Dry Eye Syndrome: How to Relieve Your Symptoms
Dry eye syndrome (also known as dry eye) doesn’t usually cause long-term vision problems. It can, however, make your eyes feel uncomfortable and irritated.
According to the National Institute for Health and Care Excellence (NICE), between five and 33 per cent of adults worldwide are affected by dry eye. People aged 50 or older, women, and those who have had vision correction surgery are more likely to experience it than others.i
The older you are, the more likely you are to have dry eye. The College of Optometrists suggests it becomes more common by between two and 10.5 per cent each decade.ii
Usually, both eyes are affected, though one eye can be more affected than the other. The main symptoms include:
Eye irritation: soreness, burning or grittiness, the feeling you have something in your eye.
Sensitivity to bright light.
Blurred vision (though this is usually temporary).
Eyes watering more than usual.
Dry eye is also a symptom of eye strain (asthenopia). This can happen when you use your eyes intensely.
Most of the information online advises treating dry eyes with eye drops. There are, however, ways of treating your symptoms more naturally. It can be treated through your diet and taking nutritional supplements. If this route interests you, this guide will tell you what you need to know.
What causes dry eye?
Dry eye is the result of having a problem with your tear film. Your tear film has three layers, with the middle watery layer producing what we know of as tears. These are made by a lacrimal gland underneath each eyelid; these glands constantly make tear fluid, then release it onto the front of the eye. When you blink your eyelid distributes the fluid across the cornea (the front of the eye).
A tiny amount of oily liquid is also produced, this time by the meibomian glands, which are other glands under the eyelid. These keep the tear surface smooth and stop fluid from evaporating.
Several things can affect this process. You may not produce enough tear fluid, your tears may not be of the right quality, or the fluid may not be spread across the cornea properly.
Are you at risk?
Being dehydrated – which means the water level in your body is lower than it should be – can result in reduced tear fluid production. The following can also cause problems with tears:
Hormonal changes in women.
Eye conditions such as blepharitis and meibomian gland dysfunction (MGD).
Medicines including diuretics, antidepressants, antihistamines, treatments used for anxiety and other psychological problems, blood pressure drugs called beta-blockers, acne medicines, eye drops used for other eye conditions and cough medicines.
Wearing contact lenses.
Environmental conditions such as wind and low humidity (from central heating or living in a hot, dry climate, for example)
Having a low blinking rate (this can happen if you spend long periods looking at a digital screen or TV).
Having an eye injury or surgery.
If your eye expert confirms you have dry eye they may recommend eye drops known as artificial tears. These replace your natural tears, making your eyes feel more comfortable. Thicker drops, called gels, are also available that stay in your eye for longer. If you wake up with dry eyes, you may also be prescribed an ointment to help keep your eyes moist while you’re asleep.
A surgical procedure that blocks the tear ducts, preventing tear fluid from draining away easily, is also sometimes recommended (punctual occlusion).
How nutrition can help
Many experts believe eating certain foods or taking nutrition supplements may help treat and even prevent dry eye. Here’s what you should know:
Omega 3 fatty acids
Found in oily fish, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may help treat dry eye.iii iv One study suggested that women who eat the most omega 3s from fish may be 17 per cent less likely to develop the condition than those who eat less or no fish or seafood.v There’s also evidence that people who develop dry eyes as a result of using a computer may also benefit from taking daily omega 3 supplements.vi
To get more EPA and DHA in your diet, try eating salmon, fresh tuna, sardines, pilchards, trout, herring or mackerel. Current guidelines state you should eat at least two portions of fish a week, one of which should be oily. To learn more read our article about the benefits of omega 3 on eye health.
Lutein and zeaxanthin
Taking lutein and zeaxanthin supplements may help if you experience eye strain – including dry eyes – after spending a long time in front of a computer. In one study, researchers found such supplements may improve eye strain in such cases while reducing eye fatigue and headaches.vii
Boost your intake of lutein and zeaxanthin by eating more green leafy vegetables and other colourful fruits and vegetables.
