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Our experienced team of ophthalmologists, Opticians and optometrists provides a wide range of eye health services, including:
Comprehensive Eye Examinations in Ajuwon and Ifo
Cataract Diagnosis & Treatment in Ogun State
Glaucoma Screening & Management
Eyeglasses & Contact Lenses Fitting
Pediatric Eye Care Services for children in Ogun State
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Treatment for Eye Infections & Other Conditions
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Post typhoid fever immune related reactions affecting the eye is a rare finding which can have various presentations in which typhoid retinopathy is not a well recognized sequelae.
Case presentation
Here we present a case of 59 year old male who presented with right eye sudden painless loss of vision 4 weeks after typhoid fever which was diagnosed and treated successfully. His BCVA was 2/60 in right eye and 6/6 in left eye. Fundus examination showed retinitis along with macular serous detachment in right eye and retinitis in left eye. Significant improvement in BCVA in right eye was observed after treatment with oral steroid with resolving retinitis lesions. Diagnosis of post typhoid immune mediated retinitis was made with good resolution following treatment.
Conclusions
Immune mediated retinitis is a rare sequelae to typhoid infection which can be successfully treated with systemic steroids with good resolution of the lesions.
Keywords: Post typhoid fever, Immune mediated, Typhoid retinopathy, Retinitis
Typhoid or enteric fever is a systemic disease which is characterized by fever and abdominal pain caused due to dissemination of Salmonella typhi or paratyphi. It is transmitted by food or water due to fecal contamination by ill or asymptomatic chronic carriers. A high incidence of typhoid fever in developing countries correlates with poor sanitation and lack of access to clean drinking water [1]. Ocular manifestations of typhoid fever are rare and include lid edema or abscess, dacryoadenitis, conjunctival petechiae or chemosis, corneal ulceration, uveitis, vitreous haemorrhage, retinal haemorrhage and detachment, stellate maculopathy, pigmentary retinopathy, optic neuritis, internal or external ophthalmoplegia, orbital haemorrhage or abscess. These complications are caused either by direct invasion of the organisms into the ocular tissue, or by hypersensitivity reaction such as vitreous haemorrhage after typhoid vaccination [2]. Here we are presenting a case of retinitis with macular serous detachment developing post typhoid fever.
A 59 year old male presented to our hospital 1 week after experiencing diminution of vision in the right eye. He gave a history of typhoid fever 4 weeks prior to presentation for which Widal test was performed to confirm diagnosis. The test results showed significant titres for ‘O’ antigen (>1:80) and ‘H’ antigen (>1:160) and negative for ‘AH’ and ‘BH’ antigens. He was subsequently started on oral Ofloxacin 400 mg twice daily for 2 weeks following which fever subsided. There was no known history of diabetes mellitus or hypertension. On ocular examination his best corrected visual acuity was 2/60 in the right eye and 6/6 in left eye. Anterior segment findings were unremarkable with IOP being within normal range for both eyes. Fundus examination of right eye showed white fluffy lesions along the superior and inferior arcades with superficial haemorrhages in around the macula with a macular star suggestive of retinitis (Fig. 1a). Left eye fundus showed few dispersed retinitis lesions with superficial haemorrhage along the superior arcade with intact foveal reflex (Fig. 1b). On optical coherence tomography of right eye underlying macular serous retinal detachment was noted (Fig. 2a). Blood tests were done to rule out VDRL and HIV status. X-cyton analysis of the anterior chamber aspirate was negative for organisms like Mycobacterial Tuberculosis, Toxoplasma Gondii, Hepes Simplex Virus, Cytomegalovirus and Varicella Zoster Virus. After analysis of the reports diagnosis of post typhoid retinitis in both eyes was made. Patient was started on oral prednisolone 1 mg/kg body weight which was tapered over 2 months along with monitoring of systemic and ocular health. Patient came for follow up every 2 weeks for 3 months. Every visit fundus photo was documented. After 2 months of initiating treatment there was an improvement in the BCVA in right eye to 6/6 which was maintained on further visits. Fundus examination revealed resolving lesions in both eyes (Fig. 3a, b) and OCT of the right eye showed resolution of the serous detachment (Fig. 2b).
