Dry Eye Disease
Supplements studied for dry eye disease.
Overview
Evening Primrose Oil and Lutein each have medium evidence (WA 64, two studies) but uncertain standalone benefit. Evening primrose oil 3 g daily for six months improved some symptoms in contact lens wearers in early research. Lutein appeared in a combination with zeaxanthin, curcumin, and vitamin D3 that modestly improved symptoms and tear quality over eight weeks.
Curcumin alone has not been studied for dry eye; the same combination product showed improved tear production and symptom relief versus placebo. It is unclear which ingredient drove effects. The heatmap and evidence reviews below cover all three supplements.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Lutein | ★★★★★ | Medium |
| Evening Primrose Oil | ★★★★★ | Medium |
| Zeaxanthin | ★★★★★ | Low |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Low |
| Multivitamin | ★★★★★ | Low |
| Green Tea | ★★★★★ | Low |
| Elderberry | ★★★★★ | Low |
| Curcumin | ★★★★★ | Low |
| Bilberry | ★★★★★ | Low |
| Alpha-Lipoic Acid | ★★★★★ | Low |
| L-Carnitine | ★★★★★ | Low |
| Astaxanthin | ★★★★★ | Low |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
12 supplements for and rated at least stars. All purchase bands. No minimum star filter.
LuteinView supplement →
Consider purchase·★★★★★
How we scored this▸
- Studies in adults with dry eye show that taking a daily supplement with lutein, zeaxanthin, curcumin, and vitamin D3 for 8 weeks gave modest improvements in symptoms and tear quality compared to a placebo.
- However, people did not use fewer artificial tears.
- It is not known if these benefits come from lutein, the other ingredients, or the mix.
Browse 2 studies
RCTA novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomized, placebo-controlled clinical trial2024n=78
A randomized, double-blind, placebo-controlled study in adults with dry eye disease found that a daily supplement containing lutein (20 mg), zeaxanthin isomers (4 mg), curcumin (200 mg) and vitamin D3 (600 IU) significantly improved tear production, break-up time, ocular surface damage and symptom scores by Day 56 vs placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 600 IU/day
- Population
- Adults
- Participants
- 78
- Ages
- 18–65
Systematic reviewRole of Lutein Supplements in the Management of Dry Eye Syndrome: A Systematic Review2024n=584
A systematic review of 6 dry-eye RCTs (584 subjects) found lutein 3–20 mg/day for 4–12 weeks may reduce OSDI scores and improve tear break-up time, though results were heterogeneous.
- Effect
- Benefit
- Duration
- 4–12 weeks
- Dose
- 3 mg/day
- Population
- Patients with dry eye disease
- Participants
- 584
Evening Primrose OilView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if taking evening primrose oil by mouth helps with dry eye.
- Early research shows that taking 3 grams daily of a specific evening primrose oil product for 6 months helped improve some dry eye symptoms in people who wear soft contact lenses, compared to placebo.
Browse 2 studies
RCTOral omega-6 essential fatty acid treatment in contact lens associated dry eye2008n=76
A 6-month study including 76 female subjects with contact lens associated dry eye found that evening primrose oil (3 g/day Equazen) improved dryness after 3 and 6 months, and improved lens comfort after 6 months compared to placebo. After 6 months, there was an increase in tear meniscus height but no changes in Meibomian gland function (lipid layer thickness and quality) and ocular surface parameters (hyperaemia and staining). [10705]
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 3 g/day
- Population
- Contact lens wearers
- Participants
- 76
RCTSystemic linoleic and gamma-linolenic acid therapy in dry eye syndrome with an inflammatory component2003n=26
A 45-day study of 26 patients with aqueous-deficient keratoconjunctivitis sicca (dry eye) found that a twice daily combination of linoleic acid (28.5 mg) and gamma-linolenic acid (15 mg) taken for 45 days reduced ocular surface inflammation and improved dry eye symptoms compared to placebo. [10706]
- Effect
- Benefit
- Duration
- 45 days
- Dose
- 28.5 mg
- Population
- RA patients
- Participants
- 26
ZeaxanthinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Evidence is insufficient for this condition.
Browse 3 studies
Open-labelMulticomponent Dietary Supplementation: Impact on Tear Secretion and Ocular Surface Inflammation in Dry Eye Syndrome Patients2025n=23
In 52 dry eye patients, a 12-week supplement with 1.8 mg/day zeaxanthin plus fish oil and lutein increased tear secretion and reduced OSDI scores and tear IL-6 and IL-8 versus control.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 1.8 mg/day
- Population
- Patients
- Participants
- 23
- Ages
- 20–80
RCTThe effects of lutein/ zeaxanthin (Lute-gen®) on eye health, eye strain, sleep quality, and attention in high electronic screen users: a randomized, double-blind, placebo-controlled study2025n=70
In 70 high screen users, 6 months of lutein 10 mg plus zeaxanthin 2 mg/day improved Schirmer test, photo-stress recovery, and tear break-up time versus placebo but not self-report symptoms or contrast sensitivity.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 2 mg/day
- Population
- Adults
- Participants
- 70
- Ages
- 18–65
RCTEffect of Dietary Supplementation with Lutein, Zeaxanthin, and Elderberries on Dry Eye Disease (DED) and Immunity: A Randomized Controlled Trial2024n=110
In 110 adults over 20 days, lutein (6 mg), zeaxanthin (1 mg), and elderberry (100 mg) significantly improved Ocular Surface Disease Index scores (26.7% improvement) versus placebo; immune questionnaire changes were not significant.
