a young woman putting in eye drops, dry eye disase

Dry eye disease affects roughly 14 percent of American adults. Older women are especially susceptible to this chronic and hard-to-treat condition.

Fish Oil Put to the Test for Dry Eye Disease:

Many health professionals recommend dietary supplements containing omega-3 fatty acids to patients with dry eye disease. That’s because fish oil (the prime source of omega-3 fatty acids) has anti-inflammatory activity. The hope has been that these oral supplements would ease dry eye symptoms. Until now, however, there have not been well-controlled clinical trials to test this hypothesis.

In The New England Journal of Medicine this week, researchers report on the DREAM trial (New England Journal of Medicine, April 13, 2018). DREAM stands for DRy Eye Assessment and Management.

The researchers recruited over 500 patients with moderate to severe dry eye disease and assigned them randomly to receive either an olive oil placebo or 3,000 mg of fish oil. Participants were tested for dry eyes at six and 12 months.

Fish Oil Was No Better Than Placebo:

The results were disappointing. The authors report:

“Among patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of omega-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo.”

It is possible, of course, that the scientists chose a placebo with some anti-inflammatory properties. While olive oil has not been recommended for dry eye disease, it has been show to reduce inflammation (Schwingshackl, Christoph & Hoffmann, Nutrients, Sep. 11, 2015). For the time being, however, it seems that we can’t count on fish oil to help dry eye symptoms.

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  1. Gina

    I have been on extra strength krill oil for several years and suffer with extreme dry eyes due to intra-lasik Surgery in 2003. Am angry that I was not informed that the surgery actually causes dry eyes. Anyway, no luck with krill oil. I am on Restasis twice a day and continued krill oil–still no luck. Read an article about Castor oil and have tried it also, within luck. Feel doomed to have chronic dry eyes the rest of my life.

  2. Bill R

    Is dry-eye disease the same as a medical condition called blepharitis? I have blepharitis and this dry-eye disease sounds like the same thing. Is there a difference?

  3. Gayle

    I have Sjogrens and fish oil worked for me. I was taking it for another reason and after about a month I noticed a great improvement in my dry eye and eye pain where I didn’t need to use liquid tears eye drops as often. If I forget to take or stop for a while, the dry eye issue worsens. My husband recently developed a dry eye problem and it has helped him also. We do take a couple pills a day, not just one.

  4. Cindy

    I have taken fish oil for years. It did not prevent dry eye syndrome. However, flax seed oil truly does. It works for me and several of my friends. I just take one capsule a day. If I miss 2 or 3 days my eyes bother me again.

  5. Stacy

    I’m curious about the specific fish oil preparation that was used in this study. I take 1 capsule daily in the ratio of 410mg EPA/960 DHA (Pro -DHA 1000 Nordic Naturals). When I lapse, I have a flare up of dry eye symptoms.

  6. Blue eyes

    I have been using fish oil capsules at my eye doctors request. 6 a day. Also an eye surgeon I am seeing recommends them. But after having to quit them for surgery, I don’t think my eyes were any worse without them. If anyone has anything that really works please let me know.

  7. po

    I took fish oil supplements to reduce inflammation, and I hoped, too, dry eyes (my eyes were so dry that I woke up on day barely able to open them and convinced I had pebbles in them, or an inflammation. Went to the eye doctor who diagnosed, again, dry eyes and prescribed some eyedrops). The fish oil did not seem to have worked much, even though I rounded it up with flaxeed, olive and coconut oils.

    What I found out however was that my extremely dry eyes was due to the losartan I was taking (50mg), which eased greatly when I started cutting the pills in half without causing my blood pressure to rise.

    I went off losartan for a couple of weeks and as soon as I resumed the 25mg, the dry eye returned. Am off losartan again and the dry eyes abated.

  8. Thea
    Wilmington, NC

    Since I began taking Fish oil supplements a few years ago, I can report I rarely have dry-eye problems that I used to have. In fact, if I’m travelling for a week or so and have forgotten to include fish-oil in my daily vitamins on the road, I’ve noticed it. Perhaps olive oil would work as well – since their placebo-controlled trial found no statistical significance!?

  9. Larry M
    Raleigh, NC

    Useless. A big con. 1000 mg daily did nothing. 3000 mg daily also did nothing but had the side effect of gastric upsets.

    What actually solved the dry-eye problem was really hot compresses, starting at four times daily and working down to morning and evening. The “meibomian” glands in the eyes are like the oil glands that gave us acne fits in our teens. As we age, they cake up with oil that’s turned to a waxy substance. Regular hot compresses soften and release the wax, just as they helped our acne. You can actually feel the glands unclog sometimes.

  10. Anonymous

    In all published studies, I find myself wondering what where all the controls involved in the study. For example, always number one on my list is drinking the recommended amount of water per day strictly followed? If someone were to tell me they didn’t always drink the amount of water per day required, then their participation in the study would be void in my opinion. Are they also prohibited from all caffeine products? If these two keys are not germane to the study, then the study is also worthless in my non-expert opinion even if it is true regarding fish oil in the long run.

  11. mary

    What about hyaluronic acid? Could it be of any help?
    Thank you

  12. Jeff

    Using Krill oil, 1,000mg daily. If I run out, it takes about 3 days for eye symptoms to return. I started taking Krill oil because I thought it might be a good idea, but not for any specific reason. The effect on my dry eyes was a surprise.

  13. Kris

    My doctor put me on restasis which costs a whopping $350+ per month. When I asked if there was a natural remedy, she mentioned fish oil. So for months I used both until I realized that if I missed the restasis, I felt no noticeable difference. So I stopped the restates, and the doctor told me to double the fish oil. I have been using it for years. During allergy season, I use an allergy med on rare occasions. It works for me.

  14. Donna

    I use 4g a day (divided dose, 2g each morning and evening) of oil of evening primrose for dry eyes. My eyes remind me if I skip a dose or if I run out. Lower doses were not as effective

  15. Pauline

    Ok, so the fish oil was no better than the olive oil but what were the results overall
    as far as effectiveness? Was there some improvement in the dry eye symptoms using one or the other or none at all?
    Thank you

  16. Caryn

    Maybe they should look at coconut oil. Not sure why you need a placebo. If dry eyes is an observable condition it should be apparent if it’s relieved or not.

  17. Jan

    It would be interesting if this post had said whether there was any improvement at all after using either oil supplement, against none.

  18. Sally

    Fish oil works for my dry eyes. I know this since if I run out and don’t get a new bottle in a few days my eyes start bothering me.

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