Natural Dry Eye Remedies

February 5, 2010 Written by JP       [Font too small?]

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)
Source: BMC Ophthalmology 2007, 7:5 (link)

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)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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Posted in Alternative Therapies, Nutrition, Nutritional Supplements

16 Comments & Updates to “Natural Dry Eye Remedies”

  1. Nina K. Says:

    Morning JP :-)

    its funny i recommended all the nutrition and supplements you mentioned above a friend which is suffering from dry eyes – i think he is sitting to long in front of the pc next to the heater ;-) . want add one thing: equal if its too hot or too cold outside both conditions dry the body so drinking enough water is very important.

    wish you and yours a wonderful weekend :-)

    Nina K.

  2. JP Says:

    Your friend is lucky to have your guidance, Nina! :)

    I wish you and yours the same! I hope the weather is warming up a little bit in your part of the world! It’s pouring rain over here!

    Be well!

    JP

  3. Nina K. Says:

    Thank you JP :-)

    Rain can be relaxing…. at the moment it is a little bit warmer about 5°C but next week we get temperatures deeper than -10°C!:-(
    …but spring will come, i’m sure :-)

    Greetings from the far side!
    Nina K.

  4. JP Says:

    Good day, Nina. :)

    I love to hear the rain while falling asleep! Very relaxing indeed. In the past I’d sometimes listen to CDs of recorded storms to help me unwind and drift off at night.

    Spring will indeed come. In the meantime, lots of hot cocoa and tea is my “prescription”. ;)

    Be well!

    JP

  5. Glenn Fernandes Says:

    Thanks for the useful tips. Chronic Dry eyes develop due to the eyes not producing adequate amount of tears. There are many symptoms of chronic dry eyes which includes itchiness, prickliness, sensitiveness to light, blurry eyesight, dryness etc.It develops as your age grows, menopausal phase or medical disorders. Turbulent weather conditions, smoke, air-conditioners and heaters, constant wear of contact lenses can increase the risk of dry eyes.

  6. Natalie Says:

    Can des be reversed or decreased by going off of hrt? I have been on estrogen and progesterone 6 years and des showed up 4 years after starting hrt

  7. JP Says:

    Hi Natalie,

    Unfortunately, I’m unaware of any study that has specifically investigated this topic – HRT cessation and it’s effect on DES. If you and your doctor(s) believe HRT is necessary, supplementing with essential fatty acids (fish oil, GLA and sea buckthorn oil) may be a valuable adjunct.

    Be well!

    JP

  8. JP Says:

    Update: Fish oil benefits dry eyes caused by lengthy computer time …

    http://www.contactlensjournal.com/article/S1367-0484(15)00009-0/abstract

    Cont Lens Anterior Eye. 2015 Feb 16.

    Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye.

    PURPOSE: To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symptoms, Schirmer test, tear film break up time (TBUT) and conjunctival impression cytology (CIC) in patients with computer vision syndrome.

    SETTING AND DESIGN: Interventional, randomized, double blind, multi-centric study.
    METHODS: Four hundred and seventy eight symptomatic patients using computers for more than 3h per day for minimum 1 year were randomized into two groups: 220 patients received two capsules of omega-3 fatty acids each containing 180mg eicosapentaenoic acid (EPA) and 120mg docosahexaenoic acid (DHA) daily (O3FA group) and 236 patients received two capsules of a placebo containing olive oil daily for 3 months (placebo group). The primary outcome measure was improvement in dry eye symptoms and secondary outcome measures were improvement in Nelson grade and an increase in Schirmer and TBUT scores at 3 months.

    RESULTS: In the placebo group, before dietary intervention, the mean symptom score, Schirmer, TBUT and CIC scores were 7.5±2, 19.9±4.7mm, 11.5±2s and 1±0.9 respectively, and 3 months later were 6.8±2.2, 20.5±4.7mm, 12±2.2s and 0.9±0.9 respectively. In the O3FA group, these values were 8.0±2.6, 20.1±4.2mm, 11.7±1.6s and 1.2±0.8 before dietary intervention and 3.9±2.2, 21.4±4mm, 15±1.7s, 0.5±0.6 after 3 months of intervention, respectively.

