Have a few annoying gray spots and strands constantly moving around in your vision? Vitreal floaters are a common for adults (but if you are seeing new flashes or floaters in your vision, make sure you get checked out by an eye doctor immediately to rule out a retinal detachment or bleeding inside the eye!). The inside of the eye is filled with a jelly-like substance called the vitreous. With time the vitreous jelly begins to liquify and breakdown, causing clumps of protein and hyaluronic acid to form and free-float around within the eye. These are normal, age related floaters - annoying, but perfectly harmless. And to this point in the medical literature there has been no real treatment or prevention for floaters discovered.
A 2019 study published in the Journal of American Science proposes a possible nutritional approach to reducing the appearance of age-related, benign vitreal floaters. In this small study of 388 people with either 1 or multiple vitreal floaters in their vision, participants were split into different test groups and assigned to eat either 1, 2, or 3 pieces of fresh pineapple with lunch every day over a 3 month time period. They found a dose-dependent effect with people eating more pineapples having more resolution of their floater complaints. After 3 months, 45.5% of people eating 1 piece of pineapple per day, 37.8% of those eating 2 pieces of pineapple per day, and 30.2% of those eating 3 pieces of pineapple per day complained of floaters in their vision (versus 100% at the start of the study).
2019 Study outcome of daily fresh pineapple intake on floater improvement via |
Patients enrolled in this study were 18 years or age or older and had both visual symptoms and confirmed floaters or PVD (posterior vitreous detachment - a condition where a large floater forms when the vitreous jelly fully separates from the retina, typically due to age) as viewed during a dilated eye exam and with B scan ultrasonography or OCT imaging. In addition to subjective improvement in floater complaints with eating fresh pineapple, improvement in floaters was also confirmed using B scan and OCT imaging.
B Scan Ultrasonography can be used to detect floaters as well as conditions like retinal detachment. via |
The study authors concluded "concluded that pineapple intake may
decrease the aggregation of collagen fibrils forming
fibers and the rates of symptomatic floaters." They did caution that eating more than 3 pieces of pineapple per today could potentially increase blood sugar and cause concerns with diabetes, so eating more than the maximum 3 pieces per day was not advised by the study authors. There were no side effects or adverse events during the course of the study.
Why would pineapples apparently improve floater symptoms? Pineapples are rich in bromelain, a proteinase (or enzyme) that breaks down clumps of proteins. The idea of using a proteinase to treat floater complications in the eye is not new; before it was removed from the market in 202 due to risks of retinal hemorrhage and ocular inflammation, an intra-vitreal injection of a proteinase called ocriplasmin (brand name, Jetrea) was FDA approved for breaking down tractional adhesions between the vitreous and retina.
With such a small study over such a limited time frame, much more research is needed to provide a clear picture as to the benefit of pineapple intake as a floater treatment. Pharmaceutical and nutraceutical companies are rapidly investigating this as a potential treatment option.
A 2022 study looked at another very small population (n=224) of people with symptomatic vitreous floaters or vitreous hemorrhage taking a supplement of 190 mg bromelain, 95 mg papain, and 95 mg ficin for 3 months. The study was double blind and placebo controlled (placebo was a vitamin C supplement) and patients were split into either a control group taking vitamin C placebo, or a treatment group broken up into 1, 2, or 3 capsules of the supplement per day. They also found a dose dependent effect of symptom and floater improvement:
In this study, symptomatic vitreous floaters resolved in 55% of patients taking 1 supplement capsule, 62.5% taking 2 capsules and 70% in those taking 3 capsules at the end of 3 months. Only 5% of patients taking Vitamin C for placebo effect had improvement in floaters during the 3 month time frame. For vitreous hemorrhage patients, vitreous hemorrhage disappeared in 18% of those taking 1 dose, 25% of those taking 2 doses, and 56% taking 3 doses at the end of 3 months. Because vitreous hemorrhage does clear with time for most patients, even in the placebo group, 18% of patients had resolution of their symptoms at the end of the 3 month time period.
Study authors also reported patient satisfaction surveys for supplement use; supplements were very well tolerated by patients, with 92% of patients who took supplement therapy reporting satisfaction with their results of improved floaters at the end of the 3 month study.
This research is still very new and much larger studies are needed to show effectiveness and establish the beneficial amounts of raw pineapple or bromelain supplementation needed to achieve results. If you are experiencing new floaters it is essential to have an eye doctor exam your eyes to make sure there is no underlying issue like a retinal tear or detachment requiring urgent surgery.
If you have confirmed, benign and age-related floaters, you may want to talk with your primary care doctor and ensure there are no concerns for your personal health from eating 2-3 pieces of fresh pineapple per day for the next 3 months; it may be worth a try to see if you experience an improvement in your floater symptoms!