AREDS2 vs AREDS3: What Changed in the New Eye Vitamin Formula

AREDS2 is a nutrient formula tested in a large National Eye Institute trial. AREDS3 is not a trial. It is a Bausch + Lomb product name for a newer over-the-counter supplement that keeps the AREDS2 nutrients and adds eight B vitamins. That addition has research behind it. It does not have AREDS2-grade proof behind it.

That gap is the whole AREDS2 vs AREDS3 question, and it is easy to miss on a drugstore shelf, because the "3" reads like the next chapter in a government study series. It is not. We compared the published National Eye Institute trial data against Bausch + Lomb's own launch materials and the review article the company cites. We did not test either product.

If you have not settled the prior question — should you take an eye vitamin at all? — we answered it separately in do eye vitamins really work. For the wider picture, see our guide to eye health after 50.

What AREDS and AREDS2 Actually Were

Both were real randomized clinical trials run by the National Eye Institute (NEI), part of the National Institutes of Health.

According to the NEI, the original Age-Related Eye Disease Study enrolled 4,757 participants aged 55 to 80 and tested high-dose antioxidants plus zinc against placebo. The headline finding: the formula reduced the risk of advanced age-related macular degeneration (AMD) by about 25 percent over a five-year period.

AREDS2 asked a narrower follow-up question — could the recipe be improved? The NEI reports it enrolled 4,203 participants aged 50 to 85, and only people with intermediate AMD in both eyes, or intermediate AMD in one eye and advanced AMD in the other. It tested adding omega-3 fatty acids, adding lutein and zeaxanthin, removing beta-carotene, and lowering the zinc dose.

Two decades of data, tens of thousands of person-years, and a public agency with no product to sell. That is the standard the word "AREDS" carries.

The AREDS2 Formula Ingredients, Dose by Dose

Per the National Eye Institute, the AREDS2 formula is:

Vitamin C: 500 mg
Vitamin E: 400 IU
Lutein: 10 mg
Zeaxanthin: 2 mg
Zinc: 80 mg (as zinc oxide)
Copper: 2 mg (as cupric oxide)

Six ingredients. No beta-carotene. Those are the exact amounts that were studied, which matters more than it sounds — the benefit belongs to those doses in that population, not to the general idea of "eye nutrients." One clarification on the number above: per the NEI, the 25 percent reduction came from the original AREDS formula, which contained beta-carotene. AREDS2's contribution was testing lutein and zeaxanthin as the replacement for it.

What PreserVision AREDS3 Adds to the AREDS2 Formula

Bausch + Lomb announced the US launch of PreserVision AREDS3 eye vitamins in May 2026. According to the company's own press release, the product keeps the AREDS2 nutrients and adds a B-vitamin complex: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), vitamin B6, biotin (B7), folate (B9), and vitamin B12.

The company makes two further claims worth separating from the trial data.

An absorption claim. Bausch + Lomb states the product delivers "two times better absorption of key nutrients," based on area-under-the-curve measurements of lutein and zeaxanthin compared with its own original PreserVision AREDS 2 soft gel. Read that carefully: it is a pharmacokinetic comparison of blood levels between two of the company's own products. It is not a comparison of what happened to anyone's vision.

A broader-population claim. The company describes AREDS3 as intended to support a broader range of people, including those in earlier stages of AMD. The NEI's position on the AREDS2 nutrients is the opposite: its guidance states there was no benefit for people with early AMD or for people who do not have AMD.

Bausch + Lomb's release also carries the standard supplement disclaimer that its statements have not been evaluated by the Food and Drug Administration and the product is not intended to diagnose, treat, cure, or prevent any disease.

The Evidence Gap Behind the AREDS 3 Formula

Here is where we have to be fair in both directions. The B-vitamin research is not nothing.

