For years I’ve heard people talking about dry eyes.  I never understood the problem until one morning (yes, it seemed to happen overnight), I woke up, rubbed my eyes, and the eyes went into spasms.  It felt as if grains of sand were stuck there.  My eyes streamed and my nose ran in sympathy.  While the spasm subsided, the eyes hurt the rest of the day….as if they were stuck with a splinter.  They were red, irritated and the socket ached.

What are dry eyes?  The definition.

More than ten million Americans suffer from dry eyes, and it is one of the most common problems treated by eye physicians.   Dry eyes are usually caused by a problem with the quality of the tear film that lubricates eyes.  The tear film is comprised of three layers: The mucus layer, which coats the cornea (the eye’s clear outer window), forms a foundation so the rest of the tear film can adhere to the eye. The second layer in the middle provides moisture and supplies oxygen and other important nutrients to the cornea. (This layer is 98 percent water along with small amounts of salt, proteins and other compounds.)  The third and outer layer is an oily film that seals the tear film on the eye, and helps prevent evaporation.

Tears are formed in several glands around the eye. The water layer is produced in the lacrimal gland, located under the upper eyelid. Several smaller glands in the lids make the oil and mucus layers. With each blink, the eyelids spread the tears over the eye. Excess tears flow into two tiny drainage ducts in the corner of the eye by the nose. These ducts lead to tiny canals that connect to the nasal passage.  This connection may explain why crying often leads to a runny nose.

In addition to lubricating the eye, tears are produced as a reflex response to an injury or emotion. However, reflex tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation. The reflex tears are just the waery layer.  Aren’t you glad you’re learning about all the layers of the eye now?

What causes dry eyes? 

Normal aging is the most common reason. As we grow older, our bodies produce less oil – 60% less at age 65 then at age 18. This is more pronounced in women, who have drier skin than men.  Without as much oil to seal the watery layer, the tear film evaporates faster, leaving dry areas on the cornea.[1]

Hot, dry or windy climates, high altitudes, air-conditioning and smoke also cause dry eyes.  And computers are a big factor today.  I know I stare at that screen for hours each day!  It goes without saying that stopping to rest and blink keeps the eyes more comfortable. I’m sure the next generation will be amazed at the damage we do to ourselves by how we use computers today!

Contact lens wearers may also suffer from dryness because the contacts absorb the tear film.

What else can cause dry eyes, or damage our eyes?  Certain medications, thyroid conditions, vitamin A deficiency, and diseases such as Parkinson’s and Sjogren’s Syndrome.   Women frequently experience dry eyes as we enter menopause.  Lose estrogen and the natural lubrication of the eyes gets lost as well!

Dry eyes can happen if we don’t drink enough water or eat enough good fat, all of which said to me that I could help myself…. Yes, Gertrude, it is possible!  Read on….

What can we do about dry eyes?

Robert Abel, Jr., M.D., author of the new book, The Eye Care Revolution: Prevent and Reverse Common Vision Problems, reports that many major ophthalmology-teaching institutions are conducting studies to evaluate the link between nutrition and eye health.  He says drinking six glasses of water a day will help irrigate the lens which will aid dry eye symptoms.

