Effect of Short-Term Oral Vitamin D3 Supplementation on Tear Film in Dry Eye Subjects

Journal Article
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Vitamin D deficiency is common worldwide, particularly in the Middle East and North Africa. The prevalence of vitamin D deficiency (<50 nmol/L) is very high in Saudi Arabia and is associated with several chronic illnesses. The aim of the study is to investigate the effect of short-term oral vitamin D3 supplementation on tear film stability in dry eye subjects. Thirty male dry eye subjects aged 19–37 years (mean ± standard deviation (SD) = 26.2±5.0 years) completed the study. An age-matched control group of 30 normal eye male subjects (25.6±4.3 years) was also recruited. Each subject received an oral vitamin D3 supplement (400 IU daily) for 3 consecutive days. The tear ferning (TF), phenol red thread (PRT), and tear break-up time (TBUT) tests were performed before and 24 hours after the third dose of vitamin D3 supplement. TF grades were significantly (Wilcoxon test, p<0.001) decreased (median (IQR) = 1.8 (0.8) in dry eye subjects after vitamin D3 supplementation compared to those obtained before supplementation (2.3 (0.6)). TF grades were improved in 86.7% of dry eye subjects (n=26). Although PRT and TBUT tests scores were higher post-vitamin D3 supplementation, the differences were not significant (Wilcoxon test, p>0.05). No significant differences in TF grades and PRT and TBUT scores were observed between pre- and post-vitamin D3 supplementation in healthy controls. For the study group, there were strong correlations between measurements of PRT (OD) and PRT (OS) and between TBUT (OD) and TBUT (OS) pre- and post-vitamin D3 supplementation. No correlation was found between TF (OD) and TF (OS) grades pre- and post-vitamin D3 supplementation. The TF test suggests that short-term oral vitamin D3 supplementation can improve the quality of tears in dry eye subjects. Oral vitamin D3 supplementation can be potentially used as an effective treatment for subjects with dry eye symptoms. Our study offers important insights into how vitamin D3 supplementation can improve tear film in dry eye patients and in turn improving patients’ quality of life. Future studies are needed to investigate the long-term effect of vitamin D3 supplementation on the stability of the tear film.