Omega- 3 supplements have definitely been getting a lot of attention within the past few years. Many primary care physicians and cardiovascular specialists have been recommending high dose omega-3’s to help improve risk factors for cardiovascular disease as well as help in patients’ general health.
Omega-3’s found in supplements as well as food have been proven to cause a reduction of triglyceride levels, blood pressure and blood clots. They have also been shown to combat inflammation, a critical component of dry eye. However, other research has found that they may not even be effective at all.
Here’s what we know so far about omega-3’s and their relevance in dry eye treatment and management.
Omega-3 use in dry eye treatment and management began in the early 2000’s when researchers found that people who eat tuna regularly had lower dry eye symptoms. Since then, many researchers and clinicians in practice have concluded that omega-3’s within diet as well as supplementation do improve signs of dry eye. It is a very accessible treatment protocol that ensures good patient compliance.
Enter the DREAM study. This study was randomized, controlled and double-blind. Participants of the study were patients of optometry and ophthalmology practices that had signs and symptoms of dry eye. These were dry eye patients, just like yours! They were given 3000mg of omega-3 fatty acids derived from fish. After twelve months, the researchers found no significant improvement signs and symptoms of dry eye compared to the placebo (olive oil).
This result has been open to interpretation. This didn’t necessarily mean that the omega-3’s derived from fish oil were not effective, however, they were just as effective in comparison to the olive oil arm. Therefore, the study showed that both olive oil and omega-3’s can improve dry eye symptoms!
It’s also important to note that the omega-3 fish oil used in the study was derived from n-3 eicosapentaenoic and docosahexaenoic acids and not gamma-linolenic acid (GLA). GLA has been the star of a few studies of it’s own. In fact, GLA is an omega-6 fatty acid, which is usually pro-inflammatory. Studies have shown that patients who are given GLA see significant improvements in their dry eye symptoms, but only if it is taken in conjunction with EPA and DHA, which are found in (you guessed it), omega-3 fish oil.
Omega-3’s aren’t going anywhere. As more and more insurance companies cover omega-3 supplements on their drug formularies, it is important to educate patients on which one actually will have a positive effect on their dry eye. If patients are taking an unknown or unspecified brand of omega-3’s, stop and take the time to make a recommendation.
Do your research and find a formulation that you like for dry eye treatment and management and have them talk to their doctor about switching brands. It may also be helpful to have handouts with information about the different anti-inflammatory components required when treating dry eyes with omega-3 supplementation.
Perhaps your extensive knowledge of the topic can bring you closer to a new referral source!
-Dr. Amadian
