By: Vanessa Caceres
October 2012

Looking at science and clinical experience

Omega-3 fatty acids seem like a cure-all for just about anything that ails patients nowadays. They're hailed for promoting better heart health, reducing inflammation, providing more lustrous hair and skin, and even promoting better mood. The question is, how beneficial are omega-3s for dry eye patients? "We're in the infancy stages of understanding what this is and what it does for dry eye," said Robert Latkany, M.D., founder and director, Dry Eye Clinic, New York Eye and Ear Infirmary, New York.

Right now, ophthalmologists are using the fledgling research that is available along with their clinical experience to decide whether or not they will recommend omega-3 supplementation to dry eye patients.

The research

Some recent research has tried to pin down the specific effects of omega-3 supplementation on dry eye. In a pilot, double-masked study published in March 2011 in Cornea, investigators gave patients various doses of fish oil and flaxseed oil (TheraTears Nutrition, Advanced Vision Research, Woburn, Mass.) for 3 months. Investigators measured patients' subjective symptoms and tested for tear breakup time and corneal staining as well as performing other tests.

Of the 36 patients included, 70% of the patients receiving treatment became asymptomatic. In the placebo group, 37% of the symptomatic patients became asymptomatic. Schirmer's testing and fluorophotometry seemed to indicate that omega-3 use increased tear secretion, according to investigators. Although those results are promising, they only begin to reveal how omega-3 might help dry eye and which patients would benefit the most, Dr. Latkany said.

A study presented at the 2012 Association for Research in Vision and Ophthalmology (ARVO) meeting in Ft. Lauderdale, Fla., and sponsored by ScienceBased Health (Houston) focused on omega-3 and gamma-linolenic acid (GLA) therapy (HydroEye) taken for 6 months by 38 postmenopausal women who had keratoconjunctivitis sicca. The double-blind, placebo-controlled, prospective, randomized, multi- center trial found that patient self-reported symptoms by OSDI (Ocular Surface Disease Index) as well as conjucnctival impression cytology CD11c and HLA-DR inflammation biomarkers statistically significantly improved after the study duration, said lead investigator John D. Sheppard, M.D., professor of ophthalmology, microbiology, and immunology, Eastern Virginia Medical School, Norfolk, Va. The study did not seem to detect differences in corneal staining or tear breakup time, but topographic corneal surface regularity stabilized significantly with the study supplementation compared to placebo. At the 2012 ASCRS•ASOA Symposium & Congress, Frank A. Bucci Jr., M.D., founder, Bucci Laser Vision, Wilkes-Barre, Pa., presented the results from a study sponsored by Physician Recommended Nutriceuticals (PRN, Plymouth Meeting, Pa.), which makes PRN Dry Eye Omega Benefits. The multicenter, blinded, randomized study randomized 60 patients to receive the PRN product, a Nature Made omega-3 product (Pharmavite, Northridge, Calif.), or TheraTears Nutrition. Investigators measured red blood cell membrane saturation of the omega-3 products at baseline, 1 and 3 months follow-up. Investigators found that red blood cell saturation was significantly greater for the PRN product compared with the other two products.