Medical information reviewed by NP Bate, Ed.S. • Last reviewed: 2026-08-09 • Not a substitute for professional care.
Treatments We're Watching
This page is our watchlist. These are treatments with a plausible mechanism and some early signals, but not enough evidence to recommend them yet. Nothing here is FDA-approved for the condition listed. We update this page as the research moves.
Bottom line up front: mechanism + early data = worth watching. Reproducible, large trials = worth recommending. Every treatment below is in the first bucket.
1. Saffron (Crocus sativus), Macular Health / Early AMD
Watching, the strongest candidate on this page.
The world's most expensive spice, and the one supplement on this page I'd actually spend money on. Its active compounds are crocin and crocetin, antioxidant carotenoids.
Mechanism (plausible)
Crocin and crocetin are potent antioxidants and anti-inflammatory agents. Preclinical work shows they protect retinal pigment epithelium (RPE) cells from oxidative stress, the same stress implicated in AMD. Some evidence also suggests anti-angiogenic activity (relevant to wet AMD).
Evidence
- RCT, N=25, 20 mg/day, 3 months (crossover). Early AMD. Saffron improved retinal flicker sensitivity vs. placebo. Falsini B, et al. Invest Ophthalmol Vis Sci 2010;51(12):6118-6124. doi: 10.1167/iovs.09-4995
- Open-label extension, N=29, 20 mg/day, ~14 months. Visual acuity improved ~2 Snellen lines; retinal sensitivity improved 0.3 log units; benefits sustained. Piccardi M, et al. Evid Based Complement Alternat Med 2012;2012:429124. doi: 10.1155/2012/429124
- RCT, BMJ Open Ophthalmology 2024. Saffron modestly improved multifocal ERG responses in AMD patients, including those already taking AREDS supplements. Broadhead GK, et al. BMJ Open Ophthalmol 2024;9(1):e001399. doi: 10.1136/bmjophth-2023-001399
Caveats
- Every trial is small (25–93 participants) and short (3–14 months)
- Endpoints are functional (ERG, acuity)—no trial has shown saffron slows structural progression (drusen, atrophy)
- Some studies involve researchers with ties to saffron suppliers
- Doses studied: 20–30 mg/day (≈8–12 threads); retail saffron varies wildly in crocin content—supplement quality is unregulated
- Cost is significant; crocin-standardized extracts are the only way to approximate study doses
Bottom Line
The only treatment on this page with multiple small RCTs behind it. Genuinely promising, but "multiple small RCTs" is not "proven." If you take AREDS2, saffron may be additive, but don't stop AREDS2 for it.
2. Ginkgo biloba, Macular Health / AMD
Wait-and-see, plausible mechanism, insufficient evidence.
If you've heard of one "brain herb," it's ginkgo. The extract (EGb 761) genuinely increases blood flow to the retina — that part checks out. What's missing is proof that it changes outcomes.
Mechanism (plausible)
Increases retinal and choroidal blood flow, antagonizes platelet-activating factor (inflammation), and has antioxidant activity. Vascular factors and oxidative damage are both implicated in AMD, so the mechanism is biologically coherent.
Evidence
- Cochrane systematic review (2013): Only 2 randomized trials (119 people total, 6 months, EGb 761 at 60–240 mg/day). Both reported some positive vision effects, but results could not be pooled and adverse effects/QoL were not reported. Conclusion: insufficient evidence. Evans JR. Cochrane Database Syst Rev 2013. doi: 10.1002/14651858.CD001775.pub2
Caveats
- Two small trials, 20+ years old, no replication since
- Ginkgo inhibits platelet aggregation: bleeding risk with aspirin, warfarin, or before surgery
- Retail ginkgo is often not standardized to EGb 761
Bottom Line
The mechanism is real; the human data is a whisper. Not enough to justify the bleeding risk for most people. Watch.
3. Astaxanthin, Macular Health / General Eye Health
Watching, promising mechanism, thin human data.
Salmon, krill, microalgae — this is the pigment that gives them their color. What makes it interesting to eye researchers is that it crosses the blood-retinal barrier, which almost no other carotenoid does.
