Dr. Grossman’s Blog

A new study shows that early diagnosis and treatment of dry eye syndrome in diabetic patients may help prevent problems such as scarring and perforation of the cornea and secondary bacterial infection.

Scientists at the Yazd Diabetes Research Center evaluated 199 type 2 diabetic patients for dry eye syndrome and other factors.  Of the 199 subjects, 108 patients (54.3%) were found to suffer from dry eye syndrome.

Although dry eye syndrome was more common in older and female patients, this association was not significant.  However, researchers did find a significant association between dry eye syndrome and duration of diabetes.   Researchers also noted that dry eye syndrome was more frequent in diabetic patients with diabetic retinopathy (DR). 

Study authors concluded that dry eye syndrome in diabetic patients may be a contributor for a variety of corneal complications including superficial punctuate keratopathy, trophic ulceration, and persistent epithelial defect.   The authors recommended that examination for dry eye should be an integral part of the assessment of diabetic eye disease.

Learn more about natural relief for dry eyes

Read proactive steps you can take to reduce the effects of diabetes

SOURCE:  Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients, Manaviat, et al, BMC Ophthalmology 2008, 8:10doi:10.1186/1471-2415-8-10.

Dry eye syndrome (DES) is a common ocular problem in the United States, particularly among older women.

The first large-scale study of DES among U.S. women reveals that DES leading to a clinical diagnosis or severe symptoms affects more than 3.2 million American middle-aged and older women, including many in their 40s and 50s.

Researchers with Boston’s Brigham and Women’s Hospital, Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, and Harvard Medical School surveyed 39,876 U.S. women participating in the Women’s Health Study about a history of diagnosed DES and dry eye symptoms.  DES was defined as the presence of clinically diagnosed DES or severe symptoms (both dryness and irritation constantly or often).

Results showed that the prevalence of DES increased with age, from 5.7 percent among women less than 50 years old to 9.8 percent among women 75 or older.

The age-adjusted prevalence of DES was 7.8 percent, or 3.23 million women aged 50 or older in the United States.

Other findings:

• Compared with whites, Hispanic and Asian-American women were more likely to report severe symptoms, but not clinically diagnosed DES
• There were no significant differences by income, but more educated women were less likely to have DES
• Women from the South had the highest prevalence of DES, though the magnitude of geographic differences was modest.

The authors of the study noted that further research is necessary to better understand DES and its impact on public health and quality of life.

Learn more about dry eye syndrome, including advice on treatment and nutrition.
 
Source:  Prevalence of dry eye syndrome among US women, Schaumberg, et al, Am J Ophthalmol. 2003 Aug;136(2):318-26.

A recent study shows that consumption of omega-6 fatty acid may help alleviate dry eye symptoms and improve overall lens comfort in patients suffering from contact lens-associated dry eye.

Researchers evaluated the effects of oral treatment with omega-6 fatty acids in the form of evening primrose oil (EPO) on subjective symptoms, ocular surface signs and tear film characteristic in patients with contact lens-associated dry eye.

76 female soft contact lens wearers were treated for six months either with omega-6 fatty acids in the form of EPO or placebo (olive oil). The patients were given three examinations (baseline, three and six months) to test tear film characteristics (tear meniscus height, break-up time), meibomian gland function (lipid layer thickness and quality) and ocular surface parameters (hyperemia and staining). At each examination the women were given a questionnaire relating to lens comfort and dry eye symptoms.

The EPO group showed a significant improvement in the specific symptom of “dryness” at three and six months as well as a significant improvement in overall lens comfort at six months. Tear meniscus height was increased in the EPO group at six months relative to baseline, although all other objective signs were unchanged.

These findings support a 2003 study on omega-6 fatty acids which evaluated the effect of systemic linoleic acid (LA) and gamma-linolenic acid (GLA) on patients with dry eyes.

GLA is an essential fatty acid in the omega-6 family that is found primarily in plant-based oils, such as evening primrose oil, black currant seed oil, and borage seed oils. Essential fatty acids help the body’s natural ability to fight inflammation, but cannot be made in the body and must be obtained from food. LA, another omega-6 fatty acid, is found in plant oils such as safflower oil and is converted to GLA in the body.

In a randomized clinical trial, 26 patients with dry eye (aqueous-deficient keratoconjunctivitis sicca) were randomly divided into two groups of 13 patients each. The study group received tablets containing LA (28.5 mg) and GLA (15 mg) twice daily for 45 days; the control group received a placebo tablet for 45 days.

The results? Researchers found that therapy with LA and GLA and tear substitutes reduced ocular surface inflammation and improved dry eye symptoms.

