When you travel there are many uncertainties that come with the territory. Cars break down at the most inopportune moments. Planes get delayed due to fog or security issues. Or perhaps the weather ends up deciding what attractions and sites you can or cannot visit. There’s a long list of unexpected complications that can rear their ugly heads while on the road. But there’s one thing I can always count on when we fly on an airplane or stay at a hotel: my eyes become dry and red. Most hotels and resorts are temperature controlled. The use of centralized air conditioning and heating ensures the comfort of guests and discourages the growth of bacteria and mold that can thrive in a more humid environment. In the grand scheme of things, vacation-related irritation of the eyes is a small price to pay for all of the pleasure that travel brings. However, for some people this sensation is chronic and unrelenting.

There are a variety of causes of dryness of the eyes ranging from autoimmune conditions such as Sjogren’s syndrome to menopause to side effects of certain medications (antihistamines, birth control, hormone replacement, etc.). Conventional treatment often utilizes lubricating eye drops, punctal occlusion (plugs that prevent tears from draining) and occasionally surgery to permanently close ducts that normally drain tears into the nose. If you go to a typical allopathic doctor you’re likely to be prescribed one of these treatments. But if you’d like to try a more natural approach first, either alone or in combination with conventional care, you might want to consider the following options:

First things first. If you have dry eyes and you’re not taking proper care of yourself via diet and lifestyle – this is a good time to start. There are many nutrients that are required for the natural and robust production of tears. A scientific review from 1991 singles out protein, Vitamins A, B6, C, potassium and zinc as especially important. That same summary suggests that excess alcohol, salt and sugar may promote tear dysfunction. (1)

• Tip #1 - Essential fatty acids are without a doubt the strongest contender in the arena of natural health remedies for dry eyes. Fish oil (DHA and EPA) and sources of GLA (gamma linolenic acid) are considered the most therapeutic forms of omega-3 and omega-6 fatty acids with regard to this chronic condition. One of the proposed mechanisms by which these lipids help is by limiting damage and inflammation of the lacrimal gland which produces tears. Supplementing with fish oil, blackcurrant seed oil, borage seed oil and evening primrose oil is a reasonable way to increase your exposure to DHA, EPA and GLA. But diet appears to be equally important. Many people with dry eye syndrome (DES) have an imbalance of omega-6 to omega-3 fats in their system. This is generally caused by consuming too many processed foods and vegetables oils and not enough fish or other sources of omega-3s. It’s also interesting to note that alpha-linolenic acid, a plant-based omega-3 fat, can be applied topically and may result in “a significant decrease in dry eye signs and inflammatory changes at both cellular and molecular levels”. This latter finding needs to be replicated in additional studies before it can be widely accepted. In the meantime, it probably would not be wise to use just any ALA oil as an eye drop. (2,3,4,5,6,7)
• Tip #2 - Eating an antioxidant rich diet and/or supplementing with select antioxidants is another strategy that is supported in the medical literature. A recent French study tested the efficacy of a supplement containing certain nutrients and phytochemicals (acerola extract, beta-carotene, grape seed and skin extract, red algae and selenium) in a group of 24 patients with DES. The 12 week trial concluded that “Supplementation with oral antioxidants can improve both tear stability and quantity but also subjective clinical signs”. Similar results have been demonstrated using different blends of antioxidants as well. Green tea polyphenols and N-acetylcysteine may be especially useful in symptoms related to the autoimmune condition known as Sjogren’s syndrome. (8,9,10,11,12)
• Tip # 3 - Preliminary evidence suggests the acupuncture may also be a promising and safe therapy for those suffering from dry eye syndrome. Animal and human studies have found that the strategic placement of needles in acupoints surrounding the eyes can stimulate tear production via improved lacrimal gland function and secretion. According to one trial, acupuncture may be more effective in managing dry eye associated with “extrernal factors” such as allergies, contact lens irritation, drug-induced side effects and infections. On the other hand, it may not be as successful in correcting “internal causes” including hormonal imbalance, immune dysfunction and nutrient deficiencies. (13,14,15,16,17)

Not all “natural” remedies are effective. One example is DHEA (dehydroepiandrosterone), an adrenal hormone that is sold as a nutritional supplement. It’s been noted that: a) DHEA levels tend to decline with age; b) those with Sjogren’s syndrome are often lacking in DHEA and; c) DHEA is a precursor to sex hormones which also can be deficient in those with dry eyes. Unfortunately, supplementing with DHEA doesn’t appear to be the answer to correcting the previously noted hormonal issues. A recent trial provided 23 postmenopausal women with 50 mg of DHEA per day for a total of 9 months. An improvement was detected in relation to dry mouth, another common symptom of Sjogren’s syndrome. But no benefit was discovered in terms of ocular health. The researchers noted a relationship between low levels of estrogens and dry eye symptoms. However, DHEA supplementation preferentially caused an increase in testosterone levels rather than estrogen in the female participants. This likely explains why this “prohomone” has not been effective in women with dry eyes in several recent trials. (18,19,20)

DHEA isn’t the only hormone-related therapy that has been tried without success in those with DES. Conventional hormone replacement therapy (HRT) has generally been shown to increase the risk of dry eye symptoms. One researcher recently concluded that “Women who are taking or considering HRT should be informed of the potential increased risk of dry eye syndrome with this therapy”. Still, scientists are continuing to search for the optimal combination of hormones that may yet offer relief for this vexing condition. One answer may lie in a blend of estrogen and testosterone. However much more study on the long term efficacy and safety of such a combination needs to be established. (21,22,23)

There are a few other intriguing, natural options that are presently under review: a) an eye drop containing tamarind seed polysaccharide is being investigated as an alternative to conventional artificial tears; b) applying antibacterial honey to the eyelids of those with dry eyes may reduce abnormal bacterial counts (colony forming units) – which could help address one contributing factor of DES and; c) the use of a simple “wet gauze eye mask” during sleep has been shown to dramatically improve daytime ocular dryness and the subsequent need for other forms of treatment. (24,25,26,27)

In the coming days there will likely be other alternatives and complementary therapies worth considering as well. For instance, scientists are currently examining the potential of sea buckthorn extracts in the management of dry eye disorders. The fruit of sea buckthorn (Hippophae rhamnoides) is a rich source of antioxidants and essential fatty acids which have been documented as providing anti-inflammatory and immune system modulating activity. At this point, it’s far too early to make any conclusive determination about sea buckthorn. However, there seems to be a solid foundation for testing it. So, I’ll keep digging for any upcoming developments regarding this remedy and any others that may improve the quality of life and sight for those suffering from dry eye. (28,29,30,31,32,33)

Be well!

JP

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