40 years) Family history of glaucoma Myopia (myopia from -5 diopters) Neurodegenerative processes Diabetes (cf. Bonovas et al.; Diabet Med 2004/21, 609-614) Conventional therapy Reduce eye pressure to 16-18 mm Hg Medicines: e.g.b Beta-blocker timolol Prostaglandin analogues (Latanaprost / Xalatan) Alpha-2 agonists Laser therapy / surgery “Green star” (glaucoma) and micronutrients: this is mainly about.a to correct deficiencies in antioxidants and omega 3 fatty acids that often occur in glaucoma Vitamin C and E: reduce oxidative stress and eye pressure Secondary plant substances such as quercetin, OPC, carotenoids etc: improve blood circulation, reduce oxidative stress and eye pressure L-arginine: has a vascular relaxing effect and promotes blood circulation Zinc: acts as an antagonist of copper against glaucoma Chromium: lower chromium levels in the body are associated with high eye pressure Omega 3 fatty acids with high EPA content: reduce inflammation, improve blood circulation; see. on this: Tourtas T et al., Preventive effects of omega-3 and omega-6 fatty acids on peroxide mediated oxidative stress responses in primary human trabecular meshwork cells. 2012, PloS one Magnesium: promotes spasmolysis and ocular blood circulation Vitamin D: Low vitamin D levels are associated with the occurrence, but not the severity, of primary open-angle glaucoma; see. Goncalves A et al. Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma. August 2015, Maturitas Green tea: cf. Chu et al. Green Tea Catechins and Their Oxidative Protection in the Rat Eye.Journal of Agricultural and Food Chemistry, 2010  D) Mitochondrial diseases of the eyes Mitochondria are involved in many degenerative and inflammatory diseases, especially.a of tissues with high energy consumption. But there are also diseases in which disorders of mitochondrial energy production are the primary cause of the disease: Neuropathy, ataxia and retinitis pigmentosa (NARP) Leber's hereditary optic neuropathy (LHON) Chronic progressive external ophthalmoplegia (CPEO) Mitochondrial eye diseases and micronutrients L-Carnitine: serves as a carrier for fatty acids on their way to the mitochondria Coenzyme Q10: as a ubiqinol/ubiqinone redox system, an essential component of the electron transport chain (“respiratory chain”) in the mitochondria B vitamins: play a central role as cofactors in mitochondrial processes  E) Diabetic retinopathy Start: 5-30 years after the “onset” of diabetes Frequency: When diagnosed with diabetes: ~ 30% After 20 years of diabetes: ~ 90% Species (according to Airlie House classification): Non-proliferative form (early form) with microaneurysms with intraretinal microbleeds & exudates Proliferative form (late form) with fibrovascular neovascularization e.g.b in the papilla with vitreous hemorrhages & retinal detachment Cause: Reaction of glucose & amino acids (especially lysine & arginine) à (glycosylation) Schiff bases à AGEs (Advanced Glycosylation End-Products) AGEs are insoluble, non-reactive proteins that lead to a deterioration in oxygen supply as well as to thickening of the retinal capillary endothelia and ultimately to progressive capillary collapse Conventional therapy Optimized control of the pre-existing metabolic syndrome (diabetes, lipid metabolism disorder, obesity), accompanied by micronutrients: Optimization of vitamin C and vitamin Zinc: improves insulin formation, storage and release Chromium: component of the glucose tolerance factor In proliferative form Laser coagulation (reduces risk of vision loss by 50%) Vitrectomy (for late complications) In both forms (non-proliferative & proliferative): Octreotide (somatostatin analogue) Inhibits growth hormone formation in the pituitary gland Diabetic retinopathy and micronutrients Vitamin C Reduces protein glycolization in the vessel wall by 50% Reduces vessel fragility (capillary inner walls made of collagen!) Quercetin & grape seed extract (OPC) Stabilizes eye capillaries Reduces increased connective tissue synthesis in diabetes Ginkgo: see https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-0947-5712.pdf  F) Myopia (“nearsightedness”) Myopia rates continue to increase in the Western world Risk factors for myopia Reduced time spent outdoors Increased use of digital media (screen activity) Increased close work (e.g.b Read) Daylight deficit Parental smoking (especially mother during pregnancy) Pollutant pollution (e.g.b Fine dust, nitrogen oxides) Poor vitamin D supply Birth and postpartum period in seasons with a lot of light increases risk (probably leads to increased growth of the axial length of the eye) First-born children have a higher risk Children of pregnant women over 35 years old are at higher risk Myopia and micronutrients: Several scientific studies have shown that a higher Vitamin D level in the blood significantly reduces the risk of developing myopia. See for example: https://pubmed.ncbi.nlm.nih.gov/24970253/ : “Myopic participants had significantly lower 25(OH)D₃ concentrations. The prevalence of myopia was significantly higher in individuals with vitamin D deficiency compared to the individuals with sufficient levels.