Fish oil has purported benefits for numerous conditions, including cardiovascular disease, cancer, Alzheimer’s, dementia and rheumatoid arthritis, while its efficacy in dry eye disease (DED) remains a point of debate. The 2018 DREAM study found no evidence of an effect. However, a new study looking into the impact of omega-3 fatty acid supplements on the eye found a moderate daily dose may be an effective therapeutic approach for meibomian gland dysfunction (MGD).

The investigation reviewed the results of six clinical trials that cumulatively enrolled 350 participants. Optometrist and lead investigator Mashael Al-Namaeh, MS, PhD, OD, FAAO, suffers from dry eye, which she says was the impetus behind her decision to write this systemic review.

One study she considered showed statistically significant improvements in tear osmolarity, omega-3 index levels, invasive sodium fluorescein tear breakup time (NaFl-TBUT), MMP-9 levels and Ocular Surface Disease Index scores in subjects taking fish oil supplements.

Another investigation reported omega-3s taken in a moderate daily dosage for three months led to lower tear osmolarity and improved tear stability in individuals with DED. This trial also noted a significant improvement in invasive NaFl-TBUT but no change in non-invasive TBUT between those taking fish oil and controls.

An additional clinical trial suggested omega-3 fatty acids considerably enhanced contrast sensitivity and improved tear film stability in patients with moderate MGD but did not have an impact on aqueous tear production.

Still, another trial reported a combination treatment regimen of lipid emulsion eye drops, eyelid-cleansing wipes and omega-3s was effective in improving MGD and dry eye symptoms.

In her study, Dr. Al-Namaeh suggests future investigations consider non-invasive or other less variable measures for TBUT. Non-invasive TBUT is more precise compared with invasive NaFl-TBUT, which may signify the value of non-invasive TBUT in the clinic, Dr. Al-Namaeh explains.

Al-Namaeh M. A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction. Ther Adv Ophthalmol. 2020;12:2515841420952188.