My optometrist specifically recommended high quality Omega 3 supplement to prevent dry eyes from AI/tamoxifen.

My eyes became very dry several years after going through menopause which happened early-ish for me. I was 40 when I was officially considered menopausal, and I noticed the dry eyes about 5 years ago. (I'm now 52). I am on anastrazole and have noticed that my eyes feel even drier. My work environment is exceptionally dry (heat blasting and a humidity level sometimes of 22%) and I have difficulty reading my computer screen or even just keeping my eyes open some days. I am also on glaucoma eye drops twice a day as I am glaucoma suspect. The drops also have dry eyes as a side effect. I take Nordic Naturals fish oil/omega supplements. I used to take flax oil supplements, but my eye doctor said not to take them anymore since my diagnosis. The fish oil really does not help all that much (but I do feel they keep joint pain from the AI at bay). I have found that warm eye compresses and the use of an overnight eye gel help quite a bit. My eyes still dry out during the day, but at least I am waking up with eyes that are lubricated and don't hurt from the get go. During the day, I am constantly using artificial tears, but they don't help all that much either. The best ones I have found are ones that contain lipids to help prevent tears from evaporating so quickly.

I just had my first eye check up since being on my AI and I was nervous that my pressures were going to read even higher, but I was pleasantly surprised to learn they were the lowest they had been in about two years. I had been at 19 and 20 (on the glaucoma drops) but was at 15 and 16 this time (on the same drops). I was quite relieved, but who knows what they will be when I return for my next appointment in 4 months.

I've been on Tamoxifen for 2 months and my eyes are very dry now. The optometrist told me to use Soothe XP drops during the day and Systane gel at night. They have helped a little but she is probably going to put plugs in my tear ducts to help.

My eyes have always had issues and I had experienced dry eyes for years (long before cancer and AIs) but didn't recognize it. My new optometrist emphasized fish oil (I, too, use Nordic Naturals) and insisted on Crystal eye drops twice a day, plus another, lens-compatible, during the day. I've also cut back on wearing my lenses from 16-18 hours to 10-12. All of these steps have made a remarkable difference. I definitely feel the difference and she says my corneas are in the best shape she's seen them in 5 years. This is in spite of other eye medications, way too much computer work, etc.

(She also stresses the benefit of consuming lots of dark, leafy green vegetables.)

A lot of these situations creep up on us gradually and may be accentuated by AIs but I'm not sure we can blame letrozole entirely for the issues; some of it's just what was going to happen over time anyway. And some of it may be lingering effects from chemo.

Unfortunately, there is way too little research into the effects of AIs or tamoxifen on the eye. Some, but not nearly enough.