Millions of people worldwide suffer from presbyopia, a prevalent age-related eye condition. People start developing presbyopia in their 40s, but they gradually get better able to adapt to it by their 50s. By the time they reach 65, everyone has presbyopia. Smartphone and tablet use has recently accelerated presbyopia, according to some new studies (about 35 years).
In presbyopia, the eye’s lens loses some of its flexibility as we age, making it harder to focus on the closest things. People who suffer from presbyopia typically have to hold books or magazines at arm’s length in order to read them effectively. Activities requiring prolonged close-up vision may cause them to feel eyestrain, headaches, and exhaustion.
Various discoveries and developments in ophthalmology have given viable options for boosting eyesight and quality of life for those who suffer from presbyopia, such as single-vision or bifocal reading glasses and contact lenses. Some surgical options include LASIK, Corneal Inlays surgery, Refractive Lens Exchange (RLE), and Conductive Keratoplasty (CK).
Presbyopia treatment options might include pharmaceutical strategies that are approved to work to some extent. Herbal remedies have also gained widespread attention and application in treating vision issues in recent years.
One of the most recent research done for the treatment of presbyopia is done on specific Chinese herbal remedies for presbyopia.
A Recent Study For Presbyopia Treatment
The recent 2021 research named “Improvement of Presbyopia Using a Mixture of Traditional Chinese Herbal Medicines, Including Cassiae Semen, Wolfberry, and Dendrobium huoshanense” studied the therapeutic benefits of herbs using an effort to use them on a large sample of people and will their benefits last.
In this latest research, researchers combined Cassiae Semen, L. barbarum, and Dendrobium huoshanense (DD) to create an innovative herbal medicine formulation for presbyopia. Researchers gathered the extracted materials, powdered them, and combined them in a capsule at an established dosage.
Methodology of Research
A total of 400 participants (200 males and 200 females ) were included in the study who were suffering from presbyopia (at a distance of around 40 centimeters) and falling in the age bracket of 45-70 years. The combination of the Herbs was used and administered to the participants orally in the shape of capsules.
They formulated the combination herbal medication with 200 milligrams of Cassiae Semen, 200 milligrams of wolfberry, and 40 milligrams of Dendrobium huoshanense (DD) in each capsule.
The test was further carried out in three different phases or steps.
- The participant’s capacity to focus on nearby objects was evaluated in the first experiment by having them execute a series of push-up or area of accommodation tests.
For instance, the physician can move a small letter 0.4 or 0.5 meters away from the patient’s eye until the letter distorts. The doctor determines the near point of accommodation, the distance or position at which the letters became unclear. They then use the test findings to determine the appropriate lens power for reading glasses.
- The second test had 240 people divided into 6 age groups who took the herbal medicine for six months, each taking three capsules daily. After then, they were monitored for a further six months to determine if the drug’s effects persisted for different ages after they stopped taking it.
- In the third experiment, 160 participants were randomly divided into four groups to determine the appropriate doses for patients with presbyopia. One group received a placebo (a drug containing no active ingredients), the second group received a low dose of one capsule per day, the third group received a moderate dose of two capsules per day, and the fourth group received a high dose of three capsules per day. The group participants received their prescribed dosages for six months before discontinuing treatment. In addition, they were monitored for an additional six months to assess any long-term effects.The following chart shows the division of dosages for the third experiment
Group 1 Placebo drug Group 2 Low dose (1 capsule a day) Group 3 Medium dose (2 capsules/day) Group 4 High dose 3 capsules/day)
Results Gave Positive Insight
- In the first experiment, it was observed that participants’ near-focus (or “AA”) performance deteriorated with age. More advanced-aged people needed aids like reading glasses to see fine detail.
- The experiment 2, the amplitude of accommodation (AA) of all subjects increased by 2.1 D (a unit used to assess lens power) after six months of treatment with the combination of herbal medication. Uncorrected near visual acuity (UNVA) also increased by roughly two to three lines on a Jaeger chart (a chart used to test near vision) for the majority of the individuals. Average AA values dropped to 2.0 D at the nine-month point. This suggests that blended herbal medicine can stabilize the close focusing ability (AA) for three months after the herbal therapy has been discontinued.
- In the third experiment, participants were administered a combination of herbs over six months at varying dosages. In the low-dose group (LDG), the middle-dose Group (MDG), and the high-dose group (HDG), the maximum AA values were 2.8 D, 2.9 D, and 3.2 D, respectively. This suggests that there was a dose-dependent improvement in near-focusing ability (AA). That is to say; the better AA became, the more prominent the dose of the herbal treatment.
The study participants reported no side effects, such as convulsions, headaches, diarrhea, redness, itch, or rash.
These results of the above study imply that the blended herbal product improved near eyesight. Because of this, both near-focus (AA) and near-clarity (UNVA) were improved.
The results also showed that the amount of herbal medication taken affected how much near vision improved in 95% of the participants.
The parasympathetic function of cassia seeds may improve the accommodating system, while the sympathetic actions of the goji berry may alleviate presbyopic symptoms and the dry eyes accompanying them.
Cassiae Semen and wolfberry have powerful antioxidant properties, and DD slows the development of cataracts by blocking the formation of sorbitol and advanced glycation end products.
After six months of treatment, roughly 95% of patients had seen improvement. Therefore, it was proposed that herbal medicine supplements may provide an alternate option due to their accessibility, safety, and long-lasting pharmacologic effects.
Therapeutic Effects of Chinese Herbs
Several herbs with possible medicinal properties in traditional medicine include Cassiae Semen, Wolfberry, and Dendrobium huoshanense. These herbs have recently come to the forefront because of the widespread interest in the health advantages they provide. Some of the approved benefits are given below.