a Fundus photo of right eye with white fluffy lesions suggestive of retinitis in the superior and inferior temporal arcades with macular star. b Fundus photo of left eye with white fluffy retinitis lesions in the superior temporal arcade
a Post treatment fundus photo of right eye showing resolved retinitis lesions with few dispersed hard exudates. b Post treatment fundus photo of left eye with resolved retinitis lesions
Retinitis is characterized by confluent areas of retinal whitening which progresses along the retinal blood vessels, often associated with intraretinal hemorrhages and hard exudates. A significant number of retinitis cases are thought to be idiopathic in etiology but a small proportion of cases are infectious in etiology such as Toxoplasma gondii (toxoplasmosis), Leptospira spp. (leptospirosis), Mycobacterium tuberculosis (tuberculosis) and other viral and fungal etiologies [3]. Non infectious causes of retinitis include sarcoidosis, Behcet’s disease. Infectious causes are usually unilateral and may be associated with mild vitritis. Patients can present with Neuroretinitis like picture with optic disc edema and macular hard exudates [3]. The macular star becomes prominent over first 3 weeks with neuroretinitis resolving over 6–8 weeks [4]. Leakage from the optic nerve head can lead to retinal swelling, exudation and edema, whereas retinal venous occlusion due to vasculitis results in intraretinal haemorrhage, cotton wool spots and retinal and optic nerve head edema [5]. It was postulated that microbial pathogens may be responsible for immune mediated ocular and systemic pathology through postinfectious immunological effects. These may be due to molecular mimicry eliciting an immune response that cross react with self antigens. Even though active infection is an unusual cause of retinal vasculitis, it is possible that many idiopathic and systemic disease associated cases are precipitated by previous encounters with microbes bearing DNA sequence homologous to retinal and vascular autoantigens. Similarity between S-antigen and peptides derived from yeast, E. coli, and Hepatitis B virus was found and there was an ability of these microbial peptides to elicit an immune response post infection [5]. Immune mediated retinitis is a clinical diagnosis most often when there is past history of infection few weeks or days prior to the onset of ocular manifestations. In this case, treatment with oral steroids was initiated due to inflammation of the retina, especially the macula which caused decrease in vision. By taking into consideration the time of onset of ocular presentation, previous history of typhoid fever and the response to oral steroids; the most likely diagnosis was post typhoid fever immune mediated retinitis with macular neurosensory detachment in the right eye and retinitis in left eye. In our case as the disc edema was not prominent, neuroretinitis was not considered as the diagnosis. Similar case reports by Relhan et al. [6] and Laul et al. [7] showed immune mediated response post typhoid fever presenting with neuroretinitis, vasculitis and macular detachment. Successful treatment with steroids was seen in them. Fusco et al. [8] reported a case of bilateral chorioretinitis and stellate maculopathy post typhoid fever. However, in our case Xcyton analysis was done to rule out possible infectious retinitis before initiating steroid therapy, as it could exacerbate non immune mediated retinitis. Xcyton multiplex PCR analysis even though has the advantage of increasing the diagnostic yield it has certain disadvantages like false positive and negative results due to cross reactivity and preferential amplification, negative internal control if there is high amount of a particular target causing exhaustion of reagents and high cost.
Immune mediated retinitis can occur following systemic infection and can be managed with steroids followed by good resolution of the lesions. PCR analysis of the aqueous is a rapid diagnostic tool wherein multiple organisms can be detected and sight threatening bacterial and viral infections can be ruled out before initiation of steroid therapy.
PM carried out AC tap for Xcyton analysis, did the manuscript editing and review, TT did the data acquisition, literature search and manuscript preparation, GG did the data acquisition and analysis and manuscript review, SA did the data acquisition and analysis. All authors read and approved the final manuscript.
Acknowledgements
None.
Competing interests
The authors declare that they have no competing interests.
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Cerebral malaria can be diagnosed by a simple eye examination, a method that is both quick and cheap and could save thousands of lives in malarial regions, a new study shows.
Diagnosing cerebral malaria — a severe complication of malaria in which the Plasmodium falciparum parasite infects capillaries that flow through the tissues of the brain — can be difficult, as patients can be unconscious and have a number of other illnesses.
Now researchers have found that certain changes on the retina, the light sensitive tissue at the back of the eye, are unique to severe forms of malaria.
This will enable doctors to determine whether a child is suffering from cerebral malaria or some other, unrelated illness, and prescribe immediate treatment accordingly.
The findings are published this week (6 November) in the American Journal of Tropical Medicine and Hygiene.