1. He recommends the herb, ginkgo biloba, which improves blood flow to the eye.
2. He also says to stay away from artificial sweeteners, which can lead to dry eyes.
3. Many articles and studies I read say essential fatty acids (EFAs) help dry eyes.  We have a number of eye doctors in the community who send their patients in to buy flax seed oil, one of the richest sources of EFAs.  Flax seed oil helps the body’s glands produce oil which benefits dry eyes (and skin!)  Some people who shop in the store tell me that just by adding flax seed oil to their daily diet, their dry eyes dramatically improved.  Use 2 tablespoons daily.  Don’t know how?  Talk to us!
4. Other EFAs?   Fish can often replace flax.  Evening primrose and borage oils, which are very similar, have been shown to help dry eyes as well.  I use ½ teaspoon borage oil daily.  I chose borage over evening primrose because it’s more concentrated.  All these oils are great for skin.
5. I read eating 12 pecans or almonds daily helps dry eyes.  I had forgotten how much I love pecans….  Try these as an afternoon snack or on top of salad, which makes it very gourmet!  (Other nuts are still healthy but don’t address this particular condition as the do the fatty nutrients in pecans and almonds.)
6. Eating a whole avocado each day helps dry eyes (and has protein, and makes lovely skin).
7. Another article I read said dry eyes were caused by a hyaluronic acid (HA) deficiency.  HA in the eyes is defined as “a gel-like aminoglycan found in the ….vitreous humor of the eyes and acts as a binding, lubricating, and protective agent.” HA not only lubricates eyes, but dry skin and joints as well.  So I started taking HA, but because it’s expensive and needed in high doses, I asked Adam whether something else might be able to help here.  He suggested experimenting with the herbs gotu kola and hawthorn (berry, specifically).  Gotu kola increases HA synthesis; hawthorn decreases its breakdown.
8. Adam said, “If you look at what gotu kola does, in terms of wound healing, collagen integrity, spider veins, even leprosy (and yes, there have been studies) it can mostly be chalked up to increased HA.  The same for hawthorn berry and all that blood pressure/vasculature stuff.  In addition, deep red hawthorn berry is an excellent source of flavonoids, which help vitamin C work and increase HA synthesis that way as well although the same could be said for grape seed, pycnogenol, bilberry, etc.  I’d look at gingko long term.  Again, insofar as HA is relevant to dry eyes, look at alpha-lipoic acid.  It can definitely make it into the eyes, where it recycles vitamins C and E, and mops up HA-damaging free radicals.  One 99-year old woman I know says she’s gotten a lot better while taking alpha-lipoic acid, zinc, bilberry and lutein….”
9. So I take hawthorn berry, gotu kola and alpha-lipoic acid (one of my favorite antioxidants).  And I take our eye vitamin which contains bilberry and lutein.  I added zinc because it also boosts immune systems.
10. I read it’s critical for people who suffer from dry eyes to stay away from sugar and/or artificial sweeteners (also mentioned above).  Consumption of more than 11 teaspoons of sugar per day (most of which is hidden in processed foods) has been linked to dry eye syndrome. A single can of soda contains nine teaspoons of sugar!  There’s more hiding in cereals, ketchup and salad dressings.
11. Studies show fats in commercial red meats, fried foods, and partially-hydrogenated oils (margarine and shortening) interfere with proper metabolism of essential fatty acids and are indirect causes of dry eyes.
12. Dr. Celia Hinrichs, a local optometrist, told me dry eyes occur as we age because the shape of the eye and lid changes and air leaks onto the eyeballs decreasing the natural lubrication on the surface of the eyes. This lack of lubrication causes tissue irritation. Older eyes don’t recover as quickly and the irritation persists during the day.  Celia said to lubricate the eyes at night using an over the counter ointment.
13. Ghee is used in the Ayurvedic tradition to lubricate eyes.  You may also use flax seed oil, castor oil, or an ointment at night.  I use these religiously.   However, forget about using eye makeup (I have).
14. Probably the most important mineral for dry eye symptoms is potassium, which is usually very low in dry eye patients. This, at least, has a simple solution.  A banana has 400 mg, 1 tablespoon blackstrap molasses gives 700 mg, and a ½ liter can of coconut juice (Adam’s favorite) gives us 1,000 mg of potassium.  Another choice?  Eat an avocado (my favorite) which gives us 700 mg of potassium plus all that good fat.
15. Oil your eyes with a washcloth compress.
16. “Place a warm washcloth on your closed eyelids for five to ten minutes several times a day to help open the clogged oil glands in the eyelids,” says Eric Donnenfeld, M.D., associate professor of ophthalmology at North Shore University Hospital/Cornell Medical College in Manhasset, New York.  “Artificial tears, the kind sold in eyedropper form in drugstores, can replace the water component of your tears. But those drops don’t replace the oil: Only your own eyes can do that. The warm compress helps your eyes do the work they’re supposed to.”
17. If you use eye drops, use natural, homeopathic drops so you don’t cause another problem down the road.  Similasan claims their eye drops stimulate the eye’s natural ability to fight dryness and clear redness due to smog, stress, age, contact lens wear, etc.  What’s for sure is that they are safe and don’t have side-effects.  If you use a commercial drop, make sure the label says “preservative free” since the preservative can damage the delicate balance in the eye down the road this according to Donald Doughman, M.D., professor of ophthalmology at the University of Minnesota.
18. Make a conscious effort to blink frequently especially when reading or watching television.
19. Avoid rubbing the eyes. This only worsens the irritation.