Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California.

It would be difficult to overstate the importance of healthy eyes and good vision. They contribute mightily to quality of life. But millions of Americans have had their quality of life diminished because of cataracts and age-related macular degeneration (AMD)—the leading causes of visual impairment and acquired blindness in the United States.

Nutrition is one way to protect the eyes from these diseases. And research has shown that two carotenoids —zeaxanthin and lutein—can delay and even prevent the progression of these eye diseases. Carotenoids are pigments that imbue fruits and vegetables with their vibrant colors. They act as antioxidants (substances that protect the body's cells from free radical damage) and have huge cancer-fighting properties.

Zeaxanthin and lutein are the only carotenoids located in the eye—and offer great promise to those millions of people who may have lost hope the day they were diagnosed.

This article explains how zeaxanthin works, how people take the supplement, and how it can be used in tandem with a diet filled with green, leafy vegetables to improve eye health.

Consult your primary care physician or eye care professional before taking any new supplement.

Zeaxanthin plays a role in protecting the eyes from the harmful effects of oxidation and light-induced damage. Zeaxanthin is a yellow-colored pigment found in the center of the macula. It is found in high levels in dark green vegetables, orange and yellow fruits, and egg yolks. It also gives paprika, saffron, and corn their characteristic colors.

The macula is the most sensitive part of the retina. It has the most photoreceptors in the retina and counts as the place where our sharpest vision is produced. It is also responsible for our ability to perceive colors.

In the midst of all this activity, think of zeaxanthin benefits as being similar to an eye vitamin. Once inside the body, zeaxanthin is drawn to the eyes. It makes its way into the lens, macula, and fovea (the center spot of the retina). Zeaxanthin helps build a yellow-colored pigment shield to protect the eye cells from the harmful effects of certain light sources, such as the sun. It also protects the eyes from dangerous free radicals that form over time from oxidation.

Some of the dietary sources of zeaxanthin have been studied as protective factors in AMD, which is the leading cause of blindness in the U.S. It affects people aged 65 and older. Take note that some macular complications affect younger people and may be referred to as macular degeneration. However, when the last two words are grouped together, the term usually refers to age-related macular degeneration.

Zeaxanthin, along with lutein, is the only dietary carotenoid that accumulates in the retina, particularly the macular region. (Meso-zeaxanthin is the third dominant carotenoid at the very center of the macula, where zeaxanthin is dominant, just off-center.) Because both substances are found in large amounts in the macula, they’re known as macular pigments.

Macular pigment works to filter blue light, the visible light at the end of the color spectrum that researchers believe can cause macular degeneration. Further research is needed to prove the harmful effects of blue light. However, studies have shown that by filtering blue light, macular pigment helps improve several areas of vision including:

People with the following conditions may benefit from zeaxanthin and lutein:

AMD is marked by three stages:

Generally, health experts recommend that adults eat five servings of fruits and vegetables every day, which should provide about 5 milligrams (mg) of carotenoids (including zeaxanthin and lutein). However, most people don't eat this many servings of fruits and vegetables. In fact, the average intake of carotenoids is closer to 2 mg. This means supplements may be helpful to ensure you get an adequate amount of zeaxanthin.

Studies show that a daily supplement of 2 mg zeaxanthin can be beneficial for vision. However, zeaxanthin can be safely taken at higher doses. Studies have shown, for instance, that taking 20 mg daily for up to six months should cause no problems. Keep in mind that it's important to be sure that the supplements you choose are pure. While many synthetic supplements do have other materials in them, you want to be sure you don't have significant levels of anything other than zeaxanthin.

Zeaxanthin, along with lutein, can be taken at any time of day. However, both supplements and food sources should be consumed with food that contains small amounts of fat.

As a fat-soluble antioxidant, zeaxanthin requires some fat to be properly absorbed, so eating a meal after taking a supplement or sprinkling olive oil on your vegetables can help ensure that you get the full benefits of this carotenoid.

While zeaxanthin supplements have not been found to cause any adverse side effects, no studies have been done on their long-term use. In fact, researchers can't be certain whether taking a synthetic form of zeaxanthin is okay for more than five years. Thus, it's only recommended for those who have a significant and immediate concern about vision loss getting worse.

If you have not been diagnosed with macular degeneration, health experts recommend that you increase your intake of zeaxanthin by eating more foods rich in the micronutrient. This restriction includes people who may be at risk for AMD such as family members of those who have been diagnosed or smokers, who are four times more likely to develop AMD than those who have never smoked.