    CONCLUSION: This study demonstrates the beneficial effect of orally administered O3FAs in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye.

    Be well!

    JP

  9. JP Says:

    Update: Maqui berry extract shows promise re: dry eye symptoms …

    http://www.ncbi.nlm.nih.gov/pubmed/25208615

    Panminerva Med. 2014 Sep;56(3 Suppl 1):1-6.

    MaquiBright™ standardized maqui berry extract significantly increases tear fluid production and ameliorates dry eye-related symptoms in a clinical pilot trial.

    AIM: Dry eye symptoms, resulting from insufficient tear fluid generation, represent a considerable burden for a largely underestimated number of people. We concluded from earlier pre-clinical investigations that the etiology of dry eyes encompasses oxidative stress burden to lachrymal glands and that antioxidant MaquiBright™ Aristotelia chilensis berry extract helps restore glandular activity.

    METHODS: In this pilot trial we investigated 13 healthy volunteers with moderately dry eyes using Schirmer test, as well as a questionnaire which allows for estimating the impact of dry eyes on daily routines. Study participants were assigned to one of two groups, receiving MaquiBright™ at daily dosage of either 30 mg (N.=7) or 60 mg (N.=6) over a period of 60 days. Both groups presented with significantly (P<0.05) improved tear fluid volume already after 30 days treatment. Schirmer test showed an increase from baseline 16.3±2.6 mm to 24.4±4.8 mm (P<0.05) with 30 mg MaquiBright™ and from 18.7±1.9 mm to 27.6±3.4 mm with 60 mg (P<0.05), respectively. Following treatment with 30 mg MaquiBright™ for further 30 days, tear fluid volume dropped slightly to 20.5±2.8 mm, whereas the improvement persisted with 60 mg treatment at 27.1±2.7 mm after 60 days treatment (P<0.05 vs. baseline).

    RESULTS: The burden of eye dryness on daily routines was evaluated employing the “Dry Eye-related Quality of life Score” (DEQS), with values spanning from zero (impact) to a maximum score of 60. Participants had comparable baseline values of 41.0±7.7 (30 mg) and 40.2±6.3 (60 mg). With 30 mg treatment the score significantly decreased to 21.8±3.9 and 18.9±3.9, after 30 and 60 days, respectively. With 60 mg treatment the DEQS significantly decreased to 26.9±5.3 and 11.1±2.7, after 30 and 60 days, respectively. Blood was drawn for safety analyses (complete blood rheology and -chemistry) at all three investigative time points without negative findings.

    CONCLUSION: In conclusion, while daily supplementation with 30 mg MaquiBright™ is effective, the dosage of 60 significantly increased tear fluid volume at all investigative time points and decreased dry eye symptoms to almost a quarter from initial values after two months treatment.

    Be well!

    JP

  10. JP Says:

    Update 05/12/15:

    http://www.hindawi.com/journals/ecam/2015/143858/

    Evid Based Complement Alternat Med. 2015;2015:143858.

    Acupuncture therapy is more effective than artificial tears for dry eye syndrome: evidence based on a meta-analysis.

    Background. The efficacy of acupuncture in dry eye syndrome patients remains controversial. Methods. Pubmed, Ovid, Cochrane libraries, CNKI, Wanfang, and CQVIP databases were electronically searched until October 1, 2014. Outcomes including tear break-up time (BUT), Schirmer I test (SIT), and cornea fluorescein staining (CFS) were analyzed. A meta-analysis was performed using both fixed- and random-effects models based on heterogeneity across studies. Results. Seven studies were included in this study; 198 and 185 patients were randomly treated with acupuncture and artificial tears, respectively. The overall BUT of patients in acupuncture group was significantly longer than that of the artificial tears group after treatment (P < 0.00001). The SIT was significantly higher in the acupuncture group than that in the artificial tears group after treatment (P = 0.001). The CFS of patients in acupuncture group was significantly improved compared to that in artificial group (P < 0.0001). Conclusions. Acupuncture therapy is effective for the dry eye patients, partly better than artificial tear treatment.

    Be well!

    JP

  11. JP Says:

    Updated 06/12/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878667/

    Clin Interv Aging. 2016 May 19;11:571-8.

    Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study.

    PURPOSE: To assess the benefits and tolerability of a dietary supplement based on omega-3 fatty acids to relieve dry eye symptoms.

    METHODS: A total of 1,419 patients (74.3% women, mean age 58.9 years) with dry eye syndrome using artificial tears participated in a 12-week prospective study. Patients were instructed to take 3 capsules/day of the nutraceutical formulation (Brudysec(®) 1.5 g). Study variables were dry eye symptoms (scratchy and stinging sensation, eye redness, grittiness, painful and tired eyes, grating sensation, and blurry vision), conjunctival hyperemia, tear breakup time (TBUT), Schrimer I test, and Oxford grading scheme.

    RESULTS: At 12 weeks, each dry eye symptom improved significantly (P<0.001), and the use of artificial tears decreased significantly from 3.77 (standard deviation [SD] =2.08) at baseline to 3.45 (SD =1.72) (P<0.01). In addition, the Schirmer test scores and the TBUT increased significantly, and there was an increase in patients grading 0-I in the Oxford scale and a decrease of those grading IV-V. Significant differences in improvements of dry eye symptoms were also found in compliant versus noncompliant patients as well as in those with moderate/severe versus none/mild conjunctival hyperemia.

    CONCLUSION: Oral ω-3 fatty acids supplementation was an effective treatment for dry eye symptoms.

    Be well!

    JP

  12. JP Says:

    Updated 06/15/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869783/

    Clin Ophthalmol. 2016 May 9;10:813-20.

    A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome.

    PURPOSE: To evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES).

    METHODS: A prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extracts, including Cassiae semen and Ophiopogonis japonicus) with placebo on patients with DES. We assessed dry eye symptoms, visual acuity, Schirmer’s test, tear film breakup time, cornea and conjunctiva fluorescein staining, serum anti-SSA/anti-SSB antibodies, and the level of reactive oxygen species (ROS) in tears. The supplementation period was 8 weeks and patients were followed up every 4 weeks for 16 weeks. A linear mixed model was used to compare the groups, while within-group differences were tested by repeated-measures analysis of variance.

    RESULTS: Forty-three patients, 20 and 23 in treatment and placebo groups, respectively, completed the study. Liver and renal functions were normal. Diastolic blood pressure decreased in the treatment group. There were no significant differences in systolic blood pressure, dry eye symptoms, serum anti-SSA and anti-SSB, visual acuity, intraocular pressure, or fluorescein corneal staining between the groups. Tear film breakup time scores and Schirmer’s test without topical anesthesia significantly improved in the treatment group. Tear ROS level differed between the groups and decreased after treatment. Overall subjective impression revealed a significant improvement with treatment compared with placebo.

    CONCLUSION: Oral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS. The vegetable-based antioxidant supplement used in this study is safe and can be utilized as an adjuvant therapy to conventional artificial tear therapy for patients with DES.

    Be well!

    JP

  13. JP Says:

    Updated 11/11/16:

    http://www.aaojournal.org/article/S0161-6420(16)31373-2/fulltext

    Ophthalmology. 2016 Nov 3.

    A Randomized, Double-Masked, Placebo-Controlled Clinical Trial of Two Forms of Omega-3 Supplements for Treating Dry Eye Disease.

    PURPOSE: To assess the efficacy of 2 forms of oral long-chain omega-3 (ω-3) essential fatty acid (EFA) supplements, phospholipid (krill oil) and triacylglyceride (fish oil), for treating dry eye disease (DED).

    DESIGN: Randomized, double-masked, placebo-controlled clinical trial.

    PARTICIPANTS: This study was conducted at a single site and involved 60 participants with mild to moderate DED who were randomized (1:1:1) to 1 of 3 groups: placebo (olive oil), krill oil, or fish oil supplements.

    METHODS: Participants received 1 of the 3 interventions: placebo (olive oil 1500 mg/day), krill oil (945 mg/day eicosapentaenoic acid [EPA], + 510 mg/day docosahexaenoic acid [DHA]), or fish oil (1000 mg/day EPA + 500 mg/day DHA) for 90 days, with monthly study visits.

