A recent study has found that Vitamin D may play a significant role in alleviating symptoms of dry eye disease. The research indicates that participants who received Vitamin D supplementation experienced a marked improvement in tear production and a reduction in eye discomfort.
Understanding the connection between Vitamin D deficiency and dry eye disease
Dry Eye Disease (DED) (also known as dry eye syndrome) is a common condition affecting millions worldwide. It causes discomfort and sometimes serious vision issues. One emerging treatment of dry eye disease that’s gaining attention is Vitamin D supplementation. Recent findings published in Contact Lens & Anterior Eye have shown that Vitamin D could reduce the symptoms and improve the condition of those suffering from DED.
What is dry eye disease?
Dry eye disease occurs when the eyes do not produce enough tears or when the quality of tears is poor. In epidemiological studies, the prevalence of DED in people over 40 years of age ranges from 5 to 50 percent, and the disorder seems to be associated with age and female gender.
DED can lead to dryness, irritation, redness, and even blurred vision. While various treatments exist, Vitamin D has recently emerged as a potential new avenue for relief due to its anti-inflammatory and immune-boosting properties.
The role of Vitamin D in the body
Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and phosphorus. Your skin makes Vitamin D when you’re exposed to the sun. Vitamin D is well-known for supporting bone health. It regulates the immune system and helps reduce inflammation in the body. These properties make it a candidate for alleviating conditions like DED, which are partly driven by inflammation and immune dysfunction.
A deficiency in Vitamin D can cause dry eye symptoms. However, supplements may help by reducing inflammation on the eye’s surface, according to a 2020 article.
A 2019 study found that Vitamin D supplementation improves the effects of lubricating eye drops, another dry eye treatment. A 2018 study also determined that oral Vitamin D supplements improved tear quality and dry eye symptoms.
There’s no recommended Vitamin D dose for treating dry eye. If you take Vitamin D supplements, avoid exceeding 4,000 IU to prevent toxicity. Like Vitamin A, Vitamin D is fat-soluble and can accumulate in the body.
Should we take Vitamin D for dry eyes?
Researchers conducted a systematic review and meta-analysis to determine whether Vitamin D could improve dry eye symptoms. They pulled data from ten medical databases and four clinical trial registries, focusing on studies published between 2015 and January 2023 that investigated Vitamin D supplementation for dry eye disease.
Study overview
- Total studies analyzed: eight studies
- Number of cases: 439 patients with DED
- Duration: Studies ranged from daily doses to one-time injections of Vitamin D, with dosages varying from 2,000 IU (international units) daily to 200,000 IU in a single injection.
The researchers looked at key clinical indicators of dry eye improvement, such as:
- Schirmer’s test (SH test): Measures tear production
- Tear break-up time (TBUT): Measures how quickly the tear film on the eye’s surface evaporates
- Corneal fluorescein staining scores (CFSS): Assesses eye surface damage
- Lid hyperemia: Measures redness in the eyelids, a sign of inflammation
- Ocular surface disease index (OSDI): Measures the severity of dry eye symptoms based on a patient questionnaire
- Visual analog pain scale (VAS): Evaluates pain severity
The results? Significant improvement in dry eye symptoms!
The analysis revealed that patients who received Vitamin D supplementation experienced improved tear production and stability, as well as notable improvements in their eye health and quality of life.
Specifically, Vitamin D was shown to:
- Boost tear production: The Schirmer’s test showed a significant improvement (SMD 1.43), meaning patients produced more tears after taking Vitamin D.
- Enhance tear film stability: The TBUT test results showed that the tears stayed on the eye’s surface longer, helping to keep it moist and comfortable (SMD 1.19).
- Beyond tear production, Vitamin D also seemed to reduce some of the more painful and irritating symptoms of dry eye disease.
- Less lid redness (lid hyperemia): Patients showed reduced redness in the eyelids, a sign of lower inflammation (SMD -0.71).
- Lower ocular surface disease index scores: Patients reported fewer and less severe dry eye symptoms on the OSDI questionnaire (SMD -1.10).
- Decreased pain: Visual analog pain scale scores showed a slight reduction in pain symptoms (SMD -0.32).
