Detoxifying for visual longevity

As eye care professionals, we spend most of our careers treating and managing conditions by prescribing eye care products or medications. We send patients home with remedy eye drops, eyelid treatments, or even nutritional supplements. But are we spending enough time outlining toxic habits or toxic products that may need to be removed from a routine? It is easy to add new products or prescribe new treatments, but do not forget about removing the toxic offenders, which may be contributing to multifactorial eye disease.

Protecting eye health today requires more than regular eye exams and good lighting. Our eyes are delicate biological sensors, constantly exposed to what we eat, what we touch, what we breathe, and what we put on our skin. Many toxic ingredients and environmental exposures can quietly undermine ocular health over time, contributing to dryness, irritation, inflammation, retinal stress, or long-term degenerative changes. Recognizing, avoiding, and minimizing these exposures is central, and protecting the eyes is crucial. Taking intentional steps to reduce toxic input creates a cleaner biological environment in which the eyes can function and age more optimally.

Know your ingredients

The first step is becoming an informed label reader. Many everyday products contain chemicals that can affect the eyes directly or indirectly through systemic absorption or surface irritation and inflammation. Preservatives commonly found in eye drops and contact lens solutions can damage the tear film and ocular surface with chronic use. Choosing preservative-free eye drops, peroxide-based cleaners, and saline solutions reduces cumulative exposure. Similarly, cosmetics applied near the eyes often contain harmful chemicals that may trigger irritation, allergic reactions, and endocrine disruption, as well as cancer. Opting for clean beauty brands and minimalist formulations lowers the chemical burden around the eyes.

A big problem lies in understanding which ingredients could lead to a toxic load. Guide patients to research product ingredients through apps such as Healthy Living (EWG), Yuka, Think Dirty, or Toxiscan, which highlight the “bad guys” and promote the “good guys” or nontoxic products. Or, even better, create a list of your favorite products or brands to offer in-office or online that patients can trust as “eye safe.” Here is a breakdown of some commonly cited problematic ingredients^1-3 that should be used with caution or even avoided near or around the eyes:

Phenoxyethanol

• Benzalkonium chloride (BAK)
• Formaldehyde (DMDM hydantoin, quaternium-15, imidazolidinyl urea)
• Phthalates
• Parabens

PFAS (“forever chemicals”)

• Retinoids/retinyl palmitate/retinol
• Sulfates (SLS/SLES)
• Coal tar
• Synthetic fragrances
• Heavy metals/aluminum powder

Nutrition as medicine

Diet plays a powerful role in minimizing toxic stress to ocular tissues. Highly processed foods often contain artificial colors, trans fats, and pesticide residues that promote systemic inflammation and oxidative stress.⁴ Over time, this inflammation can present in the eyes as retinopathy, ocular surface disease, cataracts, and more. Prioritizing whole foods such as leafy greens, colorful vegetables, wild-caught fish, nuts, seeds, and legumes supports detoxification pathways while supplying antioxidants such as lutein and zeaxanthin; vitamins B, C, and E; omega-3 fatty acids; and zinc.^5,6 Whenever possible, choose organic produce, especially for foods known to carry higher pesticide loads. This can reduce exposure to neurotoxic and endocrine-disrupting chemicals that may affect visual processing and ocular blood flow.⁷

Poor dietary choices over time have been shown to increase oxidative stress, leading to systemic inflammation. Yet treating systemic inflammation does not happen overnight. It may take months or even years for dietary habits to improve. It is crucial to manage severe cases by coordinating care with other subspecialties while guiding patients toward a more integrative health trajectory. A healthy gut microbiome will contribute to a healthy ocular surface microbiome.⁸ When considering patient recommendations, the Mediterranean diet is continually studied as a well-rounded diet for the gut microbiome and eye health.⁹ This includes avoiding processed foods and excess sugar while focusing on foods rich in carotenoids, fatty fish, and whole grains. Provide simple steps to better nutritional habits while stressing the avoidance of foods that contribute to chronic disease.

Nutrition through diet alone may not be enough to move the needle, improve health, or produce a positive shift in symptoms. At this stage, patient education around nutritional supplements is crucial for success. Understanding that not all supplements are created equal and where ingredients are sourced truly matters. The quality of ingredients, purity of sourcing, and bioavailability of nutrients all play a critical role in whether a supplement supports its intended goal or falls short. Recommending brands that are sourced with clean ingredients, use effective dosing, and feature formulations that support absorption will become a powerful tool for long-term wellness.

Environmental exposure

Reducing environmental exposures is another critical step in addressing toxic contributors to eye disease. Indoor air pollution from cleaning products, candles, laundry detergents, and chemicals emitted by home decor can irritate the eyes and potentially contribute to ocular surface disruption.¹⁰ Switching to unscented, plant-based cleaning products and improving ventilation helps protect the ocular surface. Outdoors, ultraviolet radiation and air pollutants such as particulate matter and ozone can accelerate oxidative damage in the lens and retina.^11,12 Avoiding harmful, prolonged UV exposure; high pollution; smoke; and wind can be a simple way to protect sensitive eyes. There is even evidence showing that environmental and lifestyle factors may influence epigenetic mechanisms, such as DNA methylation, histone acetylation, and microRNA expression.¹³

Screen time

Digital toxicity deserves attention as well. Prolonged screen exposure increases blue light exposure, which can lead to sleep disorders or disturbances in circadian rhythms.¹⁴ This can also contribute to a reduced blink rate, leading to eye strain and tear film instability. Using light filters, adjusting screen brightness, taking regular visual breaks, and maintaining ergonomic screen positioning can reduce stress on the visual system and improve sleep cycles. Although blue light itself is not inherently toxic, chronic overexposure without recovery may amplify oxidative stress. A demonstration of screen positioning is always helpful, especially in the case of patients who also present with complaints of headaches, migraines, light sensitivity, neck pain, and more. Specialty tints and lens designs can help reduce exposure in severe cases when lifestyle modifications are insufficient. Lenses such as Newton Neurolens and those from Avulux and Altius are designed to reduce visual “noise” for patients with migraine, light sensitivity, traumatic brain injury, eye strain, and more.

