Dry Eye /Fish Oils

There are two big things that you need to consider before deciding to take dry eye supplements.
1. Dry eye is a chronic disease, and so you must be prepared to take fish oils for 3-6 months before you begin to evaluate their effectiveness.
2. All fish oils are not created equal, and as with many other things in life, you get what you pay for. (We’ll elaborate more on this below)

To cut straight to the point, research indicates that for the best results, you should take omega-3’s in the triglyceride form, making sure to take at least 2,000 mgs a day, with around 1,500mg of that omega 3 being of the EPA form. This is why we recommend specific products like PRN Dry Eye Omega, Viva Naturals Omega-3, or HydroEye, instead of making a general recommendation to start taking fish oils. PRN Dry Eye Omega is pretty universally accepted as the gold standard when it comes to dry eye supplementation, but is decently expensive when compared to the other two options. For that reason many of our patients choose Viva Naturals Omega-3. Finally, if for some reason you are unable to take either of the first two choices, the third option would be HydroEye, which many patients have also found great success with. To be clear, store brand fish oil is better than taking no fish oil, but if you are looking for results, they are no where near the best option.

*Be sure to consult your doctor when considering initiation of a fish oil supplementation program, as it may be contraindicated based on other systemic issues or other medications you may be taking.

Glaucoma

First and foremost, it should be made clear that both of these supplements are not meant to replace current treatments, but are meant to be used as possible additions to those treatments for added benefit.
Mirtogenol – A combination supplement that contains both bilberry extract and French maritime pine bark extract. This supplement has been shown to be as effective at lowering eye pressure as prostaglandin eye drops, and furthermore it has been shown to be effective when used in conjunction with a prostaglandin drop. It also has been shown to be quite safe, without no serious complications resulting from taking this supplement having been reported. The main disadvantage of Mirtogenol is that it takes up to 6 months to have its full effect, which is one reason why it is not one of the first treatments for glaucoma.
At our office, we reserve Mirtogenol for patients that have had issues with other drops, or are already taking the maximum amount of drops, but are still having problems with progression of their glaucoma.

Another option that can be helpful is Ginkgo biloba, though through a completely different method. Instead of working to lower the eye pressure, Ginkgo biloba works to protect the nerves themselves. That being said, it has been observed to show improvements in the visual fields of patients with vision loss from glaucoma, even though the eye pressure remains unaffected.
Before initiating Ginkgo biloba it is important to consult with your doctor since it can have blood thinning effects. For this reason, it is generally not recommended to take Ginkgo biloba if you are already taking blood thinners. Other, more mild, side effects that have been reported include nausea/diarrhea and mild irritability.

Blue light exposure is an issue that has really only become a topic of discussion around 2012. This is partly because of the increasing use of digital devices (and therefore increased exposure) as well as the growing body of evidence demonstrating that this light can be harmful to both our eyes and the visual system in general. This is a difficult topic to discuss given that the jury is still out with regards to how much is too much, but here are a few of the facts that have lead eye care providers to be more apt to discuss blue light protection with you:
1 – Health: We all know that UV light is high energy and can be damaging to our eyes, but blue light is right next to UV on the energy scale and has been shown to have the ability to be damaging to ocular structures including the retina.
2 – Sleep: Blue light has been shown to alter sleep patterns, which is why companies like Apple have integrated technologies like ‘night-shift’ to decrease the amount of blue light emitted from devices in the evening.
3 – Eye Strain: With the widespread use of computers and other hand-held digital devices, we are consistently exposing our eyes to this high energy light. High energy light, such as blue light, is bent differently and scatters more easily than other light on the visible spectrum, which can make it difficult for the eyes to bring things into focus. It has been shown that blocking blue light can both increase the clarity and comfort of people who spend a significant amount of time on digital devices.

The dangers of blue light was initially being examined because people were spending more time on the computer, but now there are much bigger issues on the horizon. This is because blue light exposure is a viewing distance game.
Here is a thought experiment to try and drive this idea home:
Lets assume that the amount of blue light emitted from the TV is a safe amount and start from there.
The computer sits about 5 times closer than the TV, which means we are getting 25 times more exposure from the computer compared to the TV. Lets take this one step further…
If the average person uses their phone or tablet at about half the distance of their computer, that means that they are getting 4 times more exposure from that devices compared to the computer, or 100 times that of a television. Lets go even further and look at the use of Virtual Reality devices like Samsung Gear, Google Cardboard, and the Oculus Rift….
These devices place a screen within a few inches from the front of your eye, so lets conservatively say that this is four times closer than a normal working distance for a phone or tablet. The exposure for these devices would then be 16 time worse than using a phone/tablet, or 64 times worse than a computer, or an astounding 1,600 times worse than viewing a television (our assumed amount of blue light that is safe)

(Insert diagram that illustrates this.)