- Effect
- Benefit
- Duration
- 20 days
- Dose
- 6 mg/day
- Population
- Pregnant women
- Participants
- 110
- Ages
- 18+
Alpha-Lipoic AcidView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain whether eye drops containing alpha-lipoic acid help with dry eye.
- One small study in people with diabetes found that using drops with 0.1% alpha-lipoic acid and another moisture ingredient (HPMC) three times daily for two months did not improve dry eye symptoms compared to HPMC alone.
Browse 1 study
RCTEffects of the Topical Use of the Natural Antioxidant Alpha-Lipoic Acid on the Ocular Surface of Diabetic Patients with Dry Eye Symptoms2022n=70
In 70 diabetic dry-eye patients, 2 months of topical 0.1% alpha-lipoic acid with HPMC improved tear break-up time, OSDI, corneal staining, and tear morphology more than HPMC alone.
- Effect
- Benefit
- Duration
- 2 months
- Population
- Diabetic patients
- Participants
- 70
- Ages
- 50–79
BilberryView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- A small study in people with severe dry eye found that taking a daily supplement with bilberry extract and fish oil for 3 months helped improve tear quality and reduced dry eye symptoms.
- The improvements were seen in both tests and how patients felt.
- However, the study didn’t compare these results statistically to a control group, so more research is needed to confirm if these benefits are real and whether they come from bilberry, fish oil, or their combination.
Browse 1 study
RCTBilberry-containing supplements on severe dry eye disease in young and middle-aged adults: A 3-month pilot analysis2023n=24
A pilot randomized controlled trial involving 24 adults with severe dry eye disease (12 in the intervention group and 12 controls) found that daily supplementation with 600 mg of bilberry extract plus 240 mg of fish oil for 3 months improved subjective symptoms (OSDI score) and objective measures (non-invasive tear break-up time, phenol red thread test) compared to no supplement.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 240 mg/day
- Population
- Adults
- Participants
- 24
CurcuminView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Turmeric or curcumin on its own has not been studied for dry eye, but supplements combining curcumin with lutein, vitamin D3, and zeaxanthin have shown some benefits.
- In a study of adults with dry eye, taking this blend for eight weeks led to better tear production and improvement in symptoms like burning, sore eyes, and blurred vision compared to a placebo.
Browse 1 study
RCTA novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomized, placebo-controlled clinical trial2024n=78
An 8-week manufacturer-funded study of 116 patients with dry eye disease found that a combination of 20 mg lutein, 4 mg zeaxanthin, 200 mg curcuminoids and 600 IU vitamin D3 led to improvements in Ocular Surface Disease Index by day 14 (P < 0.05), which was maintained after 56 days (P < 0.001). The treatment group experienced improvements in tear film break-up time (P < 0.001), tear film osmolarity (P < 0.001), corneal and conjunctival staining (P < 0.001) and inflammation (P < 0.001) after 56 days. There was no difference between groups for artificial tear usage. [10200]
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 600 IU/day
- Population
- Adults
- Participants
- 78
- Ages
- 18–65
ElderberryView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- No summary is available.
Browse 1 study
RCTEffect of Dietary Supplementation with Lutein, Zeaxanthin, and Elderberries on Dry Eye Disease (DED) and Immunity: A Randomized Controlled Trial2024n=110
In 110 adults over 20 days, lutein (6 mg), zeaxanthin (1 mg), and elderberry (100 mg) significantly improved Ocular Surface Disease Index scores (26.7% improvement) versus placebo; immune questionnaire changes were not significant.
- Effect
- Benefit
- Duration
- 20 days
- Dose
- 6 mg/day
- Population
- Pregnant women
- Participants
- 110
- Ages
- 18+
Green TeaView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In people with dry eyes caused by meibomian gland problems, using green tea extract eye drops three times a day for a month helped reduce itching, burning, feeling like something is in the eye, and redness better than regular artificial tears alone.
- Tests showed that eye tear quality and gland function also improved.
- The drops were safe to use and did not cause side effects.
