Astaxanthin (AstaReal®) Improved Acute and Chronic Digital Eye Strain in Children: A Randomized Double-Blind Placebo-Controlled Trial

Abstract

Introduction

This study assessed the effects of astaxanthin supplementation on chronic and acute digital eye strain in school-aged children (10–14 years) and evaluated its safety. While previous studies focused on adults, this study examined astaxanthin’s effects on developing eyes.

Methods

A randomized, double-blind, placebo-controlled trial was conducted over 84 days involving 64 children engaged in ≥ 4 h of screen time daily and experiencing mild to moderate computer vision syndrome (CVS) symptoms as indicated by a CVS-Questionnaire (CVS-Q) score ≥ 8 and < 19. Participants received a daily 4-mg astaxanthin soft capsule for 84 days. Primary outcomes were measured using CVS-Q, while secondary outcomes included visual fatigue Likert scale (VFLS), visual acuity, spherical equivalence, near point of accommodation, near exophoria, dry eye intensity, pupil size, stereopsis, blinking frequency, immunity, and safety variables.

Results

Of the 64 participants (mean age 11.5–11.7 years), 35 were male and 29 were female. Astaxanthin supplementation significantly improved CVS-Q scores after 84 days (− 4.00 ± 4.05 arbitrary units (A.U.) from baseline, p < 0.0001) compared to placebo (− 1.72 ± 3.61 A.U., p < 0.05), a 20% between group difference. The mean VFLS scores were significantly lower in the astaxanthin group (11.55 ± 5.78 A.U.) compared to placebo (15.78 ± 7.12 A.U., p = 0.01), showing a 27% improvement after 84 days. Stereopsis improved significantly after acute visual load at 28 and 84 days (p < 0.05, p < 0.0001 vs. placebo, respectively), and pupillary light reflex improved after 84 days (p < 0.05 vs. placebo). Tear production increased after 14, 56, and 84 days (p < 0.05, p < 0.001, and p < 0.001 vs. baseline, respectively) in the astaxanthin group, with no significant intergroup difference in the Schirmer I test, visual acuity, spherical equivalence, near point of accommodation, near exphoria, immune markers, or safety variables.

Conclusion

Astaxanthin supplementation effectively reduced chronic and acute digital eye strain, while enhancing objective measures of visual performance in school-aged children, underscoring the benefits of astaxanthin in pediatric visual health and performance.

Trial Registration

NIH ClinicalTrials.gov (Identifier: NCT05602402); Clinical Trials Registry India (Registration Number: CTRI/2022/10/046606).