Nutrition for Dry eye: What do you really know about Omegas?

January 18, 2019

It was previously thought that the so-called "Omega Fatty Acids" (or "fish oils") could be used to treat DED, as well as prevent the progression of the disease. Is it true?

And do all types of Omega Fatty Acids have the same effect ?

Here are some facts you might not know about Omegas.

Not all types of Omegas provide DED patients with benefits

Two well-known Omega types are Omega-3 and Omega-6. Omega-3, a combination of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and other elements, are proven to have some beneficial impacts in DED.^1-5 In contrast, there is insufficient evidence regarding Omega-6 as being beneficial for DED.⁶

References

Oral omega-3 fatty acid treatment for dry eye in contact lens wearers. Cornea. 2015 Apr;34(4):413-20. doi: 10.1097/ICO.0000000000000386. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=25719253
Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr. 2005 Oct;82(4):887-93. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=16210721
Pilot, prospective, randomized, double-masked, placebo-controlled clinical trial of an omega-3 supplement for dry eye. Cornea. 2011 Mar;30(3):308-14. doi: 10.1097/ICO.0b013e3181f22e03. Link https://www.ncbi.nlm.nih.gov/pubmed?term=21045648
Short-term consumption of oral omega-3 and dry eye syndrome. Ophthalmology. 2013 Nov;120(11):2191-6. doi: 10.1016/j.ophtha.2013.04.006. Epub 2013 May 1. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=23642375

To what extent does Omega-3 help your dry eyes?

Omega-3 could improve the activity of meibomian glands, which produce the outer oily layer in your eyes’ tear film.^1,2 In this way, it could help to protect your tears from excessive evaporation. Omega-3 might benefit in slightly relieving such symptoms of DED like irritation or itchy feeling.^3-7
This, however, is just a supplementation option and cannot replace proper dry-eye treatment as initiated by an ophthalmologist.

“Fish oil” is not always a good option in DED

It is commonly misunderstood that “fish oil” and Omega-3 supplements are the same. In fact, many “fish oil” products contain just a small amount of EPA and DHA.^8-14
Before using Omega-3 supplements for managing your DED, consult your doctor on their utility and remember to choose only certified products instead of “fish oil” products from unknown sources.

References

Marian S. Macsai. The Role of Omega-3 Dietary Supplementation in Blepharitis and Meibomian Gland Dysfunction (An AOS Thesis). Trans Am Ophthalmol Soc. 2008 Dec; 106: 336–356. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646454/
J. Qiao, X. Yan. Emerging treatment options for meibomian gland dysfunction. Clin Ophthalmol. 2013;7:1797-803. doi: 10.2147/OPTH.S33182. Epub 2013 Sep 9. https://www.ncbi.nlm.nih.gov/pubmed/24043929
Bhargava R, et al. A randomized controlled trial of omega-3 fatty acids in dry eye syndrome. Int J Ophthalmol. 2013 Dec 18;6(6):811-6. doi: 10.3980/j.issn.2222-3959.2013.06.13. eCollection 2013. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=24392330
Bhargava R, Kumar P. Oral omega-3 fatty acid treatment for dry eye in contact lens wearers. Cornea. 2015 Apr;34(4):413-20. doi: 10.1097/ICO.0000000000000386. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=25719253
Miljanović B, et al. Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr. 2005 Oct;82(4):887-93. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=16210721
Wojtowicz JC, et al. Pilot, prospective, randomized, double-masked, placebo-controlled clinical trial of an omega-3 supplement for dry eye. Cornea. 2011 Mar;30(3):308-14. doi: 10.1097/ICO.0b013e3181f22e03. Link https://www.ncbi.nlm.nih.gov/pubmed?term=21045648
Kangari H, et al. Short-term consumption of oral omega-3 and dry eye syndrome. Ophthalmology. 2013 Nov;120(11):2191-6. doi: 10.1016/j.ophtha.2013.04.006. Epub 2013 May 1. Link: https://www.ncbi.nlm.nih.gov/pubmed?term=23642375
Hilleman D, Smer A. Prescription omega-3 fatty acid products and dietary supplements are not interchangeable. Manag Care. 2016;25(1):46-52. https://www.ncbi.nlm.nih.gov/pubmed/26882630
Questions and answers on dietary supplements. FDA website. Web Updated January 13, 2016. https://www.fda.gov/food/information-consumers-using-dietary-supplements/questions-and-answers-dietary-supplements
Davidson MH. Omega-3 fatty acids: new insights into the pharmacology and biology of docosahexaenoic acid, docosapentaenoic acid, and eicosapentaenoic acid. Curr Opin Lipidol. 2013;24(6):467-474. doi: 10.1097/MOL.0000000000000019. https://www.ncbi.nlm.nih.gov/pubmed/24184945
Zargar A, Ito MK. Long chain omega-3 dietary supplements: a review of the National Library of Medicine Herbal Supplement Database. Metab Syndr Relat Disord. 2011;9(4):255-271. doi: 10.1089/met.2011.0004. https://www.ncbi.nlm.nih.gov/pubmed/21787228
Suvarna P. Phadatare, et al. A Comprehensive Review on Dry Eye Disease: Diagnosis, Medical Management, Recent Developments, and Future Challenges. Advances in Pharmaceutics. http://dx.doi.org/10.1155/2015/704946
Omega-3 Fatty Acids. NIH Office of Dietary Supplemen:ts. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ Updated: July 9, 2019. Last accessed: August 25, 2019.
Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000;71:179S-88S. https://www.ncbi.nlm.nih.gov/pubmed/10617969

Finally, it should be kept in mind that when you are suffering from DED, try to get medical advice from ophthalmologists as soon as possible.

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