Exploring the potential of short-term oral folic acid on the ocular tear film: An intervention study

ObjectiveFolic acid deficiency has been implicated in various systemic and ocular conditions and is essential for the development of specific ocular tissues. Folic acid has antioxidant and anti-inflammatory effects and can benefit the tear film. Therefore, the current single-arm pre-post intervention pilot study aimed to assess the short-term impact of folic acid supplementation on the comfort, stability, volume, and quality of the tear film among young healthy participants.MethodsA total of 46 subjects (24 males and 22 females) aged 19 to 34 years (23.2 ± 3.4 years) with no pre-existing eye diseases or disorders were recruited. No control group took part in the study. All participants were given oral folic acid tablets at a daily dose of 1 mg for three consecutive days. The standard patient evaluation of eye dryness (SPEED) questionnaire was completed first, followed by the noninvasive tear breakup time (NITBUT), tear meniscus height (TMH), and tear ferning (TF) tests. The first set of measurements was taken before folic acid intake, and the second was taken 24 hours after the third dose.ResultsSignificant differences (p < 0.001, Wilcoxon signed-rank test) were observed in the SPEED, NITBUT, TMH, and TF scores before and after the consumption of folic acid supplementation. The SPEED [7.0 (9.2) versus 4.0 (7.3)] and TF [1.3 (0.6) versus 0.9 (0.9)] scores were significantly lower after the consumption of folic acid. On the other hand, the NITBUT [5.5 (4.1) versus 9.9 (6.7) s] and TMH [0.19 (0.05) versus 0.21 (0.03) mm] scores were significantly higher after folic acid consumption.ConclusionA 3-day regimen of folic acid supplementation may improve tear film parameters. Benefits may include improved comfort, stability, volume, and overall quality of the ocular tear film. However, the results are preliminary and hypothesis generating.