Dry eye is a common condition that you may have experienced in your lifetime. Many factors influence dry eye, including computer use, contact lens wear, air quality, climate, hormones, medications, laser eye surgery, and systemic diseases. One factor that is often overlooked, however, is nutrition. What you eat can have a noticeable impact on how your eyes feel, and it involves more than eating carrots!
What Is Dry Eye?
Dry eye may sound simple, but it’s a complex disease that involves changes in the quality of your tears, a decrease in the volume of tears, and inflammation of the ocular surface. These changes can cause significant discomfort and vision problems.
There are two major categories of dry eye:
- Aqueous-deficient dry eye occurs when the lacrimal gland (located above each eye) does not function normally and produces fewer tears. This form of dry eye comprises less than 15% of dry eye cases. Sjogren’s syndrome is an autoimmune disease that causes aqueous-deficient dry eye and other symptoms that affect the entire body. However, not everyone with aqueous-deficient dry eye has Sjogren’s syndrome.
- Evaporative dry eye is the most common type of dry eye. Your tears are composed of a lipid layer on the outside, an aqueous (water) layer, followed by a mucin (mucous) layer. In evaporative dry eye, a deficiency in the lipid layer causes your tears to evaporate too quickly. Typically, this type of dry eye is associated with meibomian gland dysfunction, which causes inflammation of your eyelid margin and clogged oil glands. People with rosacea or seborrheic dermatitis may be prone to this condition.
General symptoms of dry eye include:
- Burning
- Grittiness
- Itching
- Discharge
- Tearing
- Redness
- Eye pain
- Blurred vision
- Light sensitivity
Treating Dry Eye
The treatment of dry eye depends on the severity and type of dry eye. Therapies may include:
- Artificial tears provide additional moisture and can target specific dry eye issues. For example, some artificial tears are oil-based to help stabilize the lipid layer of the tear film. Preservative-free formulas are available for people with sensitive eyes or severe dryness.
- Heat compresses help to open up clogged oil glands. You can purchase a moist heat mask and use it for 10 minutes twice a day. Alternatively, a warm washcloth can be used, although the mask is much better at maintaining the necessary heat level.
- Moisture goggles create a chamber of moisture around your eyes to keep them hydrated as you sleep. They also function as a blackout sleep mask!
- Punctal plugs are an in-office (nonsurgical) treatment that slows down tear drainage and allows more tears to remain in your eyes. These are tiny silicone or collagen plugs inserted into the puncta, which are the small holes in the inner corner of your eyelids that drain tears out of your eyes.
- Antibiotic pills such as doxycycline and azithromycin are effective treatments for meibomian gland dysfunction since they target both the inflammatory and bacterial aspects of the condition.
- Topical medications may include steroids or lifitegrast to reduce inflammation associated with dry eye. Cyclosporine is an eye drop that stimulates your eyes to produce more tears.
- Meibomian gland expression unclogs the oil glands in your eyelid margin. This procedure can alleviate symptoms of evaporative dry eye. The eye doctor may perform the expression manually with simple handheld tools, an instrument that applies heat and pressure to open up the glands, or intense pulsed light therapy to liquefy the oil.
- Autologous serum eye drops are customized eye drops made from your blood. This serum is very similar to your natural tears, which is why this treatment may be more effective than artificial tears. They also help promote healing of the cornea, which may become damaged if the dryness is severe enough.
- Amniotic membranes help heal the cornea if you have severe dry eye. These membranes are created from placental tissue when female donors have an elective cesarean section. The membrane is placed into the eye during a simple in-office procedure and dissolves several days later.
- Nutritional supplements specifically formulated for dry eye can improve signs and symptoms of dry eye disease. We’ll dive into these supplements below.
Nutritional Considerations
What you eat has a considerable impact on your eye health. Omega fatty acids are some of the key nutrients for addressing dry eye. They have anti-inflammatory effects, which are particularly helpful in addressing inflammation associated with dry eye disease. There are a few types of omega fatty acids to look for in a supplement:
- Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are omega-3s found in fish oil. A review of several studies found that omega-3 supplements effectively treat signs and symptoms of dry eye disease.
- Gamma-linolenic acid (GLA) is found in evening primrose oil, borage seed oil, hemp oil, and black currant seed oil. Though most omega-6s are pro-inflammatory, GLA actually decreases inflammation. The combination of DHA, EPA, and GLA provides powerful anti-inflammatory effects to improve dry eye symptoms in those with Sjogren’s syndrome, meibomian gland dysfunction, or previous laser refractive surgery.
Other nutrients that are beneficial for dry eye:
- Vitamin A is a fat-soluble vitamin that is essential for maintaining corneal health and lubrication of the eyes. Specifically, vitamin A plays a role in goblet cell health, which are the cells in your eye that produce the mucin layer of tears.
- Vitamin B deficiency (including B12, B6, B1, and B2) may contribute to dry eye, particularly in patients with Sjogren’s syndrome. Supplementing vitamin B complex may aid in tear secretion. Vitamin B6 is also important for the metabolism of fatty acids.
- Vitamin C is a powerful antioxidant that helps with collagen formation, a protein abundantly found in the cornea (along with the skin, bones, and other tissues in the body). This vitamin also reduces oxidative stress that may lead to ocular surface inflammation.
- Vitamin E is another antioxidant that plays a role in the metabolism of fatty acids.
HydroEye is a dry eye supplement that contains a unique blend of GLA, EPA, and DHA. This proprietary formula works to prevent the formation of pro-inflammatory prostaglandins and produce anti-inflammatory prostaglandins. The addition of vitamins A, B6, C, E, and magnesium boosts fatty acid metabolism, reduces inflammation, and maintains corneal and tear film integrity. This supplement is more effective than taking fish or flaxseed oil alone.
HydroEye is an excellent option for patients with post-LASIK dryness, inflammatory conditions, Sjogren’s syndrome, and many other causes of dry eye. To find out more about HydroEye, contact our practice for a dry eye consultation!