The team led by Nick Beare of the UK-based Royal Liverpool University Hospital analysed the retinas of 45 children admitted to hospital in Blantyre, Malawi with cerebral malaria.
They found that white opaque patches and whitened blood vessels on the retina were unique signs of cerebral malaria. Other signs include bleeding of the retina and swelling of the optic nerve.
The diagnosis only requires an instrument called an ophthalmoscope, which is commonly used in Africa for studying eye disease.
“Diagnosis requires special training in eye examination, but is relatively straightforward and cost effective, which is essential in resource-poor settings such as Africa,” says Beare.
His team suggests that the malaria parasites stick to the linings of the small blood vessels in the brain and eyes where they disrupt oxygen and nutrients supply, causing the unique whitening of blood vessels in the eye.
Richard Idro of the Kenya Medical Research Institute says that the specific nature of the changes in the eye makes them useful for differentiating between coma due to malaria and coma from other causes.
A multi-centre evaluation of the findings will be undertaken by researchers in Gabon, the Gambia, Ghana and Kenya. “If they prove useful, doctors will need to be trained in the recognition of these signs,” says Idro.
Willis Akhwale, head of the department of malaria control at Kenya’s Ministry of Heath, welcomed the study, but cautioned that it is vital to test the methodology to ensure that correct diagnosis is made so that malaria drugs are not prescribed for other illnesses.
Eye twitching — which actually is twitching of an eyelid — is common and harmless.
Most eye twitching lasts only a few minutes, but sometimes an eyelid twitch can persist for days or longer. If you have an eye twitch that doesn’t go away relatively quickly, see an eye doctor.
The medical term for eye twitching is myokymia.
If you experience eye twitching that doesn’t go away, this could signal a serious neurological condition affecting the eyelid — such as blogs to spasm orhemifacial spasm.
These relatively rare conditions are more obvious and severe than common eye twitching and should be evaluated immediately by an eye doctor.
What causes eye twitching?
Triggers of eye twitching include:
Stress
Fatigue
Eye strain
Caffeine
Alcohol
Dry eyes
Nutrition problems
Allergies
If you experience eye twitching, take a close look at this list and note which of these potential triggers might apply to you. Sometimes, making minor changes to your diet and lifestyle can significantly reduce your risk of eye twitching or help make an eyelid twitch disappear.
Eye twitching causes and fixes
1. Stress
Stress is probably the most common cause of eye twitching. Yoga, breathing exercises, spending time with friends or pets and getting more down time into your schedule are ways to reduce stress that may be causing your eyelid twitch.
2. Fatigue
Lack of sleep, whether because of stress or some other reason, can trigger eye twitching. Catching up on your sleep and having a consistent sleep schedule can help.
3. Eye strain
Eye strain — particularly digital eye strain from overuse of computers, tablets and smartphones — also is a common cause of eyelid twitching.
Follow the “20-20-20 rule” when using digital devices: Every 20 minutes, look away from your screen and allow your eyes to focus on a distant object (at least 20 feet away) for 20 seconds or longer. This reduces fatigue that may trigger eye twitching.
Also, ask your eye doctor about computer eyeglasses to relieve digital eye strain.
Eye twitching — which actually is twitching of an eyelid — is common and harmless.
Most eye twitching lasts only a few minutes, but sometimes an eyelid twitch can persist for days or longer. If you have an eye twitch that doesn’t go away relatively quickly, see an eye doctor.
The medical term for eye twitching is myokymia.
If you experience eye twitching that doesn’t go away, this could signal a serious neurological condition affecting the eyelid — such as blepharospasm
. These relatively rare conditions are more obvious and severe than common eye twitching and should be evaluated immediately by an eye doctor.
What causes eye twitching?
Triggers of eye twitching include:
Stress
Fatigue
Eye strain
Caffeine
Alcohol
Dry eyes
Nutrition problems
Allergies
If you experience eye twitching, take a close look at this list and note which of these potential triggers might apply to you. Sometimes, making minor changes to your diet and lifestyle can significantly reduce your risk of eye twitching or help make an eyelid twitch disappear.
When your eyelid is twitching, you might think everyone else can see it. But most eye twitches are subtle and are not easily seen by others.