Cassia Seed/ Cassiae Semen
The Chinese have known about Cassiae Semen or Cassiae seeds for their vision, liver function, and various types of inflammation for thousands of years.
These days, dry eye and retinitis pigmentosa are on the list of ocular ailments that cassia seeds are being used to treat, along with headaches, obesity, periocular discomfort, constipation, high blood pressure, high cholesterol, Alzheimer’s disease, ischemic stroke, and bronchospasm.
It is also rich in many other compounds (almost 55 of these) such as flavonoids, emodin, chrysophanol, physcion, obtusin, rhein, aurantio-obtusin, chryso-obtusin, and anthraquinones. These chemicals have been found to have different pharmacological functions, such as anticoagulant, antiangiogenic, antimicrobial, and antioxidant properties.
Cassia seeds tea is found to be equally effective. Among the many advantages of cassia seed tea are the following:
- Aids in relaxing the mind and relieving tension
- Benefits heart health by lowering “bad” cholesterol levels while raising “good” ones
- It might aid digestion by encouraging the growth of beneficial bacteria in the intestines.
How Much to Take?
The China Pharmacopeia recommends a daily intake of 9-15 g of Semen Cassiae for adults. The same goes for the Cassiae seeds consumption orally.
Herbal teas and pills containing Cassiae Semen are frequent ways to ingest this supplement. It should be noted, however, that ideal dosage and reaction may differ across individuals.
The compounds chrysophanol, obtusin, and Aurantio-obtusin are responsible for the beneficial effects of Cassia seeds. There are negative consequences from the substances as well. That is,
- Its potential adverse effects include hypoglycemia (low blood sugar), psoriasis, hypotension, muscular spasms, nausea, irritable bowel syndrome, and diarrhea.
- Because it might trigger uterine contractions, the extract should be avoided by pregnant women.
- According to many studies, those with liver-related conditions should also avoid its use.
Lycium barbarum (Goji berries)
Goji berries (Wolf Berries), also known as the fruit of L. barbarum, have been used for centuries as an antiaging plant. Its high nutritional content and high reputation have earned it the label of “superfood.”
Clinical studies have shown that it is effective against dry eye, hazy vision, ocular tiredness, AMD, diabetic retinopathy, UV light-induced retinal degeneration, and pathology, particularly in the cases of retinitis pigmentosa and age-related macular degeneration. (1) Recent research also proves it may help protect against glaucoma damage. It has also been proven to treat dry eyes, blurred vision, photosensitivity, night blindness, and reduced visual acuity.
Another research also suggests that eating these tiny red berries daily might reduce the risk of developing hypopigmentation and drusen (yellow deposit) in the eye.
How Much to Take?
Individual conditions and the manner of consumption (fresh berries, dried berries, juice, extract, etc.) might affect the recommended dosage of goji berries for supporting eye health. But the following has been proven by researchers.
- Consumption of 25 g of Goji berries for 90 days has been found to improve age-related macular degeneration. Also, their best-corrected visual acuity increased from baseline.
- In another research, 5 gs of L. barbarum was given twice daily to 50 individuals for 12 months, and follow-up was done after every 6 months. The study’s results led to the conclusion that this extract causes improvements in visual acuity and macular thickness in adults with retinitis pigmentosa.
The recommended dosage is just 10 to 20 grams. But the dosage may change depending on the individual’s weight and condition. You should get your doctor’s approval before trying anything.
Goji berries have a reputation for being healthy and well-tolerated by most of its consumers, but it’s important to be cautious of individual sensitivities or allergic responses such as,
- Goji berries may interact with blood thinners, diabetes, and hypertension medicines.
- Those allergic to other fruits may have an adverse response to these berries.
- They contain betaine, a chemical that may harm fetal health. Thus, pregnant women should use it cautiously.
Dendrobium huoshanense (DD)
Dendrobium, also known as “Shihu,” is a member of the orchid family (Orchidaceae) that is used in traditional Chinese medicine. The medicinal properties of Dendrobium species as a whole have been investigated.
The stem of has Dendrobium huoshanense (DD) been used traditionally to cure throat irritation, chronic superficial gastritis, body strengthening, and longevity.
DD has several active substances with various pharmacological effects, including alkaloids, stilbenoids, anthracene, polysaccharides, fluorine, flavone, phenanthrene, and gigantol. For eye-related diseases, it has been found to be effective in treating dry eye, diabetes, and ischemic retinopathy, among other ocular conditions.
The effectiveness of the plant in preventing and treating senile cataracts and improving children’s eyesight has been validated by modern pharmacological studies.
How Much to Take?
Dendrobium huoshanense is typically ingested as herbal tea, extracts, or supplements.
When brewed as tea, Dendrobium is taken at a dosage of 6–12 grams for dried form and 12–30 grams for fresh form. Higher dosages, up to 20g, are acceptable.
Dendrobium has been awarded a class one grade by the American Herbal Products Association, which means it is safe to ingest at reasonable levels; nevertheless, excessive consumption is not recommended.
It is usually considered safe but somehow can also have adverse effects such as,
- It is not suggested that nursing or pregnant women take Dendrobium.
- Overdosing of Dendrobium can result in seizures, and high dosages can harm the heart and lungs.
- Dendrobium has been linked to an increased risk of seizures in some people.
The findings of the above-discussed research suggest that the mixed herbal treatment, when used as directed, can help people with presbyopia maintain or improve their visual acuity.
It is essential to note that even though these herbs have a long history of traditional use and exhibit promising potential, scientific research is ongoing to understand their therapeutic effects better. Nonetheless, these findings emphasize the potential of traditional Chinese herbal medicines in maintaining eye health and give promise for alternative and complementary ways to address presbyopia.