Research is increasingly showing that a number of herbal and food medicines can significantly help relieve dry eye syndrome (DES) or dry eye disease (DED).
Depending upon the type, chronic dry eye symptoms include not just a lack of tears in the eyes. They can include itchiness, fatigue, red eyes and burning eyes.
In this article, we’ll discuss the occurrence, anatomy and types of dry eyes. Then we’ll discuss various proven natural strategies that can significantly help solve the dry eye condition.
Dry eyes are rampant
A number of studies have investigated the occurrence of dry eye syndrome.1 Millions of people have dry eye syndrome.
Some of the research has indicated that prevalence ranges from region to region, from 5 percent to 34 percent. Some research finds that up to 20 percent of the global population will have dry eye syndrome at some point in their lives.
In the U.S., about 15 percent of the population suffers from dry eye syndrome. But as we age, the incidence increases. Some studies have shown that about one-third of seniors have dry eye.
Artificial tears are by far the most prescribed medication for the syndrome. For example, in 2014, there were 6.4 million prescriptions of artificial tears in the U.K. alone.2
Furthermore, less than 60% of those with dry eye disease actually have noticeable symptoms.
Tear testing and the anatomy of dry eye
The tears are important to the eyes because they help keep the eyes clean and keep foreign objects such as dust and bacteria away from the ocular membranes.
There are several situations that can produce the symptom of dry eyes:
• Keratitis sicca: Cornea inflammation and dry eyes
• Keratoconjunctivitis sicca: Dryness affecting the cornea and the conjunctiva
• Dysfunctional tear syndrome: Inadequate production of tears
Doctors use two basic tests to diagnose dry eyes. These are the Schirmer’s test and the Tear film breakup test (TBUT)
Schirmer’s test measures the moisture produced by the tears, by the doctor placing a strip of filter paper between the eye and lower lid and waiting five minutes. The moisture produced can be measured downward on the strip. 15 millimeters or more is considered normal. The more it is less than 15 the more severe the condition.
The TBUT test uses a tear film to collect some of the patient’s tears. The film is then analyzed through a cobalt imaging system.
Tears contain crucial ingredients including mucin, lipids and a watery base of natural antioxidants that reduce free radicals. Some research has also indicated there are natural probiotics moving within tears.
Each of these are secreted differently. Goblet cells within the conjunctiva produce the mucin. Lacrimal glands behind the upper eyelids produce the water and antioxidants. The lipid part of the tears is secreted by the meibomian glands within the eyelids.
Inadequate secretion by any of these glands can produce dry eye. Often the lacrimal glands don’t secrete enough aqueous portions of the tears. But the meibomian glands can also become deficient, producing something called meibomian gland dysfunction or evaporative dry eye.
What causes dry eye?
A number of things can cause these glands to stop working. These include smoking, dry environments, air conditioning, or a number of metabolic issues such as diabetes or vascular issues, may be related. Aging and menopause can also contribute depending upon the health of the individual. Constant computer screen exposure can also contribute to or exacerbate dry eye syndrome.
Recent research has found that the accumulation of free radicals in these glands can be a foundation for many dry eye conditions. Free radical accumulation can shut down or slow down the glands of the eyes.
A less-discussed cause is the use of a number of pharmaceuticals. Many pharmaceuticals will list dry eyes as one of the medication’s possible side effects. Antihistamines, antidepressants, birth control pills and many other medication types have been known to cause dry eyes in some people.
This is also likely related to the notion of free radical build up because chemicals typically increase free radicals – or radical oxidative species (ROS) as they are referred to clinically.
We should add that various medications are regularly prescribed for dry eyes. These include topical cyclosporine, corticosteroids, autologous serum, tetracyclines and other antibiotics, and systemic immunosuppressants. These have shown limited or short-term effects, along with their risk of adverse effects.
Longer term solutions for dry eyes are related to changing the metabolic and antioxidant activities of the body. These can be achieved with a number of plant medicines as shown below.
