Effects of short-term oral vitamin A supplementation on the ocular tear film in patients with dry eye

Saud A Alanazi, Gamal A El-Hiti, Abdulaziz A Al-Baloud, Mohamed I Alfarhan, Ammar Al-Shahrani, Abdulkareem A Albakri, Saad Alqahtani, Ali M Masmali Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia Objective: To investigate the effects of short-term oral vitamin A supplementation on the ocular tear film in patients with dry eye. Methods: In total, 30 male patients with dry eye (age range, 18–38 years; mean age, 25.2±2.8 years) who did not wear contact lenses or exhibit any ocular (other than dry eye) or systemic diseases were included, along with 30 age-matched men (control group; mean age, 24.5±2.3 years) with healthy eyes. Subject exclusion was based on the findings of the McMonnies questionnaire (cutoff score for dry eye: 14.5) and slit-lamp biomicroscopy. All subjects received an oral vitamin A supplement at a daily dose of 1,500 mg for 3 consecutive days. The phenol red thread (PRT) test was performed along with assessments of tear ferning (TF), tear osmolarity, and the tear break-up time (TBUT) before and 24 hours after the third dose of the vitamin A supplement. A 10-minute interval was observed between different tests. Results: In the dry eye group, the TF grade (Wilcoxon test, P=0.01) exhibited a significant decrease, while the tear osmolarity value (t-test, P=0.01) exhibited a significant increase after vitamin A supplementation. The PRT test findings (P=0.17) and TBUT (P=0.49) showed no significant differences before and after vitamin A supplementation. In the control group, vitamin A supplementation showed no significant effects on TF (P=0.74), tear osmolarity (P=0.55), the TBUT (P=0.19), and the PRT test scores (P=0.48). Conclusion: Our findings suggest that short-term oral vitamin A supplementation improves the quality, but not quantity, of tears in patients with dry eye. Future studies should involve larger patient samples and longer periods of vitamin A supplementation. Keywords: vitamin A supplement, dry eye, tear film, tear ferning, phenol red thread test, tear break-up time, tear osmolarit