Ophthalmology has (at last!) increased research into vitamins and other nutritional supplements used to treat dry eye. As a result, many ophthalmologists and rheumatologists now recommend specific vitamins and other nutritional supplements to aid in the treatment of dry eye pain. In addition, for some people, the more traditional eye compresses, of one type or another, might help provide relief from the discomfort of dry eye associated with blepharitis or meibomianitis.

This page provides the following information:

• What dry-eye vitamins are available?
• Does mainstream research about vitamin use for dry eyes exist?
• What eyelid compresses can I try for blepharitis or meibomianitis?
• How is aloe vera used to help blepharitis?
• How can I check if a remedy is safe?

For information about artificial tears and other lubricants used for mild or moderate dry eye, as well as typical eyelid scrubs used for blepharitis and meibomianitis, see the Standard Treatments page. For information about some medications and certain types of eye surgery that can cause or contribute to dry eye pain, see the Medications & Surgery page.

What dry-eye vitamins are available?

Vitamin or nutritional supplement-based therapy for dry eye has entered the mainstream, triggered in part by the occurrence of short- or long-term dry eye pain in some people who have undergone lasik surgery. See, for example, Awareness facilitates treatment of LASIK-associated dry eye, published in the May 15, 2003 online issue of Ophthalmology Times.

The following table lists several supplements that might provide relief for people with dry eye. Currently, the primary researcher at DryEyePain uses BioTears. However, what works best for one person might not be the best option for a different person, so you might have to try these — one at a time, not in combination! — until you find the one (if any) that works best for your eyes. As always, before you begin any over-the-counter therapy, ask your eye doctor whether that remedy is appropriate for you.

Does mainstream research about vitamin use for dry eyes exist?

The following table lists a few examples of information about dry eye supplements published in Ophthalmology Times or studies showing the relationship between nutritional supplements and dry eye treatment.

For Web sites that explain in layman's terms the use of nutritional supplements for dry eye, as well as which foods contain these supplements, see the following table.

What eyelid compresses can I try for blepharitis? or Meibomianitis?

If you have blepharitis or meibomianitis, don't underestimate the contribution that these eyelid conditions make to dry eye and therefore to dry eye pain. An eyelid compress can help.

See also Eyelid scrubs for blepharitis and meibomianitis on the Standard Treatments page, and see Allergic reactions to eyelid compresses on the Allergic Eye Tips page.

Blepharitis, an inflammation of the eyelids, can "glue shut" your eyes in the morning. Blepharitis, or the related meibomianitis, can cause dry eye pain even in the presence of sufficient tear production, or it can greatly increase dry eye pain already present due to insufficient tear production.

Plain water compress

If your local area has clean tap water and your eyes do not have an allergic reaction to the water, you may be able to use plain warm water for an eye compress. Be sure to use a freshly clean washcloth. Alternatively, you can use 2 or 3 lint-free tissues instead of a washcloth for the compress.

Alternatively, to make sure that the compress is sterile, boil the water first, let it cool to warm or lukewarm, and then use it for the compress. NEVER use hot water for a compress if you have severely dry eyes or severe blepharitis or meibomianitis — hot water might "burn" your eyelids, making them feel worse instead of better.

Plain water plus (a very small amount of) vinegar compress

Before using a vinegar compress, first put a drop of artificial tears in each eye, such as Refresh Lubricant Eye Drops, available at MedShopExpress.com or at Drugstore.com. Add 1 teaspoon of distilled white vinegar to 2 or 3 cups of clean water, and then use a clean washcloth (or 2 or 3 lint-free tissues instead of a washcloth) for the compress.

Baking soda compress

1. Boil distilled water for 10 minutes in a clean, stainless steel pan that you use only for this purpose (not for food).
2. Pour one cup of the boiled water into a clean pyrex measuring cup, and dissolve 1/4 or 1/2 teaspoon baking soda (not baking powder) in the water. Use a measuring cup and measuring spoon that are used only to make the compress (not for food).
3. Set the water aside until it is lukewarm.
   Caution!     Typically, you are told to use a warm (possibly even a hot) compress. However, even a warm compress can sometimes "burn" the eyelids of a person with very sensitive eyelids. If a warm compress hurts your eyes, use a lukewarm compress instead.
4. Wash your hands, and then dip a clean wash cloth (or two or three lint-free tissues) in the lukewarm water. If you have eye allergies or are prone to get eye infections or styes, use the lint-free tissues rather than a washcloth. Apply the compress to your eyes for five to ten minutes. The compress softens the hard caps that clog the eyelid's oil glands.
5. When finished, if you have short fingernails, your hands are clean, and you are not wearing hand lotion, gently massage your eyelids near the eyelashes, or gently pinch the eyelids near the eyelashes. This helps free oil from your eyelids into your eyes.
6. Discard the excess solution. When you want another compress, make it again from scratch.