    MAIN OUTCOME MEASURES: Primary outcome measures were mean change in (1) tear osmolarity and (2) DED symptoms (Ocular Surface Disease Index [OSDI] score) between days 1 and 90. Secondary outcomes included mean change in key clinical signs (tear stability, tear production, ocular surface staining, bulbar and limbal redness, tear volume, anterior blepharitis, meibomian gland capping) and tear inflammatory cytokine levels.

    RESULTS: In total, 54 participants completed the study. At day 90, tear osmolarity was reduced from baseline with both krill oil (mean ± standard error of the mean: -18.6±4.5 mOsmol/l; n = 18; P < 0.001) and fish oil (-19.8±3.9 mOsmol/l; n = 19; P < 0.001) supplements, compared with placebo (-1.5±4.4 mOsmol/l; n = 17). OSDI score was significantly reduced at day 90 relative to baseline in the krill oil group only, compared with placebo (-18.6±2.4 vs. -10.5±3.3; P = 0.02). At day 90, there were also relative improvements in tear breakup time and ocular bulbar redness, compared with placebo, for both forms of ω-3 EFAs. Basal tear levels of the proinflammatory cytokine interleukin 17A were significantly reduced in the krill oil group, compared with placebo, at day 90 (-27.1±10.9 vs. 46.5±30.4 pg/ml; P = 0.02).

    CONCLUSIONS: A moderate daily dose of both forms of long-chain ω-3 EFAs, for 3 months, resulted in reduced tear osmolarity and increased tear stability in people with DED. Omega-3 EFAs in a predominantly phospholipid form (krill oil) may confer additional therapeutic benefit, with improvements in DED symptoms and lower basal tear levels of interleukin 17A, relative to placebo.

    Be well!

    JP

  14. JP Says:

    Updated 06/17/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28617532

    Eur Rev Med Pharmacol Sci. 2017 May;21(10):2518-2525.

    The effect of a natural, standardized bilberry extract (Mirtoselect®) in dry eye: a randomized, double blinded, placebo-controlled trial.

    OBJECTIVE: Dry eye, a chronic disease of lachrymal fluid and corneo-conjunctival epithelium, could significantly impact visual function, affects quality of life and work productivity. Beside several conventional treatments, nutritional supplements based on bilberry extract have been identified as effective contributors to eye health. Here, we aim at investigating the bioavailability of a standardized bilberry extract, its ability to alleviate dry eye symptoms and its antioxidant potential.

    MATERIALS AND METHODS: Either bilberry dried standardized extract derived from Vaccinium myrtillus L. fresh frozen fruits (Mirtoselect®) or a highly purified anthocyanin-rich extract, devoid of the non anthocyanin component and supported on maltodextrins, were each orally administrated to 5 male rats. Blood samples were collected at 5, 10, 15, 20, 30, 45, 60, 90, 120 minutes after treatment, processed and analyzed by UV spectrophotometric method. In a parallel analysis, 22 otherwise healthy subjects suffering from dry eye symptoms were enrolled randomly assigned to receive the more bioavailable bilberry extract or placebo. Ophthalmological and clinical examinations including Schirmer’s test, pupil constriction, diacron-reactive oxygen metabolites (d-ROMs) test and biological antioxidant potential (BAP) test were performed at inclusion and after the 4-week study period.

    RESULTS: The area under the curve of plasmatic levels of anthocyanosides in rats resulted 202.34±24.23 µg·min/ml for Mirtoselect® and 130.93±4.93 µg·min/ml for the highly purified anthocyanin-rich bilberry extract, notwithstanding the fact that the highly purified anthocyanin-rich extract group received an anthocyanins dosage much higher than the Mirtoselect® group (354 mg/Kg in anthocyanosides vs. 136 mg/Kg in anthocyanosides). 21 subjects, 11 subjects in the bilberry extract (Mirtoselect®) group and 10 subjects in the placebo group completed the clinical study. Schirmer’s test values indicating the volume of tear secretion were significantly improved in the bilberry extract group (p=0.019), whereas no significant changes were observed in the placebo group. A subset analysis revealed that Mirtoselect® could be more effective in subjects with higher tendency of dry eye. In terms of antioxidant potential, the bilberry extract produced significant improvement of BAP (p=0.003) and an increase of modified BAP/d-ROMs ratio, an indicator of overall balance between antioxidant potential and oxidative stress.

