Two landmark clinical trials. Twelve years apart. Both showed that a specific combination of nutrients could reduce the risk of AMD progressing to its advanced stage by approximately 25%. But there’s one important difference between them — and it matters, particularly if you smoke or have smoked.

The Original AREDS Trial (2001)

The Age-Related Eye Disease Study (AREDS) was conducted by the US National Eye Institute. It studied over 3,600 people with varying stages of AMD over an average of six years. The result was significant: a specific high-dose antioxidant and zinc combination reduced the risk of progression to advanced AMD by around 25% in people with intermediate AMD or advanced AMD in one eye.

The original AREDS formula per daily dose:

• Vitamin C 500mg
• Vitamin E 400 IU
• Beta-carotene 15mg (as provitamin A)
• Zinc 80mg (as zinc oxide)
• Copper 2mg (as cupric oxide, to offset zinc’s effect on copper absorption)

The Problem with Beta-Carotene

Separate research — notably the ATBC trial in Finland and the US CARET trial — had already established that high-dose beta-carotene supplements significantly increased lung cancer risk in current and former smokers. This applied specifically to supplemental beta-carotene, not beta-carotene from whole food sources.

For non-smokers, the original AREDS formula remained safe. But for anyone who smoked — or had previously smoked — the beta-carotene component was a genuine concern. Health bodies including the NHS advise that current and former smokers should not take high-dose beta-carotene supplements.

The AREDS 2 Update (JAMA, 2013)

The US National Eye Institute ran a follow-up study specifically to address this issue, as well as to explore whether omega-3 fatty acids added any benefit. The AREDS 2 trial enrolled over 4,000 participants with intermediate AMD or advanced AMD in one eye.

The key change: beta-carotene was replaced with Lutein 10mg + Zeaxanthin 2mg.

These are the carotenoids that actually concentrate in the macula. They form the macular pigment — the eye’s natural blue-light filter — and are the nutrients the retina specifically needs. Critically, they don’t carry the lung cancer risk associated with beta-carotene. The rest of the formula was unchanged.

The Exact AREDS 2 Formula

Ingredient	Amount per 2 soft gels
Vitamin C	500 mg
Vitamin E	400 IU
Lutein	10 mg
Zeaxanthin	2 mg
Zinc (as zinc oxide)	80 mg
Copper (as cupric oxide)	2 mg

Copper is included because the high zinc dose can deplete copper levels over time — the 2mg copper offsets this effect.

Did AREDS 2 Work as Well?

Yes. The AREDS 2 formula showed similar efficacy to the original — approximately 25% lower risk of progressing to advanced AMD compared to placebo, over five years. A secondary analysis also found that participants who received lutein and zeaxanthin (rather than beta-carotene) did particularly well — especially among former smokers.

Which Should You Take Today?

For almost everyone: AREDS 2.

The original AREDS formula is no longer recommended for current or former smokers due to the beta-carotene risk. AREDS 2 offers the same proven efficacy with a safer, more physiologically appropriate carotenoid profile. If you’re currently taking a product labelled simply “AREDS” (not AREDS 2), check the ingredients list. If it contains beta-carotene and you smoke or have smoked, speak to your optician about switching.

PreserVision AREDS 2 by Bausch + Lomb is formulated to the exact AREDS 2 trial specification.

Read more about why we chose the AREDS 2 formula and who it’s intended for.