Vitamins C and E
Antioxidants in general – including vitamin C and vitamin E – may help with dry eye. One study trialled a supplement containing both vitamins along with B2, zinc and grape polyphenols. The supplement may have helped improve tear stability while reducing the burning, itching, redness and the sensation of having something in your eye.viii
The easiest way to up your vitamin C intake is by eating citrus fruits, red and green peppers, kiwifruit, tomatoes, strawberries, broccoli, spinach, potatoes and Brussels sprouts. Vitamin E is found in nuts, seeds and vegetables; especially green leafy vegetables.
Evidence suggests having low vitamin D levels may increase susceptibility to dry eyes. One study discovered 52 per cent of women with low vitamin D had dry eyes, compared with four per cent of those with normal vitamin D levels.ix
Getting enough vitamin D can be a challenge since a major source is sunlight. The UK government recommends everyone take a vitamin D supplement during the autumn and winter months. You can get vitamin D from your diet too: try eating oily fish, eggs, red meat, and foods fortified with the vitamin.
Interested in learning more about how vitamin D improves your eye health? Find more information here.
Sea buckthorn berries
Found in China and Russia, these berries are rich in antioxidants, and some experts believe supplementing your diet with sea buckthorn berry oil may help improve dry eye symptoms by reducing tear film osmolarity, a mechanism thought to cause dry eye.x
Want to read more about how your lifestyle can help you maintain healthy vision? Take a look around the rest of our Vision Health Hub.
Dry eye syndrome. (2017). National Institute for Health and Care Excellence. Available online: https://cks.nice.org.uk/dry-eye-syndrome#!backgroundsub:2
Dry Eye (Keratoconjunctivitis Sicca, KCS). (2018). The College of Optometrists. Available online: https://www.college-optometrists.org/guidance/clinical-management-guidelines/dry-eye-keratoconjunctivitis-sicca-kcs-.html
Rahul, B., Prachi, K., et al. (2013). A randomized controlled trial of omega-3 fatty acids in dry eye syndrome. Int J Opthalmol. 6(6):811-816. Available online: https://www.ncbi.nlm.nih.gov/pubmed/24392330
Bhargava, R., et al. (2013). A randomized controlled trial of omega-3 fatty acids in dry eye syndrome. Int J Ophthalmol. 6(6): 811–816. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874521
Miljanovic, B., et al. (2005). Relation between dietary n−3 and n−6 fatty acids and clinically diagnosed dry eye syndrome in women. The American Journal of Clinical Nutrition, Volume 82, Issue 4. Pages 887–893. Available online: https://academic.oup.com/ajcn/article/82/4/887/4607578
Bhargava, R., et al. (2015). Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye. Cont Lens Anterior Eye. Jun;38(3):206-10. Available online: https://www.ncbi.nlm.nih.gov/pubmed/25697893
Stringham, J.M., Stringham, N.T., O’Brien, K.J. (2017). Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods. Jun 29;6(7).
Drouault-Holowacz, S., Bievelet, S., et al. (2009). Antioxidants intake and dry eye syndrome: a crossover, placebo-controlled, randomized trial. Eur J Opthalmol. May-Jun;19(3):337-42. Available online: https://www.ncbi.nlm.nih.gov/pubmed/19396775
Yildirim, P., et al. (2016). Dry eye in vitamin D deficiency: more than an incidental association. Int J Rheum Dis. Jan;19(1):49-54. Available online: https://www.ncbi.nlm.nih.gov/pubmed/?term=Dry+eye+in+vitamin+D+deficiency%3A+more+than+an+incidental+association
Larmo, P.S., Jarvinen, R.L., et al. (2010). Oral sea buckthorn oil attenuates tear film osmolarity and symptoms in individuals with dry eye. J Nutr. Aug;140(8):1462-8. Available online: https://www.ncbi.nlm.nih.gov/pubmed/20554904