Dry eyes treatment and solution with natural supplements, vitamins, alternative therapy
February 1 2017 by Ray Sahelian, M.D.

The eye depends on a constant flow of tears to maintain lubrication and comfort. When the eye becomes dry, this can be a source of irritation. Dry eye syndrome is a common and often painful condition that can cause damage to the cornea and harm vision. People who wear contact lenses often suffer from dry eye syndrome, as do many of those who undergo laser procedures to correct their vision. Women going through menopause also frequently develop this condition. There are many causes for dry eye syndrome and I have listed them below.

Dry eyes can effect the eyes in many ways. Patients can have burning, pain, irritation, blurred vision, and the most common symptom of dry eyes is excess tearing as the eyes try to compensate for the dryness.

Diet and dry eyes
The idea that diet may have an influence on dry eyes is being explored, and it is possible that consuming a higher amount of fatty acids from fish may help.

Natural treatment for dry eyes
There may be some natural treatment for dry eyes that could be helpful to certain individuals. Discuss with your doctor if these are appropriate for you.

Fish oils and / or krill oil should be considered, as well as decreasing the intake of omega 6 fatty acids and increasing the intake of omega 3 fatty acids. Omega 3 fatty acids are found in fish, particularly the highly unsaturated EPA and DHA fatty acids. 
Testimonial by email: I have been taking fish oils to assist with a dry eye condition. It has helped greatly.

Flax seed oil capsules taken internally may be helpful or you can substitute flax seed oil for other types of common cooking oils. It is best to not heat flax oil. Cooking oils changes their structure and takes away their benefits.

Hemp oil - I am not sure if hemp oil is helpful since I have not seen any trials with it yet. Same with borage or evening primrose oils.

Eat more fish and less vegetable oil, and avoid white bread and refined cereals. Avoid margarine and processed foods.

Clin Dermatol. 2016. An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract. Visual impairment is a global epidemic. In developing countries, nutritional deficiency and cataracts continue to be the leading cause of blindness, whereas age-related macular degeneration (AMD) and cataracts are the leading causes in developed nations. The World Health Organization has instituted VISION 2020: "The Right to Sight" as a global mission to put an end to worldwide blindness. In industrialized societies, patients, physicians, researchers, nutritionists, and biochemists have been looking toward vitamins and nutrients to prevent AMD, cataracts, and dry eye syndrome. Nutrients from the AREDS2 study (lutein, zeaxanthin, vitamin C, vitamin E, zinc, copper, eicosapentanoic acid [EPA], and docosahexanoic acid [DHA]) set forth by the National Institutes of Health remain the most proven nutritional therapy for reducing the rate of advanced AMD. Omega-3 fatty acids, especially DHA, have been found to improve dry eyes in randomized clinical trials. Conflicting results have been seen with regard to multivitamin supplementation on the prevention of cataract.

Eyesight Rx For Healthy vision

Unlike some vision products that provide nutrients and herbs for long term healthy eyesight support, and prevention of visual impairment, but don't seem to have much of an immediate effect on visual acuity, Eyesight Rx was formulated to provide a quick and noticeable eyesight improvement within hours or days of use.

Reports from Eyesight Rx users indicate enhanced clarity of vision, colors being brighter, better focus, and overall improvement in close and distance vision. We've had reports of some people noticing this effect within a few hours. Most people realize their eyesight is sharper after a few days of use.

What's in it:
Vitamin C (Ascorbic acid)
Carnosine antioxidant
Citrus bioflavonoids (eriocitrin, hesperidin, flavonols, flavones, flavonoids, naringenin, and quercetin)
Mixed carotenoids (astaxanthin, beta carotene, cryptoxanthin,
Lutein, Lycopene,  Zeaxanthin)
Bilberry extract (Vaccinium myrtillus) contains anthocyanins which protect the retina.
Eyebright extract (Euphrasia officianales)
Jujube extract (Zizyphus jujube)
Ginkgo biloba (Ginkgo biloba)
Suma extract (Pfaffia paniculata)
Mucuna pruriens extract (Cowhage)
Cinnamon (Cinnamomum zeylanicum)
Lycium berry extract (Lycium Barbarum)
Alpha Lipoic Acid is a powerful antioxidant that enhances glucose use in brain and eye cells.

I have been taking a tablet Eyesight Rx for 2 weeks. My eyes are less dry and my distance vision is better. I am wearing my glasses less.
   That's great that your vision and dry eyes are better. We suggest cutting back and using the eye formula 4 or 5 days a week.