Bausch + Lomb points to a narrative review published in the journal Ophthalmology and Therapy in December 2025, which the company says synthesized more than 20 human studies involving roughly 30,000 people. The strongest single piece of evidence in it is the Women's Antioxidant and Folic Acid Cardiovascular Study (WAFACS). In that trial, 5,442 women were randomized to a daily combination of 2.5 mg folic acid, 50 mg vitamin B6 and 1 mg vitamin B12 or to placebo, and the 5,205 of them who had no AMD at the start were tracked for eye outcomes. Over an average of 7.3 years, the B-vitamin group had a 34 percent lower risk of confirmed AMD and a 41 percent lower risk of visually significant AMD.

There is also a biological story. A systematic review and meta-analysis published in Scientific Reports found that plasma homocysteine averaged 2.67 micromoles per liter higher in people with AMD than in controls, while vitamin B12 levels averaged lower — and B vitamins can lower homocysteine.

Now the honest part.

WAFACS was not an AMD trial. It enrolled women aged 40 and over who already had cardiovascular disease or multiple cardiovascular risk factors, and AMD was examined as a secondary analysis. The Ophthalmology and Therapy review itself presents that result as a secondary analysis of the WAFACS data, and it points to no randomized trial designed from the outset to test B vitamins for AMD.
The review is not independent. Its own disclosures state that the journal's publication fee and editorial assistance were funded by Bausch + Lomb, and its authors report advisory, consulting or speaking relationships with the company.
It is a narrative review, not a trial. Synthesizing existing literature is useful work. It does not produce new randomized evidence about a specific product.
The trial does not exist yet. Ophthalmology Times reported at launch that the evidence for the B-vitamin additions comes from observational studies and a review rather than from a dedicated, prospectively designed trial of this specific formulation, and that Bausch + Lomb has a long-term clinical trial in planning.

So the accurate sentence is not "AREDS3 does not work." It is: nobody has run the study that would tell us. A formula that borrows its name from a trial series has not been through the trial series.

Why AREDS2 Changed the Original Formula

This part is the model for how a formula change should be justified, and it is worth contrasting.

The original AREDS formula contained beta-carotene. According to the NEI, lung cancers appeared in 2 percent of participants taking an AREDS formulation with beta-carotene, compared with 0.9 percent of those taking it without — and current smokers, or people who had quit less than a year before enrollment, had been excluded from receiving beta-carotene in the first place. Lutein and zeaxanthin were substituted in. The NEI notes that participants whose ordinary diets were lowest in lutein and zeaxanthin saw a 26 percent lower risk of progressing to advanced AMD on the supplemented formula.

That is a change made because a trial produced a safety signal and a trial tested the replacement.

Omega-3 fatty acids tell the other side of it. AREDS2 tested them, and per the NEI, adding omega-3s had no additional overall effect on the risk of advanced AMD. They were left out of the formula on the evidence. That says nothing about omega-3s for other purposes — we cover those separately in our look at the best omega-3 fish oil supplements — but for slowing AMD, the trial answered no.

Who Either Formula Is For

Narrower than the marketing suggests, and the boundary has not moved.

The National Eye Institute states that the supplements benefited people with intermediate or late AMD only, that there was no benefit for people with early AMD or for people without AMD, and that nutritional supplements cannot prevent AMD. The American Academy of Ophthalmology frames it similarly: these vitamins are most likely to help people who have a lot of drusen, they are not a cure for AMD, and nutritional supplements alone are not enough to prevent or delay advanced AMD.

Neither AREDS2 nor AREDS3 is a general vision supplement. Neither will sharpen your reading vision, and neither is insurance for healthy eyes. Macular degeneration risk factors are a separate subject that we will cover on their own.

If your eye doctor has placed you in the group the trials studied and the remaining question is which bottle to buy, that is a shopping decision, and we have written it up in our guide to the best eye vitamins for aging eyes.

Zinc, Copper and the Interaction Footnotes

The two products do not carry the same zinc dose, and that deserves a second look.

