Can Omega 3 Cure Dry Eye?

Your Current Dry Eye Treatment Isn’t Working and Is Damaging Your Eyes

If you suffer from dry eye then you know how painful and irritating it can be. Your eyes sting, burn and tear, and sometimes worse. It’s just maddening to deal with.

Standard treatments from the doctor or chemist can only so far only offer temporary relief. In the USA alone, sales of eye drops have reached around $300 million a year, however whilst these ‘artificial tears’ can help relieve the symptoms in the short term, they have little to no long lasting effects (1,2).

In fact their use long term can actually cause eye damage. For example, many eye drops contain chemicals that can further irritate the eye, like Tetrahydrozoline. Their use has been shown to cause an improvement in symptoms initially, but over time their effectiveness decreases, encouraging overuse (3,4).

This chronic use of Tetrahydrozoline has been shown to cause significant change in the cornea of 27% of users (5). Studies have also shown these eye drops can cause conjunctivitis (inflammation of the conjunctiva) (6).

Prescription eye drops are little better, brands such as Restasis have side effects including pain, stinging, redness, watery eyes, discharges etc. One study showed that 54.2% of the people using these treatments experienced eye discomfort and pain from them (7).

Other treatment such as corticosteroids which act as anti-inflammatories can also help symptoms, but again only on a short term basis, as corticosteroids cannot be taken safely longer term.

Treat The Cause Not The Symptoms

But what if there was a way to treat the cause and not just the symptoms. What if we knew the real cause of dry eye, and that cause was actually in our diets, and therefore it could be cured or at least significantly improve by something as simple as nutrition? To answer that let’s take a closer look at what actually causes Dry Eye

Where Does Dry Eye Come From?

The name Dry Eye literally says what’s happening, our eyes get Dry! The water layer covering the cornea, also know as the tear layer, drys up either because we are not producing enough tears, or because we’re not producing enough lipids to protect the layer of tears. When this tear layer dries up our eyes hurt, sting, become much more sensitive and get red and puffy.

5-6% of us suffer from Dry Eye at any one time, but that rises to 10% in post menopausal women and 34% in the elderly, and the rates are currently increasing (8). Dry Eye can also worsen with age, so this makes it really important to understand the how to cure dry eyes naturallyroot causes so we can prevent this happening.

This digram shows this water layer covering the eye which is called ‘The Tear Film’. There are 2 key glands around the eyeballs that are instrumental in forming the tear film. They are the Lacrimal glands and the Meibomian glands.

The Lacrimal Glands – These glands produce the tears, like the ones we cry except they actually run continuously to keep the layer there constantly, and bring glucose vitamins, antioxidants and antimicrobials to the cornea of the eye.

The Meibomian glands – The glands produce the lipid lay that surrounds the tear film to stop it from evaporating too quickly. When either of these glands isn’t working properly it can result in dry eyes, and the main thing that stops them working is inflammation. When the lacrimal glands become inflamed not enough tears are produced to keep the eyes moist and when the Meibomian glands are inflamed not enough lipids are produced to stop the tears evaporating (9)(10). As well as Dry Eye, inflammation in the Meibomian glands can also cause Blepharitis and Meibomian Gland Dysfunction, and Blepharitis and MGD symptoms are often indistinguishable from Dry Eye (11).natural remedies for dry eye

So What Causes this Inflammation?

2 things – Lifestyle and Diet.

Lifestyle

Staring at the TV or Computer screen for too long time can be a factor in developing dry eye, so if this is something you do, or it’s required for your job, make sure to take regular breaks and remember to blink! Also exposure to pollution or other irritants can cause inflammation, and if you wear make up try hypoallergenic brands. Smoke also aggravates dry eye, so anyone with dry eye should really try to give up smoking.

Also try to get enough sleep, drink plenty of water and try to reduce stress as much as possible. Lastly make sure you are exercising! Exercise will improve blood flow to the eyes, which will always reduce inflammation and improve your overall health.

Diet

The modern diet that of us eat is also very inflammatory. One of the key reasons for this is that we have moved from eating natural foods to processed ones. Processed foods contain very little nutrients and are also very high in omega 6 fatty acids. Humans needs both omega 3 and omega 6 fatty acids to be healthy, however when we get too much omega 6 and not enough omega 3 to balance this out, we get a cascade of inflammation being produced in our bodies. For much of our evolution our balanced diets would have led to a omega-6 to omega-3 fatty acid ratio of roughly 1:1 (12), however today this ratio has been increased to about 20:1, so we are consuming around 20 times as much omega 6 as omega 3.

So it’s hardly surprising that our many people live in inflamed bodies, and the delicate tissues of the eye are especially at risk. However, there is a great solution to this and that’s supplementing with a high quality omega 3. There have been several comprehensive studies conducted on omega 3 supplementation and Dry Eye. The results have been very exciting.

The first study supplemented with 6 grams of flaxseed per day for a year. Flaxseed is rich in the omega 3 fatty acid ALA (which would be equal to around 600mg of EPA per day). The results showed that as the omega 6:3 ratio was reduced (i.e more omega 3 and less omega 6), there was less occular inflammation (less inflammation on the surface of the eye), and an increase in tear break up time (so tears did not evaporate so quickly), and a significant increase in the health of the meibomian glands so that they produced a more fluid meibum. This lead to a significant improvement in all Dry Eye symptoms (13). There was also a reduced risk for the glands clogging, or suffering permanent damage from inflammation.

