By Michael Lange OD, CNS

After more than three decades in practice, I’ve learned that Dry Eye Disease (DED) and Meibomian Gland Dysfunction (MGD) are not just local ocular surface disorders—they’re systemic, nutritionally responsive conditions.

At the Lange Eye Institute, we’ve developed an integrative model that merges advanced technology—Lumenis OptiLight IPL and OptiLift DMS + RF—with targeted, evidence-based nutrition from Fortifeye® Vitamins.

This “inside-out” approach reduces inflammation, improves mitochondrial efficiency, restores meibomian gland output, and rebuilds the tear film naturally and sustainably.

1. The Lange Philosophy: Treat the Whole Patient, Not Just the Eye

The ocular surface mirrors systemic inflammation. Poor diet, oxidative stress, and metabolic imbalance all degrade tear quality and glandular function.

That’s why every plan begins with nutrition and lifestyle.

The Lange Survival Diet

• Eliminate seed oils, refined carbohydrates, and processed foods.
• Focus on wild-caught fish, grass-fed meats, and organic produce.
• Maintain hydration with mineral-balanced water.
• Eliminate anti nutrients like: oxalates, lectins, phytic acid, fodmaps, and gluten

This baseline lowers systemic inflammation and primes the body for ocular recovery.

2. Omega-3 and GLA Synergy: The Cornerstone of Fortifeye® Dry Eye Nutrition

Our studies at the Lange Eye Institute demonstrate that combining Fortifeye® Super Omega-3 or Super Omega-3 Max with Fortifeye® Black Currant Oil (GLA) is foundational for restoring meibomian gland and tear-film function.

The Ideal Ratio

• 140 mg of GLA to ≥ 1,400 mg of rTG omega-3 (EPA + DHA) is the minimum effective ratio.
• Higher ratios (1,600–2,400 mg omega-3 to 140 mg GLA) produce greater anti-inflammatory effects in the eye and glands getting faster and better results.

Omega Index Optimization

At the Lange Eye Institute:

• Omega index study at Lange Eye Institute close to 100 % of patients ≤ 220 lbs reached an omega index of 8–9 % on Fortifeye® Super Omega-3 (1,600 mg EPA + DHA/day).
• Patients > 220 lbs required Fortifeye® Super Omega-3 Max (2,400 mg/day) for the same range.

Achieving an omega index of 8–9 % correlates with marked improvement in tear stability, gland expressibility, and ocular comfort. Using a high quality rTG omega 3 fish oil at these levels is crucial when dealing with meibomian gland dysfunction

3. Carotenoid Science: Lutein, Zeaxanthin, and Astaxanthin for Ocular Surface and Brain Health

Lutein and Zeaxanthin Isomers

Beyond their well-known macular roles, these carotenoids enhance tear-film stability and meibomian gland integrity.

Evidence shows:

• Six months of lutein/zeaxanthin supplementation improved Schirmer’s and TBUT scores in high-screen users.
• Animal and clinical work demonstrated reduced ocular surface inflammation and better lipid-layer function.
• Multi-nutrient complexes combining lutein, zeaxanthin, curcumin, and vitamin D3 improved tear stability and reduced corneal staining.

Fortifeye® Formulas Featuring These Nutrients

• Fortifeye® Focus — 10 mg lutein, 2 mg zeaxanthin, 6 mg astaxanthin.
• Fortifeye® Focus & Brain — identical formula plus Cognizin® Citicoline for neuro-visual support.
• Fortifeye® Next Gen Macular Defense and Zinc-Free Macular Defense — full spectrum lutein, zeaxanthin, meso-zeaxanthin, saffron, ALCAR, astaxanthin, bilberry, pine bark extract, grape seed extract, resveratrol, CoQ10, alpha-lipoic acid, taurine, zinc and vitamins B, E, C and D3 . No beta carotene.
• Fortifeye Next Gen Curcumin- 500mg of Curcugen (food grade oleo resin curcumin)

These carotenoids and nutrients filter high-energy blue light, stabilize cell membranes, lower inflammation and support tear-film lipid integrity.

Astaxanthin — The Master Antioxidant

Astaxanthin is a potent fat-soluble antioxidant that protects the lipid layer of the tear film and reduces inflammatory cytokines such as TNF-α and IL-1β.

Clinical data:

• 6 mg/day for 8 weeks improved dryness, redness, and irritation.
• 12 mg/day for 30 days improved meibum quality and gland function.

Fortifeye® Focus and Fortifeye® Focus & Brain supply clinically validated astaxanthin for ocular surface and retinal protection.