The National Institutes of Health Office of Dietary Supplements sets the tolerable upper intake level for zinc at 40 mg a day for adults 19 and older — half the 80 mg in the AREDS2 trial formula. That is not a contradiction; the trial dose was chosen deliberately and studied under supervision. It does mean the AREDS2 dose is a pharmacological one, not a nutritional top-up. Bausch + Lomb states that its PreserVision AREDS 2 soft gels deliver that same 80 mg of zinc a day, while PreserVision AREDS3 delivers 25 mg a day — a level the company says it chose because AREDS2 found no statistically significant difference in outcomes between the 80 mg and 25 mg zinc doses.

The copper is there for a reason. According to the NEI, copper was added to zinc-containing formulas to reduce the risk of copper deficiency anemia, a condition associated with high zinc intake. The Office of Dietary Supplements notes that high zinc intakes can inhibit copper absorption, sometimes producing copper deficiency and anemia, and that zinc supplements can interfere with tetracycline antibiotics — its guidance is to separate the two by at least two hours before or four to six hours after.

Three practical consequences:

If you already take a multivitamin or a separate zinc supplement, you can stack up past the upper limit without noticing. Bring every bottle to your appointment.
If you are on antibiotics or other prescriptions, ask a pharmacist about timing rather than guessing.
Adding B vitamins to the mix is another set of ingredients to reconcile with whatever else you take. Our broader notes on supplement safety after 50 go through how these overlaps happen.

What to Ask Your Eye Doctor

Short, concrete, and worth writing on a card:

What stage of AMD do I actually have — early, intermediate, or advanced in one eye?
Based on that stage, does the AREDS2 evidence apply to me at all?
Is there any reason my zinc dose should be reconsidered given my other medications?
Do you have a view on the added B vitamins, given there is no outcomes trial on that combination yet?
How often should I be back for a dilated exam?

The fourth question is the one that separates the two products. If the answer is "it probably does not hurt, and we do not know that it helps," that is an honest answer, and it should inform what you pay.

Monitoring Between Appointments

Whatever is in your bottle, monitoring is the part that actually catches trouble early.

The American Academy of Ophthalmology recommends the Amsler grid — a simple square grid of lines with a center dot — used once a day, one eye at a time. If lines look wavy, bent, or if a blank or dark patch appears near the center, that is a change to report. It is a between-visit check, though, not a replacement for a dilated eye exam. We walk through the technique, and the rest of the at-home checks worth doing, in how to test your vision at home.

A Note on Medical Advice

This article is general information, not medical advice. Mary Burson is a health writer, not a doctor and not an eye care professional. Whether either formula makes sense for you depends on your diagnosis, your other medications and your own physician's judgment — ask an eye doctor or physician about your situation before starting or changing any supplement.

Some symptoms are not a supplement question at all. Sudden vision changes, eye pain, light sensitivity with redness, or a new shower of floaters or flashes of light need to be seen promptly. The American Academy of Ophthalmology notes that a sudden burst of new floaters, a sudden increase in flashes, or a dark curtain or shadow moving across your vision can signal a retinal tear or detachment and requires immediate evaluation.

AREDS2 vs AREDS3: What We Would Tell a Friend

AREDS2 is a formula with trial numbers attached to it: the NEI reported about a 25 percent reduction in the risk of advanced AMD over five years, in a defined group of people, on the original AREDS formula, and AREDS2 then tested the substitutions that produced today's version — all of it from a trial program run by a public agency.

AREDS3 is that nutrient set — at a lower zinc dose — plus eight B vitamins and a better-absorption claim measured in blood levels rather than in eyesight. The B-vitamin literature is genuinely interesting and genuinely unfinished. Even the company-funded review that supports the idea says the dedicated randomized trials have not been done.

We are not telling you to avoid it. We are telling you what you are buying: a well-established formula, plus an addition that is a reasonable hypothesis. If a product's name implies a third NEI trial, and no third NEI trial exists, you should know that before the checkout screen — and you should ask your eye doctor what, if anything, the extra ingredients are worth in your case.

For how eye vitamins fit alongside exams, screens, light, and the rest of what changes in your forties and fifties, read our complete guide to eye health after 50.