Is there a way to slow the progress of age-related macular degeneration? Vitamins may help those who have intermediate or advanced cases. If no symptoms are showing, you can reduce your risk of AMD with regular eye exams and an eye-healthy diet.

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Age-related macular degeneration (AMD) is the most common cause of impaired vision in older Americans. It leads to a breakdown and thinning of the light-sensitive retina at the back of the eye. If not caught early, it can lead to irreversible damage. The good news is that routine eye exams can uncover the signs of AMD at an early and more treatable stage. A daily supplement of macular degeneration vitamins and minerals can slow the progress of the condition.

But it’s important to understand that taking daily “eye vitamins” won’t help prevent age-related macular degeneration unless you already have signs of the disease. If your vision is fine for the time being, skip the supplements and just eat a nutritious diet.

Dry vs. Wet AMD

Macular degeneration vitamins help slow the progress of “dry” AMD. In dry AMD, residue slowly builds up in the eye from breakdown of the macula, part of the retina responsible for sharp central vision. Tiny spots of yellow, fatty protein called drusen build up.

The more drusen that form, the greater the chance that AMD will get worse and begin to damage your vision. Drusen on their own don’t appear to cause blindness, though people with dry AMD may have slightly blurred vision. Usually, dry AMD often has no early warning symptoms that you notice.

Dry AMD is so named because it does not involve the growth of abnormal, leaky blood vessels beneath the macula—the hallmark of “wet” AMD. Wet AMD can be treated with injected medications but cannot be fixed.

Who Should Take Macular Degeneration Vitamins?

Only people with intermediate or advanced AMD stand to benefit from macular degeneration vitamins.

• Intermediate AMD means that you have developed relatively numerous drusen, or one very large drusen.
• Advanced dry AMD means that in at least one eye, cells in the retina have started to waste away and die—a condition called geographic atrophy.

We know that macular degeneration vitamins help people with intermediate or advanced dry AMD because of the Age-Related Eye Disease Study, or AREDS, a randomized clinical trial led by the National Eye Institute.

AREDS established that people with intermediate-stage dry AMD who took a cocktail of high-dose vitamin and mineral supplements were 25 percent less likely to develop more advanced AMD over five years and 19 percent less likely to lose visual acuity. Here’s what the AREDS cocktail contains:

• 500 milligrams (mg) vitamin C
• 400 International Units (IU) vitamin E
• 10 mg lutein (a pigment normally found in the macula)
• 2 mg zeaxanthin (also found in the macula)
• 80 mg zinc
• 2 mg copper

In 2017, health experts with the prestigious Cochrane Collaboration published a review of 19 studies on the use of macular degeneration vitamins for treating AMD. The review confirmed that supplements can slow the progression of AMD and prevent vision loss—but only if caught early.

Should You Take Macular Degeneration Vitamins Just In Case?

You’ll see many “eye vitamin” products on store shelves. If you’re an older person concerned about AMD—and you should be—it’s tempting to take eye vitamins just in case.

But the research to date suggests you’d be wasting your time to take macular degeneration vitamins without a diagnosis of intermediate to advanced dry AMD. AREDS showed that if you have less than an intermediate amount of AMD, the chance of it progressing to advanced disease is very low—around 1 percent over five years—with or without taking macular degeneration vitamins.

But you are far from powerless to preserve your vision as you age. In other words, to lower your risk of macular degeneration, vitamins shouldn’t be your first thought. Here are two steps any older person can take:

1. Get regular eye exams. If you could do just one thing, get regular eye exams. It should be a dilated eye exam, which allows the ophthalmologist or other vision specialist to closely inspect the retina. Early signs of AMD that may appear in a dilated eye exam include drusen as well as a mottled appearance of the macula, which normally appears uniform.

The American Academy of Ophthalmology (AAO) recommends that adults with no symptoms or risk factors for eye disease still get a baseline eye exam at age 40. Then, your doctor will tell you how often to have dilated eye exams, based on family history of eye disease and other risk factors. By age 65, have an exam every one to two years with an ophthalmologist.

2. Eat an eye-healthy diet: For general health and possibly preventing eye diseases, the AAO recommends that you eat a nutritious diet with dark leafy greens (like broccoli, kale, peas, and spinach) along with yellow, orange, and other colorful fruits and vegetables. These healthy foods have high levels of antioxidants, including lutein and zeaxanthin.

In fact, certain diets may help to stave off AMD. One of them is the Mediterranean-style diet. Some studies have found that the more closely people adhered to a Mediterranean eating pattern, the lower the odds of developing AMD. Mediterranean-style diets tend to be heavy in fruit, vegetables, legumes, whole grains, fish, and lean meats.

What about fish oil? Preliminary studies found that people with a relatively high intake of omega-3 fatty acids are less likely to develop advanced AMD. But the AREDS clinical trial did not find that adding omega-3s to macular degeneration vitamins had any effect.