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Dry Eye Vitamins

8 min read

Jovi Boparai MD Profile Picture
Written byJovi Boparai, MD
Reviewed by Max Padilla, MD
Jovi Boparai MD Profile Picture
Jovi Boparai, MDCo-founder & CEO of CorneaCarePhiladelphia, PA

Bio

Dry eye disease is tough! I get it. I have struggled with dry eyes for several years from contact lens use, and from spending countless hours looking at computer screens. In college, my dry eyes got so bad that I couldn’t wear contact lenses, because of a constant “foreign body sensation” when I had them in. I had to stop reading every 30 minutes because my eyes would start to burn and my vision would get blurry. I tried a plethora of treatments and nothing seemed to work. Dry eye disease was not only impacting my eyes, but also my emotional wellbeing. It was preventing me from enjoying life, and getting in the way of my professional training. I felt overwhelmed, frustrated and hopeless.

It was only when I realized that my dry eyes were linked to my lifestyle, environment and overall health did things start to make sense. I noticed that on days when I spent less time on the computer, my eyes felt better. My symptoms would flare when it was windy, or when there was low humidity. I knew that if I wanted to get ahead of my dry eyes, I needed to not only treat my eyes, but to also address my lifestyle. I started a consistent regimen of artificial tears and eyelid hygiene. I switched from monthly contact lenses to daily contact lenses. I started taking scheduled breaks from looking at a computer. I ate a healthier diet focused on anti-inflammatory/antioxidants foods, and I bought a humidifier for my room. In the beginning doing all this seemed impossible, but over time it became part of my usual routine. Not only did my eyes feel better, but I was overall healthier and happier! Turns out what is good for my eyes, was also good for my mind and body. I carried this lesson with me as I started my career to become an ophthalmologist and ophthalmic surgeon.

Because of my personal journey and professional training, I believe dry eye treatment starts by listening to and empowering the patient. I listen for the struggles and cue in on their strengths, while picking up on their lifestyle. Only then do we together start building a treatment plan that incorporates good eye hygiene with small, but impactful lifestyle changes. Our sight is our most important sense, and it is intimately linked to our very being. I want dry eye patients to not only get their dry eyes under control, but to also enjoy good mental and physical health, and live a fulfilling life. What is good for the eyes should also strengthen the mind and fortify the body!

Get to know me a little better!

Hobby: vintage watches
Food: peanut butter
Superhero: Superman
Guilty pleasure: desserts
Secret power: has never had a headache

Training:

Undergraduate: University of Pittsburgh Honors College
Medical school: Weill Cornell Medicine
Ophthalmology residency: Wills Eye Hospital.

Max Padilla, MD
Max Padilla, MDOculo-facial plastic surgeonFort Myers, FL

Bio

Maximilian R. Padilla MD, or Dr. Max, as his patients call him, is a fellowship training Oculo-Facial Plastic Surgeon, with broad expertise in ophthalmology and facial plastic surgery. Dr. Max’s goal is to combine his love of art with his passion for surgery to provide his patients with the most aesthetically pleasing and functionally optimal outcomes possible. Given his dynamic practice, Dr. Max personally understands the link between dry eye disease, eyelid anatomy and overall full body health. Dr. Max treats patients like family, and thus for him, dry eye treatment starts by listening, and coming up with a plan tailored to the patient’s eyes, health and lifestyle.

Get to know Dr. Padilla a little better!

Hobby: boating
Favorite Food: pizza
Superhero: Batman!
Guilty pleasure: ice cream
Greatest weakness: getting sunburnt
Secret power: trivia! You definitely want me on your team

Training

Medical School: University of Utah
Ophthalmology residency: University of South Florida
Oculo-facial plastic surgery fellowship: Wills Eye Hospital.

Best vitamins for dry eyes

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Table of Contents

Key points

  • In addition to artificial tears and eyelid hygiene, “what you eat” can significantly impact your dry eye treatment.
  • Eating a balanced diet with protein, carbs, essential fatty acids, vitamins and minerals, and drinking enough water is beneficial for the eyes, mind and body.
  • Oral supplements can help address any deficiencies in your diet, and make sure you get all the essentials your body needs.