4. Vitamin D, Performance, and Tissue/Barrier Support — The Complete Nutritional Core

For a broad foundation, Fortifeye® Complete and Fortifeye® Macular Defense deliver:

• Lutein, zeaxanthin, meso-zeaxanthin
• CoQ10, alpha-lipoic acid, resveratrol, taurine
• Methylated B-complex, zinc, selenium, vitamins C ,E and D3
• Saffron, astaxanthin, grape sed extract, pine bark extract, bilberry

These serve as the core nutritional base for ocular and systemic health.

Fortifeye® Rejuvenate

A skin and ocular-adnexa tissue-support formula that enhances hydration, elasticity, and barrier function—ideal for patients undergoing OptiLift DMS + RF or skin/eyelid rejuvenation.

Key ingredients:

• Morikol® marine collagen tripeptides
• Hyaluronic acid
• Rice ceramides
• Dermaval® phytonutrient blend
• PureWay-C® liposomal vitamin C
• Biotin
• Multivitamin support matrix

Rejuvenate pairs synergistically with omega-3 therapy for skin and lid tissue resilience.

Fortifeye® Fit Pro

A performance and recovery formula that supports muscle, metabolism, and ocular rehabilitation through cellular energy optimization.

Key ingredients:

• Creapure® creatine monohydrate
• myHMB® (β-hydroxy-β-methylbutyrate)
• Betaine anhydrous
• Vitamin D3
• L-citrulline
• Peak ATP®
• Grass-fed collagen protein
• Grass-fed whey protein

Fit Pro is an ideal partner to Super Omega-3 and Black Currant Oil to achieve the 8–9 % omega-index and promote whole-body recovery.

5. Gut–Eye Axis: Microbiome and Systemic Inflammation

Balanced gut flora reduces systemic cytokines that drive ocular surface inflammation.

Fortifeye® Probiotics and Fortifeye® Organic Blue-Green Superfood help restore microbial balance, enhance immune resilience, and lower oxidative stress to support tear film homeostasis. Consumption of fermented food three times per week and try to follow the Lange Survival Diet will speed up positive results.

6. Comprehensive Blepharitis and Demodex Management

At the Lange Eye Institute, blepharitis is addressed from both the inside and outside.

1. Tea Tree Oil Lid Hygiene: Removes biofilm and Demodex mites.

2. Lumenis OptiLight IPL: Treats vascular inflammation and eradicates Demodex while improving meibomian gland output.

3. Xdemvy™ (lotilaner 0.25 %) FDA-approved topical therapy for Demodex blepharitis.

Nutritional Synergy

Patients on Fortifeye® Super Omega-3, Black Currant Oil (GLA), Focus, and Rejuvenate demonstrate faster lid healing, better meibum quality, and more stable tear films—confirming that systemic nutrition amplifies local therapy.

7. Advanced Technology Integration: OptiLight IPL and OptiLift DMS + RF

Our Dry Eye Center of Excellence pairs OptiLight IPL for vascular/inflammatory control with OptiLift DMS + RF (Deep Muscle Stimulation + Radiofrequency) for eyelid rejuvenation and collagen remodeling.

When combined with Fortifeye® nutrition, patients experience superior blink dynamics, meibomian gland flow, and tear film stability with visible periocular rejuvenation.

8. Implementation Protocol

1. Assess: Omega index, diet, vitamin D status, tear film, meibography.
2. Prescribe:
   • Fortifeye® Super Omega-3 / Super Omega-3 Max
   • Fortifeye® Black Currant Oil (GLA 140 mg)
   • Fortifeye® Focus or Focus & Brain
   • Fortifeye® Complete, Rejuvenate, or Fit Pro
   • Fortifeye® Probiotics and Superfood
3. Combine: OptiLight IPL, OptiLift DMS + RF, Xdemvy™, and tea tree oil lid hygiene.
4. Monitor: Omega index (8–9 %), TBUT, osmolarity, OSDI scores, and gland expression.

9. Dr. Lange’s Closing Philosophy

“Dry eye and meibomian gland dysfunction are inflammatory diseases of modern living.

When we combine advanced technology with precise, science-based nutrition, we treat the root cause — not just the symptom.

Fortifeye® Vitamins deliver the Right Ingredients, Right Science, and Right Results for our patients.”

— Dr. Michael P. Lange, O.D., CNS

Founder, Lange Eye Institute & Fortifeye® Vitamins

Conclusion

The combination of precision nutrition, light-based therapy, and targeted lid management offers a true paradigm shift in treating dry eye and MGD.

By optimizing the omega index, using carotenoid and collagen-based nutrients, and integrating OptiLight and OptiLift technologies, we can restore tear-film homeostasis and ocular comfort naturally.

Fortifeye® Vitamins — Right Ingredients. Right Science. Right for You.

learn more about Fortifeye Vitamins here www.fortifeye.com