THERAPEUTICS

New Formula Quells Swelling

This dry-eye neutraceutical now contains ingredients to dampen inflammation.

By Kathy Kelley, O. D. & Faye Peters, O. D.

Millions of people in the United States suffer from Dry Eye Syndrome. To help these people, ScienceBased Health recently launched its next-generation HydroEye, a patented oral formulation for dry-eye relief.

HydroEye now provides the omega-3 fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA) that meet standards set by United States Pharmacopeia(USP). It also offers a potent level of the ocular antioxidant vitamin C.

HydroEye has long addressed dry-eye discomfort with its proprietary blend of gamma linolenic acid (GLA) from black currant seed oil and other nutrient co-factors.

Inflammation plays a central role in dry eye. In a study published in the April 2007 issue of Cornea, inflammation was present in most patients who were diagnosed with a dry-eye severity level of 2 (on a scale of 1 to 4, with 4 being the most severe).

Further, in studies such as those published in the March 2003 issue of Cornea, the unique omega-6 fatty acid GLA has been shown to dampen inflammation and relieve dry-eye symptoms. GLA is not found in flaxseed or fish oils. Nor is it present to any extent in the diet.

GLA: an anti-inflammatory

The body can form GLA from linoleic acid, an essential fatty acid found abundantly in the Western diet. However, the conversion to GLA is very slow and further restricted by alcohol use, stress, smoking, saturated and trans-fatty acid intake and deficiencies of magnesium, vitamin B6 and zinc. These factors — as well as hypertension, arthritis, psoriasis and diabetes — can impair the activity of the enzyme required to convert linoleic acid to GLA.

This dry-eye oral formulation decreases inflammation.

Providing GLA directly from HydroEye allows the body to bypass this often sluggish metabolic step.

GLA is rapidly converted to the precursor for the anti-inflammatory prostaglandins of series 1 (PGE1) and thromboxane A1. It can also slow production of the potent pro-inflammatory compound leukotriene B4 from inflammatory cells.

EPA and DHA bolster action

With the addition of the omega-3 fats EPA and DHA from fish oil, HydroEye now delivers a one-two punch in helping to calm chronic inflammation. Not only can EPA form anti-inflammatory prostaglandins of series 3, it also helps to block the formation of other pro-inflammatory compounds. When EPA and GLA are present in balanced amounts, EPA inhibits the formation of pro-inflammatory prostaglandins (PGE2). While the role of DHA is less clear, experimental data in the Journal of Nutrition (May 2000) suggests that DHA works synergistically with vitamin E to protect ocular surface cells from apoptosis.

Optimal ratio of fats

A number of organizations, including the American Heart Association, have advised Americans who generally obtain an excess of omega-6 fats through consumption of meat, dairy, vegetable cooking oils and shortenings to consume more omega-3s from such sources as fatty fish and nuts.

One misconception about the HydroEye formulation is that it adds to the excessive intake of omega-6 fats. The black currant seed oil in HydroEye, however, is not only rich in GLA, it also contains the omega-3's stearidonic acid and alpha linolenic acid — the fatty acid found in flaxseed oil.

The composition of black currant seed oil already reflects the recommended optimal dietary intake of omega-3 and omega-6 fatty acids. It has a ratio of omega-3 to omega-6 that's roughly one to four. The omega-3 fatty acids from fish oil significantly enhance that ratio, making it even more favorable for overall health.

According to Stephen C. Pflugfelder, M.D., director of the Ocular Surface Center at Baylor College of Medicine, in Houston, "Next-generation HydroEye contains USP-verified fish oil that, together with GLA from black current seed, provides the optimum balance of long-chain fatty acids to suppress the inflammatory response in dry eye."

Support a healthy tear film

In addition to black currant seed and fish oils, HydroEye contains other important nutrients: vitamin A to facilitate gene expression of mucin; vitamin E to protect HydroEye's fatty acids and magnesium and vitamin B6 to assist in their metabolism; and vitamin C to quell free radicals generated by the inflammatory response.

According to a study in the April 2001 issue of the Journal of Cataract and Refractive Surgery, there is a significant decline in tear levels of ascorbic acid, such as vitamin C, after LASIK surgery. Clinicians have found HydroEye to raise levels of lactoferrin lactoferrin in patients about to undergo LASIK and mitigates the expected decrease in this indicator of ocular surface health after this procedure. Together, these ingredients help counter dry eye from a variety of causes.

A Clinical prospective

We've found that HydroEye is very effective in the treatment of our dry-eye patients. And, we've noted an improvement in the comfort level of our patients who've taken this product, regardless of the underlying causes of their dry eye.

We start all our patients who have signs or symptoms of dry eye on HydroEye prior to LASIK. Within four to eight weeks of first taking it, most patients report a decrease in dryeye symptoms. Typically, the formulation is well tolerated, especially if consumed with food. Used in conjunction with lubricants, Restasis (cyclosporine 2%, Allergan) or punctal plugs, HydroEye helps increase the level of relief for the more severe dry-eye patients. OM

Drs. Peters and Kelley specialize in cornea and anterior segment treatment and management as well as refractive surgery pre and post-op care. Both are graduates of Indiana University School of Optometry and practice at Price Vision group in Indianapolis, IN.