Frequently Asked Questions

The following are Frequesntly Asked Questions answered.

Hello, I have wet macular degeneration and want to start taking Macushield. Is it safe to take along with Bilberry extract, grapeseed extract and Omega 3 vitamins? I have been taking I-Caps for one month but have read information that suggests Macushield may be better as it contains MZ.

Macushield is a dietary supplement which contains the three macular carotenoids; lutein, zeaxanthin and meso-zeaxanthin, which are naturally occurring carotenoids found in nature. A recent study conducted by the research group in Waterford has shown that there are no adverse side effects from taking a supplement containing the three macular carotenoids. This study was conducted on patients who were also taking additional food supplements such as the ones you are currently taking. There have also been many other animal and human studies conducted to investigate the safety of consuming carotenoids such as those contained in Macushield. These can be found on the Publications page of this website.

I am a 73 year old female with dry AMD.  Can MZ help me at this stage or age?

We would strongly recommend that you take a supplement containing meso-zeaxanthin, especially because of your age and the fact that you have AMD. A supplement containing all three macular carotenoids such as Macushield (available in pharmacies and opticians), is aimed at promoting a healthy macula, the part of the back of the eye affected by AMD. Research has shown that the eye pigments such as MZ may play a role in reducing risk of developing advanced stage AMD. As you have AMD we recommend that you visit your ophthalmologist regularly.

What is astaxanthin and if you are taking Macushield for macular degeneration would you need it, or does the meso-zeaxanthin do the same thing?

Lutein, zeaxanthin and meso-zeaxanthin are carotenoids (naturally occurring plant pigments). These carotenoids are found at the back of the eye; the macula. Research has shown that macular pigment (the yellow pigment at the macula believed to protect against age-related macular degeneration, or AMD) increases upon supplementation with lutein, zeaxanthin and meso-zeaxanthin, and that macular pigment increases are higher when all three are taken together. 

Astaxanthin is also a carotenoid like lutein, zeaxanthin and meso-zeaxanthin, but to our knowledge it is not found in the eye. It is typically used as a food colourant given its bright colour.

Please let me know what the benefits are of meso-zeaxanthin versus omega 3.

Omega-3 fatty acid and meso-zeaxanthin are very different compounds with very different functions. Omega-3 is a fatty acid, a naturally occurring fat found in fish and plant oils. Omega-3 is believed to be important as it may help replace the damaged cells at the back of the eye (photoreceptors). Typically these cells at the back of the eye which are required for vision are destroyed when AMD develops. The idea, therefore, is that Omega-3 may help replace the destroyed cells at the back of the eye. However, research has not yet confirmed that this is the case and further study is needed.

Meso-zeaxanthin (MZ), on the other hand, is believed to be important as it has the required properties to protect the cells at the back of the eye before they are damaged. In other words, MZ may prevent the disease and Omega-3 may be important to replenish damaged cells.

My wife was diagnosed with AMD two months ago. We immediately went to the hospital, where the diagnosis was confirmed. My wife immediately started taking Macushield upon recommendation from the ophthalmologist. The photos showed most obviously that the cyst had reduced significantly. My wife will of course continue to take the Macushield and, in fact, her vision is still distorted and with some strange colour effects (particularly yellow). But I wonder if it is possible that the Macushield is significantly responsible for the improvement. Or is it a happy chance - even though the Macushield may have helped.

We are glad to hear your wife's positive results. Over the last number of years we have learned of similar cases to your wife’s situation, and this is consistent with a recent survey performed in the UK and Ireland.  Scientists and doctors understandably interpret individual cases with caution. However, case studies do contribute to the scientific evidence base which the medical and scientific organisations learn from. With respect to the reduced cyst identified, this is good news and may or may not be related to the supplement. The important thing to observe is if visual performance is improving or at least staying the same. Clinical trials have shown that supplementation with Macushield does, indeed, improve visual performance in patients with AMD. However, the benefits for the disease itself have not yet been confirmed and require continued study which is currently underway. We would recommend that your wife continues taking Macushield and remains under the observation of her ophthalmologist and other eyecare specialists.

I am about to start taking a vitamin with lutein, zeaxanthin and meso-zeaxanthin (MZ).  The formulation has 10mg of lutein, 2mg of zeaxanthin and 10mg of MZ.  Since I have AMD, what is the maximum amount of these ingredients I can take to benefit me?

Lutein, zeaxanthin and meso-zeaxanthin are all naturally occurring plant pigments, known as carotenoids. The levels of carotenoids you are currently taking have been developed according to a scientific method to provide optimal absorption and minimal waste. Recent studies at Waterford Institute of Technology, Ireland, have shown that the optimal response to these nutrients can be achieved when consumed in the formulation of 10mg, 2mg and 10mg (lutein, zeaxanthin and meso-zeaxanthin respectively) such as that which you are taking. It is possible that taking more of this supplement may not have any benefit but this would require additional study. The reason for this is that carotenoids can compete for uptake into the bloodstream and it is therefore possible to take too much.

Where can I source and purchase the MZ material?

MZ is only commercially available within a supplement called Macushield (

It is written on your website that "research has also shown that individuals at risk of developing AMD are lacking in MZ, suggesting that these individuals are unable to form MZ from L at this important retinal location, but do respond positively when MZ is provided in a dietary supplement. The researchers suggested that the deficiency of MZ generation in such individuals may be genetic." This is very interesting: could you send me the reference?

