October 16, 2024

When you are experiencing dry, gritty, irritated eyes; your first thought probably isn’t about your gut health, but many of these symptoms can be linked to harmful changes in your eyes that first arose in the gut. 80% of our immune cells live in the GI tract, and changes in the gut microbiome have been shown to cause changes in the proteins expressed in our tears. 

Our eyes and our gut aren’t so different after all. They both have mucus membranes (called the conjunctiva in the eyes) that are exposed to our environment (even though our stomach and intestines are inside of us, everything passing through is “outside” of our system). These mucus membranes allow for nutrient absorption in the gut and produce the mucus layer of our tears. More importantly for today’s discussion, they help regulate your immune and inflammatory response to the things you encounter every day.

There is still much to learn about gut health and the role of the microorganisms that make it up. Our gut microbiome can weigh up to 2kg (4.4 lbs.) and contain 100 trillion microorganisms. That is ten times the number of cells in the human body! 

Roles of the Gut Microbiome 

- Gut motility

- Modulates immune system

- Impact on inflammation

- Metabolism and glucose regulation

- Mood management 

- Improves nutritional status

If we start to get an overgrowth of bad bugs in our gut (gut dysbiosis) we get changes leading to producing more pro-inflammatory mediators. These unhealthy bacteria eat away at the mucus lining and allow for a leaky gut. This means that toxins can penetrate gaps where there is no longer a protective lining and get into our blood circulation. Pro inflammatory markers now in the blood can go around all over the body and start to wreak havoc. 

Causes of Gut Dysbiosis

- SAD (standard American diet) 

- Born via C-section, formula feeding as an infant

- Xenobiotics (drugs, PPIs) 

- Mold exposure

- Infections

- Alcohol abuse 

- Lack of exercise

- Stress

If you have made it this far and are starting to think that this could be something you are dealing with, what are the next best steps? If you haven’t already, come into the Dry Eye Center at East Main Vision Clinic and we can help to assess and treat your form of dry eye disease. Next, working with a registered dietician to properly assess and treat your gut issues is the best way to manage any sort of gut dysfunction. Below I will go over things you can start doing right now to make an impact on your eye and gut health. 

Omega 3 and Omega 6 are both essential fatty acids. This means that your body cannot produce them on its own. They must come from your diet. Omega 3s typically come from fatty fish. Omega 6 is found in nuts, eggs, and vegetable oils. There is strong evidence that the ratio of omega 3s to omega 6s plays a significant role in dry eye disease. The ideal ratio of Omega 6:Omega 3 is 3-4:1, while the standard American diet has a typical ratio of 25:1. This increased Omega 6:Omega 3 ratio leads to a 2.5x higher risk of dry eye disease, and there is a 30% reduction of dry eye disease with every gram of omega 3 added to the diet. Both nutrients are especially important for the body, and so the goal isn’t to reduce omega 6 intake, but to increase omega 3 intake to get closer to the ideal ratio between the two. 

There is also convincing evidence that vitamins A, C, D and E have vital roles in keeping the tear film strong and healthy. 

Sources of Eye Healthy Vitamins

Vitamin A: Orange vegetables such as carrots, sweet potatoes; as well as leafy green vegetables such as spinach and kale. 

Vitamin C: Citrus such as oranges and lemons, as well as other fruits such as bananas, strawberries, and blueberries.

Vitamin D: SUNLIGHT, cheese, yogurt, eggs, salmon. About 40% of US adults are vitamin D deficient, more so in our great state of Washington. 

Vitamin E:  nuts, seeds, vegetable oils

Caffeine has been found to be very protective against dry eye, so feel free to keep drinking your morning coffee, in fact, I encourage it. This doesn’t mean you should decrease water intake, though.

Turmeric has moderate evidence of positive effects with dry eye disease thanks to its anti-inflammatory effects. Prebiotics and probiotics as well as fermented foods all improve overall symptoms. Eating a diet high in fiber is great for the gut as well as overall well-being and longevity. 

If this all seems like a lot to remember and you are struggling to come up with a way to implement these changes, you’re not alone. The Mediterranean diet encompasses much of the changes discussed today. It remains one of the most studied diets with benefits not only in eye and gut health but also preventing heart disease, stroke, obesity, diabetes, high cholesterol, and high blood pressure. So, start with challenging yourself to one change a day and then continue the habit. 

Little steps go a long way! 

Dr. Shane Hager