“ "> 40 years) Family history of glaucoma Myopia (myopia from -5 diopters) Neurodegenerative processes Diabetes (cf. Bonovas et al.; Diabet Med 2004/21, 609-614) Conventional therapy Reduce eye pressure to 16-18 mm Hg Medicines: e.g.b Beta-blocker timolol Prostaglandin analogues (Latanaprost / Xalatan) Alpha-2 agonists Laser therapy / surgery “Green star” (glaucoma) and micronutrients: this is mainly about.a to correct deficiencies in antioxidants and omega 3 fatty acids that often occur in glaucoma Vitamin C and E: reduce oxidative stress and eye pressure Secondary plant substances such as quercetin, OPC, carotenoids etc: improve blood circulation, reduce oxidative stress and eye pressure L-arginine: has a vascular relaxing effect and promotes blood circulation Zinc: acts as an antagonist of copper against glaucoma Chromium: lower chromium levels in the body are associated with high eye pressure Omega 3 fatty acids with high EPA content: reduce inflammation, improve blood circulation; see. on this: Tourtas T et al., Preventive effects of omega-3 and omega-6 fatty acids on peroxide mediated oxidative stress responses in primary human trabecular meshwork cells. 2012, PloS one Magnesium: promotes spasmolysis and ocular blood circulation Vitamin D: Low vitamin D levels are associated with the occurrence, but not the severity, of primary open-angle glaucoma; see. Goncalves A et al. Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma. August 2015, Maturitas Green tea: cf. Chu et al. Green Tea Catechins and Their Oxidative Protection in the Rat Eye.Journal of Agricultural and Food Chemistry, 2010  D) Mitochondrial diseases of the eyes Mitochondria are involved in many degenerative and inflammatory diseases, especially.a of tissues with high energy consumption. But there are also diseases in which disorders of mitochondrial energy production are the primary cause of the disease: Neuropathy, ataxia and retinitis pigmentosa (NARP) Leber's hereditary optic neuropathy (LHON) Chronic progressive external ophthalmoplegia (CPEO) Mitochondrial eye diseases and micronutrients L-Carnitine: serves as a carrier for fatty acids on their way to the mitochondria Coenzyme Q10: as a ubiqinol/ubiqinone redox system, an essential component of the electron transport chain (“respiratory chain”) in the mitochondria B vitamins: play a central role as cofactors in mitochondrial processes  E) Diabetic retinopathy Start: 5-30 years after the “onset” of diabetes Frequency: When diagnosed with diabetes: ~ 30% After 20 years of diabetes: ~ 90% Species (according to Airlie House classification): Non-proliferative form (early form) with microaneurysms with intraretinal microbleeds & exudates Proliferative form (late form) with fibrovascular neovascularization e.g.b in the papilla with vitreous hemorrhages & retinal detachment Cause: Reaction of glucose & amino acids (especially lysine & arginine) à (glycosylation) Schiff bases à AGEs (Advanced Glycosylation End-Products) AGEs are insoluble, non-reactive proteins that lead to a deterioration in oxygen supply as well as to thickening of the retinal capillary endothelia and ultimately to progressive capillary collapse Conventional therapy Optimized control of the pre-existing metabolic syndrome (diabetes, lipid metabolism disorder, obesity), accompanied by micronutrients: Optimization of vitamin C and vitamin Zinc: improves insulin formation, storage and release Chromium: component of the glucose tolerance factor In proliferative form Laser coagulation (reduces risk of vision loss by 50%) Vitrectomy (for late complications) In both forms (non-proliferative & proliferative): Octreotide (somatostatin analogue) Inhibits growth hormone formation in the pituitary gland Diabetic retinopathy and micronutrients Vitamin C Reduces protein glycolization in the vessel wall by 50% Reduces vessel fragility (capillary inner walls made of collagen!) Quercetin & grape seed extract (OPC) Stabilizes eye capillaries Reduces increased connective tissue synthesis in diabetes Ginkgo: see https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-0947-5712.pdf  F) Myopia (“nearsightedness”) Myopia rates continue to increase in the Western world Risk factors for myopia Reduced time spent outdoors Increased use of digital media (screen activity) Increased close work (e.g.b Read) Daylight deficit Parental smoking (especially mother during pregnancy) Pollutant pollution (e.g.b Fine dust, nitrogen oxides) Poor vitamin D supply Birth and postpartum period in seasons with a lot of light increases risk (probably leads to increased growth of the axial length of the eye) First-born children have a higher risk Children of pregnant women over 35 years old are at higher risk Myopia and micronutrients: Several scientific studies have shown that a higher Vitamin D level in the blood significantly reduces the risk of developing myopia. See for example: https://pubmed.ncbi.nlm.nih.gov/24970253/ : “Myopic participants had significantly lower 25(OH)D₃ concentrations. The prevalence of myopia was significantly higher in individuals with vitamin D deficiency compared to the individuals with sufficient levels.“ ">
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Eye diseases and micronutrients