Eye twitching causes and fixes
1. Stress
Stress is probably the most common cause of eye twitching. Yoga, breathing exercises, spending time with friends or pets and getting more down time into your schedule are ways to reduce stress that may be causing your eyelid twitch.
2. Fatigue
Lack of sleep, whether because of stress or some other reason, can trigger eye twitching. Catching up on your sleep and having a consistent sleep schedule can help.
3. Eye strain
Eye strain — particularly digital eye strain from overuse of computers, tablets and smartphones — also is a common cause of eyelid twitching.
Follow the “20-20-20 rule” when using digital devices: Every 20 minutes, look away from your screen and allow your eyes to focus on a distant object (at least 20 feet away) for 20 seconds or longer. This reduces fatigue that may trigger eye twitching.
Also, ask your eye doctor about computer eyeglasses to relieve digital eye strain.
Infographic: How To Stop Eye Twitching [Enlarge]
4. Caffeine
Too much caffeine can trigger eye twitching. Try cutting back on coffee, tea and soft drinks (or switch to decaffeinated versions) for a week or two and see if your eye twitching disappears.
5. Alcohol
If you experience eye twitching after drinking beer, wine or liquor, try abstaining for a while, since alcohol consumption may cause eyelids to twitch.
6. Dry eyes
Many adults experience dry eyes, especially after age 50. Dry eyes also are very common among people who use computers, take certain medications (especially antihistamines and some antidepressants), wear contact lenses and consume caffeine and/or alcohol.
If you have a twitching eyelid and your eyes feel gritty or dry, see your eye doctor for a dry eye evaluation. Restoring moisture to the surface of your eye may stop the eye twitching and decrease the risk of twitching in the future.
7. Nutrition problems
Some reports suggest a lack of certain nutritional elements, such as magnesium, can trigger eyelid spasms. Although these reports are not conclusive, this may be another possible cause of eye twitching.
If you are concerned that your diet may not be supplying all the nutrients you need for healthy vision, discuss this with your eye doctor before purchasing over-the-counter nutritional supplements.
8. Allergies
People with eye allergies can have itching, swelling and watery eyes. Rubbing your eyes because of allergy symptoms releases histamine into your eyelid tissues and tear film, which may cause eye twitching.
Sometimes, over-the-counter eye drops formulated to reduce allergy symptoms can be helpful. But antihistamines in these drops can cause dry eyes. It’s best to consult your eye doctor to make sure you’re doing the right thing for your eyes if you experience allergy symptoms and eye twitching.
Another way to stop eye twitching: Botox
In rare cases, some eye twitching just won’t go away, despite applying the remedies above.
Persistent eyelids twitches can be treated with Botox injections to stop the involuntary muscle contractions in the eyelid that cause the twitching.
When to see an eye doctor
See an eye doctor immediately if you experience persistent eye twitching, sudden changes in appearance or movement of half your face (including your eyelids), or if both eyelids clamp down so tight it’s impossible to open your eyes. These can be signs of a serious condition.
According to the World Health Organization, cataracts cause a third of worldwide blindness, affecting approximately 12.6 million people. Cataracts additionally cause moderate to severe vision loss to 52.6 million individuals, 99% of whom live in developing countries.
Although it is a relatively simple condition to treat surgically in the developed world, in many developing countries, access to eye care is extremely limited. Moreover, as populations age and average life expectancy continues to increase worldwide, the number of people with cataracts will only grow more widespread.
A Healthy Eye and an Eye with A Cataract
Risk Factors
Biological aging is the most common cause of cataracts, but exposure to ultraviolet radiation, skin diseases, injury, infection, smoking, and genetic factors are also causes. Some children are even born with the condition.
Those living in developing countries, particularly those with agrarian societies, are at increased risk. Individuals who spend much of their day working outdoors without eye protection are exposed to UV-B radiation, which can lead to cataracts.
Prevention
While there is no way to completely prevent getting cataracts, the following can lessen the likelihood of developing them:
1. Living a healthy lifestyle by reducing smoking and alcohol consumption
2. Avoiding eye trauma by wearing safety goggles
3. Wearing sunglasses to protect eyes from UV radiation
Treatment
Cataract removal is a simple, non-invasive surgical process with a high success rate – 90% of patients report a corrected vision of 20/40 or better afterwards. SEE performs three types of cataract surgery: Phacoemulsification (or “Phaco”), Extra Capsular Cataract Extraction (ECCE) and Manual Small Incision Cataract Surgery (MSICS).
