AREDS vs AREDS2: What Changed, and Which Formula Makes Sense
Short answer: AREDS2 is the current version. It keeps vitamins C and E, zinc and copper, but swaps beta-carotene for lutein and zeaxanthin, which worked at least as well without the lung cancer risk for smokers. Both are for people who already have intermediate or advanced AMD.
The short version
- AREDS (2001): vitamins C and E, beta-carotene, zinc and copper lowered the odds of advanced AMD by about 25% in people at higher risk
- AREDS2 (2013): lutein and zeaxanthin replaced beta-carotene; adding omega-3 didn’t help
- 10-year follow-up (2022): beta-carotene nearly doubled lung cancer risk; lutein and zeaxanthin did better against late AMD
- Neither prevents AMD in people who don’t have it, according to the National Eye Institute
The two formulas side by side
| Nutrient | AREDS (original) | AREDS2 |
|---|---|---|
| Vitamin C | 500 mg | 500 mg |
| Vitamin E | 400 IU | 400 IU |
| Beta-carotene | 15 mg | Removed |
| Lutein | — | 10 mg |
| Zeaxanthin | — | 2 mg |
| Zinc | 80 mg | 80 mg |
| Copper | 2 mg | 2 mg |
Doses as published by the National Eye Institute. Copper is included because high-dose zinc can lower copper levels.
What the original AREDS found
The first Age-Related Eye Disease Study followed 3,640 people aged 55 to 80 for an average of 6.3 years. Compared with placebo, the combination of antioxidants (vitamins C and E, beta-carotene) plus zinc and copper lowered the odds of developing advanced AMD. The effect was clearer in people at higher risk: those with intermediate AMD, or advanced AMD in one eye. The same combination was the only one that significantly reduced moderate vision loss.
People with no AMD or only early AMD had a very low chance of progressing during the study, and the National Eye Institute says the formulas showed no benefit for them.
What AREDS2 changed
AREDS2 enrolled about 4,000 people with intermediate AMD in both eyes, or advanced AMD in one eye. Everyone could take the AREDS formula, and the trial tested what happened when researchers added lutein and zeaxanthin, omega-3 fatty acids (DHA and EPA), or both. It also tested removing beta-carotene and lowering zinc to 25 mg.
- Adding lutein and zeaxanthin or omega-3 didn’t further reduce progression to advanced AMD in the main analysis.
- Beta-carotene: more lung cancers occurred in the group taking it (2.0% vs. 0.9%), mostly in former smokers.
- The conclusion: lutein and zeaxanthin could be an appropriate substitute for beta-carotene. That swap is what the “AREDS2 formula” on store shelves reflects today.
The 10-year follow-up
Researchers kept following nearly 3,900 AREDS2 participants for ten years. The longer view made the case for the switch clearer:
Beta-carotene nearly doubled the risk of lung cancer (odds ratio 1.82), with no significant increase for lutein and zeaxanthin. Compared directly with beta-carotene, lutein and zeaxanthin were linked to a lower risk of progressing to late AMD.
Chew EY, et al. AREDS2 Report 28. JAMA Ophthalmology, 2022.
The follow-up also found no meaningful difference between the 25 mg and 80 mg zinc doses for progression, and no benefit from omega-3.
Which formula makes sense for you?
- You’ve been diagnosed with intermediate AMD, or advanced AMD in one eye: this is who both formulas were tested on. The AREDS2 version is the one current evidence favors. Your eye doctor can confirm it’s right for you.
- You smoke or used to: avoid the original AREDS formula with beta-carotene. AREDS2 was designed with you in mind.
- You have no AMD or only early AMD: neither formula has been shown to help or to prevent AMD. A dilated eye exam is the way to know your stage.
How to read an “AREDS2” label
Plenty of products borrow the name. A label matches the tested formula only if it lists all six nutrients at the doses in the table above, and no beta-carotene. Three things to watch for:
- “AREDS2-inspired” or “with AREDS2 ingredients”: usually means some of the nutrients at lower doses.
- Long lists of extras (bilberry, saffron, astaxanthin): these weren’t part of the trial and add no proven AMD benefit.
- “Vitamin A” without a source: it may be beta-carotene.
We applied this check to specific products in VisionMD vs PreserVision AREDS 2 and Retina Clear and Vision Enhance Pro vs AREDS2.
Where other eye supplements fit
If you don’t have AMD, no formula has been shown to prevent it. Some people still choose a lutein and zeaxanthin supplement for everyday visual comfort, since a one-year trial found it raised macular pigment and improved contrast and recovery from glare. If that’s you, these are the two products that held up best in our reviews. Neither matches the AREDS2 doses.
Reader-supported: we may earn a commission if you buy through the links below, at no extra cost to you. It never changes a rating.
VisiFlora · 3.4 / 5
Five of the six AREDS2 nutrients, with zinc well below the tested dose and beta-carotene still included. Best for people who have never smoked.
Check VisiFlora’s price →VISIVRA · 2.8 / 5
A simpler formula built around lutein and zeaxanthin, plus zinc. No doses published and its vitamin A source isn’t stated.
Check VISIVRA’s price →Not sure which of the two? See VisiFlora vs VISIVRA.
Frequently asked questions
What is the difference between AREDS and AREDS2?
Is AREDS2 better than AREDS?
Why was beta-carotene removed?
Does AREDS2 prevent macular degeneration?
Does omega-3 fish oil add any benefit?
Is the 80 mg zinc dose necessary?
The bottom line
AREDS2 is the updated, safer version of the AREDS formula: the same vitamins and minerals, with lutein and zeaxanthin in place of beta-carotene. It’s meant for people with intermediate or advanced AMD, not for preventing AMD. If you’re over 55, a dilated eye exam is how you find out whether it applies to you.
This article is for informational purposes and isn’t a substitute for medical advice. Talk to an eye care provider before starting any supplement, especially if you have diagnosed AMD, smoke or used to, or take other medications.
Sources
- Age-Related Eye Disease Study Research Group. “A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8.” Archives of Ophthalmology, 2001.
- Age-Related Eye Disease Study 2 Research Group. “Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration.” JAMA, 2013.
- Chew EY, et al. “Long-term outcomes of adding lutein/zeaxanthin and ω-3 fatty acids to the AREDS supplements on age-related macular degeneration progression: AREDS2 report 28.” JAMA Ophthalmology, 2022.
- National Eye Institute. “About AREDS and AREDS2.”
- Hammond BR, et al. “A double-blind, placebo-controlled study on the effects of lutein and zeaxanthin on photostress recovery, glare disability, and chromatic contrast.” Investigative Ophthalmology & Visual Science, 2014.
Photo: Wesley Tingey / Unsplash