Oral Vitamin D found to be most effective
The researchers conducted additional analyses to determine which Vitamin D supplementation worked best. They found that oral Vitamin D capsules provided better results than buccal sprays or intramuscular injections. This suggests that taking Vitamin D as a daily oral supplement may be the most effective method for alleviating DED symptoms.
Other vitamins that have been thought to benefit dry eye disease
Two other vitamins have been shown to improve dye eye syndrome but are not considered to be a cure of any kind.
They are:
Vitamin B12
Vitamin B12 is a water-soluble vitamin that helps the body make DNA and nerve cells. Deficiency of this nutrient is associated with severe dry eye disease and eye pain, according to a 2017 study.
In a 2020 study, combining oral vitamin B12 supplements and artificial tears improved symptoms of dry eye syndrome. According to the researchers, vitamin B12 may repair the corneal nerve layer or the nerves on the eye’s outer surface. This can help reduce the burning associated with dry eye.
A 2015 case report also shares that vitamin B12 supplements improved symptoms in a person with chronic dry eye.
There isn’t a recommended vitamin B12 dosage for dry eye symptoms. Additionally, how much you should take depends on your ability to absorb the vitamin. Though 2,000 micrograms are generally considered safe, talk with a healthcare professional before taking vitamin B12 for dry eye.
Omega-3
Omega-3 is a polyunsaturated fatty acid. It provides structure to cell membranes and reduces inflammation in the body.
In a 2016 study, Omega-3 supplements improved dry eye symptoms in people with rosacea. Another 2015 study found Omega-3 supplements eased dry eye symptoms in people with computer vision syndrome. The study found that Omega-3 fatty acids reduced the tear evaporation rate.
A 2019 review shares that Omega-3 fats may work by reducing inflammation. This can alleviate symptoms like irritation and pain.
There is some conflicting evidence, though. For example, a 2018 study found that Omega-3 fatty acid supplements didn’t improve symptoms of dry eye. More research is necessary.
There is no official recommended Omega-3 dose for treating dry eyes. However, according to a 2014 review, ophthalmologists suggest 1,000 milligrams of Omega-3 fats daily.
Could Vitamin D be a new tool against dry eye disease?
These findings suggest that Vitamin D supplementation could be a helpful addition to current treatments for dry eye disease. Patients showed improvements in tear production, reduced eye surface damage, and experienced relief from discomfort. However, more research is needed to determine the ideal dosage and method of Vitamin D supplementation.
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Where do we go from here?
While the study is promising, the authors caution that further research is required. Future studies will need to determine the most effective dosage and form of Vitamin D to maximize the benefits for people with dry eye disease.
But for now, the findings provide a potential new option for those struggling with dry eyes.
Assil Gaur Eye Institute is your best partner in treating and monitoring dry eye disease
Sometimes, despite lifestyle modifications, people may notice that their eyes become drier over time, and techniques used to provide relief are no longer effective. That’s why it’s essential to have regular follow-up appointments with our dry eye specialists to monitor any changes in your symptoms and explore new treatment options that can address your situation.
There may be no single treatment to address your dry eye condition completely. Our dry eye care ophthalmologists and optometrists will work with you to find the underlying cause of your dry eye to provide the correct combination of therapies that best suit your symptoms.
To request a consultation, please make an appointment online or call us at 866-945-2745.
Our dry eye center is conveniently located for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
Sources:
Effects of Short-Term Oral Vitamin A Supplementation on the Ocular Tear Film in Patients with Dry Eye – PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462169/
Dry Eye Disease: When to Treat and When to Refer – PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202299/
Can Fish Oil Relieve Dry Eye? – American Academy of Ophthalmology
https://www.aao.org/eye-health/tips-prevention/does-fish-oil-help-dry-eye
Commentary: Dry Eye Syndrome and Vitamin D Deficiency – PMC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508114/
Management of Ocular Neuropathic Pain With Vitamin B12 Supplements: A Case Report
https://pubmed.ncbi.nlm.nih.gov/26266431/
Ocular neuropathic pain
https://doi.org/10.1136%2Fbjophthalmol-2014-306280
Miljanović, B., Dana, R., Sullivan, D. A. & Schaumberg, D. A. Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol 143, 409–415 (2007).
