Vitamins and Supplementation in Dry Eye Disease: Current Evidence and Clinical Implications according to the TFOS Lifestyle Report: Nutrition: Vitaminas y suplementación en la enfermedad del ojo seco: evidencia actual e implicaciones clínicas según el informe TFOS Lifestyle: Nutrición.

Dry eye disease (DED) is a chronic, multifactorial inflammatory disorder characterized by tear film instability, epithelial damage, and neurosensory abnormalities that compromise ocular surface (OS) homeostasis. Oxidative stress, immune dysregulation and metabolic imbalance contribute to epithelial damage and inflammation. Emerging evidence highlights nutrition as a modifiable adjunctive factor in DED management. This review examines the biological rationale and clinical evidence supporting the role of vitamins A, B12, C, D, and E, as well as polyunsaturated fatty acids, in OS health. Mainly, vitamin A maintains epithelial differentiation and mucin expression; vitamin B12 supports corneal nerve integrity; vitamins C and E mitigate oxidative stress; vitamin D and omega-3 fatty acids modulate inflammatory pathways. Although supplementation may benefit selected patients, clinical findings remain heterogeneous. Nutritional strategies should therefore be considered complementary, rather than primary, interventions in comprehensive DED management.