Causes of dry eyes
Dry eyes can be caused or made worse by exposure to many environmental conditions that have a drying effect, such as a dry climate, sun exposure, wind, high altitude, cigarette smoke, hot blowing air and the dry air that commonly occurs in the cabins of commercial airplanes. Those who wear contact lenses can have dry eyes. It is common in winter because of cold, dry outdoor air and dry indoor heat. Most often dry eyes is not a serious eye disorder, however it is extremely annoying and reduces quality of life.
   Dry eyes occur due to lack of tears being produced or the quality of the tear is suboptimal. There may be inflammatory cells within the tears, and because of this inflammation, (that cannot be seen unless under a microscope), the tears may not stick to the surface of the sclera or the cornea.
   Dry eyes may occur after LASIK treatment.
   SSRIs and serotonin-norepinephrine reuptake inhibitors, medications used for depression, increase the risk for eye dryness.

Residents of American cities with high levels of air pollution are much more likely to develop this condition than people who live in cities with cleaner air, American Academy of Ophthalmology, news release, Nov. 16, 2013.

In some people, dry eye syndrome may be related to:
Conditions that affect the ability to produce tears, such as Sjogren's syndrome, scleroderma, rheumatoid arthritis, and collagen vascular diseases.
Medications that can cause dry eyes include diuretics, antihistamines and decongestants, certain sleeping pills, tricyclic antidepressants, and isotretinoin-type drugs for treatment of acne. Clozapine is an atypical anti-psychotic that can cause this eye problem.
Eyelid structural problems that prevent them from closing properly.

Dry eyes diagnosis
An ophthalmologist can put a strip for five minutes and see how much tear production there is.

Dry eyes treatment -- medication for dry eyes
Artificial tears eye drops can be used for dry eyes. The treatment for dry eyes has to be customized to the patient. Dry eyes are typically treated with artificial tears often containing hyaluronic acid. The problem with these eye drop preparations is that they do not stay on the eye surface for very long.

Tear duct plugs
Plugging the tear ducts is another option for severe dry eyes. The most widespread treatment for dry eyes in clinical practice is an instillation containing artificial tear fluid. When an instillation does not improve dry eye,  punctal plugs are used. The insertion of punctal plugs is an eminent curative that positively improves the corneal and conjunctival epithelial disorders and the amount of lacrimal fluid accumulated in the conjunctival sac.

Research references
Cont Lens Anterior Eye. 2015. Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye. To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symptoms,  This study demonstrates the beneficial effect of orally administered fish oils in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye.

Relation between dietary n3 and n6 fatty acids and clinically diagnosed dry eye syndrome in women.
From the Division of Preventive Medicine, Brigham and Womens Hospital, Boston, MA; the Schepens Eye Research Institute, Boston, MA; the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary (MRD, JPG, DAS) and the Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA; and the Department of Epidemiology, Harvard School of Public Health, Boston, MA.
The researchers tried to determine the association between the dietary intake and ratio of n3 and n6 fatty acids and dry eyes syndrome occurrence. Of the 39876 female health professionals in the Womens Health Study, 32470 women aged 4584 y who provided information on diet and DES were cross-sectionally studied. Fatty acid intakes were assessed by using a validated food-frequency questionnaire and assessed dry eyes syndrome by using self-reports of clinically diagnosed cases. Of the sample, 1546 (4.7%) subjects reported dry eyes. The researchers found that a higher dietary intake of n3 fatty acids is associated with a decreased incidence of dry eyes in women.

Association between Symptoms and Signs of Dry Eye among an Elderly Chinese Population in Taiwan: The Shihpai Eye Study.
Invest Ophthalmol Vis Sci. 2005.
To analyze the association between dry eye symptoms and signs in an elderly Chinese population in Taipei, Taiwan. The participants were those of the Shihpai Eye Study, a population-based survey of eye diseases in the elderly (>/=65 years) in Shihpai, Taipei, Taiwan. Dry eye symptoms were evaluated with an interviewer-administered questionnaire. Dry eye signs, including tear-film breakup time, Schirmer test result, score for fluorescein staining of the cornea, and meibomian gland dysfunction, were assessed. Of the participants, 33% were symptomatic, defined as reporting one or more dry eye symptoms often or all the time. A Schirmer result of </=5 mm was the only sign associated with frequent symptoms. Its sensitivity and specificity in detecting symptomatic subjects were 62% and 43%, respectively. The agreement between each sign was statistically significant, although weak, except that no correlation was found between the Schirmer result and meibomian gland anomalies. Of the symptomatic subjects, 85% had either a low Schirmer result or a meibomian gland anomaly; 38% of them were abnormal on both tests. The Schirmer test was shown to be incapable of detecting meibomian gland disease. However, a low Schirmer result was significantly associated with dry-eye symptoms in this elderly Chinese population. This result differs from that of previous reports of elderly white populations.

