I recommend a combined total of 1000-2000 mg/day of EPA and DHA. Most farm raised animals, including seafood, are now fed grain instead of grazing on grass, eating algae or other fish, so their meat has omega 6 fats instead of omega 3 fats. If you are not eating foods like wild tuna, salmon, mackerel, sardines, free range chicken, 100% grass fed and FINISHED beef 2-3 times per week, you are likely deficient. Many farms put their cows on a grain fed lot to fatter them up before slaughter so their fat is like a grain fed cow. Ocean Blue Omega 3 2100 and Nutrigold Triple 3 Omega Gold fish oil provides about 1000 mg combined EPA and DHA in one (big) capsule. A 2:1 ratio of EPA to DHA would be preferred but it’s one pill in a pharmaceutical grade, certified source at a reasonable price. Carlson, Nordic Naturals and Biosyntrx are other good brands and there are now algae based sources of EPA and DHA for vegetarians and people concerned with overfishing. Always take Omega 3 supplements with food and keep them in the refrigerator to keep them fresh. If its smells like fish it’s rancid.
While ground flaxseed is an excellent source of fiber and may may help prevent breast and prostate cancer, all plant based sources of Omega 3 provide ALA, which does not convert to EPA and DHA very well, especially in men.
Since the ratio of Omega 6 to Omega 3 in the diet is also important, try to reduce your intake of Omega 6 oils by eating less meat from grain fed animals and less processed foods (which typically use Omega 6 oils for their longer shelf life).
Supplements for Macular Degeneration
Systane iCaps Vision Health is a vitamin/mineral supplement that is beneficial for patients with macular degeneration and is readily available in drugstores. It is only one capsule a day, the components are good quality and it contains 10 mg of lutein and 2 mg of zeaxanthin which has been shown to be protective against macular degeneration. However it is not a complete vitamin/mineral supplement and it only contains 280 mg of Omega 3 (of undisclosed type) so an Omega 3 supplement (described above) should be taken along with the iCaps Vision Health.
There are an increasing number of coconut oil products out there. The key is to use cold-pressed virgin coconut oil for maximum benefits. It will have a coconut flavor. Anything other than cold-pressed virgin oil is refined which, depending on the method used, can significantly decrease the benefits of the oil. That is true for other oils, like olive oil, too. I currently use Tropical Traditions Expeller-Pressed Coconut Oil when I don’t want the coconut flavor. It is not super-heated or chemically extracted so it still provides most of the benefits of the coconut oil without the coconut taste. For more information on coconut oil see my blog post In Defense of Coconut Oil.
HypoChlor lid cleanser- used twice daily for 2 weeks for treatment of blepharitis and some dry eye. It is available in our office or online.
Ocusoft Original or Plus formula Lid Scrubs, TheraTears Sterilid Eyelid Cleanser, Systane lid wipes or Blephadex lid wipes for daily maintenance care of lids.
Cliradex is a tea tree oil based formulation with convenient moist towelettes. I do not currently carry it in the office but it is available online. You can also make a tea tree oil formulation at home, if desired.
OTC Allergy Eye Drops
Look for products containing ketitofen including Alaway, Zaditor, Zyrtec Allergy Eyes, etc. They can be used twice a day as needed for allergy symptoms. Wait at least 15 min after using the drops before putting in contact lenses. The drops do sting quite a bit but they are more effective and last longer than older allergy drops like Vasocon-A. If symptoms do not improve, you should schedule an appointment. You may need a prescription strength antihistamine or steroid or your symptoms might be from another problem.
Look for brands such as Optive, Refresh, Genteal, Theratears, Bion Tears, Blink, Retaine, Systane, and Endura that come in either non-preserved and/or gentle preservative formulas. Avoid any products preserved with benzalkonium chloride (BAK or BAC). It is toxic to the cornea and can actually make your eyes dryer when used regularly.
Systane Balance and Refresh Optive Advanced are good for patients with problems with the oil layer of tears. Gel formulations last longer but tend to blur the vision so they are generally used in more severe cases of dry eye or at bedtime. Ointments like Refresh PM are generally reserved for use at bedtime.
Retaine MGD by Ocusoft is a non-preserved artificial tear that uses a new nanoemulsion formula that prolongs the effect of the drop in the eye without causing blur like most longer-acting artificial tears. It is currently only available at Walgreens, online or at doctor’s offices. I have heard very positive reports from other doctors but I do not carry it in the office at this time.
Biotears Supplement For Dry Eyes
Biotears is a nutritional supplement specifically formulated for patients with dry eyes. It may also help increase lubrication of other mucous membranes and joints. I generally recommend supplementing with 1000-2000 mg of the Omega 3s EPA + DHA first since most people are deficient and that can help dry eye symptoms in addition to other health benefits. But if dryness persists, I recommend Biotears. The scientific rationale is provided on the Science tab of the webpage. We have the product in the office or you can order it directly from Biosyntrx. It takes a 4-6 wks for the full effect but they provide a 60 day money back guarantee.
F.lux is a freeware program that changes the color temperature of your computer monitor/iPhone/tablet so itmatches the lighting in the room, typically making it less blue after sunset, reducing eyestrain. If you do a lot of computer work in the evening, it may also help you sleep at night because the decrease in blue light triggers the production of melatonin which in turn helps make you sleepy. The program also allows you to easily change the intensity of the monitor with hotkeys and you can temporarily disable it if you are doing color sensitive work such as editing images.