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Nutritional Interventions for Ocular Surface Health

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Nutrition plays a vital role in maintaining the integrity of ocular surface health. Read the article below to know in detail.

Medically reviewed by

Dr. Achanta Krishna Swaroop

Published At June 11, 2024
Reviewed AtJune 11, 2024

Introduction

In today's health-conscious society, individuals are seeking guidance from healthcare experts regarding nutrition and its impact on overall health. Nutrition obtained from the diet provides energy and structural support, regulates chemical processes, and is required to perform various functions. Nutrients are classified as macronutrients and micronutrients. The prevalence of nutrition-related disorders has been increasing worldwide. There is an intricate relationship between nutrition and ocular health, from genetic disorders to lifestyle, metabolic, or age-related conditions. It has become evident that nutritional interventions are necessary as they significantly impact the progression and management of various eye disorders.

A balanced diet provides all the fundamental components necessary to maintain the structural integrity of the tissues and facilitate the proper functioning of the body. Poor nutrition can exacerbate various medical conditions, and similarly, certain systemic conditions can affect the absorption or distribution of nutrients by the body. Certain medications taken to treat these systemic disorders can also affect the absorption of micro and macronutrients that are necessary for maintaining overall health. Therefore, there is a complex association between the nutritional status of the individual and systemic disorders.

What Are Ocular Surface Diseases?

The interface between the eye and the external environment is referred to as the ocular surface. The ocular system comprises various components of the eye that are structurally and functionally associated with epithelium, nerves, endocrine, and immune systems. All these components act synergistically to maintain ocular surface health and protect the vital structures. The ocular surface diseases are conditions affecting the cornea, conjunctiva, and glandular network, including lacrimal and meibomian glands. Some of the common ocular surface diseases include dry eye disease, blepharitis (inflammation of the eyelids), ocular rosacea (inflammation of the eyes causing itching and redness), meibomian gland dysfunction, neurotrophic keratitis (a rare eye disorder affecting the cornea), etc. Some of the common symptoms of ocular surface diseases include dryness, blurred vision, redness, itching, watery eyes, sensitivity to light, sticky or crusty eyes, etc. The cause varies depending on the condition, and each type has different treatment modalities. Therefore, if any of these conditions are suspected, an eye specialist must be consulted as early as possible to avoid any further complications.

What Are the Nutrients Required for Maintaining Ocular Surface Health?

A balanced diet comprises proteins, carbohydrates, vitamins, minerals, essential fatty acids, antioxidants, and water. All these nutrients also help promote overall eye health, and intricate mechanisms contribute to proper vision. The hydration status of the body also affects the eyes as it requires adequate water content to maintain the fluid regulation system necessary for optimum ocular health. According to the American Optometric Association, certain vitamins and minerals must be consumed regularly to reduce the risk of eye diseases and maintain general health. Fat-soluble vitamins such as vitamins A, D, E, and K and water-soluble vitamins like vitamins B and C have harmonious roles in the preservation of eye health. Minerals like zinc, calcium, selenium, etc, carotenoids such as lutein and zeaxanthin, and antioxidants like omega-3 fatty acids are essential to protect the eyes from oxidative stress. Poor nutrition and dehydration can result in conditions such as dry eye syndrome, vision problems, cataracts, retinal or corneal issues, etc.

How Do Nutritional Interventions Influence Ocular Surface Health?

The first line of treatment in ocular surface diseases is to nourish the ocular surface, increase lubrication, and reduce inflammation. Anti-inflammatory and anti-oxidative properties of nutrients and proper hydration help in managing these conditions along with certain medications. Various clinical studies have also demonstrated the beneficial effects of dietary constituents in maintaining ocular surface health. Some of the fundamental nutrients that uphold the integrity of ocular tissues and facilitate optimum eye function include:

  • Vitamin A: It is required for the integrity of the mucosal tissues, retinal health, and growth and differentiation of ocular surface epithelium. Deficiency of vitamin A can cause corneal epitheliopathy, ulceration, and conjunctival keratinization and lead to night blindness. The most biologically active form of vitamin A is present in animal sources and carotenoids in a wide range of fruits and vegetables.

  • Vitamin B12: It is a cofactor in DNA (deoxyribonucleic acid) synthesis and is also involved in amino acid and protein metabolism. A deficiency of vitamin B12 may cause neurosensory abnormalities in patients with dry eye disease (DED). Recent studies have shown that consuming foods or supplements rich in vitamin B12 resulted in the improvement of dry eye symptoms in many patients.

  • Vitamin C: It is a water-soluble vitamin abundantly found in citrus fruits such as oranges, cherries, tomatoes, berries, and broccoli. It plays an important role in maintaining tear film stability and corneal wound healing. Vitamin C and E supplementation is known to be effective in improving tear production and stability. It also enhances lacrimal gland function and decreases ocular surface oxidative stress.

  • Vitamin D: It is a fat-soluble vitamin that stabilizes the ocular surface by enhancing corneal function, maintaining the composition of the tear film, modulating calcium absorption, and maintaining fluid secretion in the lacrimal glands. Vitamin D supplementation is investigated to be a potential therapy for dry eye disease. It reduces eyelid hyperemia, enhances tear production, and improves the symptoms of DED.

  • Flavonoids: These are polyphenols found in different fruits and vegetables, green tea, red wine, and cocoa. They possess antioxidant and anti-inflammatory properties and also improve tear quality, reduce eye fatigue, and prevent corneal damage. Curcumin is a broadly used spice and flavoring agent rich in anti-microbial and anti-inflammatory properties. It helps in maintaining epithelial integrity, promotes wound healing, and reduces inflammation in conditions such as neurotrophic keratitis.

  • Essential Fatty Acids: Polyunsaturated fatty acids such as omega-3 fatty acids (FAs) are vital structural components of the cell membrane and precursors for the synthesis of biologically active substances. It is rich in neuroprotective and antioxidant properties. Studies have shown the relationship between low dietary intake of omega-3 fatty acids and increased risk of DED. Omega-3 fatty acids supplementation is known to improve tear quality and stability and reduce the symptoms of dry eye disease.

  • Selenium and Lactoferrin: Selenium is an essential micronutrient widely distributed in various tissues, including the ocular surface. Lactoferrin is an iron-binding glycoprotein present in tears and is responsible for protecting corneal epithelium from ultraviolet radiation. Selenium and lactoferrin concentrations are reduced in ocular surface diseases, and oral supplementation can improve the symptoms, restore the mineral balance, and prevent ocular damage.

Conclusion

Various dietary compounds have positive effects and influence ocular surface health. Nutrients such as vitamins, minerals, essential lipids, water, and antioxidants play a vital role in preserving the structural integrity and function of the eyes. A deficiency of certain essential nutrients can lead to conditions such as blepharitis, dry eye disease, neurotrophic keratitis, and glandular dysfunction. Therefore, the consumption of a healthy, balanced diet is necessary to support the ocular tissues and maintain overall health.

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Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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balanced dietmicronutrient deficiency
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