Parkinson's Disease!Another study supplementing with 712mg of omega 3 (427 EPA 285 DHA) per day found that it lead to a significant reduction in inflammation of the conjunctiva, which is the mucous membrane of the ‘tear film’ (14).

A 2013 study using just 600mg (360mg EPA and 240mg DHA) of omega 3 per day found a significant reduction in tear evaporation and significant improvement in tear production and overall Dry Eye symptoms, including burning, stinging, dryness, and the sensation of a foreign object in the eye, etc (15).

A 2011 study with 450mg of EPA, 300mg of DHA and 1000mg of flaxseed (equivalent to around 100mg of EPA) found that by the end of the 90 day study period 70% of the participants were symptom free! (16)

And finally another 2013 study found that with a 1000mg daily dose of omega 3 (650 EPA and 350 DHA) that was a 400% improvement in Dry Eye symptom scores after just 3 months (17).

The studies really show the power of fish oil supplementation for improving Dry Eye symptoms. Fish oil will not just improve symptoms, but is also valuable in Dry Eye prevention.

Perhaps the most exciting part is that so far all the studies on omega 3 supplementation and dry eye have been at quite low doses, so there is great potential for even better results at higher doses, as they will be able to decrease the omega 6:3 ratio even more. Supplementing with omega 3 is really easy to do and it can take a short period of time before you see improvements, just choose a really high quality omega 3 fish oil to give yourself the best chance reducing the inflammation and helping your dry eye.

References:

(1) Moon SW, Hwang JH, Chung SH, Nam KH. The impact of artificial tears containing hydroxypropyl guar on mucous layer. Cornea. 2010 Dec;29(12):1430-5.

(2) Benelli U. Systane lubricant eye drops in the management of ocular dryness. Clin Ophthalmol. 2011;5:783-90.

(3) . Impact of dry eye syndrome on vision-related quality of life in a non-clinic-based general population, Le Q, Zhou X, Ge L, Wu L, Hong J, Xu J BMC Ophthalmol. 2012 Jul 16;12:22.

(4) Bron AJ, Tiffany JM. The contribution of meibomian disease to dry eye. Cornea. 2004;2:149–164.

(5) Peyton SM, Joyce RG, Edrington TB. Soft contact lens and corneal changes associated with Visine use. J Am Optom Assoc. 1989 Mar;60(3):207-10.

(6) Soparkar CN, Wilhelmus KR, Koch DD, Wallace GW, Jones DB. Acute and chronic conjunctivitis due to over-the-counter ophthalmic decongestants. Arch Ophthalmol. 1997 Jan;115(1):34-8.

(7) Ragam A, Kolomeyer AM, Kim JS, et al. Topical cyclosporine a 1% for the treatment of chronic ocular surface inflammation. Eye Contact Lens. 2014 Sep;40(5):283-8.

(8) Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study, Lin PY, Cheng CY, Hsu WM, et al. (May 2005), Investigative Ophthalmology & Visual Science 46 (5): 1593–8

(9) Horwath-Winter J, Schmut O, Haller Schober EM, Gruber A, Rieger G. Iodide iontophoresis as a treatment for dry eye syndrome. Br J Ophthalmol. 2005 Jan;89(1):40-4.

(10) Macsai, M. (2008). The Role of Omega-3 Dietary Supplementation in Blepharitis and Meibomian Gland Dysfunction (An AOS Thesis). Transactions of the American Ophthalmological Society, 106, 336–356-336–356.

(11) Udell IJ, Nally L, Abelson M. An update on blepharitis treatment. Rev Ophthalmol. 2000:164–166.

(12) Simopoulos AP: Evolutionary aspects of the dietary omega-6:omega-3 fatty acid ratio: medical implications. World Rev Nutr Diet 2009; 100: 1-21.

(13) Macsai, M. (2008). The Role of Omega-3 Dietary Supplementation in Blepharitis and Meibomian Gland Dysfunction (An AOS Thesis). Transactions of the American Ophthalmological Society, 106, 336–356-336–356.

(14) William Stevenson, MD, Sunil K. Chauhan, PhD, and Reza Dana, MD, MSc, MPH, Dry eye disease: an immune-mediated ocular surface disorder, Arch Ophthalmol. 2012 Jan; 130(1): 90–100.

(15) Kangari, H., Eftekhari, M., Sardari, S., Hashemi, H., Salamzadeh, J., Ghassemi-Broumand, M., & Khabazkhoob, M. (2013). Short-term Consumption of Oral Omega-3 and Dry Eye Syndrome. Ophthalmology, 120(11), 2191-2196.

(16) Wojtowicz, J., Butovich, I., Uchiyama, E., Aronowicz, J., Agee, S., & Mcculley, J. (2011). Pilot, Prospective, Randomized, Double-masked, Placebo-controlled Clinical Trial of an Omega-3 Supplement for Dry Eye. Cornea, 30(3), 308-314.

(17) Bhargava R, Kumar P, Kumar M, Mehra N, Mishra A. A randomized controlled trial of omega-3 fatty acids in dry eye syndrome. Int J Ophthalmol. 2013;6(6):811-6.