Vitamin D and Dry Eye

On the surface of your eye, you will find a film of three layers that coats it. Each time you blink, this film provides your eye with lubrication and nutrients. If you have ‘dry eye’, which is a recognized condition, you may feel stinging, itching or pain on the eye. In many cases, people who suffer from it look for supplements, particularly vitamin D3 to alleviate the condition. It is important, however, to understand the link between vitamin D and dry eye, so that you can find out whether or not supplementation will benefit you.

What Is Dry Eye?

Dry eye disease or dry eye syndrome is quite a common condition that happens when the eye is not capable of making sufficient tears, or if the tears themselves evaporate too fast. As a result, the eyes become swollen, red and irritated. The official medical name for this condition is keratoconjunctivitis.

Symptoms of Dry Eye

Dry eye can occur in one or both the eyes and is characterized by:

• Red eyes
• Feelings of soreness, grittiness or dryness, often worsening as the day progresses
• Waking up with eyelids stuck together
• Blurred vision, which does get better through blinking

Causes of Dry Eye

Your eyes have a number of glands in them responsible for the production of tears. Sometimes, they stop producing sufficient tears, or the tears are not of good quality. This leads to dry eye. It is possible that an inflammation on the eye’s surface caused it as well. There are many reasons why the production of tears, which is a very complex process, is disrupted. As a result, the exact cause of dry eye is often not known. However, there are a number of common causes, including:

• Wearing contact lenses
• Being in a windy or hot climate
• Underlying medical conditions, particularly blepharitis
• Medication
• Hormonal changes, particularly during menopause
• Skin diseases
• Gland diseases, particularly Meibomian gland dysfunction
• Pregnancy
• LASIK surgery
• Thermal or chemical burns
• Allergies
• Infrequent blinking, particularly in people who spend excessive amounts of time in front of a screen
• Homeopathic remedies
• Immune system disorders, particularly Sjogren’s Syndrome
• Chronic conjunctiva inflammation
• Thyroid disease
• Exposure keratitis
• Vitamin deficiencies or overdoses

Dry eye can occur in anybody, but it is more common in the elderly, as well as in women. It is estimated, however, that around 33% of people over the age of 65 will suffer from it occasionally.

Types of Dry Eye

There are two types of dry eye:

1. Aqueous tear deficient dry eye. This happens when the eye’s lacrimal glands produce insufficient levels of the water component found in tears. This means the surface of the eye can no longer be healthy.
2. Evaporative dry eye. This happens when the Meibomian glands become inflamed. These glands, found inside the eyelids, are responsible for the oily part of tears, keeping them stable and preventing them from evaporating too quickly.

Dry Eye Treatment

In most cases, dry eye is uncomfortable but not serious. This is why most treatments are designed not for healing the condition but for alleviating the symptoms. Generally, people turn to eye drops to provide some medication and perhaps some over the counter anti-inflammatory medication. Very rarely, surgery may be required to stop tears from draining away very quickly. Because dry eye is usually symptomatic of an underlying condition, this is generally what treatment is directed at.

There are plenty of things that you can do yourself if you suffer from dry eye. These include:

• Making sure your eyelids and eyes are clean and protected from smoke, dust, wind and general dryness
• Stepping away from the computer regularly to lower the chance of eye strain
• Moistening the air in the rooms you spend the most time in
• Increasing your levels of omega 3 and vitamin D

Dry Eye and Vitamin D

Vitamin D (particularly D3) is a vital nutrient to the body. You obtain it mainly through sun exposure. While the vitamin’s primary role is to help your body absorb phosphorus and calcium, research now says that it is responsible for many other things as well. We know that it helps in proper nerve and muscle functioning, supports the immune system, and more. There is now also some suggestion that it could help people with dry eye.

What Research Studies Say

Vitamin D is perhaps one of the most researched drugs in the world. This is because it affects as many as 2,000 individual parts of our body. Furthermore, virtually every cell in our body has a vitamin D receptor. As a result, scientists are fascinated by its various abilities and roles.

In a recent study at the Turkish Kocaeli Derince Training and Research Hospital, Dr. Pelin Yildrim, M.D., wanted to determine whether there was a link between vitamin D deficiency and impaired tear function and dry eye. To test this, they studied 98 premenopausal women, 50 of whom had a vitamin D deficiency.

Through the study, they found that those with the deficiency also scored lower on the TBUT (tear break-up time test) and on the Schirmer’s test. They also scored higher on the OSDI (Ocular Surface Disease Index). The results of this study enabled researchers to theorize that there is a role to play for vitamin D in protecting the eye. They believe that it does this by reducing ocular surface inflammation and by enhancing tear film parameters.

The findings were fascinating and included the following:

• 52% of the participants in the study who had a vitamin D deficiency also had dry eye according to the Schirmer’s test. Only 4% of non-deficient women also had dry eye according to this test.
• 74% of the women with a deficiency had dry eye according to the TBUT test, compared to 12% of those without deficiency.

Researchers will now conduct further studies to find support for their hypothesis.

Scientists are preparing to conduct a randomized Omega-3 and Vitamin D trial, which will look at some 25,875 people in this country. The goal of this study is to determine whether taking both Vitamin D and Omega-3 could help to reduce the chances of stroke, heart disease and cancer in people who did not already suffer from such a condition. One of the things that they will look at, as well, is whether dry eye can be reduced in frequency and severity through these supplements. The table below shows the four groups of people that will be tested.

Condition Treatment Test
Dry Eye Disease Omega-3 fatty acids, fish oil, to be prescribed as a drug.

Fish oil placebo to be prescribed as a drug.

Vitamin D3 to be prescribed as a dietary supplement.

A Vitamin D3 placebo to be prescribed as a dietary supplement.

Dry Eye Treatment

It is always important to speak to a medical professional before deciding on any kind of at home treatment, including supplementation. It is quite widely accepted that taking an Omega 3 supplement and a vitamin D supplement is beneficial, although it isn’t clear which one of the two is most important and why. Instead of supplementing, you can also increase your intake of flaxseed and oily fish.

Whether or not a supplement may benefit you depends on your exact condition. This is why you must consult with your medical professional first. While you may think that taking a vitamin supplement can never harm, this is not entirely true. Vitamin D in particular can have significant interactions with other drugs and illnesses, so you should never simply decide to take it, even though it is an over the counter remedy.

Resources and References:

New Study Suggests Vitamin D Deficiency Is Related to Dry Eye – Link between dry eye and vitamin D. (Vitamin D Council)
Dry Eye in Vitamin D Deficiency – More Than an Incidental Occasion – Connection between dry eye and vitamin D deficiency. (NIH.gov)
Low Vitamin D Tied to Dry Eye Syndromes – Relationship between dry eye syndromes and low vitamin D levels. (MedicalXPress)
Dry Eye Disease in the Vitamin D and Omega-3 Trial (VITAL) – Study on whether taking vitamin D3 or omega-3 supplements can help in dry eye. (ClinicalTrials.gov)
Facts about Dry Eye – General information about dry eye. (NIH National Eye Institute)