Keywords

Antioxidants, dry eye disease, omega-3 fatty acids, supplements for dry eye, vitamin A

Taking the first step

When people think of dry eye treatment, they typically think of eye drops and warm compresses. But did you know that your diet can make a significant impact on your dry eye symptoms and treatment? Unfortunately, nutrition is seldom addressed in a dry eye treatment regimen. This is likely because it takes time and effort for the eye doctor (ophthalmologist or optometrist) to explain the impact of nutrition, and even more effort for the patient to implement and stick with the nutritional plan. Not only is good nutrition important for the mind and body, but it’s also crucial for eye health. 

We get it. It’s really hard to eat a balanced diet with our busy lifestyles. But you should certainly make an effort to do so, and if you feel like you’re falling short, oral supplements can help with any deficiencies.

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    What is dry eye disease

    Before diving into eye vitamins and supplements, let’s cover some dry eye basics. Dry eye disease (DED) is also known as dry eye syndrome, keratoconjunctivitis sicca and ocular surface disease.1 The classic symptoms of dry eye are blurry vision, gritty sensation, light sensitivity, watery eyes, dryness, stinging or burning, and red eyes.

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    We typically break down the causes of DED into two categories: aqueous deficient and evaporative. With aqueous deficient DED, your lacrimal glands do not produce enough natural tears to lubricate the eye’s surface (the cornea and conjunctiva). With evaporative DED, your body’s tear production is normal, but the tears evaporate too quickly. Most forms of DED are usually a combination of both aqueous deficient and evaporative, leading to tear film dysfunction.

    Causes of dry eye disease

    Environmental factors, such as low humidity, high winds and air pollution can worsen dry eye symptoms. Lifestyle risk factors for dry eye patients include extended use of digital screens, wearing contact lenses, poor diet, and smoking.

    DED can affect you physically, emotionally, financially and even socially. It’s therefore important to start a treatment plan to improve your symptoms, and prevent long-term side effects and eye conditions from chronic DED.

    Basics of dry eye treatment

    The treatment of dry eye should address your eye’s surface, but also take into consideration your overall eye health, mind, body, lifestyle and environment. Lubricating eye drops can help augment your tear production, while eyelid hygiene can stabilize your tear film by treating meibomian gland dysfunction and reducing tear evaporation.

    Treatments for dry eye disease

    The treatment options for dry eye include over-the-counter (OTC) eye drops (artificial tears), gels, ointments and eyelid hygiene (warm compress and eyelid wipes). Eating a well-balanced diet and drinking lots of water can help, as can taking an oral dry eye supplement. A humidifier and air purifier can reduce environmental risk factors in the house. In some cases of severe dry eyes, a person may require prescription eye drops and in-office ophthalmic procedures.

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    Nutrition and dry eye disease

    Nutrition is essential for all aspects of life, including your eyes, mind and body. However, the importance of nutrition in eye health and eye care is seldom addressed. Not only can good nutrition provide you with a healthy foundation for eye health, but it can also amplify the positive effects of other treatments. It all starts with eating a healthy, balanced diet containing proteins, carbs, essential fatty acids, vitamins and minerals, and drinking lots of water.

    Nutritional health

    We cannot stress the importance of nutrition in treating DED enough.2 In fact, the lack of certain vitamins, such as vitamin A, can cause dry eye disease, and the lack of other nutrients can worsen dry eye symptoms. A healthy diet may be used to both prevent and treat DED. There is no “best” vitamin for dry eyes, but nutrients with antioxidant and anti-inflammatory properties are particularly important. These include vitamins A, E, C, D, B6, and B12, coenzyme Q10, zinc and copper, selenium, lactoferrin and curcumin. Eating foods with all these nutrients can sometimes be difficult, and this is where a dietary supplement can augment your diet and address any deficiencies. 

    Below we’ll cover some of the nutrients to look for in your diet and in your dry eye health supplement. These nutrients have many health benefits, but we’ve focused specifically on how they impact the eyes. We’ve also provided a limited list of foods that contain these nutrients. 