Lifestyle habits

Finally, personal habits and occupational exposures matter. Smoking and secondhand smoke introduce thousands of chemicals that damage blood vessels supplying the eyes. Nicotine and other harmful substances in tobacco impair the microcirculation and promote oxidative stress and inflammatory processes, leading to an increased risk of macular degeneration, glaucoma, and cataracts.¹⁵ Snoring or chronic sleep apnea can also lead to hypoxic inflammatory conditions with increased risk of ocular surface disease and macular degeneration.¹⁶ For individuals working with solvents, pesticides, or industrial chemicals, proper skin and eye protection with adherence to safety guidelines is essential to prevent acute and cumulative toxic injury.

Various lifestyle factors, such as diet, obesity, physical activity, tobacco smoking, alcohol consumption, environmental pollutants, psychological stress, and working on night shifts, might influence epigenetic patterns.¹³ Minimizing exposure is not about perfection but about steady reduction. Each conscious choice, cleaner product, better meal, or protective habit lowers the overall toxic load. Over time, these small shifts create a healthier internal and external environment, allowing the eyes to remain clearer, more resilient, and better supported across the lifespan.

Join the Ocular Wellness and Nutrition Society (OWNS) to stay on top of the latest science in the care of patients through nutritional support for eye diseases and disorders at www.ocularnutritionsociety.org.

References

1. Ocular (Eyes). Agency for Toxic Substances and Disease Registry. Updated March 3, 2011. Accessed June 26, 2026. https://wwwn.cdc.gov/tsp/substances/ToxOrganListing.aspx?toxid=19

2. Rauchman SH, Locke B, Albert J, De Leon J, Peltier MR, Reiss AB. Toxic external exposure leading to ocular surface injury. Vision (Basel). 2023;7(2):32. doi:10.3390/vision7020032

3. Sullivan DA, da Costa AX, Del Duca E, et al. TFOS Lifestyle: impact of cosmetics on the ocular surface. Ocul Surf. 2023;29:77-130. doi:10.1016/j.jtos.2023.04.005

4. Du S, Chen J, Kim H, et al. Protein biomarkers of ultra-processed food consumption and risk of coronary heart disease, chronic kidney disease, and all-cause mortality. J Nutr. 2024;154(11):3235-3245. doi:10.1016/j.tjnut.2024.08.029

5. Ozen S, Ozer MA, Akdemir MO. Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain. Graefes Arch Clin Exp Ophthalmol. 2017;255(6):1173-1177. doi:10.1007/s00417-017-3632-y

6. Falkowska M, Młynarczyk M, Micun Z, Konopińska J, Socha K. Influence of diet, dietary products and vitamins on age-related cataract incidence: a systematic review. Nutrients. 2023;15(21):4585. doi:10.3390/nu15214585

7. Pontelli RCN, Rocha BA, Garcia DM, et al. Endocrine disrupting chemicals associated with dry eye syndrome. Ocul Surf. 2020;18(3):487-493. doi:10.1016/j.jtos.2020.01.001

8. Zheng W, Su M, Hong N, Ye P. Gut-eye axis. Adv Ophthalmol Pract Res. 2025;5(3):165-174. doi:10.1016/j.aopr.2025.01.003

9. Shah S, Mu C, Shen-Tu G, et al. Influence of dietary components on the gut microbiota of middle-aged adults: the gut-Mediterranean connection. BMC Microbiol. 2025;25(1):573. doi:10.1186/s12866-025-04170-6

10. Hartiala M, Elenius V, Pesquera AA, et al; IDEAL Consortium. Exposures in indoor air affecting health. Allergy. 2026;81(3):700-719. doi:10.1111/all.70179

11. Zhang G, Qu Y, Wan X, et al. Ozone exposure and increased risk of age-related macular degeneration: evidence from nationwide cohort and toxicological studies. Innovation (Camb). 2025;6(4):100808. doi:10.1016/j.xinn.2025.100808

12. Tian Y, Li L, Sun Z, et al. Decoding ozone’s impact on the cornea: disruption of barrier integrity and its molecular drivers. Ecotoxicol Environ Saf. 2025;296:118213. doi:10.1016/j.ecoenv.2025.118213

13. Alegría-Torres JA, Baccarelli A, Bollati V. Epigenetics and lifestyle. Epigenomics. 2011;3(3):267-277. doi:10.2217/epi.11.22

14. Li L, Li H, Chen B. Chronobiological and neuroendocrine insights into dry eye. Trends Mol Med. 2025;31(6):522-534. doi:10.1016/j.molmed.2024.10.012

15. Barth T, Arnds J, Mohr S, Schreiner L, Helbig H. Smoking and eye diseases. Article in German. Ophthalmologie. 2025;122(9):753-762. doi:10.1007/s00347-025-02299-3

16. Vlad M, Bendelic E, Bikov A, Ceasovschih A, Corlateanu A. Burden of ophthalmologic disorders in obstructive sleep apnea. Respir Med. 2025;249:108448. doi:10.1016/j.rmed.2025.108448