Unfortunately, you can't stop the aging process, which is the biggest risk factor for AMD. The disease most often surfaces in people ages 55 and older. Other risk factors include:

Researchers have found no side effects from or negative interactions with zeaxanthin. Although, people with fair skin may develop a yellowish coloration of the skin if they exceed the maximum daily recommended dosage for adults (10 mg).

On a daily basis, there doesn't seem to be a risk of taking too much lutein and zeaxanthin via supplements or through diet. However, no research has looked into using supplements for more than a few years.

If you are looking for a decades-long plan to support eye health, focus on eating fruits and vegetables every day.

Be aware that dietary supplements are not regulated by the U.S. Food and Drug Administration (FDA) to the extent that pharmaceuticals are, other than to prohibit unsupported health claims. No health claims have been approved by the FDA or the European Food Safety Authority (EFSA) for zeaxanthin supplements.

Several groups are trying to fill the shoes of the FDA with regard to supplements, including ConsumerLab.com, NSF International, and U.S. Pharmacopeia (USP). The most recent addition is UL, a for-profit company known for testing electronics. USP, a nonprofit, has set standards for supplements that Consumer Reports says are the most widely accepted.

USP publishes the Dietary Supplements Compendium, an online, subscription-based database that provides quality standards for the production of dietary supplements. Those that pass USP's quality requirements are awarded a distinction called the USP Verified Mark.

If you are looking to boost your zeaxanthin intake, look for green, leafy vegetables first since they have the highest amount of the carotenoid. In fact, zeaxanthin is the reason these foods are richly colored since it modulates light energy and keeps chlorophyll at appropriate levels during photosynthesis. The chlorophyll in dark green vegetables actually masks the lutein and zeaxanthin pigments, giving the vegetables their recognizable green color.

But you shouldn't limit yourself to just a few veggies. In addition to greens, brightly colored fruits and vegetables are also a good source of both zeaxanthin and lutein.

Expanding your diet to include carotenoid-rich foods is one extremely promising way to protect your eyes from disease according to the American Optometric Association.

People often associate root vegetables such as sweet potatoes and carrots with carotenoids, but as discussed, green vegetables should also be top of mind.

If you're wondering exactly what foods contain zeaxanthin, think beyond the basics. Among the foods that teem with the carotenoids you need for eye health are:

If you're the family cook, then you know that even the hungriest people care about what a dish looks like and what it's called. Vegetables (which can be blah in name and execution) aren't known to cooperate in either regard. So if you're trying to add more zeaxanthin and lutein to your diet, try jazzing things up with broccoli rabe with pine nuts; pumpkin mousse; salmon with mango salsa; sunset gazpacho; or a veggie frittata with orange pepper, spinach, and sundried tomatoes.

She may not have had any details, but your mother was right about vegetables being good for your eyes. Two carotenoids found in the eye—zeaxanthin and lutein—can delay and even prevent the progression of cataracts and age-related macular degeneration. Ironically, carotenoids are pigments that give fruits and vegetables their vibrant colors. And carotenoids can be found in many vegetables, in particular. If you've been diagnosed with vision loss and can't get between 6 mg and 10 mg of the two carotenoids from your diet, consider taking a supplement to fill the gap.

Besides eating at least five portions of fruits and vegetables a day, being physically active and refraining from smoking will improve your health, and, by extension, keep your eyes healthy. To protect your eyes from damage, wear sunglasses or protective eyewear when it's smart to do so, rest your eyes from heavy-duty computer work every 20 minutes, and be proactive about preventing eye infections if you wear contact lenses.

In recent years, researchers have learned that zeaxanthin may have positive effects on the skin. Daily zeaxanthin consumption may protect skin cells from premature aging as well as UVB-induced tumors. A research study showed that consuming 10 mg of lutein and 2 mg of zeaxanthin a day may also improve skin tone.

Meso-zeaxanthin dominates at the direct center of the macula. Zeaxanthin, lutein, and meso-zeaxanthin together form macular pigment, the natural blue light filter and anti-oxidant presence in the retina. Macular pigment is generally depleted in people with normal diets. Therefore, it is a good idea to consider taking an eye supplement that contains all three macular pigment carotenoids.

No. They're both carotenoids, pigment compounds that give fruits, vegetables, and seafood their vibrant colors, but zeaxanthin is a yellow pigment and astaxanthin is a red one.

Both are important antioxidants, but they play different roles. Zeaxanthin is found mostly in the center of the eye’s macula, while lutein is mainly in the retina.

Eggs may be your best source. While some vegetables contain more of zeaxanthin, your body's better able to use what it gets from an egg, possibly because of its fat content. Research shows that eating eggs daily for several weeks raises zeaxanthin (and lutein) levels significantly.

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