of Patrick Linder

What is my risk of eye diseases?

The more questions that are answered with “yes”, the greater the individual risk of eye diseases could be and the more important preventive measures are.

  • Do you smoke or does someone around you smoke regularly (daily)?
  • Are you often exposed to the sun or bright light (solarium, work)?
  • Do you spend a lot of time in front of the computer or smartphone (blue light exposure)?
  • Do you have light eyes?
  • Are you nearsighted?
  • Are you regularly exposed to psychological or physical stress?
  • Do you or a blood relative suffer from type 1 or type 2 diabetes?
  • Do you have arteriosclerosis or Are there known circulatory disorders in the heart, brain or legs?
  • Are there any cases of glaucoma (“glaucoma”) in your family?
  • Do you have excessive body weight (BMI >25)?

 

What are common eye diseases?

  • Senile cataract (“cataract”)
  • Age-related macular degeneration (AMD)
  • Glaucoma (“glaucoma”)
  • Mitochondrial eye diseases
  • Diabetic retinopathy
  • Myopia (nearsightedness)

 

The specific therapy of eye diseases naturally belongs primarily in the hands of ophthalmologists. But micronutrients can be very useful for prevention and basic therapy.

 

 

A central cause of many age-related eye diseases is oxidative stress

Freie Radikale

  • The rod outer elements (with photoreceptors) of our eyes consist of 65% unsaturated fatty acids (highest proportion of all body tissue!)
  • Unsaturated fatty acids are easily peroxidized by free radicals, i.e.H are damaged by free radicals
  • The formation of free radicals generally occurs through
    • oxidative stress (oxidation of O2), but in the eye v.a by
    • photo-oxidative stress (UV light activates oxygen radicals very quickly)
  • Antioxidants defuse these free radicals
    • Antioxidant enzymes (formed in the body): peroxidases (e.g.b glutathione peroxidase, phospholipid hydroperoxide glutathione peroxidase), catalases, superoxide dismutases (SOD)
    • Non-enzymatic antioxidants (essential = must be supplied through food): e.g.b Vitamin C and E, alpha lipoic acid, secondary plant substances such as quercetin, OPC, beta carotene etc.
  • If there is an imbalance to the detriment of antioxidants, damage to the eyes caused by free radicals occurs.
  • If this is the case, supplementing with a synergistic antioxidant complex could make sense.
  • In addition, the formation of free radicals can be prevented by a kind of "inner sunglasses": Carotenoids such as lutein or beta-carotene as well as vitamins E and C protect against (blue ) LightInnere Sonnenbrille

A) Cataract (“cataract”)