Augmentation of macular pigment following supplementation with all three macular carotenoids: an exploratory study.
Curr Eye Res. 2010 Apr;35(4):335-51.
Connolly EE, Beatty S, Thurnham DI, Loughman J, Howard AN, Stack J, Nolan JM.

A central dip in the macular pigment spatial profile is associated with age and smoking.
Invest Ophthalmol Vis Sci. 2010 Dec;51(12):6722-8. Epub 2010 Jun 30.
Kirby ML, Beatty S, Loane E, Akkali MC, Connolly EE, Stack J, Nolan JM.

Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment.
John M Nolan, Mukunda C Akkali, James Loughman, Alan N Howard, Stephen Beatty

In addition to supplements, what else do you recommend to help prevent AMD?

There are other steps you can take to keep your eyes healthy. Try to consume at least five portions of fruit and vegetables a day, especially brightly coloured ones like spinach, curly kale, peppers, sweetcorn, red grapes and oranges; also egg yolks. Do not smoke, as smoking is an established risk factor for AMD. Try to wear protective sunglasses or lenses when you are in bright light (either sunlight or artificial light). Keep your body mass index (BMI) under control, as well as blood pressure and cholesterol.

AMD is a genetic eye disease, which means that if you have AMD, any siblings or children you have may be at a higher risk of AMD themselves, and should also take the preventative measures listed above.

Visit for more information on AMD risk factors.

Do you know any natural source of meso-zeaxanthin?

There has not been much research conducted to date on the source of meso-zeaxanthin (MZ), however, one publication (Maoka et al) has stated that some seafood (e.g. sea bass, trout) contains amounts of MZ, and it is thought that MZ is most concentrated in the skin of the fish. However, although these foods did contain MZ they did so in very small amounts. Research is currently ongoing (at the Waterford Institute of Technology, Waterford, Ireland, and Tufts University, Boston, USA) to test if other foods (e.g. eggs) contain MZ. Therefore, based on the information that is currently available, the only major known source of MZ is the dietary eye-related supplement called MacuShield.

Maoka et al 1985 "The first isolation of enantiomeric and meso-zeaxanthin in nature":

Where can I purchase mesozeaxanthin? Is it sold separately so I can take it with the pills I now take with Lutein and Zeaxanthin?  I found a product on line that contains all three ingredients; however the amount of mesozeaxthin is not nearly enough. My doctor told me I need 15mg of lutein, 5 mg zeaxanthin and 10 mg meso-zeaxanthin?

There is a commercially available product called Macushield that contains all three macular carotenoids; lutein, zeaxanthin and meso-zeaxanthin. This product is available in most Uk pharmacies and optician practices. Visit for information. This product contains Lutein, zeaxanthin and meso-zeaxanthin in appropriate amounts.

Does meso-zeaxanthin go by any other name?  Is it included in the Bausch and Lomb preservision Areds 2 formula?

Meso-zeaxanthin does not go by any other name. Also, it is not part of the AREDS 2 formula. Therefore, the AREDS 2 results will not be investigating the potential of meso-zeaxanthin for patients with AMD. Many other trials are, however, investigating the potential of this central macular carotenoid.

Can you tell me the difference between Meso-zeaxanthin and Zeaxanthin please?  A recent eye-test revealed that I have drusen.  My sister has AMD (the wrong sort) and I have been recommended to take MacuShield which uniquely contains both these, but the suspicious side of me wonders whether it's Boots way of making more money when I can buy cheaper supplements that lack MZ but contains just the Z.

Lutein, zeaxanthin and meso-zeaxanthin are very similar molecules (scientifically, they are known as structural isomers). However, they are also different molecules in that they are shaped differently and function differently with respect to their antioxidant capacity and ability to filter light. We know that best results are seen when all three are present in the supplement. This is likely why the eye has evolved to have the three present.

Do Macushield  capsules contain Omega 3 ?

No macushield do not contain omega 3. Macushield only contains the macular carotenoids to help protect the central macula.

I have been recommended macushield by my optician but he suggested I check the contents as I also take multibionta probiotic tablets which contain a range of vitamins. Do your tablets contain everyday vitamins as well?

Macushied does not contain any multivitamins. It is a specialised eye supplement containing the macular carotenoids only

Is there any evidence base of a beneficial effect of Meso-Zeaxantin as a prophylaxis against Macular Degeneration?

Only insofar as the following: macular pigment (MP) is lacking decades before onset of age-related macular degeneration (AMD) [Nolan J et al, 2007], and the best means of increasing MP is by means of supplementation with meso-zeaxanthin [Sabour-Pickett S et al, 2014);

I have myopic macular degeneration with CNV in my right eye. Would lutein, zeaxanthin & meso-zeaxanthin supplement have any effect on the condition of my macular degeneration?

It is known that a supplement containing L, Z and MZ represents the best way of preserving vision in age-related macular degeneration (AMD);  myopic macular degeneration represents a risk to vision for the same reasons as AMD (I.e. atrophy and choroidal neovascularisation); therefore, there is a biologically plausible rationale whereby Macushield would benefit patients with myopic macular degeneration

Hi ,my mum has md as well as glaucoma ,is it ok to take macushield ?

Yes, one of the benefits of enhancing macular pigment is its ability to reduce the effects of light scatter and glare. We know that patients with Glaucoma suffer greatly with glare and we also know that patients with Glaucoma have lower macular pigment.