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Examining the essential role of the lymphatic system, at your disposal

Optometry Times JournalDecember digital edition 2021
Volume 13
Issue 12

Eye holds the key to identifying lymphatic disorders; healthy lifestyle choices make a difference.

Examining the essential role of the lymphatic system, at your disposal
Stuart Richer

When was the last time your physician ordered a lymph test? There are blood tests for lymphocytes, the immune cells of the lymphatic system, but no test to evaluate the integrity of the major disposal pathway of your body.

None of us want to drown in our own waste products—or have chronically bloated extremities—so let’s explore a few basic principles, as the lymph system is part of both the circulatory and immune system.

Lymph is analogous to blood. It has an elaborate weave of superficial and deep plexus vessels across tissues and organs, including the eyes, with 4 major lymph node drainage points: the 2 groin areas and 2 armpits.

Previously by Dr. Richer: How to build a lifestyle and nutritional firewall against viruses like COVID-19

The tonsils, thymus, and spleen are the immune cell factories of the lymphatic system, along with the gastrointestinal lymphatic tissue (GALT).

The latter constitutes 80% of our immune system. Roughly 17 liters of filtered plasma are reabsorbed directly into blood vessels each day, while the remaining 3 liters are left in the interstitial fluid.1

Yes, the lymph system is essential.

Lymph is 95% water (derived from blood plasma) and is also called interstitial fluid. Unlike the blood, this clear to white lymph moves in 1 direction only: outward.

Without a pump, the liquid trash is dependent on healthy habits to move it out of our bodies.

These habits include deep muscular diaphragmatic breathing and physical movement. Here again, we see that the shallow breathing and sedentary lifestyle—all too common in Americans—are is dangerous.

Lymph blockage might also result from microbial (bacterial and viral) infection, parasitic infection, cellulitis, removal of a lymph node, surgery, postradiation treatment, or blockage by a tumor.

Related: Ocular nutrition: Dr. Neda Gioia's whole-body approach to eye care

There are a range of associated signs and symptoms of poor lymph disposal that could include accumulation of cellulite, constipation, mucous and phlegm production, bloating of the stomach or extremities, stiff joints, excessive sweating, eczema, brain fog, chronic headaches, and sluggishness.

An obvious, severe obstruction, such as lymphedema, requires medical intervention.2

Hippocrates’ “white blood cells,” and less than severe obstruction, are underrated by modern medicine. We now know that the lymph system serves 3 major purposes:

1. Detoxifying old immune cells, cellular growth bioproducts, microbes, heavy metals, mold, and other pollutants

2. Returning excess protein back to the circulation

3. Absorbing lipids and fat-soluble vitamins (A, D, E, and K) to redirect them back into our blood stream1

Ocular manifestations

Broad spectrum lymphatic disorders have also been identified in the eye, whether focal or from ocular manifestations of systemic disease.

Unlike most tissues in the body, which are typically endowed with lymphatic vessels, ocular tissues are by nature heterogeneous.

Related: Nutrition in the future of primary-care optometry

Although the conjunctiva is rich in lymphatics, the cornea and the retina are devoid of them.3

Many optometrists see common signs and symptoms of lymphatic obstruction in themselves or their patients, such as puffy eyelids or enlarged conjunctival lymphatic cysts on slit lamp examination.

We also see the more serious conditions of myxedema of the extraocular muscles in thyroid eye disease and even ocular lymphoma. Regardless, stagnation from the buildup of toxins and waste products breeds sickness.

From a broader perspective, the cornea provides an ideal tissue for lymphatic immunologic studies due to its accessible location, transparent nature, and lymphatic-free and -inducible characteristics.3

Related: How to incorporate nutrition into dry eye practice

Healthy lifstyle choices

Whatever one’s interest in the lymphatic system, gym-less stretching and walking are great ways to move lymph, as is spending 10 minutes on a home trampoline or vibrational machine.

Lemon juice and lemon rind–infused water is a great early morning lymph detoxifier and alkalizer.

The dietary approach also consists of anti- inflammatory foods such as leafy greens, healthy fats, and omega-3 from salmon, herring, and sardines—the very same foods that are helpful in preventing age-related macular degeneration (AMD).

Foods that are high in fiber and low in sugar and those with medium-chain triglycerides (eg, coconut, and several herbs) also join the list.

Additionally, dry brushing after a shower, avoiding tight clothing, and receiving periodic professional lymphatic massages by a licensed practitioner will help you and your patients “go with the flow.”

See more nutrition content



1. Lymphatic system. Wikipedia. Updated November 13, 2021. Accessed November 15, 2021. https://en.wikipedia.org/wiki/Lymphatic_system

2. Lymphatic obstruction. MedLinePlus. Accessed November 15, 2021. https://medlineplus.gov/ency/article/001117.htm

3. Chen L. Ocular lymphatics: state-of-the-art review. Lymphology. 2009;42(2):66-76.

4. Vallet M. Go with the flow: manual lymphatic drainage. American Massage Therapy Association. August 16, 2016. Accessed November 15, 2021. https://www.amtamassage.org/publications/massage-therapy-journal/manual-lymphatic-drainage/

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