Dry eye herbs and antioxidants
Researchers from the College of Medicine at National Taiwan University conducted a double-blinded study of 43 people with dry eye syndrome at the university medical hospital.3
The patients were split into two groups. One group was a placebo. The other group was given a combination supplement consisting of:
• Vitamin A
• Vitamin C
• Vitamin E
• Plant extract anthocyanosides
• Algae extract astaxanthin
• Cassia seed (Cassia obtusifolia)
• Dragon beard (Ophiopogonis japonicus)
• The supplement also contained a few other plant extracts.
After eight weeks of supplementation, the patients were tested with the Schirmer’s test and the TBUT test. Those who took the supplement were producing significantly more moisture and better quality tears compared to those in the placebo group.
The researchers also tested the free radical levels of the tears in the patients. They found that the supplement significantly reduced the level of free radicals in the tears.
The researchers safely concluded:
“Oral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS [free radicals].”
Other research has found that Vitamin C can help protect against cataracts in the eyes.
Maqui berry extract for dry eyes
In a 2019 study from Japan, researchers tested 74 dry eye patients with a standardized maqui berry extract called MaquiBright®.4 In this double-blind study, the researchers gave half a placebo. The other half was given 60 milligrams of the maqui berry extract.
After four weeks, the researchers found the maqui berry group had significantly better results on the Dry Eye-related Quality of Life Score questionnaire. They also found that the Schirmer’s test results improved by over 6 millimeters (a huge increase).
They also found that eye fatigue and stiff shoulders were decreased among the patients – most of whom worked at a computer terminal for more than four hours per day at their jobs.
The researchers concluded:
“Thus, the consumption of 60 mg of MaquiBright® per day for 4 weeks reduced eye dryness and seemed to alleviate eye fatigue.”
Goji berries for dry eyes
As detailed elsewhere, human clinical research has confirmed that goji berries help prevent macular degeneration in the eyes.
Research from Tajen University tested goji berry on rats with dry eye disease.5 They found the rats given the goji berry extract had significantly improved tear production and eye health. The rats given the higher doses of goji berry had better results.
Goji berry has also been tested on humans for a number of conditions, with great results. They have a very high antioxidant capacity with a number of special plant medicine constituents. Goji berries can be eaten as a delicious and nutritious snack.
Herbal extract drops
Internal use of antioxidants such as those discussed above have been proven to be effective for dry eyes. But what about drops?
A 2001 study from the All India Institute of Medical Sciences6 conducted a multi-center clinical study of dry eye patients with drops called Ophthacare®. Ophthacare contains extracts from the following plant medicines:
• Carum copticum
• Terminalia belirica
• Emblica officinalis
• Curcuma longa
• Ocimum sanctum
• Cinnamomum camphora
• Rosa damascene
The researchers found that the drops improved the tear production and eye health of the patients. They concluded:
“An improvement was observed with the treatment of the herbal eye drop treatment in most cases.”
Researchers from the College of Biomedical Engineering at the National Taipei University of Technology put a combination of ferulic acid and kaempferol into a buffer solution for eye drops. Both ferulic acid and kaeumpferol are significant plant-derived antioxidants.
The researchers then tested the eye drops on rabbits. They found that the rabbits given the eye drops had significantly better eye health. They had more tear production and less cornea damage compared to the rabbits not given the drops.
Apricot kernel seed drops
Research from China has found that Apricot kernel oil from the apricot seed (Prunus armeniaca) has been tested on heart patients, dandruff and acne with success.
An extract from the seed oil was put into some eye drops.7 The researchers found it significantly improved the tear production and the health of the cornea in female rats given the eye drops. The drops were safe.
Chinese herbs and acupuncture
Researchers from the School of Medicine at the National University of Singapore tested 150 people with dry eye disease.8 The researchers divided the patients into three groups. One group was prescribed artificial tears. Another group was given an herbal supplement. The third group was given acupuncture.
