What Goes Into Dry Eye Formulations?

Dry eye formulationWith drier weather of windy fall and cold winter, added to our hours on the computer, come increased dry, burning, and itchy eyes, known as dry eye syndrome. This is the number one complaint that eye doctors hear from patients. Most of us experience it at least from time to time.

Some nutrients and formulations are especially helpful.

Why Dry Eyes Develop

Dry eye syndrome (DES) develops either because fewer tears are produced (aqueous-deficient DES) or tears evaporate too quickly (hyper-evaporative DES).

The moisture-laden surface of the eye contains three interrelated layers known as the tear film. If their balance is lost the tear film deteriorates and we experience dry eye.  The innermost layer is a mucous layer of electrolytes, proteins and water.  Outside that is a thicker, more watery aqueous layer that is mildly alkaline. And the outer protecting lipid layer made of oily meibum that keeps the tear film from evaporating.

Eye surgery often damages the goblet cells floating in the conjunctiva which supply mucin to create the thin mucous layer. Lacrimal glands, which can become blocked, supply the pH 7.4 watery fluid which is pumped across the surface of the eye by blinking. They are linked to nerves (making you tear up when smoke gets in your eyes) and are also linked to the lymphatic system (helping remove debris).  Meibomian glands can become blocked and dysfunctional, resulting in too rapid evaporation of the tear film.

Causes of Dry Eye

Anything that reduces the tear film or its even and regular distribution causes dry eye syndrome.

  • Most DES is caused by meibomian gland dysfunction (MGD).1
  • Computer users blink less; their blink rate decreases by about 40%.2 Blinking acts as a pump to keep the tear film spread evenly over the eye. Tear film begins to naturally degrade after about 10 seconds, so we automatically blink about 10-12 times a minute. But when focused intently on something (like a computer), our blink rate slows and our eyes get dry and tired. Computer users have low concentrations of mucin 5AC, which is an essential component of the mucous layer.3 4
  • Dry eye syndrome is inflammatory in nature. The “vicious cycle of inflammation” is a major contributor to dry eye syndrome.5 Age-related inflammation attacks all layers of the tear film:  mucous, watery, and lipid layers.6
  • Dry eyes in women appear to be related to fluctuations in hormone levels, particularly estrogen and androgens.7 Aging alone is considered a serious risk factor for dry eye syndrome.8
  • There is increasing evidence that DES is autoimmune related.9
  • Environmental and lifestyle factors like pollutants in the air, smoking, and certain medications increase the likelihood of DES.

Essential Nutrients to Prevent Dry Eye

We believe that the best way to target dry eye syndrome is to support the integrity of the tear film components, as well as reduce eye and whole-body inflammation.

Omega-3 fatty acids, consumed in foods (like fish), may contribute as much as 66% reduction in dry eye syndrome. 10 With omega-3 supplementation the tear film breakdown is slowed.11 Of the omega-3’s DHA has especially proven helpful for DES.12  The other omega-3 sources, ALA, and GLA are supportive as part of a holistic dry eye therapy.

Omega-7 fatty acids are effective against inflammation, an issue in severe DES. In randomized controlled trials purified palmitoleic acid (omega-7) reduced inflammation markers such as hs-CRP.13

Vitamin D supplementation improves dry eye symptoms, quality of tear film, and the ocular surface.14 Vitamin D deficiency is linked to tears without enough watery content and tear film deterioration.15  Since older people tend towards low vitamin D levels for a number of reasons, supplementing with vitamin D3 is a good idea.

Source of Nutrients for Dry Eye

If you decide to use supplements to reduce eye and whole-body inflammation as well as support the integrity of the tear film, then we recommend the following.

Dr. Grossman’s Dry Eye and Tear Support Formula is designed to help relieve symptoms of dry eyes and internally moisten the body. It is the basic formula for dry eyes.

Dr Grossman’s Omega-7 Formula provides anti-inflammation support and is useful for severe dry eyes.

Homeopathic Eye Drops (you can pre-order, they’ll re-stock in early October) or Optase Dry Eye Drops (helpful for more chronic dry eye issues). These are both natural preservative free drops.  They strengthen the tear film and relieve dry eye symptoms.

These nutrients are available in several discounted packages, such as Dry Eye Package 1, Dry Eye Package 2 (adds omega-7), and Dry Eye Package 3 (adds moist heat compress kit).

Luckily, there are many ways to prevent and treat dry eyes so that the condition does not become chronic and cause other damage. Drinking more water, using a humidifier, and using natural eye drops are all simple ways to ease dry eyes. For more information you can read our pages on dry eye syndrome and support for dry eye.

Take care of your precious vision!

  1. Nowinska, A., Wylegala, E., Tarnawska, D., Janiszewska, D., Dobrowolskia, D. (2012). Meibomian gland dysfunction—review. Klin Oczna, 114(2):147-52.
  2. Hauser W. (2017). Dry Eye: A Young Person’s Disease? Rev Optom. Feb 15.
  3. Gipson, I.K., Hori, Y., Argueso, P. (2004). Character of ocular surface mucins and their alteration in dry eye disease. Ocul Surf, 2(2):131-148.
  4. Uchino, Y., Uchino, M., Yokoi, N. (2014). Alteration of Tear Mucin 5AC in Office Workers Using Visual Display Terminals: The Osaka Study. JAMA Ophthalmol, 132(8):985-992.
  5. Yamaguchi, T. (2018). Inflammatory Response in Dry Eye. Invest Ophthalmol Vis Sci, 2018 Nov 1;59(14):DES192-DES199.
  6. de Paiva CS. (2017). Effects of Aging in Dry Eye. Int Ophthalmol Clin. Spring;57(2):47-64.
  7. Lurati AR. (2019). Menopause and Dry Eye Syndrome. Nurs Womens Health. Feb;23(1):71-78.
  8. Ibid. de Paiva. (2018).
  9. Ibid. de Paiva. (2018).
  10. Epitropoulous, A.T., Donnenfeld, E.D., Shah, Z.A., Holland, E.J., Gross, M., et al. (2016). Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea, Sep;35(9):1185-91.
  11.  Miljanovic, B., Trivedi, K.A., Dana, M.R., Gilbard, J.P., Buring, J.E., et al. (2005). Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr, Oct;82(4):887-93.
  12. McCusker MM, Durrani KK, Payette MJ, Suchecki J. (2016). An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract. Clin Dermatol. Mar-Apr;34(2):276-85.
  13. Bueno-Hernandez N, Sixtos-Alonso MS, Garcia MDLP, Yamamoto-Furusho JK. (2017). Effect of Cis-palmitoleic acid supplementation on inflammation and expression of HNF4Y, HNF4a and IL6 in patients with ulcerative colitis. Minerva Gastroenterol Dietol. Sep;63(3:257-263.
  14. Yang CH, Albietz J, Harkin DG, Kimlin MG, Schmid KL. (2018). Impact of oral vitamin D supplementation in people with dry eye and/or low serum vitamin D. Cont Lens Anterior Eye. Feb;41(1):69-76.
  15. Gemirci G, Erdur SK, Ozsutcu M, Eliacik M, Olmuscelik O, et al. (2018). Dry Assessment in Patients with Vitamin D Deficiency. Eye Contact Lens. Sep;44 Suppl 1:S62-S65.