fascinating as they did not find association with other micronutrients vitamins A, D, E, C, α-carotene, trans-βcarotene, lutein zeaxanthin. Another study performed by Xu et al., using the NHANES data 2005-2008 showed that although vitamin-D and magnesium were protective against diabetic retinopathy and the protective effect of vitamin-D primarily benefited the individuals deficient in magnesium. Thus, highlighting the complex interplay of nutrients in health and disease states. Bhandarkar et al. looked at the low carbohydrate, high-fat diet in individuals with diabetes and found health benefits going beyond glycemic control, changing the lipid profile and ocular inflammatory biomarkers. Although not significantly correlated to Hb a1c, this study indeed sows' seeds for the need for further investigation in this area as various biomarkers ICAM-1, IL-17A, IL-1β, and TNF-α all showed clinically significant changes during the follow-up.Cataract is indeed one of the reversible causes of vision loss (15). Most of us have accepted that a complex set of circumstances eventually causes a naturally occurring clear crystalline lens to opacify. If we are what we eat, can there be nutritional benefits in preventing formation of cataract? Zhang et al., and Feng et al., add to the body of literature already present in the area. Zhang et al., summarize the current body of work in their mini review article, whereas Feng et al., find that famine exposure during the early stages of life is associated with a heightened risk of developing cataracts. This bring another question to mind: although we all would like to be citizen of the planet earth, there are significant dietary constraints in various countries and one plan to fix the nutritional requirements of various countries will not work. Thus, studies that of Thirunavukkarasu et al., and Nuredin et al., highlight the need for targeted nutritional intervention measures to improve the vision health in different regions.Lastly AMD (16) and glaucoma (17) are not only the leading causes of irreversible blindness but also huge socioeconomic burden. The current therapy for glaucoma is to lower intraocular pressure is the main stay however, lowering of IOP does not guarantee the halting of the disease or progression of the disease. Further, the patients are on multiple medications often on maximal medical therapy and requiring surgery. Both AMD and glaucoma are at high proportions due to the aging population (16)(17)(18). Thus, it remains important to look for alternative and adjunct therapies for both these disease states. Yang et al's work on vitamin-B6 points to a lower risk of glaucoma in highest quartile and Lee et al's work shows that higher intake of omega-3 long chain polyunsaturated fatty acids decrease risk of AMD. These are easy for patients to implement and furthermore these nutrients have many other benefits to the body that also contributing to overall health.To say that we live in the golden age of science is an understatement. We have more knowledge and technology than our predecessors in research only wish they had. On the other hand, our predecessor clinicians and scientists will not envy our luck on the endemic chronic diseases that both developing and developed countries face. It will require a conscious change in both physician's and patients' mentality and thinking. We need to stop looking at food as just calories and start looking at food as a flexible spending account to be used for the betterment of our health and quality of life.