The researchers found that the herbal medicine group had improved significantly from the beginning of the study, slightly better than the artificial tear group. But the acupuncture group showed even more success in reducing symptoms of eye dryness.
Are Chinese herbs better than conventional treatment?
A 2016 review of research analyzed 31 clinical studies of 2,137 cases9 of Sjögren’s syndrome, which typically includes dry eye syndrome. The research found that Chinese Traditional Medicine herbs were 87 percent effective compared to 65 percent effective in conventional cases.
The researchers concluded that TCM was significantly more effective.
This seems elementary, you might say. But yes, a 2019 study from the University of California at San Diego tested 58 eyes of patients with dry eyes.10
The researchers tested the complete blink rate of each patient. They found that those who had the higher levels of incomplete blinking also had the worst levels on the TBUT testing. They also had higher levels of surface disease compared to those who completely blinked more.
So if you are staring at a screen reading this, don’t forget to blink – and blink completely and slowly. You might also consider looking away from the screen every so often, and look into the distance. Then blink completely again. And again.
1. The management of dry eye. Drug Ther Bull. 2016 Jan;54(1):9-12. doi: 10.1136/dtb.2016.1.0378.
2. (60%)Bron AJ, Tomlinson A, Foulks GN, Pepose JS, Baudouin C, Geerling G, Nichols KK, Lemp MA. Rethinking dry eye disease: a perspective on clinical implications. Ocul Surf. 2014 Apr;12(2 Suppl):S1-31. doi: 10.1016/j.jtos.2014.02.002.
3. Huang JY, Yeh PT, Hou YC. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome. Clin Ophthalmol. 2016 May 9;10:813-20. doi: 10.2147/OPTH.S106455.
4. Shin-ichiro Yamashita, Naoko Suzukia, KazuoYamamotoa, Shin-ichiro Iio, TakahiroYamada. Effects of MaquiBright® on improving eye dryness and fatigue in humans: A randomized, double-blind, placebo-controlled trial. Journal of Traditional and Complementary Medicine Volume 9, Issue 3, July 2019, Pages 172-178.
5. Chien KJ, Horng CT, Huang YS, Hsieh YH, Wang CJ, Yang JS, Lu CC, Chen FA. Effects of Lycium barbarum (goji berry) on dry eye disease in rats. Mol Med Rep. 2018 Jan;17(1):809-818. doi: 10.3892/mmr.2017.7947.
6. Biswas NR, Gupta SK, Das GK, Kumar N, Mongre PK, Haldar D, Beri S. Evaluation of Ophthacare eye drops–a herbal formulation in the management of various ophthalmic disorders. Phytother Res. 2001 Nov;15(7):618-20.
8 Hyun SW, Kim J, Park B, Jo K, Lee TG, Kim JS, Kim CS. Apricot Kernel Extract and Amygdalin Inhibit Urban Particulate Matter-Induced Keratoconjunctivitis Sicca. Molecules. 2019 Feb 12;24(3). pii: E650. doi: 10.3390/molecules24030650.
9. Tong L, Htoon HM, Hou A, Acharya RU, Tan JH, Wei QP, Lim P. Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial. BMJ Open Ophthalmol. 2018 Jun 18;3(1):e000150. doi: 10.1136/bmjophth-2018-000150.
10. (TCM)Liu J, Zhou H, Li Y, Wu B. Meta-analysis of the efficacy in treatment of primary sjögren’s syndrome: Traditional Chinese Medicine vs Western Medicine. J Tradit Chin Med. 2016 Oct;36(5):596-605.
3. (blink)Jie Y, Sella R, Feng J, Gomez ML, Afshari NA. Evaluation of incomplete blinking as a measurement of dry eye disease. Ocul Surf. 2019 May 29. pii: S1542-0124(19)30104-1. doi: 10.1016/j.jtos.2019.05.007.