More than 2.2 billion people around the world have a near- or distance-vision impairment, according to the World Health Organization. In about half of those cases, impairment could have been prevented or hasn’t yet been addressed.

In addition to health and quality of life matters, vision impairment presents a global financial burden. The annual cost of productivity losses associated with vision impairment is estimated to be $411 billion. Meanwhile, the estimated cost gap of addressing the unmet need of vision impairment is estimated at about $25 billion.

“The prevalence of vision loss, regardless of cause, increases with age, but many younger people are also being affected by vision impairment,” said Sue Hewlings, director of scientific affairs at Nutrasource/GRAS Associates. “Globally, there are an estimated 596 million people with distance vision impairment and a further 510 million, or 22% of people over 50 years of age, with uncorrected presbyopia, difficulty seeing up close.”

Age-related macular degeneration is the most common cause of severe loss of eyesight among people 50 and older. As the global population ages, vision will be front and center in health and wellness.

Vision health is also a growing concern for younger consumers, particularly with excessive screen time embedded into their daily lives and the emergence of esports and gaming, which requires strong visual acuity for long periods of time.

Behavioral Shifts Lead to New Health Concerns

The market for eye health supplements is growing rapidly due to the global prevalence of visual impairment, particularly in emerging economies; but it’s a trend that has accelerated as an indirect result of the pandemic, according to Karin Hermoni, head of science and nutrition at Lycored.

“The shift to virtual working has really affected eye health and comfort. Many of us are now far more familiar with eye fatigue than we were three years ago,” she said. “Additionally, growing awareness of the value of nutrition for holistic wellness means consumers are increasingly receptive to the idea of supplementation with nutrients like carotenoids for their eyes.”

An aging population has been rethinking how to manage health, including vision, according to Leslie Gallo, president of Artemis International. “Pollution and UV rays are factors, and especially now, as the day-to-day effects of Covid continue, the trend toward increased use of mobile phones, computers, and tablets is a major concern.”

Gallo also noted the growth in gaming, which can take a significant toll on the eyes. “The esports industry is mainstreaming gaming, which should be taken seriously by brands developing products to support healthy vision. Digital eye strain is a very real problem that is only going to continue to grow.”

A 2021 Pew Research study showed that 31% of U.S. adults go online “almost constantly.” For those aged 18-29, the rate spikes to nearly half (48%). “This group is at-risk for chronic eye fatigue and long-term problems,” said Maria Stanieich, marketing manager at Kyowa Hakko USA. “Young adults will benefit from practicing good screen-time habits, as well as maintaining good immune health.” Interestingly, she added, studies suggest that proper immune function may reduce digital stress-related eye fatigue and other ocular discomforts.

Hewlings noted “gaming disorder,” categorized as a disorder due to addictive behaviors, is defined in the WHO’s classification of diseases (11th Revision of the International Classification of Diseases, ICD-11). 

“A related classification, ‘video game vision syndrome’ has been proposed to specifically address vision issues related to large periods of continuous use of screen-enabled devices in order to play videogames,” she said.

Digital Effects

What effect does all the excess screen time have on our eyes and vision?

Digital devices emit high-energy blue light which is part of the visible spectrum of light, noted Sara Zoet, assistant director, global communications, at OmniActive Health Technologies. “Most of us know how to protect our eyes against the sun, but high-energy blue light from digital screens and artificial lighting bombards our eyes daily.”

Blue light, technically high-energy visible light (HEV), is in the violet/blue band of the visible spectrum, explained Hermoni. “It’s present in sunlight but is also emitted by white fluorescent light bulbs and by LED light sources, such as computer monitors, cellphones, and TV screens. When HEV and UV radiation hit the eye, a chain reaction can lead to the creation of oxidants such as free radicals and reactive oxygen species, which cause inflammation and damage in many structures.”

Along with UV, HEV light can damage the lens of the eye—sometimes causing cataracts—and the retina, increasing the risk of age-related macular degeneration.

There is an experiential element to these concerns as well, said Zoet. The American Optometric Association (AOA) defines digital eye strain (also referred to as computer vision syndrome) as a “group of eye- and vision-related problems that result from prolonged computer, tablet, e-reader and cell phone use,” with common symptoms including: eyestrain, headaches, blurred vision, and dry eye.

Ultimately, consumers are experiencing eye strain and related vision issues younger than ever, said Gallo.

“We can attribute most of this to changes in digital behavior,” she suggested. “Regular use of screens of varying sizes and brightness continually demands that the eyes compensate and adjust to changing conditions, which is wearying.”

According to the American Academy of Ophthalmology, when Gen Xers were younger, in the 1970s, about 20% of children in the U.S. needed glasses. That number has now doubled, Gallo noted.

“Current estimates suggest that by 2050, 25% of the world will be nearsighted. Talk about a daunting number. We know digital screens are not going away, so we need to act now to support vision health from an early age,” Gallo said.

“It is incumbent upon ingredient manufacturers and suppliers to produce clinically validated ingredients and blends, and then work with brands to develop effective products,” she continued. “However we do it—with gummies, shots, beverages, or other delivery systems—we need to create products to incorporate vision-supporting ingredients into the diets of children and young adults, demographics not previously targeted.”