  • Causes
    • Change in lens protein structure
    • Conversion of water-soluble proteins into cloudy, water-insoluble proteins
    • Eye damage from UV radiation (especially oxidation from UV-B)
    • Inflammation and infections (e.g.b by cytomegalovirus)
  • Symptoms
    • Lens clouding, loss of lens transparency
    • Impairment of vision (“fog vision”)
    • Can cause blindness
  • Risk factors
    • Diabetes (Diabetes increases the risk of cataracts 3-5 times! à Osmotic stress / osmotic excess pressure (through diffusion of glucose + galactose in the lens) à conversion into Sugar alcohols sorbitol + galactite
    • Age & predisposition (genetics)
    • Smoking
    • Arteriosclerosis (incl. Lipid peroxidation and inflammation)
    • Bright eyes
    • Light exposure
      • Photo-oxidative stress (e.g.b Solariums)
      • Blue light (especially computers and smartphones)
    • Stress
  • Conventional therapy
    • Surgery: implantation of an artificial, flexible lens (e.g.b Intraocular lens IOL “Tecnis”)
    • Risk reduction
      • Diabetes
      • Overweight
      • Smoking
      • Light & radiation exposure
      • Inflammation

     B) Macular degeneration

    • Symptoms
      • Disturbing spot in the middle of the field of vision
      • Colors become palerMakuladegeneration
    • Cause: Degenerative processes (exact causes are still unknown); play a central role:
      • Photoreceptors of the retina (especially in the macula area) with high metabolic activity and high O2 consumption à increased radical formation
      • Retinal pigment epithelium (RPE) behind the retina: Cells of the RPE dispose of oxidized (unusable) photoreceptor parts through phagocytosis and removal à Disturbances in the process (a lack of oxygen, metabolic disorders, arteriosclerosis are discussed) lead to deposits (“drusen”),
        which accelerate the degeneration of RPE cells and promote macular degeneration
    • Risk factors
      • Age & predisposition (genetics)
      • Smoking
      • Arteriosclerosis (incl. Lipid peroxidation and inflammation)
      • Bright eyes
      • Light exposure
        • Photo-oxidative stress (e.g.b Solariums)
        • Blue light (especially computers and smartphones)
      • Stress
    • Senile cataract and micronutrients
      • Secondary plant substances with strong antioxidant potential (antioxidative enzymes such as glutathione peroxidase, SOD and catalase are reduced in cataracts!), such as:
        • Quercetin
        • Grape seed extract with a high OPC content
        • Green tea (cf. Kumar, V. et al. (2017): Effect of Green Tea Polyphenol Epigallocatechin-3-gallate on the Aggregation of αA(66-80) Peptide, a Major Fragment of αA-crystallin Involved in Cataract Development.Curr Eye Res. 2017 Oct;42(10):1368-1377, https://www.ncbi.nlm.nih.gov/pubmed/28628342 )
        • Triphala
        • Carotenoids (beta-carotene, lutein etc)

      Cf. Schalch, W. and Chylack, L.T (2003): Antioxidant micronutrients and cataracts. The ophthalmologist. 2003; 100:181–189, https://link.springer.com/article/10.1007/s00347-003-0788-0

      • Vitamin E
        • Prevents lens clouding
        • Vitamin E deficiency increases risk by 1.8 to 3.7 times (9 studies with 10.355 subjects)
        • Zhang, Y. et al. (2015): Vitamin E and risk of age-related cataract: a meta-analysis. Public Health Nutr. 2015 Oct;18(15):2804-14. https://www.ncbi.nlm.nih.gov/pubmed/25591715
      • Riboflavin (Vitamin B2)
        • Important for lens metabolism
        • Studies suggest a 40% reduction in the incidence of senile cataracts
      • Vitamin C
        • Prevents lens clouding
        • Reduces risk by approx. 40% (9 intervention studies with 80.675 subjects)
      • Zinc (has a regulating effect on the hormone balance)
      • Selenium (has an antioxidant effect)
      • Omega 3 fatty acids with a high EPA content (have an anti-inflammatory effect)

     

    How do wet and dry macular degeneration differ?

