Ointment with or without Vitamin A

[HempOil]

I use ointment at bedtime due to lagophthalmos. The one I have always used contains vitamin A. However, I just found the following passage in the TFOS DEWS II - Iatrogenic Dry Eye report:

"Normal vitamin A is needed for corneal epithelial differentiation, increasing corneal wound healing and strength and reducing corneal and conjunctival epithelial keratinization [38]. However, excess retinoic acid (RA), used in the treatment of severe acne, cancer chemotherapy and anti-aging can cause dry eye and blepharitis; as isotretinoin is secreted in tears by the lacrimal gland, and is attributed to inducing atrophy of the meibomian glands, it can lead to changes in lipid secretion, tear osmolality and tear film stability."

Hence, I was wondering if we should avoid ointments that contain vitamin A?

[dryboy]

Actually, when they say that "isotretinoin is secreted in tears by the lacrimal gland, and is attributed to inducing atrophy of the meibomian glands", they are probably referring to the acne medication (Isotretinoin or Roaccutane), which in fact has a big dose of an derivate of Vitamin A and as a side effect the possible atrophy of the glands and consequently the dry eye.

As they themselves point out, vitamin A in NORMAL levels is "needed for corneal epithelial differentiation (...)". That is beneficial and desirable as long as there is no overdose.