Cataracts in the developing world generally have gone untreated for a longer period of time than in places like the United States. Thus they are usually denser and harder to remove. MSICS is the generally the ideal technique to use, as it allows the doctor to get the more mature cataract out in a shorter amount of time than if they were to use Phaco.
Doctors most commonly use Phaco in the developed world. The technique utilizes an expensive handheld ultrasonic probe, which emulsifies (turns to liquid) the clouded lens, which surgeons then replace with an artificial (man-made) lens. ECCE uses a larger incision than phaco and generally needs stitches and thus is less commonly used. The Manual Small Incision technique improves upon ECCE, in that it does not require stitches. Find out more about MSICS here .
SEE International & Cataracts Around the World
SEE works diligently to reduce the number of cataract cases around the world in the following ways:
Performing cataract surgery
Teaching appropriate cataract surgical techniques, such as Manual Small Incision Cataract Surgery.
Training local eye care personnel in ophthalmology in rural and urban areas.
Strengthening local health care infrastructure.
Smoking more than 20
cigarettes a day may damage your vision by affecting blood vessels and neurons in the retina, a study warns.
The study, published in the journal Psychiatry Research, included 71 healthy people who smoked fewer than 15 cigarettes in their lives and 63 who smoked more than 20 cigarettes a day, were diagnosed with tobacco addiction and reported no attempts to stop.
The participants were between the ages of 25 and 45 and had normal or corrected-to-normal vision as measured by standard visual acuity charts, said researchers from the Rutgers University in the US.
They looked at how participants discriminated contrast levels (subtle differences in shading) and colours while seated 59 inches from a 19-inch cathode-ray tube monitor that displayed stimuli while researchers monitored both eyes simultaneously.
The findings indicated significant changes in the smokers’ red-green and blue-yellow colour vision, which suggests that consuming substances with neurotoxic chemicals, such as those in cigarettes, may cause overall colour vision loss.
They also found that the heavy smokers had a reduced ability to discriminate contrasts and colours when compared to the non-smokers.
“Cigarette smoke consists of numerous compounds that are harmful to health,” said Steven Silverstein, director of research at Rutgers University Behavioral Health Care.
“it has been linked to a reduction in the thickness of layers in the brain, and to brain lesions, involving areas such as the frontal lobe, which plays a role in voluntary movement and control of thinking, and a decrease in activity in the area of the brain that processes vision,” said Silverstein.
Previous studies have pointed that long-term smoking doubles the risk for age-related macular degeneration and causes lens yellowing and inflammation.
“Our results indicate that excessive use of cigarettes, or chronic exposure to their compounds, affects visual discrimination, supporting the existence of overall deficits in visual processing with tobacco addiction,” Silverstein said.
Although the research did not give a physiological explanation for the results, Silverstein said that since nicotine and smoking harm the vascular system, the study suggests they also damage blood vessels and neurons in the retina.
He said the findings also suggest that research into visual processing impairments in other groups of people, such as those with schizophrenia who often smoke heavily, should take into account their smoking rate or independently examine smokers versus non-smokers.
People often believe that failing eyesight is an inevitable result of aging or eye strain. In truth, a healthy lifestyle can significantly reduce the risk of eye health problems.
The Age-Related Eye Disease Study (AREDS), published in 2001, found that certain nutrients — zinc, copper ,
vitamin C, vitamin E, and beta carotene — may reduce the risk of age-related decline in eye health by 25 percent .
This study was updated in 2013 to test different versions of the original formula. The variations included
omega-3 fatty acids, zeaxanthin, lutein, and beta carotene; the study found that certain combinations may work better than others.
Further studies agree that omega-3 fatty acids (including DHA), copper, lutein, and zeaxanthin are vital for eye health.
In this article, we look at the evidence for 10 nutrient-rich foods to boost eye health. We also discuss other tips for healthy eyes and eye health warning signs.
Ten best foods for eye health
Organizations such as the American Optometric Association (AOA) and the American Academy of Ophthalmology (AAO) continue to recommend nutrients for eye health based on the AREDS reports.
The AREDS reports support the following 10 nutrient-rich foods:
1. Fish
Maintaining a healthy lifestyle can help to lower the risk of eye problems.
Many fish are rich sources of omega-3 fatty acids.