Eye fatigue affects every waking moment, said Stanieich. “It affects your mood, your work, and everything you see and do. Long exposure to digital devices strains the eyes and may cause dryness and irritation. Fortunately, most people can reduce their eye fatigue.”

In addition to decreasing screen time and taking breaks during long sessions, most people with eye fatigue will benefit from better sleep, adjusting lighting to reduce glare, and maintaining a healthy immune system, said Stanieich. “Studies suggest a relationship between immune health and eye fatigue caused by digital devices. EYEMUSE, a clinically researched postbiotic for eye health, stimulates immune cells that produce regulatory cytokines to support eye health.”

Nutrition Solutions

Screens are nearly ubiquitous, and prolonged exposure to high energy blue light from digital devices can lead to eye strain and fatigue, eventually compromising vision. So what more can consumers do to protect themselves?

“Fortunately, lutein and the zeaxanthin isomers support eye health by acting as powerful antioxidants and filtering high-energy blue light,” said Zoet. “OmniActive’s B.L.U.E. (Blue Light User Exposure) study was the first human clinical trial in young, healthy subjects, which demonstrated improvements in outcomes associated with prolonged blue light exposure from digital devices, including eye strain and fatigue, headache frequency, and glare tolerance through supplementation of an efficacious 24 mg dose of Lutemax 2020 (20 mg lutein and 4 mg zeaxanthin isomers).”

Lutein, astaxanthin, zeaxanthin, and vitamin A are arguably some of the most studied and well-known vision health ingredients in the supplement market. “These ingredients are regularly formulated in vision health consumer products and work directly to support the retina from negative effects of inflammation and stress,” said Gallo.

Beyond these current go-to ingredients, she suggested new and more effective ingredients are needed to address the unique vision challenges people face today.

“Artemis developed CurrantCraft—a clinically validated European black currant extract—to bring a new, differentiating ingredient to the vision health market. We believe vision health will be the next big health concern, and because of that, we are investing heavily in research this year and beyond.”

There’s a broad body of data demonstrating the benefits of carotenoids for vision health, said Hermoni. The Age-Related Eye Disease Study (AREDS), sponsored by the National Eye Institute, found that supplementing with the AREDS formulation of vitamin C, vitamin E, zinc, copper, and beta-carotene reduced the risk of progression from intermediate to advanced AMD by around 25%. A follow-up study, AREDS2, reported that when replacing the beta-carotene with lutein and zeaxanthin there was a reduction in the risk of developing advanced AMD by 26% in people who had a diet lacking in green, leafy vegetables (which are rich sources of these two carotenoids).

In 2019, a Lycored-funded study published in the International Journal for Vitamin and Nutrition Research found that supplementation with a lutein complex impacted positively on retinal capillary blood flow, which is essential for eye health and proper function, said Hermoni.

Macular pigments like lutein and zeaxanthin not only absorb blue light before it has a chance to hit the photoreceptor cells, but also neutralize oxidants and free radicals, thereby supporting eye health in a very holistic way. Furthermore, the synergy between lycopene and lutein supports biological accessibility, as the lutein is better preserved through the journey to the eye, said Hermoni.

Several studies have shown that EYEMUSE, a clinically researched postbiotic, stimulates a balanced immune response to support eye health. After eight weeks, adults taking EYEMUSE showed reduced eye fatigue and discomfort. Taken daily, EYEMUSE helps maintain optimal eye function and comfort, according to Stanieich.

Delivering for Consumers

Expertly formulated and effective vision support products present an enormous opportunity for both brands and consumers, said Gallo. “Brands can target parents to begin feeding kids’ eyes to keep them healthy from their tween years, and virtually every adult who spends a significant amount of time in front of screens. That’s a huge pool of potential buyers.”

The benefits of lutein have long been associated with the senior population and therefore have been traditionally included in formulations marketed to the 50+ demographic, noted Zoet.

“However, studies have shown that lutein is a major carotenoid in breast milk and is believed to be key in developing healthy vision and is now also found in infant formula,” she said. “Moreover, there is a growing number of studies done in young, healthy populations which show multiple health and performance benefits of macular carotenoids throughout a lifetime. Considering the benefits of lutein and zeaxanthin isomers are cumulative and important at all stages, it is no wonder that we are now seeing more products marketed to children, teens, and young/middle-aged adults as well.”

Consumers are targeting different goals, including visual sharpness as well as eye comfort, dry eye support, and, of course, visual longevity, said Hermoni. “They’re also looking at eye health in a more holistic way; they appreciate that vision wellness is best achieved within a well mind and body, and are increasingly likely to respond positively to holistic messaging around eye health.”

As in other areas of nutrition, people want ingredients that are natural and scientifically substantiated, “hence the appeal of the natural carotenoids that were investigated in the AREDS studies,” she added. “Furthermore, consumers are looking for precision in their nutrition and supplementation, so opting for a synergistic formula that is scientifically proven to provide more than the sum of its ingredients is a good way to differentiate.”