Case Study: Benefits of Adding Carotenoids to Treat Light Sensitivity

By Damon Dierker, OD, FAAO


A large body of research has found that the macular carotenoids—lutein, zeaxanthin, and meso-zeaxanthin—are linked to a reduced risk of degenerative eye disease due to their blue-light-filtering,[1] antioxidant,[2] and anti-inflammatory properties.[3] These three naturally occurring xanthophylls are collectively termed the “macular pigment,” and the pre-receptoral accumulation of them optimizes vision through reduction of chromatic aberration and light scatter.[4] Optimal macular pigment density is associated with reduced visual discomfort,[5] a condition that manifests clinically as photophobia, as we’ll explore in the following patient.


Patient Case With Added Carotenoids


A 66-year-old white female presented for a dry eye follow-up visit complaining of persistent light sensitivity. She had been previously treated with a topical steroid course and was now using topical cyclosporine drops twice daily, as well as lubricant drops as needed. Her ocular redness and foreign body sensation had improved with this regimen, and her superficial punctate keratopathy had completely resolved. The remainder of her exam was remarkable only for mild cataracts. Interestingly though, she noted that this light sensitivity had been present most of her adult life.


The patient was asked to continue her current drop regimen. Additionally, she was prescribed MacuHealth With LMZ (MacuHealth) once daily to help her photophobia. At her follow-up visit 6 months later, she reported that the addition of the triple carotenoid supplement had improved her light sensitivity by about 80%. We elected to continue present management.


A healthy amount of macular pigment significantly improves several metrics of visual performance, including photostress recovery, disability glare, and visual discomfort.[6] While light sensitivity due to corneal sequelae from dry eye is common, persistent symptoms after appropriate treatment should prompt us to look further. Adding MacuHealth With LMZ3was the easy solution in this case.


Reference(s):

  1. Lima VC, Rosen RB, Farah M. Macular pigment in retinal health and disease. Int J Retin Vitr. 2016;19(2):1-9.

  2. Khachik F, Bernstein PS, Garland DL. Identification of lutein and zeaxanthin oxidation products in human and monkey retinas. Invest Ophthalmol Vis Sci. 1997;38(9):1802–1811.

  3. Suk-Yee Li, Frederic K. C. Fung, Zhong Jie Fu, David Wong, Henry H. L. Chan, Amy C. Y. Lo; Anti-inflammatory effects of lutein in retinal ischemic/hypoxic injury: In vivo and in vitro studies. Invest Ophthalmol Vis Sci. 2012;53(10):5976-5984.

  4. Hammond BR Jr, Wooten BR, Snodderly DM. Preservation of visual sensitivity of older subjects: association with macular pigment density. Invest Ophthalmol Vis Sci. 1998;39(2):397-406.

  5. Stringham, JM et al. Action Spectrum for Photophobia. J Opt Soc Am A. 2003;20:1852-1858.

  6. Stringham, JM et al. Macular Pigment and Visual Performance in Glare: Benefits for Photostress Recovery, Disability Glare, and Visual Discomfort. Invest Ophthalmol Vis Sci. 2011;52:7406-7415.

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