Eyeworld

83 EW INTERNATIONAL February 2016 Epitropoulos currently prescribes re-esterified omega-3 supplements that have a vitamin D component (Dry Eye Omega Benefits, Physician Recommended Nutriceuticals, Plymouth Meeting, Pa.). "There's the possibility that it's more than just the omega-3 that's helping patients," she said. "Having vitamin D probably helps people who are deficient but won't help people who are not vitamin D defi- cient and within the normal range." The definition of dry eye is still evolving—the Dry Eye WorkShop (DEWS) group is currently working on a revision to its landmark 2007 publication—and the next iteration may need to include vitamin D deficiency as a more prominent risk factor. EW References 1. Yildirim P, et al. Dry eye in vitamin D defi- ciency: more than an incidental association. Int J Rheum Dis. 2015 Aug 13. [Epub ahead of print] 2. Galor A, et al. Effect of a Mediterranean dietary pattern and vitamin D levels on dry eye syndrome. Cornea. 2014;33:437–441. Editors' note: The physicians have no financial interests related to this article. Contact information Epitropoulos: aepitrop@columbus.rr.com Yildirim: drpeliny@gmail.com The study authors also noted a limitation with the small study sample size. However, as the main symptoms of vitamin D deficiency are fatigue, pain, and functional impairment, this study is the first to demonstrate an association between dry eye and the clinical parameters of hypovitaminosis D, the authors wrote. "In our study, fatigue was found to be correlated with dry eye param- eters, including amount of tears and the stability of the tear film layer," they wrote. They also found pain to be associated with the tear film layer stability. There was not, however, an association between dry eye parame- ters with functional status. An upside is that the study did employ TBUT analysis, which tests for tear instability, one of the hall- marks in the development of dry eye disease, Dr. Epitropoulos said. "But the problem with TBUT is that it's variable in mild to moderate dry eye disease. In severe form it's not quite as variable," she said. "Tear film breaks up almost instantaneous- ly with more advanced forms of dry eye disease." For those who treat patients with dry eye, Dr. Epitropoulos said vitamin D is found in some sources of fish and many omega-3 prepa- rations. Many anterior segment surgeons already prescribe re-ester- ified omega-3 preparations, and Dr. A NEW ERA IN STERILE CORNEA ALLOGRAFTS EASY-PEEL PACKAGING Patented easy-peel packaging allows for quick introduction of sterile tissues to the surgical field, saving valuable OR time. 99.9% CLARITY Unlike traditional patches, Halo corneas are clear and will remain clear, resulting in simplified post-op assessment and improved patient cosmesis. STABLE STORAGE Halo tissues can remain at room temperature and never need reconstitution, so you'll always be ready for emergencies as well as scheduled procedures. Developed at Lions VisionGift's renowned Vision Research Laboratory, Halo sterile tissues provide surgeons with distinct procedural and cosmetic benefits. © Copyright 2015 Lions VisionGift and Stephens Instruments ( 800 ) 354-7848 stephensinst.com halo@stephensinst.com Distributed exclusively through For more information visit halograft.org " There's the possibility that it's more than just the omega-3 that's helping patients. Having vitamin D probably helps people who are deficient but won't help people who are not vitamin D deficient and within the normal range. " –Alice Epitropoulos, MD

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