In the modern era of evidence-based scientific medicine, there is little recognition of centuries of shaman observational evidence. Yet it is extremely difficult to conduct long duration controlled studies of large populations. The controversy surrounding the issue of flavonoid bioactivity and alleged benefits for eye health is also plagued by natural product industry marketing efforts that rely on small, often poorly designed studies. Ample laboratory evidence exists from in vitro and in vivo studies that provide plausible mechanistic evidence for flavonoid interactions relevant to visual function. Lacking are large randomized double-blind placebo-controlled studies in older subjects who have early signs of vision impairment. These studies could link flavonoid intake and bioavailability to efficacy in prevention of age related vision disorders that develop over decades. Support for clinical trials remains to be found before a full "recommendation" can be made regarding the value of diets high in flavonoids for eye health.