Boric acid compress

1. Boil distilled water for 10 minutes in a clean, stainless steel pan that you use only for this purpose (not for food).
2. Pour 1 cup of the boiled water into a clean pyrex measuring cup, and dissolve 1/8 teaspoon of boric acid powder (available in many grocery stores or pharmacies) in the water. Use a measuring cup and spoon that are used only to make the compress (not for food).
   Warning!     Do NOT use a boric acid solution without first getting an OK from your doctor. Be sure to keep undiluted boric acid powder away from your eyes — undiluted boric acid powder is great for killing cockroaches, but it is toxic to your eyes and skin. Do not take boric acid internally. Never use a compress that contains even a very small amount of boric acid on the eyes of an infant or small child.
3. Set the water aside until it is lukewarm.
   Caution!     Typically, you are told to use a warm (possibly even a hot) compress. However, even a warm compress can sometimes "burn" the eyelids of a person with very sensitive eyelids. If a warm compress hurts your eyes, use a lukewarm compress instead.
4. Wash your hands, and then dip a clean wash cloth (or two or three lint-free tissues) in the lukewarm water. If you have eye allergies or are prone to get eye infections or styes, use the lint-free tissues rather than a wash cloth. Apply the compress to your eyes for one to two minutes. Blink a couple of times to be sure some of the water containing boric acid gets onto the edges of your eyelids, where your eyelashes emerge from the eyelids. The warm compress softens the hard caps that clog the eyelid's oil glands.
5. When you are finished, if you have short fingernails, your hands are clean, and you don't have hand lotion on your hands, gently massage your eyelids near the eyelashes, or gently pinch the eyelids near the eyelashes. This helps free oil from your eyelids into your eyes.
6. Make a new compress using two or three lint-free tissues and plain cold water (without boric acid). Apply the compress to your eyes for one to two minutes. This cold compress rinses off the boric acid solution and contracts the oil gland openings back to their normal size.
7. Discard the excess solution. When you want another compress, make it again from scratch.

How is aloe vera used to help blepharitis?

Aloe vera is a traditional remedy for dry skin or skin with scrapes or mild burns. Some ophthalmologists now recommend its use to help stimulate tear production. You can buy aloe vera in many health food stores. Be sure to get 99% pure, fragrance-free, clear, non-mentholated aloe vera — any other product will harm your eyes.

Although aloe vera is expected to sting sharply for a minute or two even for a person with mild dry eyes, for someone with severe dry eye, putting even a very small amount of aloe vera directly into the eye can cause too much pain and thus be counterproductive. Instead, the following three subsections describe ways to use aloe vera either indirectly (on the eyelids) or in a diluted form.

Aloe vera eyelid stimulant:

1. Wash your face, hands, and eyelids. Use a fragrance-free soap, such as Ivory, or, if you have eye allergies, you might instead prefer to use a solution of water with a little baking soda (not baking powder) dissolved in it. If washing your eyelids hurts your eyes, put some artificial tears in your eyes beforehand (such as Refresh Lubricant Eye Drops, available at MedShopExpress.com or at Drugstore.com). Be sure to rinse thoroughly.
2. Massage or gently pinch your eyelids (upper and lower) to release oil into your eyes. This should feel pleasant for your eyes even if you don't have a chronic eyelid condition.
3. Apply 99% pure, fragrance-free aloe vera gel to both the upper and lower lids, especially the part where the eyelashes emerge.
4. Blink your eyes a couple of times, and then keep your eyes closed for a minute or two until the stinging stops. Don't be alarmed even if the stinging is quite sharp.
5. Repeat once in the morning and once in the evening. If using aloe vera twice a day leaves your eyelids sore, apply it only once, at bedtime.
6. Try this for a day or two. If it helps your eyes feel better, continue using aloe vera on your eyelids. If it doesn't help or makes your eyes feel worse, discontinue use.

