Wednesday, May 16, 2018

Dry Eye Treatments: The Good Oil!

Dry eye disorders are common as we age and usually show up as gritty sore eyes that worsen as the day progresses. Closed eyelids as we sleep offers a recovery period but next day the whole annoying cycle starts over again. Current treatments are usually targeted at relieving symptoms of irritation with extra lubrication or punctal plugs that decrease tear outflow. Recently though our understanding of dry eye problems has improved dramatically. Better understanding of dry eyes problems helps lead to better diagnosis and newer treatment options that either prevent difficulties or reduce discomfort.

Age inevitably produces a gradual decline in our tear function. And there are two clear mechanisms involved. The first is decreased tear production from the primary lacrimal glands. This can happen because of autoimmune problems like arthritis or problems like diabetes which decrease eye sensitivity. The second is increased tear evaporation with reduced function of some of the glands in the lids called meibomium glands. Age and recurrent inflammatory conditions reduce the function of these glands which produce an essential "oily" layer. This layer sits on top of tears and slows tear evaporation. Reducing this layer causes tears to evaporate quickly causing the gritty dry eyes and the intermittent blurry vision usually seen.


In 2003 a scientific study showed that high dietary intake of the Omega-3 group of essential oils decreased the risk of developing dry eye disease. It has been known for quite some time that the American diet is top heavy in Omega-6 oils and lacking in Omega-3 oils. This study showed that improving the amount of Omega-3 essential oils seems to address an imbalance and decreases the likelihood of developing dry eyes.

What mechanism helps omega-3 essential oils aid dry eyes? The heart of it seems to be the known fact that the omega-3 group of oils decreases inflammation in conditions such as rheumatoid arthritis. It appears that they also help decrease inflammatory conditions that affect the eye. Reducing the effects of lacrimal gland inflammatory problems improves tear production, hopefully avoiding dry eye disorders such as Sjogren's syndrome. Tear evaporation is reduced by decreasing inflammatory problems affecting the meibomium glands such as blepharitis and acne rosacea. An interesting third factor is that omega-3 essential oils actually seem to be some of the active ingredients in producing a healthy tear film oil layer.

Tools such as extra lubrication and punctal plugs will still be needed to treat dry eyes with significant discomfort. Our improved understanding of the natural history of dry eye will allow however for the future use of alternative treatments such as dietary supplements. Omega-3 dietary supplements have already been shown to be essential nutrients in other health areas, now we know that they are also the "good oil" for dry eye management.

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