Having eyes that are a bit dry may sound trivial, but tell that to the millions of Americans who experience the daily misery. Visualize having eyes that feel like sandpaper- all day, every day. Simple pleasures like reading and watching television become painful endurance contests.
As we age, just about everything in the body begins to dry out. From the skin to the intestines, moisture is slowly disappearing, causing symptoms that range from itching to constipation.
And for more than 10 million Americans- mostly women- dry eyes are the problem, causing itchiness and constant pain. This syndrome is the most frequent patient complaint that eye doctors hear. About 20 percent of the adult population suffers from dry eye problems to some extent.
A scientific paper in the journal Cornea looked at the economic impact of this common disorder. Economic resources used up for dry eye sufferers include healthcare professional visits, nonpharmacological therapies, and costly pharmacological treatment and surgical procedures. Complementary and alternative medicine therapies now contribute to the dry eye economic burden. And, given the prevalence of the condition, indirect costs are large. The researchers conclude that dry eye is a prevalent disorder with the potential for a high economic impact.
Dry Eye Syndrome – A Deeper Look
Dry eye syndrome, or keratoconjunctivitis sicca, is distinguished by a decline in the quality or quantity of tears that normally bathe the eye. This lack of moisture causes symptoms such as pain, irritation, dryness, and a sandy or gritty sensation. In serious cases, reading, driving, working or participating in other activities of daily life is difficult or impossible. Severe dry eye syndrome can even lead to scarring or ulceration of the cornea, with vision loss.
An evaluation of the amount of tears your eye produces is done with a Schirmer test. Tiny paper tabs are placed in the lower eyelids. The strip is removed from the lid and wet area measured. If smaller than average, you may not produce enough tears to lubricate your eye sufficiently.
Not all the causes of dry eye are known, but normal aging of tear glands seems to be involved. It’s more common in women than men.
All parts of the eye can become dry. Macular degeneration (MD) is a degenerative disease of the elderly in which retinal function declines, destroying central vision. One version of MD is dry (in which the blood supply is inadequate).
Dry eye can also result from several immune disorders that affect tear production, including rheumatoid arthritis, lupus and Sjogren’s syndrome. Sometimes allergies are involved. Research has shown a link between levels of the male sex hormone androgen and the disease.
Healthy tears consist of three layers: The outer fatty layer (from the Meibomian oil glands in the eyelids) prevents evaporation. The second provides antibodies, salinity and acidity to the cornea (the “aqueous” tears from the lachrymal gland and accessory lachrymal glands located in the conjunctiva of the eyelids). Finally, the inner layer includes mucus (from the goblet cells deep inside the eyelid) that coats the cornea. Contemporary thought, though, describes the tears as being aqueous throughout their entire thickness, with varying concentrations of various types of mucins located in different layers.
Contrary to popular wisdom, the problem is usually not that there aren’t enough tears, but that the tears have poor chemistry and are too thin and dry. Thin tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation.
Current treatment research also reveals that the syndrome frequently involves inflammation as well, and that it affects both the tear glands and the surface of the eyeball.
A Holistic View
Dry eye syndrome is largely incurable in conventional medicine. Artificial tears in the form of eye drops offer some relief. Some folks resort to surgery that blocks the tear exit ducts (punctual plugs).
Fortunately, natural medicine offers effective remedies.
George Dever, O.D., has been my eye doctor and close colleague for almost three decades. He is an herbalist and has been a doctor of optometry for almost 50 years. His busy downtown Seattle clinic serves eye patients conventionally as well as holistically. Dr. Dever’s practice represents the best of what’s possible in holistic eye therapy—he uses nutritional and herbal support to enhance the eyes and visual system, and conventional tools and developmental therapies to train the body to use the eyes better.
According to Dever, the holistic view is that dry eye disease is caused at least in part by oxidative/free radical damage, toxic buildup and decreased circulation to or around the eyes. Therefore, anything you consume that has antioxidant properties and free radical scavengers; that promotes better, stronger circulation; and that supports waste elimination, particularly liver function, will directly or indirectly benefit your eye. Dry eye is a particularly responsive condition, according to Dever.
The same herbs and supplements that treat osteoarthritis (another disease of dryness, which often occurs coincidentally with dry eye) help strengthen other membranes such conjunctiva, mouth, nose and ears, so glucosamine sulfate, at 750 mg. twice per day is used to treat dry eyes.
Dever suggests drinking more water and using appropriate amounts of healthy fats. In particular, omega-3 oils from fish and monounsaturates, such as olive oil, are helpful. Supplements of flaxseed oil, black currant oil, and cod liver oils have all produced dramatic results in patients with dry eye. St. Luke’s Eye Center says that 12 almonds or pecans daily will suffice. These oils are anti-inflammatory, and may be working in that manner. They also contribute to the oily layer in the tears.
A recent German study showed that hyaluronic acid is particularly useful, and that lid hygiene, warm compresses and lid massage are fundamentally important.
Glutathione is the body’s master antioxidant, maintaining a healthy liver, boosting the immune system, repairing cell damage and reducing inflammation. Alpha lipoic acid helps cells make glutathione. Spinach is well endowed with glutathione and alpha-lipoic acid. But only use it raw or lightly stir-fried- boiled veggies retain none of the glutathione. Asparagus/avocado salad contains the two richest sources of glutathione.
Other dietary factors affect eye lubrication. In a paper published in Optometry and Vision Science, the scientists note that dietary habits in well nourished North American society have been implicated as a cause of tear problems. They remind us that that sufficient protein, vitamins A, B6 and C, potassium, and zinc are necessary for normal tear function. However, excesses of dietary fats, salt, cholesterol, alcohol, protein, and table sugar are causes of tear dysfunction.
Many herbs affect glutathione status. They contain glutathione or otherwise boost its action. Use elderberry, blueberry, astragalus root, milk thistle seed, turmeric root, garlic and wheat sprouts. Every one of these herbs is also known for reducing inflammation.
Vitamin A and carotenoids aid epithelial tissue and goblet cells in production of mucin.
For 2,000 years, Ayurvedic doctors have used drops of goat’s milk or a dab of clarified butter in the eye to treat dry eyes. Castor oil drops have shown good effect for modern practitioners.
From the Asian medicine perspective, dry eye in the elderly is classic Yin and blood deficiency. Blood and Yin nourishing herbs that moisten include alfalfa root, American ginseng root, cooked rehmannia root, dang quai root, ho shou wu root, white peony root, lycium fruit and wild asparagus root.
Several studies of Asian herb combinations have shown benefit for dry eye. In 2005, Chinese researchers performed a study with 80 dry eye patients. They determined that the herb combination Chi-Ju-Di-Huang-Wan, a formula for moisturizing tissue, poor eyesight and dry eye, containing Rehmannia root, Cornus fruit, Poria fungus, Lycium fruit, Chrysanthemum flower, Wild yam, Peony root and Water plantain effectively stabilized tear film and supports proper function of the corneal epithelium, and that it provides an alternative choice for dry eye treatment. Ginkgo has been found to benefit dry macular degeneration.
Acupuncture shows some promise in relieving symptoms of eye dryness, tear quality, tear secretion and ocular surface disease.
The Eyes Have It!
Don’t use the eye drops that “get the red out” to treat dry eyes. The vasoconstrictors in those formulas reduce the circulation to the eye.
Staying well nourished and healthy will go a long way toward keeping your eyes healthy and comfortable. We’re all looking for quality elder years. Add in these valuable natural remedies, and dry eye should be a thing of the past. The eyes have it!