Oily fish are fish that have oil in their gut and body tissue, so eating them offers higher levels of omega-3-rich fish oil. The fish that contains the most beneficial levels of omega-3s include:
tuna
salmon
trout
mackerel
sardines
anchovies
herring
Some studies have found that fish oil can reverse dry eye, including dry eye caused by spending too much time on a computer .
2. Nuts and legumes
Nuts are also rich in omega-3 fatty acids. Nuts also contain a high level of vitamin E, which can protect the eye from age-related damage.
Nuts and legumes that are good for eye health include:
walnuts
Brazil nuts
cashews
peanuts
lentils
3. Seeds
Like nuts and legumes, seeds are high in omega-3s and are a rich source of vitamin E.
Seeds high in omega-3 include:
chia seeds
flax seeds
hemp seeds
4. Citrus fruits
Citrus fruits are rich in vitamin C. Just like vitamin E, vitamin C is an antioxidant that is recommended by the AOA to fight age-related eye damage.
Vitamin C-rich citrus fruits include:
lemons
oranges
grapefruits
5. Leafy green vegetables
Leafy green vegetables are rich in both lutein and zeaxanthin and are also a good source of eye-friendly vitamin C.
Well-known leafy greens include:
spinach
kale
collards
6. Carrots
Carrots are rich in both Vitamin A and beta carotene. Beta carotene gives carrots their orange color.
Vitamin A plays an essential role in vision. It is a component of a protein called rhodopsin, which helps the retina to absorb light.
Research on beta carotene’s role in vision is mixed , though the body needs this nutrient to make vitamin A.
7. Sweet potatoes
Like carrots, sweet potatoes are rich in beta carotene. They are also a good source of the antioxidant vitamin E.
8. Beef
Beef is rich in zinc, which has been linked to better long-term eye health. Zinc can help delay age-related sight loss and macular degeneration.
The eye itself contains high levels of zinc, particularly in the retina, and the vascular tissue surrounding the retina.
Meats such as chicken breast and pork loin also contain zinc, but at lower levels than beef.
9. Eggs
Eggs are an excellent source of lutein and zeaxanthin, which can reduce the risk of age-related sight loss. Eggs are also good sources of vitamins C and E, and zinc.
10. Water
It may come as no surprise that a fluid essential to life is also vital to eye health.
Drinking plenty of water can prevent dehydration , which may reduce the symptoms of dry eyes .
Recommended daily intake
The current daily recommendations for healthy eye nutrients, as suggested by the AAO to slow the progression of eye disease, are:
500 milligrams (mg) of vitamin C
400 international units of vitamin E
10 mg lutein
2 mg zeaxanthin
80 mg of zinc oxide
2 mg of copper oxide
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Five tips for healthy sight
Diet is not the only way to keep your eyes healthy. Learn about other strategies to boost eye health here.
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Other eye health tips
Wearers of contact lenses should follow their doctors’ instructions to reduce the risk of infection.
According to the AAO, the following strategies can help to ensure healthy eyes:
wearing sunglasses outside, since excessive sun exposure can cause cataracts
stopping smoking
getting regular eye exams, particularly if there is a family history of eye disease
wearing eye protection when working with possible eye irritants or dangerous chemicals
washing hands before applying contacts
wearing contacts only for the period recommended by the doctor or manufacturer
protecting eyes from computer-related eye strain by looking away every 20 minutes at something 20 feet away, for 20 seconds
Diabetes is a leading cause of blindness. People with diabetes should carefully monitor blood sugar levels, take medications exactly as prescribed by their doctor, and manage carbohydrate intake while focusing on eating low-moderate glycemic index (GI) foods.
Early treatment for eye health problems can prevent them from getting worse. So people who notice changes in their vision should schedule a comprehensive eye exam with an optometrist or ophthalmologist.
Warning signs for eye health
Possible symptoms that a person may be experiencing vision trouble include:
frequent changes in visual clarity
seeing distorted images
seeing floaters or flashes in the field of vision
reduced peripheral vision
Summary
Citrus fruits are rich in vitamin C which may help lower the risk of age-related eye damage.
Eating a varied diet that includes lots of fruits, vegetables, and lean proteins is enough to ensure most people get the right nutrients for eye health.
People who cannot get these nutrients from their diet should ask an eye doctor about eye health supplements.
People with vision problems or those with very restrictive diets should talk to an eye health provider about the right foods to eat.
