Do you have dry eyes? Are you worried about dry eyes after LASIK? Recent research suggests a diet rich in omega-3 fatty acids may reduce the risk of dry eye symptoms before and after LASIK surgery.

What is "dry eye"?

Dry eye, or dry eye syndrome (DES), is a problem where there is an inadequate amount of tears to moisten the front surface of the eye. It can be caused by an insufficient production of tears, or by changes in the chemistry or composition of tears, causing them to evaporate too quickly.

Symptoms of dry eye include:

• A foreign body sensation (like there is sand in your eyes)
• The need to blink constantly
• Itching and/or burning
• Sensitivity to light
• Blurred vision
• A lack of tears, alternating with excessive tearing
• Difficulty opening your eyes after sleeping
• Contact lens discomfort

Mild cases of dry eye can be treated with the occasional use of artificial tears to supplement the natural tear film. But in more severe cases, dry eye can be difficult to treat with artificial tears alone, and can cause significant discomfort, blurred vision, and damage to the cornea.

How common is dry eye?

Dry eye can cause discomfort symptoms after LASIK.

Dry eye syndrome is a common problem, especially in people over age 40. It's generally accepted that more women than men have dry eyes, and this is especially true among post-menopausal women. A recent study suggests that more than 3.2 million American women over the age of 50 suffer from chronic dry eye.

How does dry eye affect LASIK?

Significant dry eye is a contraindication to LASIK surgery because the condition can cause problems with healing after surgery. And LASIK can cause or worsen dry eye in some individuals, especially patients with high refractive errors who need a significant amount of laser ablation to correct their eyesight.

Many people desire LASIK surgery because their contact lenses aren't as comfortable as they want them to be. If the underlying problem in contact lens discomfort is dry eye, the dry eye may have to be treated prior to LASIK surgery for a safe, effective surgical outcome.

Dry eye is among the most common complications of LASIK surgery. Post-LASIK dry eye can occur even if you have no symptoms of dry eye prior to surgery.

Traditional treatment of dry eye

The traditional treatment of dry eye has been the frequent use of artificial tears throughout the day, sometimes augmented with lubricating ointments at bedtime. If artificial tears and lubricating ointments aren't sufficient to reduce dry eye problems, your eye doctor may also recommend punctal occlusion. In this simple in-office procedure, your doctor inserts small plugs in the openings (puncta) of the ducts in your eyelids that drain tears away from your eyes, to your nose and throat. (This passage is why your nose runs when you cry.) By reducing the drainage of tears, more tears stay on the surface of your eyes.

While artificial tears, lubricants, and punctal plugs can help reduce dry eye symptoms, new research is finding ways to prevent dry eye before it becomes problematic.

Nutritional prevention of dry eye

Salmon is a great source of beneficial omega-3 fatty acids.

By increasing the consumption of foods rich in omega-3 essential fatty acids and perhaps also taking a daily nutritional supplement of at least 1,000 milligrams of omega-3s, you may be able to avoid dry eye problems.

Research suggests omega-3s may be able to reduce the inflammation of the lacrimal glands, meibomian glands, and the surface of the eye that has been associated with dry eye symptoms. Oily fish, such as salmon and sardines, are among the best food sources of omega-3 essential fatty acids. Another good source is flax seed oil.

In addition to increasing your intake of beneficial omega-3 fatty acids, its also good to limit your intake of a different fatty acids called omega-6 fatty acids. These potentially harmful substances are found in meat, animal products, corn oil and other cooking oils).

Many researchers believe a healthy diet should have a 1:1 ratio of omega-6 ("bad" fatty acids) to omega-3 ("good fatty acids). Unfortunately, this dietary ratio is 20:1 or higher for many Americans due to overconsumption of meat and fried foods.

In the Women's Health Study, a survey of nearly 40,000 American women, subjects with an omega-6 to omega-3 fatty acid ratio of 15:1 or greater were 2.5 times more likely to have dry eye than women with a ratio of 4:1 or lower.

If you aren't a lover of salmon and sardines, a good way to increase your intake of beneficial omega-3 fatty acids is to take a daily supplement of fish oil and/or flax seed oil. These are available in gel-cap form in nearly all health food stores and drugstores. Most experts recommend a daily dose of at least 1,000 milligrams of each.

Don't expect immediate results

The beneficial effects of dietary modifications and omega-3 fatty acid supplementation in the preventing and treating dry eye symptoms takes time. Wait at least 90 days after you've begun your new daily regimen to see if your eyes start feeling better. Until then, continue to use artificial tears and ocular lubricants as directed by your eye doctor.

Even if dietary changes and omega-3 supplements don't solve your dry eye problems, you'll still be doing your body a favor: Studies show the anti-inflammatory effects of getting a better balance of omega-3 to omega-6 fatty acids in your diet may also decrease your risk of heart disease, cancer, asthma, arthritis, and depression.


SOURCES:

1. Effective dietary supplements for dry eye symptoms. Refractive Eyecare; Vol 11, No 11, November 2007.
   
2. Omega-3 nutraceuticals helps dry eye. EyeWorld; September 2007.

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