Browse 1 study
RCTEfficacy of Green Tea Extract for Treatment of Dry Eye and Meibomian Gland Dysfunction; A Double-blind Randomized Controlled Clinical Trial Study2017n=60
In a 2-month double-blind RCT of 60 dry eye patients (ages 30–70), green tea extract improved tear break-up time and symptom scores versus standard artificial tears alone.
- Effect
- Benefit
- Population
- Adults
- Participants
- 60
- Ages
- 30–70
MultivitaminView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if taking multivitamins helps with dry eye.
- A small study in people over 45 who had dry eye that did not improve with other treatments looked at a specific multivitamin taken twice daily along with their usual eye drops.
- This multivitamin included B vitamins, vitamin C, vitamin E, beta-carotene, zinc, selenium, and coenzyme Q10.
- After three months, people reported better dry eye symptoms, and tests showed improved tear production and tear stability.
- However, because the study did not include a comparison group and the length of treatment was not clearly stated, more research is needed to confirm these results.
Browse 1 study
RCTEffect of multivitamin drug on intractable dry eye symptoms2022n=42
An RCT of 42 patients with intractable dry eye found multivitamin supplementation improved symptom scores versus baseline.
- Effect
- Benefit
- Duration
- 3 months
- Population
- Dry eye patients
- Participants
- 42
- Ages
- 45+
N-Acetyl Cysteine (NAC)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Some small studies suggest that eye drops with N-acetylcysteine (NAC), alone or with chitosan, may help improve dry eye signs.
- Using 20% NAC drops every two hours for 2 months improved eye moisture but not how patients felt.
- Another drop with both NAC and chitosan improved tear thickness for up to 24 hours whether used once or twice a day.
- It is unclear which ingredient is responsible for the benefit.
Browse 2 studies
RCTA Controlled, Randomized Double-Blind Study to Evaluate the Safety and Efficacy of Chitosan-N-Acetylcysteine for the Treatment of Dry Eye Syndrome2017n=21
A 5-day double-blind RCT found NAC reduced symptom severity in acute viral conjunctivitis versus placebo eye drops.
- Effect
- Benefit
- Duration
- 5 days
- Population
- Adults with dry eye syndrome
- Participants
- 21
Acetylcysteine in kerato-conjunctivitis sicca1968
A clinical report found acetylcysteine eye drops improved symptoms in keratoconjunctivitis sicca (dry eye) patients.
- Effect
- Benefit
AstaxanthinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Taking astaxanthin twice daily at 6 mg for one month may improve symptoms and tear stability in people with mild to moderate dry eyes compared to baseline.
Browse 1 study
The Benefits and Safety of Astaxanthin in the Treatment of Mild-To-Moderate Dry Eye Disease2022
In 60 middle-aged and elderly mild-to-moderate dry-eye patients, oral astaxanthin 12 mg/day for 30 days improved OSDI, tear break-up time, meibomian function, and blink frequency in metabolic-syndrome-related cases.
- Effect
- Benefit
- Duration
- 30 days
- Dose
- 12 mg/day
- Population
- Older adults
L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Eye drops with benzalkonium chloride can cause dry eye by making tears unstable.
- A small study in people with glaucoma found that using a special eye drop containing L-carnitine and other ingredients three times a day for 15 days cut dry eye symptoms by about half.
- However, it is not clear if L-carnitine is responsible for this benefit.
Browse 2 studies
RCTIatrogenic dry eye disease: an eledoisin/carnitine and osmolyte drops study2013n=40
In 40 glaucoma patients with dry eye from preserved drops, eledoisin/carnitine eye drops improved ocular surface symptoms versus baseline over the study period.
- Effect
- Benefit
- Duration
- 15 days
- Dose
- 40 g/day
- Population
- Patients with primary open-angle glaucoma and ocular discomfort
- Participants
- 40
Narrative reviewPreservatives in eyedrops: the good, the bad and the ugly2010
A review discusses how chronic topical preserved eye drops can cause ocular surface toxicity and inflammation, relevant to dry eye in glaucoma patients.
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Zeaxanthin | ★★★★★48% | 3 | 0 | 17% |
| Evening Primrose Oil | ★★★★★56% | 2 | 0 | 11% |
| L-Carnitine | ★★★★★40% | 2 | 0 | 11% |
| Lutein | ★★★★★64% | 2 | 0 | 11% |
| N-Acetyl Cysteine (NAC) | ★★★★★44% | 2 | 0 | 11% |
| Alpha-Lipoic Acid | ★★★★★44% | 1 | 0 | 6% |
| Astaxanthin | ★★★★★40% | 1 | 0 | 6% |
| Bilberry | ★★★★★44% | 1 | 0 | 6% |
| Curcumin | ★★★★★44% | 1 | 0 | 6% |
| Elderberry | ★★★★★44% | 1 | 0 | 6% |
| Green Tea | ★★★★★44% | 1 | 0 | 6% |
| Multivitamin | ★★★★★44% | 1 | 0 | 6% |