HEALTH NEWS

Are Dry Eyes Bugging You?

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

April 11, 2022

Are Dry Eyes Bugging You?
You may not think about it until you’re in a staring contest with your child or your eyes feel gritty and dry from a hot windy day, but blinking your eyes is a very important job. The average individual blinks their eyes about 15-20 times per minute or 900 blinks per hour. Blinking brings lubrication to your eyes and helps refresh them. You may blink to help blurry vision and focus. You blink your eyes because of irritation from pollens, smoke and other allergens or with eye stress. Blinking is necessary for eye health and its moisture needs.

Tears and eye lubrication help remove debris and dirt from the environment. It keeps the surface of the eye clean and helps repel germs that come in contact your eye. Blinking bathes your eye in moisture necessary for comfort, protection, and function.

Ducts and glands within the eyelids produce a blend of oils, water, proteins, electrolytes, and other compounds which lubricate the outer surface of the eye. This fluid is critical to protect the cornea and conjunctiva from irritation and is essential for eye comfort. When eye lubrication diminishes, it leads to dry, itchy, burning eyes and can progressively inflict inflammatory damage to the cornea and surface of your eyes.

Dry Eyes Impact Millions

An estimated 75 percent of adults over the age of 40 experience some effects of mild dry eyes. Recent research also shows that nearly 17 million adults in the United States are substantially impacted by dry eyes and have inflammatory damage to the cornea and conjunctiva.

Factors that Affect Tear Production and Eye Moisture

Tear production and management is the result of four different processes in the eyes that require nourishment. Adequate amounts of different oils, water, electrolytes, and nutrients are necessary for tear production, otherwise lubrication suffers.

Other issues can contribute to or cause dry eyes, like advanced age, Asian ethnicity, low humidity climates and windy conditions, air conditioning, dry heat, dehydration, allergies, and environmental chemicals. Contact lens use as well as LASIK or other eye surgery can also cause dry eyes.

Eye lubrication and moisture may be impaired by antihistamines and decongestants, anticholinergics, antidepressants, antipsychotic medications, antivirals, beta blockers, oral contraceptives, diuretics/water pills, estrogens, opioids, and glaucoma medications. Heavy metal toxicity from mercury also causes dry eyes.

Neurological disorders and other illnesses affect eye lubrication or blinking mechanisms. These include Bell’s palsy, depression, diabetes, glaucoma, hepatitis, and Parkinson’s disease. Autoimmune disorders like lupus, rosacea, scleroderma, rheumatoid arthritis, and thyroid also affect eye lubrication.

Prolonged Focus and Screen Time

More commonly, reading or driving for extended periods are causes of dry eyes. Prolonged computer use along with other tech screens has greatly increased prevalence and symptoms of dry eyes. When you focus on the screen, the number of times that you blink your eyes each minute decreases, leading to tear evaporation. Glare from the screen, lighting, small font size, and screen radiation also affect your eyes.

A recent 2021 study with high school students showed high prevalence of dry eyes due to computer use and not blinking. Of the 94 students tested, 87 percent had “evaporative” dry eyes.

A study on college students demonstrated that at least 1 in 2 individuals had symptoms of dry eyes due to computer and electronic device use. Smart phone use also contributes to dry eyes. Dry eye issues have increased with COVID-19 lockdowns with work and school at home.

20-20-20 Rule

Sometimes simple steps are all that is needed to help minor dry eye concerns. Adequate hydration and following the 20-20-20 rule when dealing with eye strain, computer work, and lack of blinking can help common concerns. The 20-20-20 rule is: every 20 minutes, look away at something 20 feet away from you for 20 seconds to reduce eye strain. Take a few minutes to do some deep belly breathing and drink water to help relax, too.

Nutrients Needed for Eye Lubrication

Your eyes need several nutrients for overall health and function. Most fundamental to eye lubrication and support are omega-3 fish oils, vitamin A, and hyaluronic acid. Also critical for eye lubrication include vitamin D and astaxanthin. Low intake of these nutrients decreases eye moisture and lubrication.

Omega-3 DHA

Omega-3 fish oil DHA is vital to natural tear production and lubrication. A 2021 prospective, randomized, double-masked, placebo-controlled clinical trial in adults with dry eyes demonstrated the effectiveness of high-dose omega-3 fish oil DHA. Significant improvements in dry eye scores and tear film quality were noted after 8 weeks of DHA use. Omega-3 dosage used in this study was 1640 mg of DHA and 600 mg of EPA per day.

Other trials have found that a much lower omega-3 DHA and EPA intake can also be helpful for mild eyes caused by tear film evaporation. Omega-3 needs vary from person to person which may explain the dosage differences in these two studies.

Numerous tissues require omega-3 fish oils for structural and cell membrane repair, immune signals, prostaglandin and inflammation management, bone and gut health, and so much more. Use enough omega-3 DHA to fulfill your body’s needs. It may be much more than you realize.

Make sure to review the “Supplement Facts” on your omega-3 fish oils product. “Total omega-3 oils” or “total marine oils” is not the same as the amount as DHA and EPA contents. Read your omega-3 label oil carefully. Plant-based omega-3 DHA (algae) requires a markedly higher number of capsules to reach a therapeutic level.

The big box store omega-3 product that says 1000 mg of marine lipid or omega-3 fish oil with a break down of DHA 120 mg and EPA 240 mg per capsule may seem like a good deal price wise, but it lacks adequate levels. To achieve the 1640 mg of DHA listed in the study above, you would have to take 14 capsules per day of that big box store product. Compare that to Daily DHA or Leptinal. You would need only 6 capsules per day to reach 1500 mg of omega-3 DHA.

Vitamin A

Adequate vitamin A is necessary for eye lubrication. Vitamin A is found in animal foods, but not in plants. Carotenes which are found in plants can be converted into vitamin A, however, various factors like sluggish thyroid function and gene SNPs or receptor site mutations may interfere with the conversion of carotenes into vitamin A increasing your need. Plant-based diets may not provide the necessary amount of vitamin A and you may need to supplement.

More information may be found in the article: Vitamin A – An Essential Nutrient for Immune, Respiratory, and Gut Health.

Hyaluronic Acid

Your eyes naturally contain significant amounts of hyaluronic acid as it provides excellent lubrication for ocular health, just like it provides lubrication for joints.N-acetyl-d-glucosamine (NAGS) provides similar structural compounds as hyaluronic acid for lubrication and may provide additional eye moisture support.

Additional Support

Two other compounds are also very helpful for eye lubrication. These include the natural carbohydrate-fiber arabinogalactan and r-alpha lipoic acid.

Dry eyes are not just a nuisance symptom. It is a cry for essential support necessary for normal eye function. With the many hours of screentime you put in per day and the reduced number of times that you blink, your eye’s nutritional needs for moisture increases. Make sure you support them!

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