    CONCLUSIONS: Our results suggested that natural, standardized bilberry extract (Mirtoselect®) is a natural more bioavailable delivery form anthocyanins, suggesting a strong matrix effect exerted by the non-anthocyanin component. Furthermore, it can improve tear secretion and plasmatic antioxidant potential in subjects suffering from DED symptoms.

    Be well!

    JP

  15. JP Says:

    Updated 08/25/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28777385

    Eur J Ophthalmol. 2017 Aug 2:0.

    Efficacy of eyedrops containing cross-linked hyaluronic acid and coenzyme Q10 in treating patients with mild to moderate dry eye.

    PURPOSE: Dry eye disease (DED) is a common condition causing substantial burden. A randomized, controlled, single-masked study was performed in 40 patients with mild to moderate DED to evaluate the efficacy and safety of a collyrium based on crosslinked hyaluronic acid (XLHA) with coenzyme Q10 (CoQ10).

    METHODS: Enrolled subjects were divided into 2 groups: group A, treated with XLHA + CoQ10; and group B, treated with hyaluronic acid (HA). Eyedrops were administered 4 times daily for 3 months. The Ocular Surface Disease Index (OSDI) questionnaire, tear break-up time (TBUT), corneal and conjunctival staining, and meibomian gland assessment (MGD) were evaluated; furthermore, corneal aesthesiometry, in vivo corneal confocal microscopy, visual acuity, intraocular pressure (IOP), and fundus examination were performed.

    RESULTS: At the end of treatment, OSDI score significantly decreased in groups A and B (p<0.01 and p<0.05, respectively); the decrease was significantly higher in group A. Corneal staining decreased in both groups, with lower scores in group A. The MGD was significantly ameliorated in group A patients. No differences were found for corneal aesthesiometry or TBUT. Epithelial cell reflectivity was significantly reduced only in group A. For keratocytes and stromal matrix parameters, there was a significant improvement in group A. No changes were found for visual acuity, IOP, or fundus examination.

    CONCLUSIONS: The XLHA + CoQ10 treatment showed greater effectiveness in DED compared to HA alone, probably due to the longer permanency on ocular surface and the antioxidant activity of CoQ10. Therefore, XLHA + CoQ10 eyedrops could represent a new possibility in dry eye treatment.

    Be well!

    JP

  16. JP Says:

    Updated 09/20/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28919183

    Cont Lens Anterior Eye. 2017 Sep 11.

    Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D.

    PURPOSE: To determine the possible association between serum vitamin D levels and dry eye symptoms, and the impact of an oral vitamin D supplement.

    METHODS: Three linked studies were performed. (i) 29 older adult participants, (ii) 29 dry eyed participants, and (iii) 2-month vitamin D supplementation for 32 dry eyed/low serum vitamin D levelled participants. All participants were assessed by the Ocular Surface Diseases Index (OSDI) to determine dry eye symptoms, and the phenol red thread test (PRT) and/or Schirmer’s tear test, tear meniscus height, non-invasive tear break up time, grading ocular surface redness and fluorescein staining of the cornea to detect the tear quality and ocular surface conditions. Blood samples were collected for serum vitamin D analysis and interleukin-6 (IL-6) levels.

    RESULTS: Among older adult participants, vitamin D levels were negatively correlated with dry eye symptoms, the severity of dry eye, and associated with tired eye symptom. Vitamin D levels of people with dry eye diagnosis were not correlated with OSDI scores and IL-6 levels; while IL-6 levels showed correlation with tear production. In supplement study, vitamin D levels increased by 29mol/l, while dry eye symptoms and grading of corneal staining appeared significant reductions. No significant changes in IL-6 levels.

    CONCLUSIONS: Low vitamin D levels (<50nmol/l) were associated with dry eye symptoms in older individuals but not those diagnosed with dry eye. Vitamin D supplement increased the vitamin D levels, and improved dry eye symptoms, the tear quality and ocular surface conditions.

    Be well!

    JP

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