Dry Eye Assessment in Patients with Vitamin D Deficiency
DOI:
https://doi.org/10.64105/Keywords:
Dry Eye Disease, Vitamin D Deficiency, Ocular Surface Inflammation, Tear Film Instability, Tear Break-Up Time (TBUT), Schirmer Test, Tear Osmolarity, Ocular Surface Disease Index (OSDI), Meibomian Gland Dysfunction, Vitamin D SupplementationAbstract
Introduction: Vitamin D deficiency has emerged as a potential contributor to ocular surface inflammation and tear‑film instability. Evidence suggests that inadequate vitamin D alters epithelial integrity, immune regulation, and lacrimal gland function.
Areas Covered: This review evaluates the impact of vitamin D deficiency on dry‑eye diagnostic parameters, including OSDI, Schirmer test, TBUT, osmolarity, staining, and meibomian gland assessment. Proposed mechanisms and clinical implications are discussed.
Expert Opinion: Vitamin D deficiency appears to amplify the inflammatory and evaporative components of DED; however, heterogeneity in study designs and inconsistent diagnostic standards limit clinical generalization. Vitamin D assessment may be valuable in chronic, refractory, autoimmune-associated, or inflammation-dominant DED. Supplementation may improve select clinical markers, but standardized thresholds, dosing strategies, and predictive biomarkers are needed.
Conclusion: Vitamin D deficiency influences multiple dry‑eye parameters, and supplementation may improve outcomes in appropriately selected patients.
Key Issues
Vitamin D deficiency is emerging as a systemic factor that may worsen ocular-surface inflammation and destabilize the tear film.
Individuals with low vitamin D levels often demonstrate impaired Schirmer scores, reduced TBUT, elevated tear osmolarity, and higher staining grades.
Vitamin D plays a regulatory role in epithelial integrity, immune modulation, and maintenance of meibomian gland health.
Supplementation has shown potential benefits in improving objective dry-eye parameters, particularly in patients with confirmed deficiency.
Variability in diagnostic techniques and heterogeneous study designs currently limit firm clinical guidelines.
Screening for vitamin D levels may be especially relevant in chronic, refractory, or autoimmune-associated dry eye.
A multimodal treatment approach combining ocular therapy with systemic vitamin D correction may enhance outcomes.
More standardized clinical trials are required to determine optimal serum thresholds, dosing strategies, and long-term effects.