Mechanism (plausible)
One of the most potent natural antioxidants; anti-inflammatory; improves retinal blood flow in small studies. The ability to reach the retina directly sets it apart from most other carotenoids.
Evidence
- Review of clinical applications (2020): Several small clinical trials suggest potential benefit in AMD, eye fatigue, and accommodation, but most are small, short, and use surrogate outcomes (blood flow, ERG, symptom scores). Giannaccare G, et al. Mar Drugs 2020;18(5):239. doi: 10.3390/md18050239
Caveats
- No trial has tested astaxanthin against an AMD progression endpoint (drusen growth, conversion to late AMD)
- Most positive studies are industry-funded or small single-center
- No established dose for AMD; common retail doses (4–12 mg/day) are not study-backed for this indication
Bottom Line
A real molecule with a real mechanism. But "reaches the retina" is not "treats AMD." Watching.
4. Bilberry (Vaccinium myrtillus), Night Vision / Eye Health
Skeptical — the famous claim failed rigorous testing.
European blueberries. The whole industry rests on a WWII story about RAF pilots eating bilberry jam to sharpen their night vision, great folklore, bad evidence. The supposed actives are anthocyanins (delphinidins, cyanidins).
Mechanism (plausible in theory)
Anthocyanins are antioxidants; some animal work suggests effects on rhodopsin regeneration and retinal blood flow.
Evidence
- Systematic review of placebo-controlled trials (2004): Bilberry anthocyanosides do not improve night vision in rigorous trials. The famous claim is not supported. Canter PH, Ernst E. Surv Ophthalmol 2004;49(1):38-50. doi: 10.1016/j.survophthal.2003.10.006
- No meaningful human data for AMD outcomes.
Caveats
- The one thing bilberry is famous for (night vision) failed systematic review
- No AMD-specific trials of consequence
- Supplement quality varies; anthocyanin content unregulated
Bottom Line
Popular, not promising. Included because it's the most-bought "eye health" herb, and the evidence says the marquee claim doesn't hold. If you enjoy bilberries as food, eat them. Don't buy the pills for vision.
5. Manuka Honey Eye Drops, Dry Eye
Watching, cheap and low-risk, but small studies.
Yes, sterile Manuka honey in an eye drop bottle (Optimel is the main one). It sounds like a gimmick. The mechanism, antibacterial, anti-inflammatory, osmotic, actually fits evaporative dry eye, and it's cheap enough to be worth a conversation with your optometrist.
Mechanism (plausible)
Manuka honey has antibacterial (methylglyoxal), anti-inflammatory, and osmotic activity on the ocular surface. For evaporative dry eye (the 86% type), the antibacterial angle targets lid flora implicated in meibomian gland dysfunction.
Evidence
- Prospective controlled study (2026): Manuka honey drops associated with greater improvement in post-cataract-surgery dry eye symptoms vs. standard care. García-Bardera J, et al. Front Ophthalmol 2026. doi: 10.3389/fopht.2026.1812914
- Contact-lens-related dry eye (2017): Optimel Manuka+ well tolerated; dry eye symptoms improved. Wong D, et al. Cont Lens Anterior Eye 2017.
- Review (2023): Significant improvement in corneal staining and meibum quality reported after Manuka therapy. Prinz J, et al. Pharmaceuticals 2023;16(5):762. doi: 10.3390/ph16050762
Caveats
- Small samples, short follow-up, mostly post-procedure or contact-lens populations
- Stinging/burning on instillation is common, the #1 reason people quit
- Not a first-line therapy; warm compresses + lipid tears + omega-3 remain the proven starting point
Bottom Line
Low-risk, cheap, and the mechanism fits evaporative dry eye. But it stings and the trials are small. If the OTC trifecta hasn't worked after 3 months, it's a reasonable conversation with your optometrist, not a self-prescribed first move.
Watchlist Methodology
- What gets on the list: a plausible mechanism + at least one human study (any design) or a compelling animal/in-vitro mechanism chain. The bar for promotion off the list is: replicated, larger trials with clinically meaningful endpoints.
- What gets removed: replicated null results, safety signals, or retractions—we update this page and note the change (same policy as our Citations page).
- What never goes on the list: anything with no biological plausibility, no human data, and a marketing page instead of a methods section.