Vision Loss From Nutritional Optic Neuropathy Can Be Recovered

Vitamin B12 , folic acid and other B-complex vitamins are essential for a healthy brain and immune system; these vitamins enable the nervous system to function properly and are needed to make both red blood cells and DNA. The clincher is our bodies don’t make these essential vitamins; instead we must rely on our dietary intake to provide the quantities we need.  Good dietary sources of B-complex vitamins include meat, fish, poultry, eggs, milk and milk products. Vitamin B12 and other B-complex vitamins are not typically found in plant-based foods, although some nutritional yeast products and fortified foods do contain a readily-available source for those of us who choose an animal-free diet.

So what’s this got to do with our vision? A prolonged deficiency in vitamin B12 (cobalamin), vitamin B1 (thiamin), vitamin B6 (pyridoxine), vitamin B2 (riboflavin), vitamin B3 (niacin) and folic acid can lead to abnormal functioning of optic nerve fibers, resulting in a medical condition called nutritional optic neuropathy.

Nutritional Optic Neuropathy is characterized by an equal and gradual, painless loss of central vision in both eyes (i.e., a bilateral and symmetrical loss), caused by either relative (reduced sensitivity) or absolute (absence of sensitivity) defects in a patient’s field of vision.  A disturbance – or reduction in – a patient’s ability to perceive color frequently accompanies this gradual vision loss. Although the medical community does not yet have an exact understanding of how this neuropathy develops, it is believed that insufficient levels of B-complex vitamins impair biochemical processes at a cellular level. Inadequate levels of vitamin B12 and/ or folic acid – for too long at time – promote synthesis and accumulation of toxic formate, which blocks the process of oxidative phosphorylation in mitochondria. This leads to a decrease in adenosine triphosphate (ATP), excessive accumulation of reactive oxygen species, and disorders of axonal transport in the optic nerve fibers.  All of this combined eventually begins to damage the optic nerve fibres causing structural abnormalities to the most central part of the optic nerve called the papillomacular bundle. It is when this structural damage occurs that any functional loss in vision becomes noticeable.

A deficiency in B-complex vitamins can result from a myriad of reasons. Epidemic outbreaks of nutritional optic neuropathy in certain geographic areas can be associated with poor economic conditions, war conflicts and extreme weather (e.g., drought, storm or flood.) Heavy use of alcohol or cigarettes can exert a toxic effect on optic nerve fibers, which is then exasperated by a vitamin B-complex deficiency. A poorly balanced or overly restricted diet can result in nutritional deficiencies that wreak havoc on our body’s systems. Certain medical treatments – like bariatric surgery – can result in neurological and/ or ophthalmic complications (in up to 16% of patients) due to impaired intestinal absorption and the recommended protein-rich and fat-deficient diet that follows surgery. And malignant anemia can also cause reduced absorption of vitamin B12 from the ileum, resulting in a severe deficiency of this essential vitamin.

So although the cause may vary, the treatment goals of a B-complex deficiency remain similar – increase absorption and/ or dietary intake so that adequate vitamin levels are available to support essential body functions. (It’s assumed that a treatment goal is also to eliminate or reduce the underlying cause of the deficiency.) Increasing vitamin intake/ absorption at early stages can help to avoid or minimize vision impacts, however, once damage to the optic nerve has occurred the available treatment options become more limited.  Even so, vision loss from nutritional optic neuropathy can be improved or recovered. Even after several years of vision loss, our experience has shown that Fedorov Restoration Therapy can expand a patient’s field of vision and improve visual acuity and low contrast.