    • Wet macular degeneration
      • 10% of all cases of macular degeneration
      • Fluid accumulation under the macula (“macular edema”)
      • Retina swells & stands out
      • Loss of central visual acuity and distortion of lines & edges
      • Established forms of therapy available
    • Dry macular degeneration
      • 90% of all cases of macular degeneration
      • Formation of “drusen”: Drusen are a collection of waste products (crystalline-looking fatty dots/deposits) under the macula lutea, e.g.b as a result of genetics and/or oxidative stress: many of the proteins found in drusen are the result of chronic inflammatory processes
      • Initially limited to external regions of the macula with little effect on photoreceptors
      • Later increasing deterioration in vision, in individual cases loss of vision due to cell death
      • Currently cannot be treated reliably and effectivelyDrusen
    • Macular degeneration and micronutrients
      • So far there is only prophylaxis against the dry form of AMD : “Since you cannot replace dead photoreceptors, you have to hope that cell death will be inhibited.“ (Source: Gerste RD; Modulation of the visual cycle; Deutsches Ärzteblatt 20.12012; 82-83)
        • Antioxidants: Antioxidant vitamins and mineral supplements slow down the progression of AMD (cf. Evans, J. R and J. G Lawrenson, "Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. The Cochrane Database of systematic reviews, 2012)
        • Secondary plant substances such as Beta-carotene, lutein, zeaxanthin, ginkgo, green tea; see. Willett W et al., "Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration."Jama 272.18 (1994): 1413-1420; see. Age-Related Eye Disease Study 2 Research Group, "Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial, JAMA, May 2013
        • Curcuma Extract: Curcumin protects retinal pigment epithelial cells against oxidative stress via the induction of heme oxygenase-1 expression and reduction of reactive oxygen (cf. Chung HT et al., "Curcumin protects retinal pigment epithelial cells against oxidative stress via induction of heme oxygenase-1 expression and reduction of reactive oxygen, Molecular Vision, April 2012)
        • Ginkgo: Ginkgo extract for impaired vision, treatment of dry AMD (cf. Fies, P., and A. Dienel. "[Ginkgo extract in impaired vision--treatment with special extract EGb 761 of impaired vision due to dry senile macular degeneration]."Vienna Medical Weekly (1946) 152.15-16 (2001): 423-426)
        • Zinc: reduces oxidative stress (is a building block of SOD); reduced zinc and copper levels in the retinal pigment epithelium and in the choroid in AMD (cf. Pulido JS et al., "Reduced zinc and copper in the retinal pigment epithelium and choroid in age-related macular degeneration, American Journal of Ophthalmology, February 2009)
        • Unsaturated omega-3 fatty acids (anti-inflammatory): “With the administration of 5 g/day EPA/DHA, there was an improvement in vision of more than one line in the eye test within 4.5 months. The greatest improvement of 15 letters in the vision test was achieved by patients who had an AA/EPA <2. Even patients with severe AMD were able to achieve significant improvement within just a few months. (Source: Georgiou T, Prokopiou E: The New Era of Omega-3 Fatty Acids Supplementation: Therapeutic Effects on Dry Age-Related Macular Degeneration. J Stem Cells. 2015;10(3):205-15.)
        • L-arginine: has a vascular relaxing effect and promotes blood circulation
        • Alpha lipoic acid: Antioxidant, improves glutathione supply
      • “In ARED-1 there is a positive effect of the high-dose micronutrients Vitamin C and E, beta-carotene and zinc on intermediate stages of AMD (OR 0.72). In ARED-2, lutein/zeaxanthin and omega-3 fatty acids work in intermediate and advanced stages (OR 0.89)” (Source: Stahl A; macular degeneration; Deutsches Ärzteblatt 8/2020, 371)

     C) Glaucoma (“glaucoma”)

    What specific causes and symptoms does “glaucoma” have?

    • Symptoms
      • Restriction of the field of vision
      • Blindness
    • Causes
      • Aqueous humor outflow disturbed
        • Increase in intraocular pressure (normal: 14-18 mm Hg)
        • Damage and destruction of optic nerve fibers
      • Autoimmune processes with the formation of auto-IgG antibodies are discussed (source: Deutsches Ärzteblatt, 3/04)