Aloe vera / saline eyewash or compress:

1. Buy thimersol-free saline solution. The label should say "for sensitive eyes" (not "multi-purpose solution"). You can find this in most grocery stores in the contact lens section.
   Caution!    If you have eye allergies, do NOT use this option because even a thimersol-free saline solution contains a preservative. Be aware that you can sometimes successfully use an eye preparation for two or three weeks, and then develop an allergy to it.
2. Buy 99% pure, fragrance-free aloe vera (be sure to use a normal concentration aloe vera gel, not a concentrate or tincture) available in health food stores.
3. In a clean bowl, combine equal parts of the saline solution and the aloe vera. Use a bowl reserved only for this purpose, not a bowl that you use for food.
4. Do one of the following:
   • Either do this:     Boil a clean eye-dropper bottle for 10 minutes in distilled water. Use a stainless steel pan reserved only for this purpose. Pour the half saline, half aloe vera solution into the eye-dropper bottle. Turn the bottle five or six times (gently, so as not to create bubbles). Use as an eyedrop three times a day.
   • Or do this:     Dip two or three lint-free tissues into the half saline, half aloe vera solution, and then apply the tissues to your eyelids as a compress. If you want to get a little of the solution into your eyes, with your eyes closed, splash your eyelids with some of the solution, and then blink a few times.
5. Whether you use the solution as an eyedrop or as a compress, keep your eyes closed for a minute or two after each use, until the stinging stops. Don't be alarmed even if the stinging is quite sharp.
6. Use for one day only, and then discard.
7. Try this for a day or two. If it helps your eyes feel better, make a new batch of the solution fresh each day. If it doesn't help or makes your eyes feel worse, discontinue use.

Aloe vera / boric acid eyewash or compress

1. Buy pure powdered aloe vera (in this case, aloe vera powder, not aloe vera gel; available in health food stores).
2. Buy boric acid powder (available in many grocery stores or pharmacies).
   Warning!     Do NOT use a boric acid solution without first getting an OK from your doctor. Be sure to keep undiluted boric acid powder away from your eyes — undiluted boric acid powder is great for killing cockroaches, but it is toxic to your eyes and skin. Do not take boric acid internally. Never use any kind of boric acid solution on the eyes of an infant or small child.
3. Boil distilled water for 10 minutes. Use a pan reserved only for this use.
4. Dissolve 1/2 teaspoon powdered aloe vera and 1/8 teaspoon boric acid powder in one cup of the boiled water.
5. Pour the aloe vera / boric acid solution through a clean coffee filter.
6. Do one of the following:
   • Either do this:     Boil an eye-dropper bottle for 10 minues in fresh distilled water (not the water you used to make the solution). Use a stainless steel pan reserved only for this use. Pour the aloe vera / boric acid solution into the eye-dropper bottle. Use as an eyedrop three times a day.
   • Or do this:     Dip two or three lint-free tissues into the aloe vera / boric acid solution, and then apply them to your eyelids as a compress. If you want to get a little of the solution into your eyes, with your eyes closed, splash your eyelids with some of the solution, and then blink a few times.
7. Whether you use the solution as an eyedrop or as a compress, keep your eyes closed for a minute or two after each use, until the stinging stops. Don't be alarmed even if the stinging is quite sharp.
8. Use for one day only, and then discard.
9. Try this for a day or two. If it helps your eyes feel better, make a new batch of the solution fresh each day. If it doesn't help or makes your eyes worse, discontinue use.

How can I check if a remedy is safe?

When considering new or non-standard remedies for dry eye pain, keep in mind the fact that, although mainstream medical research has begun to make efforts to scientifically test alternative remedies, alternative and home remedies are not well-regulated. Dishonest people often attempt to take advantage of people with chronic illnesses (especially illnesses that cause severe pain), and will sell you often expensive remedies that are not helpful, may be harmful, and might even cause permanent damage. In addition, well-meaning people (including the researchers for DryEyePain) might inadvertently provide information that is not appropriate or safe for you.

If you are considering using a new or alternative therapy, click the following links to search these U.S. government Web sites to see if either positive or negative information about that therapy exists:

• Food and Drug Administration
• Federal Trade Commission
• National Center for Complementary and Alternative Medicine

Other resources include:

• OpthalmologyTimes.com
• Review of Ophthalmology
• Review of Optometry Online
• MEDLINEplus Drug Information
• Drugs and Medications Search Engine and Directory
• RxList.com
• MedSafe.govt.nz
• Drugs.com
• The Scientific Review of Alternative Medicine and Aberrant Medical Practices
• Quackwatch.org
• "A Complete Guide to Prescription and Non-Prescription Drugs," by H. Winter Giffith. This book is available at BarnesAndNoble.com and other bookstores.

Never experiment with an alternative or home remedy on an infant or child.