    Vitamins3 

    • Vitamin A – plays a major role in growth and development of the surface of the eye. Long-term vitamin A deficiency can lead to conjunctival keratinization, and corneal scratches and infections. You can typically find vitamin A in meat, fruits and vegetables. 
    • Vitamins B6 and B12 – are involved in the proper functioning of your nerves and nervous tissue. DED may be a part of neuropathic pain, where your corneal nerves aren’t functioning properly, and your body doesn’t process pain correctly. Vitamins B6 and B12 may help promote proper nerve function. You can typically find vitamin B6 in chickpeas, non-citrus fruits, sweet potatoes, salmon and tuna. For vitamin B12, eat fortified cereals, dairy products, meat and fish. 
    • Vitamin C – is found in your tear film, and helps with antioxidation and wound healing of the ocular surface. Vitamin C can be found in citrus fruits, strawberries, cherries, tomatoes and broccoli.
    • Vitamin D – helps decrease inflammation, fortify the ocular surface, stabilize the tear film, and increase tear production. For some sources of vitamin D, eat eggs, fish, mushrooms and fortified cereals. Your body can also make vitamin D from exposure to sunlight. 
    • Vitamin E – primarily serves as an antioxidant, but can also help with vitamin A absorption and protecting the membranes of the cells that make up the cornea and conjunctiva. You can find vitamin E in green vegetables, nuts, seeds, avocado, and fortified cereals.

    Minerals4

    • Copper – helps with antioxidation and building strong connecting tissue which may improve the integrity of the ocular surface. Copper also binds zinc, and the two are often given together in supplements. You can find copper in shellfish, whole grains, beans, nuts, and dark leafy vegetables.
    • Zinc – is an antioxidant and plays a major role in the functioning of cells in the retina (the back of the eye), and protects against age-related macular degeneration. You can find zinc in red meats, legumes, seeds, oysters, eggs and cheese.
    • Selenium – serves as an antioxidant, and protects the surface of the eye. Meat, fish, seafood and cereals are good sources of selenium. 

    Essential fatty acids5 

    Essential fatty acids, specifically omega-3 fatty acids, may be beneficial in treating DED. In addition to improving cardiovascular health, essential fatty acids are anti-inflammatory and improve the function of your nerves and nervous tissue. Omega-3 acids are either short chain or long chain. The short chains include alpha-linolenic acid (ALA), which can be found in flaxseed oil. The long-chain fatty acids include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are present in fish (tuna, salmon, trout and sardines) and fish oil, or in algal oil (derived from algae as a vegan option). 

    It’s important to note that the average diet consists mostly of Omega-6 fatty acids (found in vegetable oil). We typically consume 15 times more Omega-6s compared to Omega-3s. While Omega-6s are helpful in many ways, when you consume such a disproportionate amount compared to Omega-3s, it can actually cause inflammation. So it’s important to make sure you’re balancing your Omega-6s with Omega-3s. This is where an Omega-3 supplement can be helpful. For DED, you want supplements with a high Omega-3 dose, usually 2000mg or more, and more EPA than DHA. 

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    Other supplements

    Carotenoids6

    Carotenoids are yellow, orange and red pigments typically found in plants. The most common types are alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, and lycopene. Your body can actually convert alpha-carotene, beta-carotene, beta-cryptoxanthin into vitamin A. Carotenoids function as potent antioxidants, and also help with visual function in the retina. You will typically find carotenoids in eye supplements protecting against age-related macular degeneration.

    • Lutein and Zeaxanthin – play a role in the visual function of the macula, which is the part of the retina that is responsible for most of your vision. Because of their antioxidant properties, they may also help with reducing damage to the ocular surface. You’ll find lutein and zeaxanthin in green leafy vegetables. 
    • Lycopene – helps with antioxidation for the eyes and the body. The best source of lycopene is from “red” fruits and vegetables, including tomatoes, watermelon and grapefruit.

    Amino acids & Proteins

    • Taurine7 – is involved in the functioning of the retina, and also may help in protecting your ocular surface by protecting against highly concentrated tears (more salt than water), which is one of the features of DED. The best source of taurine is seafood and meat.
    • N-acetylcysteine8 – is a potent antioxidant and can protect the retina and the ocular surface from oxidative damage. In fact, eye doctors sometimes prescribe compounded n-acetylcysteine as topical drops for severe dry eye cases. Good sources of n-acetylcysteine include meat, fish, grains, legumes, dairy products, broccoli, cauliflower and nuts. 
    • Lactoferrin9 – is found in natural tears, and helps protect the corneal surface from ultraviolet radiation. Lactoferrin may work synergistically with selenium to amplify antioxidation and protect the ocular surface. Lactoferrin is found in cow’s milk.

    Curcumin10

    Curcumin is anti-inflammatory, antioxidant, and antimicrobial (fights infections), and promotes wound healing. All these play a vital role in protecting the surface of the eye. Curcumin protects against the immediate side-effects of DED, such as inflammation and oxidative injury. But it also prevents the side-effects of chronic DED, such as corneal scratches and infections. The best source of curcumin is turmeric, which is widely used as a spice and flavor. 