Only a handful of tear proteins appear to be selectively downregulated in dry eye, the most common eye disease. Lacritin and lipocalin-1 are two tear proteins selectively deficient. Both proteins influence ocular surface health. Lacritin is a prosecretory mitogen that promotes basal tearing when applied topically. Levels of active monomeric lacritin are negatively regulated by tear tissue transglutaminase, whose expression is elevated in dry eye with ocular surface inflammation. Lipocalin-1 is the master lipid sponge of the ocular surface, without which residual lipids could interfere with epithelial wetting. It also is a carrier for vitamins and steroid hormones, and is a key endonuclease.

Dry eyes natural treatment emails
Q. I have used Eyesight Rx for one month now and find it beneficial for dry eyes and visual acuity.
   A. Thanks for letting us know.

Q. I was wondering how Eyesight Rx compares to Theralife dry eye product. I am ready to make a purchase and was wondering the difference in the 2 products.
   A. We are not familiar with Theralife dry eye product.

Q. I doubled my dose of EFA fish oils and stopped taking the mulberry fruit derived Chinese herbs that i had previously been taking for dry eye. As a test, I stopped taking the fish oil and a day later, i experienced dry eye symptoms.

Q.  Since several years, when I drink hot coffee or hot tea, my eyes hurt. Especially in the night. Since a year, even 1 cup hurts. I have a dry eye problem since childhood. Several eye doctors only prescribe tear drops. In July, dr prescribed gel rather than liquid for tear drops.
   A. Perhaps fish oils or flax seed oil may help.

Q. Recently I was diagnosed with dry eye syndrome by an eye doctor. Previous to my diagnoses, I experienced severe eye pain in both my eyes, along with severe light sensitivity and blurred eye vision but only when the other two symptoms occurred. I experienced these symptoms suddenly about a year previous to my diagnoses. I am 28 years old, white, female. I do not wear contacts or glasses. My question is why would I suddenly develop dry eye syndrome? My symptoms lesson when I use the eye gel, but I need quite a lot of it. Is there a more natural solution?
   A. There are many dry eye syndrome causes.

Q. I have been researching a product for dry eyes that can increase tear ducts and have found HydroEye to have black currant seed oil in it. Does the black currant seed oil have to be unrefined to do the job? The HydroEye people are saying it is not. They say many people taking this product are seeing improvement in tears and some do not need to use artificial tears anymore. I have been told my tear test shows 7 in the right eye and 5 in the left. Fifteen is the normal for most people. I'm on doxycycline for the gland dysfunction and blephamide ointment for the blepharitis. However, I feel since dry eyes are not something we are born with there should be something to help bring back the tears. I also went through early menopause which they say can cause some difficulties with dry eyes. Finally, does environment play a large part in the cause? I recently moved from Austin, Tx to the triangle of North Carolina and have been having problems with my eyes since. I thought Texas was too dry and think North Carolina is a better climate with more humidity than Texas.
   A. If environment plays a role, it is minor. There are many causes for dry eyes. Very little research has been done with black currant seed oil. We are not familiar with the HydroEye product. Although unrefined oils are often the better option, in this case, since human studies are not available to compare unrefined black currant seed oil to refined black currant seed oil, it is difficult to tell whether the former offers more benefits. Perhaps you can discuss with your doctor some of the options discussed on this page regarding the natural treatment of dry eyes.

Q. My wife has a bad case of dry eye syndrome. She is using Restasis, and TheraLife Eyes. The TheraLife seemed to be helping, slow but helping. The Product Contains the following:
Beta-Carotene 12,500 IU
Vitamin E 180 IU
Ascorbic acid 200 mg
Riboflavin 10 mg
Zinc 20 mg
Copper 1 mg
Selenium 67 mcg
L Carnitine 100 mg
Proprietary Herbal Blend 867 mg.

Q. I try fish oil, evening primrose oil, and a-z vitamins with no help for my dry eye problems.

Other possible beneficial herbs
Tamarind seed extract could be helpful.