The ONIT Study–Ocular Nutrition Impact on Tear Film

Abstract

Purpose: To better understand the role of a proprietary dietary supplement formulated to contain Omega 3 and seven other anti-inflammatories plays in patients with established clinical findings consistent with dry eye disease. Secondarily, this evaluation will attempt to discover if any of the diagnostic markers are predictive to the therapeutic approach of omega 3 anti-inflammatory dietary supplements. Design:Clinical-based, multi-center cohort study. Methods:This eight-week feasibility study was to determine if subjects presenting with dry eye confirmed by diagnostic markers and symptoms responded to nutritional therapy via an oral nutritional supplement (EyePromise EZ Tears™). Analyses were completed on a subgroup of subjects with 4 of 7 possible diagnostic criteria.Results: A total of 67 patients were enrolled between 18-79 years of age inclusive. At the conclusion of the study, improvement from baseline was demonstrated in OSDI decreasing scores by 38%. Improved tear breakup time and phenol red thread scores were seen and was reduced conjunctival staining. There was also a decrease noted in lid inflammation. Osmolarity scores were variable and inconclusive. Conclusion:Supplementation with this Omega-3 anti-inflammatory product in dry eye showed significant improvement in OSDI, TBUT, conjunctival staining lid inflammation and phenol red tear meniscus and corneal staining scores. This decrease in patient symptoms could be an indication of decreasing ocular surface inflammation and possible stabilization of the lipid layer. The change from baseline for these signs appears to be rapid, as differences were shown as early as one-week post-supplementation.

Can Nutrition Play a Role in Ameliorating Digital Eye Strain?

“…Prospective studies involving younger adults with computer vision syndrome (≥3 h/day computer use) demonstrated significant improvements in objective measures of inherent tear film stability and subjective dry eye symptoms in as few as 45 days of supplementation [ 171 , 178 ]. Marked improvements in Nelson grading scores upon impression cytology seem to mirror these findings, providing further evidence of the nutraceutical benefits of omega-3 fatty acids to promote healing of the conjunctival epithelium [ 169 , 171 , 178 ]. Given that hyperosmotic stress plays an important role in causing damage to the ocular surface, these observations wherein short-term supplementation produced a profound normalization in tear tonicity represent clinically meaningful effects to improve the severity of dry eye [ 179 , 180 ].…”

“…For the management of ocular surface symptoms in digital eye strain, the capacity for omega-3 fatty acids to offer clinical benefits against the underlying mechanisms of dry eye disease is supported by robust scientific evidence [ 76 , 146 , 147 , 148 , 150 , 152 , 163 , 164 , 165 , 166 , 167 , 168 , 169 ]. In randomized clinical trials, short-term dietary supplementation with omega-3 PUFAs demonstrated enhanced therapeutic benefits in patients with mild-to-moderate dry eye disease ( Table 1 ) [ 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 ].…”

“…There is significant molecular and mechanistic basis that purports the use of nutritional intervention, particularly the use of omega-3, anthocyanins, and carotenoids in management of digital eye strain. Perhaps well-suited for managing dry eye symptoms, short-term supplementation with omega-3 fatty acids demonstrate enhanced capacity to ameliorate pro-inflammatory mechanisms of ocular surface dysfunction and MGD [ 151 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 ]. A growing body of evidence indicates a potential role for anthocyanins to provide dietary benefits against aesthenopic symptoms along with visual fatigue brought on by hand-held devices and prolonged near-vision work [ 193 , 194 , 195 , 196 , 197 , 198 , 199 , 200 , 202 , 206 ].…”