Read more about dry eye and studies on dry eye

SOURCE: Oral Omega-6 Essential Fatty Acid Treatment in Contact Lens Associated Dry Eye. Kokke, et al. Cont Lens Anterior Eye 2008;31(3):141-6.

SOURCE: Systemic Linoleic and Gamma-Linolenic Acid Therapy in Dry Eye Syndrome With an Inflammatory Component, Barabino, et al.Cornea. 22(2):97-101, March 2003.

A recent study showed that supplement with Omega-6 fatty acid in the form of Evening Primrose Oil has a beneficial effect in alleviating dry eye symptoms and improving overall lens comfort
in patients suffering from contact lens-associated dry eye.

SOURCE: Kokke KH, Morris JA, Lawrenson JG. Oral omega-6 essential fatty acid treatment
in contact lens associated dry eye. Cont Lens Anterior Eye 2008;31(3):141-6.

For study details, go to www.naturaleyecare.com and click on ‘Research” then “Dry Eyes”

I should mention that there are quite a number of drugs which can harm your eyes – all of the following have the potential to contribute to glaucoma and other vision problems.

• NSAIDs-(non-steroidal anti-inflammatory drugs)include aspirin, ibuprofen (Advil, Motrin, Bayer, Aleve), flurbiprofen, ketoprofen and naproxen sodium. Also Tylenol (acetaminophen), though not an NSAID, can be harmful.
• Venlafaxine
• Steroids – cortisone prescriptions such as Prednisone are the most damaging drugs to the eyes of any prescription drugs. If you must take any of these drugs, be sure to supplement your diet with anti-oxidants such as vitamins E and C, and beta-carotene. Ask your doctor if you can replace Prednisone with a natural cortisone such as hydrocortisone.
• Simvastatin
• Fenfluramine
• Mirtazapine
• Gastic antispasmodics
• Antidepressants

A much safer course than automatically taking a lot of drugs, ie, for a headache, is to look at other contributing factors and make lifestyle changes in the amount of rest you get, the amount of exercise you get, your diet, levels of stress in your life, and so forth.

What are the conventional treatment options for glaucoma? Do they work?

Treatment depends on the nature and severity of each case. Commonly, open angle glaucoma is treated with eyedrops or oral medications. In the event this treatment does not lower the eye pressure inside the eye, laser therapy or surgery may be necessary. There are no guarantees!

What about alternative treatment?

Since we consider most eye conditions to be a reflection of the health of the whole body, lifestyle choices and diet can play a major factor in getting and maintaining good vision. Below are some recommendations:

• Studies show patients can reduce their eye pressure by five to seven millimeters with an improved diet and supplement program. In general, a diet high in betacarotene, vitamins C and E, and sulfur-bearing amino acids are recommended. Foods containing those nutrients include garlic, onions, beans, spinach, celery, turnips, yellow and orange vegetables, green leafy vegetables, seaweed, apples, oranges and tomatoes.
• The Vision Diet – recommended in Natural Eye Care: Your Guide to Healthy Vision, authored by Marc Grossman, O.D., L.Ac. and Michael Edson, MS, L.Ac. This CD covers 29 major eye conditions including Glaucoma with specific nutrient, diet, exercise and juicing instructions by eye condition, plus much more.
• Daily juicing of vegetables and fruits (preferably organic). Our glaucoma recipe is some combination of the following: celery, carrots, cucumber, radish, turnip, parsley, beets, cabbage, raspberries, plums, apple (not too much fruit). For more information, go to info about juicing.
• Drink lots of water – 8-10 glasses of purified water. Avoid carbonated, caffeinated and alcoholic beverages. They can actually dehydrate your eyes.
• Manage your stress – meditate, take a walk in nature, practice yoga, visualization techniques or prayer on a daily basis.
• Exercise daily – do at least 20 minutes of aerobic exercise daily. Walking and swimming are two excellent forms of exercise.
• Eye exercises can help to bring energy and blood to the eyes, thereby helping to drain away toxins or congestion to the eyes. These are free general eye exercises and acupressure points for overall eye health. See Free Eye Exercises
• Avoid foods to which you are allergic: a study of 113 patients with chronic simple glaucoma showed immediate IOP increases of up to 20 millimeters when they were exposed to foods in to which they were allergic.
• Supplement your diet with a specific eye formula such as the Optic Nerve Formula and an organic green drink daily such as Renewal Greens

I’m pleased to announce our new very short video – demonstrating 3 eye exercises especially useful for computer users with tired eyes and/or experiencing computer eye syndrome!

You can view it at YouTube.com.