Dry eye successfully treated with oral flaxseed oil

Cost-effective therapy has beneficial side effects of softening skin and treating rosacea.

ByBob Kronemyer

BROOKLINE, U.S.A. — Dry eye treated orally with flaxseed oil has a high success rate, according to a 3-year follow-up of 200 patients.

“We found that 85% had total relief of their symptoms at the 2-month check,” said investigator Carol F. Boerner, MD, an ophthalmologist in private solo practice here. “These patients, including my mother, commonly reported that the burning and stinging of their dry eyes went away in about 2 weeks. The results lasted as long as the treatment was continued.” Patients also reported that “dry skin symptoms, such as cracked cuticles; flaky elbows, legs and feet; and itchy backs were alleviated.”

Dr. Boerner said that dry eye complaints are the most frequent reason for consultation in her practice. “Whether it’s complaints from young people using video display terminals (VDTs) all day or older folks trying to read the newspaper, tear film stability is an issue,” Dr. Boerner said. “A healthy tear film is important for comfortable contact lens wear, as well as prompt healing from corneal abrasions or laser in situ keratomileusis (LASIK).”

Dr. Boerner believes that meibomian gland dysfunction leads to oily layered tear defects, “which permit aqueous layer evaporation and subsequent surface damage and symptoms.” When one of her patients cured his rosacea with parenteral flaxseed oil, “I wondered if the burning and stinging of dry eyes could also be helped with the same supplement.”

Major components

The major components of flaxseed oil are alpha-linolenic acid omega 3 (57%), linoleic acid omega 6 (15%) and oleic acid omega 9 (18%). “Flaxseed oil is the world’s richest source of omega 3 fatty acids — twice as much as fish oil, for instance,” Dr. Boerner said. Likewise, “alpha-linolenic and linoleic acids are essential to our diet because our body cannot make them, yet we use them to make other fatty acids our body must have.”

These are also important components of the stratum corneum for skin stability “and act as precursors to prostaglandins, which affect inflammation and arteriole muscle tone, among other actions,” Dr. Boerner said. Furthermore, “flaxseed oil causes hair and nails to grow more quickly, lowers triglycerides and makes platelets less sticky.”

The 200 patients in the prospective study were all from Dr. Boerner’s general practice and ranged in age from 22 to 85 years. All patients were given 2,000 mg of flaxseed oil orally every morning. “I chose 2,000 mg because that’s what helped my rosacea patient,” Dr. Boerner said.

Patients were evaluated at 2 months and then at yearly intervals for 3 additional years. “The patients were evaluated by noting changes in reported symptomatology of dryness and observation of the quantity and quality of meibomian gland secretions,” Dr. Boerner said. “We found that the change in tear break-up times did not really correlate very well with symptoms, because the values could change from morning to night on the same day, in the same patient.” The symptoms monitored were burning, stinging, redness at lid margins and the complaint of dry skin.

Grading oils

“We evaluated the oil flow on all four lids by compression with a finger at the lash line and observation of the oil flow: low, medium or normal,” Dr. Boerner said. “The quality of the oils themselves was graded by color, as well as consistency: clear to cottage-cheesy.” As treatment progressed, “clear oils could be seen surrounding the central cores of thick white oils in the gland orifices. The punctate epithelial keratopathy disappeared as symptoms improved.”

Flaxseed oil also helped increase the contact-lens wearing time in patients with borderline dry eyes and contact lens intolerance. “There was much less use of re-wetting drops in these patients,” Dr. Boerner said. “I have many Medicaid patients who come in for their monthly dry eye check to receive their free bottle of tears. Now, taking flaxseed oil by mouth, they do not need the artificial tears and they feel better, too,” Dr. Boerner estimated that flaxseed therapy is about 25% of the cost of artificial tear supplements.

Medications that deter

The 15% of patients who were not completely cured used a number of medications that caused dry eye and rendered therapy ineffective: concomitant use of diuretics, antihistamines, certain birth control pills and antidepressants. “Unfortunately, flaxseed oil at 2,000 mg a day does not help Sjogren’s syndrome or other autoimmune surface diseases,” Dr. Boerner said. “However, it is very helpful for fibromyalgia at 4,000 mg a day.”

Flaxseed oil can also help patients on cholesterol-lowering drugs. “Concomitant use of flaxseed oil will make the eyes more comfortable and further lower cholesterol by as much as 10 points,” Dr. Boerner said.

Overall, there were two major groups of patients who benefited from flaxseed oil: those with little or no oil flow and those whose meibomian gland secretions caused burning when pressed into the tear film.

“I hypothesize that the flaxseed oil affects the quantity of the oil in the tear film by increasing the oily layer thickness,” Dr. Boerner said. “The quality of the oils are also affected by a change in their components, so they become clear and less irritating.”

Flaxseed oil may be purchased in many health food stores. Dr. Boerner said, “The liquid oil tastes very good mixed in yogurt.” Capsule form is also available, with a recommended start of two capsules a day.

For Your Information:

Carol F. Boerner, MD, can be reached at Eyes of Boston, 1101 Beacon St., Brookline, MA 02446-5502 U.S.A.; +(1) 617-566-0062; fax: +(1) 617-734-3264. Dr. Boerner has no financial interest in flaxseed oil.