    Glaukom Gruener Star Augendruck 

    • Risk factors
      • Vascular processes (e.g.b arteriosclerosis)
      • Age (> 40 years)
      • Family history of glaucoma
      • Myopia (myopia from -5 diopters)
      • Neurodegenerative processes
      • Diabetes (cf. Bonovas et al.; Diabet Med 2004/21, 609-614)
    • Conventional therapy
      • Reduce eye pressure to 16-18 mm Hg
      • Medicines: e.g.b Beta-blocker timolol
      • Prostaglandin analogues (Latanaprost / Xalatan)
      • Alpha-2 agonists
      • Laser therapy / surgery
    • “Green star” (glaucoma) and micronutrients: this is mainly about.a to correct deficiencies in antioxidants and omega 3 fatty acids that often occur in glaucoma
      • Vitamin C and E: reduce oxidative stress and eye pressure
      • Secondary plant substances such as quercetin, OPC, carotenoids etc: improve blood circulation, reduce oxidative stress and eye pressure
      • L-arginine: has a vascular relaxing effect and promotes blood circulation
      • Zinc: acts as an antagonist of copper against glaucoma
      • Chromium: lower chromium levels in the body are associated with high eye pressure
      • Omega 3 fatty acids with high EPA content: reduce inflammation, improve blood circulation; see. on this: Tourtas T et al., Preventive effects of omega-3 and omega-6 fatty acids on peroxide mediated oxidative stress responses in primary human trabecular meshwork cells. 2012, PloS one
      • Magnesium: promotes spasmolysis and ocular blood circulation
      • Vitamin D: Low vitamin D levels are associated with the occurrence, but not the severity, of primary open-angle glaucoma; see. Goncalves A et al. Serum vitamin D status is associated with the presence but not the severity of primary open angle glaucoma. August 2015, Maturitas
      • Green tea: cf. Chu et al. Green Tea Catechins and Their Oxidative Protection in the Rat Eye.Journal of Agricultural and Food Chemistry, 2010

     D) Mitochondrial diseases of the eyes

    Mitochondria are involved in many degenerative and inflammatory diseases, especially.a of tissues with high energy consumption. But there are also diseases in which disorders of mitochondrial energy production are the primary cause of the disease:

    • Neuropathy, ataxia and retinitis pigmentosa (NARP)
    • Leber's hereditary optic neuropathy (LHON)
    • Chronic progressive external ophthalmoplegia (CPEO)

    Mitochondrial eye diseases and micronutrients

    • L-Carnitine: serves as a carrier for fatty acids on their way to the mitochondria
    • Coenzyme Q10: as a ubiqinol/ubiqinone redox system, an essential component of the electron transport chain (“respiratory chain”) in the mitochondria
    • B vitamins: play a central role as cofactors in mitochondrial processes

     E) Diabetic retinopathy

    • Start: 5-30 years after the “onset” of diabetes
    • Frequency:
      • When diagnosed with diabetes: ~ 30%
      • After 20 years of diabetes: ~ 90%
    • Species (according to Airlie House classification):
      • Non-proliferative form (early form)
        • with microaneurysms
        • with intraretinal microbleeds & exudates
      • Proliferative form (late form)
        • with fibrovascular neovascularization e.g.b in the papilla
        • with vitreous hemorrhages & retinal detachment
      • Cause:
        • Reaction of glucose & amino acids (especially lysine & arginine) à (glycosylation) Schiff bases à AGEs (Advanced Glycosylation End-Products)
        • AGEs are insoluble, non-reactive proteins that lead to a deterioration in oxygen supply as well as to thickening of the retinal capillary endothelia and ultimately to progressive capillary collapse
      • Conventional therapy
        • Optimized control of the pre-existing metabolic syndrome (diabetes, lipid metabolism disorder, obesity), accompanied by micronutrients:
          • Optimization of vitamin C and vitamin
          • Zinc: improves insulin formation, storage and release
          • Chromium: component of the glucose tolerance factor
        • In proliferative form
          • Laser coagulation (reduces risk of vision loss by 50%)
          • Vitrectomy (for late complications)
        • In both forms (non-proliferative & proliferative):
          • Octreotide (somatostatin analogue)
          • Inhibits growth hormone formation in the pituitary gland
        • Diabetic retinopathy and micronutrients

     F) Myopia (“nearsightedness”)

    • Myopia rates continue to increase in the Western world
    • Risk factors for myopia
      • Reduced time spent outdoors
      • Increased use of digital media (screen activity)
      • Increased close work (e.g.b Read)
      • Daylight deficit
      • Parental smoking (especially mother during pregnancy)
      • Pollutant pollution (e.g.b Fine dust, nitrogen oxides)
      • Poor vitamin D supply
      • Birth and postpartum period in seasons with a lot of light increases risk (probably leads to increased growth of the axial
        length of the eye)
      • First-born children have a higher risk
      • Children of pregnant women over 35 years old are at higher risk
    • Myopia and micronutrients: Several scientific studies have shown that a higher Vitamin D level in the blood significantly reduces the risk of developing myopia. See for example: https://pubmed.ncbi.nlm.nih.gov/24970253/ : “Myopic participants had significantly lower 25(OH)D₃ concentrations. The prevalence of myopia was significantly higher in individuals with vitamin D deficiency compared to the individuals with sufficient levels.“

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