    Hyaluronic acid11 

    Hyaluronic acid is a humectant, which means that it attracts water and promotes hydration and moisturization. This is important for your joints, skin, bones, and ocular surface. Some sources of hyaluronic acid include bone broth, rooster combs, soy-based foods, and starchy root vegetables. Hyaluronic acid can also be lab-grown.

    How to use nutritional supplements

    Nutritional supplements work best if consumed in a consistent daily dose. Generally, splitting the dose over two servings during the day (morning and evening) helps with absorption. You also want to take them after a meal, so after breakfast and dinner. Be sure to drink a full glass of water after taking your supplements to help digestion and maintain your body’s hydration. Nutritional supplements work best alongside other lifestyle changes.

    Lifestyle changes: balanced diet, working with the weather, taking regular breaks

    Putting it all together

    Your diet plays a crucial role in your eye care. Just like with diabetes or high blood pressure, the first thing your primary care doctor tells you to do is make some lifestyle changes. It’s the same with DED. In addition to your environment and work-life, nutrition can make a big impact in DED. 

    By addressing your diet, you build the foundation for lasting relief. So do your best to eat a healthy, balanced diet containing proteins, carbs, essential fatty acids, vitamins and minerals, and drink lots of water. Focus on nutrients with antioxidant and anti-inflammatory properties. If you need an extra boost, using a well-rounded eye health supplement can be a great addition to your dry eye treatment plan.

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    What’s next

    We really think everyone should take our Dry Eye 101 course. Find it here!

    If you’ve already taken it, amazing! Check out more articles in the Continuing Education section below.

    Bibliography

    1. Tear Film & Ocular Surface Society. Dry Eye Workshop II Report. Ocular Surface Journal, 2017. TFOS DEWS II Report, https://www.tfosdewsreport.org/.
    2. Pellegrini, Marco, et al. “The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases.” Nutrients, vol. 12, no. 4, 2020, p. 952. MDPI, https://www.mdpi.com/2072-6643/12/4/952.
    3. Fogagnolo, Paolo, et al. “A Review of Topical and Systemic Vitamin Supplementation in Ocular Surface Diseases.” Nutrients, vol. 13, no. 6, 2021, p. 1998. MDPI, https://www.mdpi.com/2072-6643/13/6/1998.
    4. Griff, Ann Marie. “Vitamins for dry eye: Research, sources, and treatments.” Medical News Today, 26 September 2018, https://www.medicalnewstoday.com/articles/315270. Accessed 9 October 2021.
    5. Vimont, Celia. “The Benefits of Fish Oil for Dry Eye.” American Academy of Ophthalmology, 15 October 2020, https://www.aao.org/eye-health/tips-prevention/does-fish-oil-help-dry-eye. Accessed 15 October 2021.
    6. Micronutrients Information Center. “Carotenoids.” Linus Pauling Institute, 2004, https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/carotenoids. Accessed 9 December 2021.
    7. Froger, Nicholas, et al. Handbook of Nutrition, Diet and the Eye. Academic Press, 2014. Science Direct, https://www.sciencedirect.com/science/article/pii/B9780124017177000514.
    8. Nepp, Johannes, et al. “Management of moderate-to-severe dry eye disease using chitosan-N-acetylcysteine (Lacrimera®) eye drops: a retrospective case series.” International Ophthalmology, vol. 40, 2020, pp. 1547–1552. Springer Link, https://link.springer.com/article/10.1007%2Fs10792-020-01324-5.
    9. Anshel, Jeffrey. “Lactoferrin levels can diagnose dry eye disease.” Optometry Times, 11 June 2020, https://www.optometrytimes.com/view/lactoferrin-levels-can-diagnose-dry-eye-disease. Accessed 18 October 2021.
    10. Radomska-Leśniewska, Dorota M., et al. “Therapeutic potential of curcumin in eye diseases.” Central European Journal of Immunology, vol. 44, no. 2, 2019, pp. 181-189. Termedia, https://www.termedia.pl/Therapeutic-potential-of-curcumin-in-eye-diseases,10,37377,0,1.html.
    11. Julson, Erica. “7 Surprising Benefits of Hyaluronic Acid.” Healthline, 21 April 2018, https://www.healthline.com/nutrition/hyaluronic-acid-benefits#TOC_TITLE_HDR_5. Accessed 01 December 2021.

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