Supplements alone won't completely treat dry eye, but recent studies have examined the link between certain vitamins and eye disease.
Omega-3 fatty acids that can be found in fish oil or flaxseed may help treat dry eye, along with other vitamins like A, E, and B12.
Many factors can cause dry eye and can indicate other health problems, so it's best to check with a doctor before adding any vitamins and supplements to your regimen.
When your eyes don't produce adequate tears, or if there is an abnormality in the quality of the tear film - the oil, water, and mucus layer that coats the eye - the result is dry eye. Your eyes may become red, sting, or feel irritated as if sand is caught on the surface of your eyeball.
As many as 5 million Americans suffer from dry eyes, which can range in severity from mild irritation to severe pain. The condition is common, especially in women as they enter menopause, according to the National Eye Institute at the National Institutes of Health (NIH).
Although results are inconclusive, vitamins and supplements have been studied in an effort to treat or prevent dry eyes.
Here's what you need to know about dry eyes and whether vitamins and supplements may help.
What causes dry eyes?
"Dry eye is a complex disease and is affected by not only what we eat, but also by our environment and our activities, such as prolonged computer use or TV viewing," says Rony Sayegh, MD, a dry eye specialist and ophthalmologist at Cleveland Clinic. When you're using the computer or watching television, you blink less and produce fewer tears.
He says dry eyes may also be caused by a variety of medical conditions including:
Treatment for dry eyes usually involves over-the-counter artificial tears, or an eye ointment or gel, says Robert Friedman, MD, an ophthalmologist in private practice in New York City. A humidifier can also help by adding moisture to your environment.
Research has tied a healthy diet to overall eye health. Getting vitamins and nutrients through diet and exercise have been found to be particularly helpful in ameliorating the progression of age-related macular degeneration (AMD), which has stimulated studies of the role of supplements for treating other conditions. Some doctors say the following supplements may help dry eyes:
1. Omega-3 fatty acids
Fish oil containing omega-3 fatty acids is a popular recommendation.
"Many physicians feel that omega-3 supplementation is generally safe, and many patients feel improvement in their dry eye symptoms with its use, making it one of the most recommended supplements," Sayegh says.
"These come in various forms and dosages making them difficult to study in a standardized manner," says Sayegh. "Several studies have shown a beneficial effect on inflammation of the lid margins and improvement in the oil composition of the tear film which reduces its evaporation."
For example, a 2008 study found that patients taking two 1000-mg capsules of flaxseed oil three times a day orally offered some benefit to patients with conditions such as blepharitis, and/or meibomian gland dysfunction (MGD), eyelid inflammatory disorders associated with dry eye. Flaxseed oil seemed to improve the oil quality produced by the eyelid glands.
In 2018, one of the largest NIH-sponsored studies on the effects of omega-3 fatty acids on dry eyes concluded that patients who received 3,000 mg of omega-3 for 12 months did not show significantly better results than patients who received an olive oil placebo.
Possible side effects of fish oil include increased risk of bleeding and an increased risk of stroke. Omega-3 fatty acids can potentially interfere with blood thinners, blood pressure medications, and contraception.
2. Vitamin A
Severe vitamin A deficiencies can result in dry eyes, which supplements may help.
Park points out that Vitamin A deficiency is rare in the US, as it is associated with severe malnutrition. The World Health Organization (WHO) considers vitamin A deficiency a public health problem globally. In Americans, it has been seen to occur in some patients with cystic fibrosis and some after bariatric weight loss surgery.
Vitamin A is an important component of the chemicals in the retinal cells responsible for vision, says Sayegh. In certain cases, an over-the-counter vitamin A ointment such as Vita Pos may be applied directly to the eyes to reduce dryness.
However, Park cautions "you must be cautious to not overdose vitamin A, as it is stored in the liver and an excess may produce liver toxicity." Too much vitamin A may also lead to increased intracranial pressure, which could lead to papilledema (optic nerve swelling) and blindness.
A small 2019 study concluded that in a sample of Saudi Arabian men, 1500 mg of vitamin A taken orally for three consecutive days improved "the quality, but not quantity, of tears in patients with dry eye." This finding warrants further research.
3. Vitamin B12
Several studies have linked Vitamin B12 deficiencies in patients with conditions that result in dry eye. In one case, a patient in India reportedly experienced dramatic improvement within three weeks of using a B12 vitamin serum after suffering blistering pain and a gritty feeling in her eye for one year. Within six months, the authors noted that she was symptom-free.
Since vitamin B12 is only present in foods derived from animals, vegans require B12 supplements - symptoms and signs of B12 deficiency include anemia, yellow skin, optic neuropathy, cognitive slowing, and peripheral neuropathy, leading to weakness or numbness in your extremities.
Due to the variability of absorption when taken orally, B12 is often injected - usually in the arm, buttock, or thigh, Park says.
Lutein is an anti-inflammatory nutrient found naturally in the retina and dark green leafy vegetables, such as kale and spinach. A 2015 study by Taiwanese doctors found that lutein may help reduce inflammation in cultured corneal epithelial cells, the layer which protects the front of the eye and may help to reduce dry eye symptoms.
Since lutein is considered a safe dietary supplement used in the treatment of age-related macular degeneration (AMD) and other eye diseases, the study's "promising results support further research into using lutein use to treat dry eye," the authors concluded.
5. Vitamin E
"Vitamin E is an important antioxidant, however, no direct beneficial effect of supplementation on dry eye has been shown," Sayegh says.
However, a small 2020 study in Spain tested eye drops composed of hyaluronic acid, coenzyme Q10, and vitamin E against artificial tears formulated with the sodium derivative carmellose sodium in menopausal patients. It found that a lower daily dose of the drops containing vitamin E "was sufficient to achieve better dry eye disease management compared to carmellose." That said, it's unclear whether the improvement can be wholly credited to vitamin E.
While there are no treatments for dry eyes from supplements alone, the NIH and other institutions have recently undertaken studies to examine the link between several vitamins and eye disease with promising, but inconclusive results - sparking more interest in such research.
Many doctors consider there to be little harm in it and a potential improvement from taking fish oil or flaxseed supplements to improve dry eye.
However, many factors can cause dry eye - which can indicate other health problems - so it's best to check with a doctor before adding any of the aforementioned vitamins and supplements to your regimen.
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