The People's Perspective on Medicine

Is Fish Oil Really Useless for Dry Eyes?

Research suggests that fish oil may be useless for dry eyes, but some readers have gotten significant relief by taking high-dose fish oil supplements.

Fish oil has a reputation for helping ease the symptoms of dry eye, but a recent study found it was no more helpful than the olive oil placebo the scientists used. (Both groups–those taking fish oil and those taking olive oil–reported that their symptoms of dry eye improved.) Is fish oil truly useless for dry eyes? Some readers don’t think so.

Readers Don’t All Find Fish Oil Useless for Dry Eyes:

Q. My ophthalmologist recommended fish oil capsules, but I noticed no benefit from a 2400 mg daily dose. However, a second ophthalmologist said that my eyes would be the last organ to receive the oil. She suggested I try increasing the dose if I could tolerate it.

I gradually went up to three 2400 mg capsules. I have now gone from using eyedrops about 20 times a day to 5 or 6 times a day. As a retired statistician, I can assure you that is a statistically significant difference!

A. A study published in The New England Journal of Medicine (April 13, 2018) found that 3000 mg of fish oil was no better than placebo for alleviating dry eye symptoms. That said, your experience sounds compelling. And we wouldn’t doubt you on the statistics, though it is an experiment with an N of 1.

Readers Share Their Stories:

Many other readers also believe fish oil helps their dry eyes.

One wrote:

“Fish oil most definitely helps my dry eye problem. As soon as I started taking 2000 mg a day, I could tell a difference. If I go off it, my eyes are dry within a couple days. The brand matters.”

Gayle in Maryland reported:

“I have Sjogren’s [an autoimmune condition that causes extremely dry eyes] 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 it 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.”

Thea in Wilmington, NC, shared her experience:

“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!?”

On the other hand, Larry in Raleigh, NC, got no benefit:

“Useless for dry eyes. 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.”

The meibomian glands that Larry mentioned are the critical players in a high-tech approach to treating symptoms of dry eyes.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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The placebo study, NCT02128763: They did not use a placebo. They used an alternate treatment and found that both fish oil and olive oil were effective — but not for everyone.

The first reader who wrote that “brand matters,” can he/she tell me what that brand is?

My eye doctor suggested I take fish oil pills to help keep the tiny glands in my eyes from clogging up. Because of two different clogs, one in each eye the size of a green pea, I started with 2,000 mg. of fish oil daily. One clog had to be surgically lanced it was so large, as I could feel it against my eyelid rubbing my eye.

In about six months, he said since it was doing the job to cut back to 1,000mg daily. I put a hot cloth on my eyelids in the morning to get the glands awakened. I take the burpless fish oil pill and it has been 3 years since I have had any problems. Plus the fish oil is good for your body in other ways too.

I also was instructed to take fish oil for my dry eyes. The only thing I noticed was severe bruising. I couldn’t lightly scratch an arm or leg without leaving long red stripes that lasted for weeks.
I was told that inferior brands would do this, but I used a very good & expensive one.
No fish oil for me.

Jann Olsen
Liberty Lake, Wa

I’ve read this article before, and after reading it again, it makes no sense. In the first paragraph, it says a trial suggests fish oil doesn’t help dry eyes. But in the next paragraph, it says people in the study reported improvement with fish oil and olive oil. That tells me both oils actually HELP dry eyes.

After cataract surgery I tried everything for my dry eyes. Prescription eye drops and any of the OTC eye drops did not help. I do take 2000 mg. of flax seed oil but the only thing that gave me real relief was a warm compression eye mask.

My eye doctor recommended flaxseed oil. I take a 500 mg capsule each night and it’s worked wonders. My eye problems cleared up immediately.

I’ve been taking 2000 mg. of molecularly distilled fish oil which which did not help my dry-eye problem, however 5000 mcg a day of biotin worked wonders. The fish oil did lower my triglycerides.

I have serious eye conditions and recently had a corneal endothelial layer transplant. I used to take 2000 mg of fish oil daily in a brand from a popular healthy foods store. Still had dry eyes, but recently switched to an excellent brand that only has 1480 mg of omega 3 but has 850 mg EPA and 425 mg of DHA. This brand works extremely well. It is the level of DHA & EPA that makes the difference rather than the total wt of the fish oil. If the brand is not carefully manufactured from quality ingredients, I could see why the researchers would say it doesn’t work.

Eating fish three times a week makes a huge difference in my severely dry eyes . Fish oil capsules are indigestible . .

Fish oil didn’t do much for me. I have used castor oil in the past, just a tiny amount, and it does help. The main thing I did was not use any eye drops that contain the preservative BAK and it is in almost every eye drop on the market, prescription and over the counter. I stopped latanoprost RX drops for my high eye pressure that contain BAK and switched to Travatan Z which happens to contain castor oil as one of the ingredients. No more blurry vision, no dry burning eyes.

It’s not a generic and costs more, a Tier 3 on my drug plan, but worth the extra money.
(BAK benzalkonium chloride) Read the labels !

I have Blepharitis and, thus, very dry eyes. Two things that work for me in combating this chronic situation are hot yoga classes 2-3 times/week, and staying hydrated. The hot yoga classes produce the same result as hot compresses – the opening of the glands. And anytime I am not hydrated my eyes begin to sting and swell.

I use a drop of castor oil on each eyelid before I go to bed.

I do that, too. Seems to help pretty well.

I tried the hot compresses, even scrubbing my eyelash area but no relief. Fish oil really helps, so obviously dry eye syndrome isn’t always caused by the same conditions.

According to my eye doctor, the study is severely flawed since olive oil contains some of the same nutrients as fish oil. Published by the prestigious NE Journal of Medicine??

My eye doctor recommended skipping the fish and instead taking algae oil (Prenatal DHA), much cheaper. She also strongly recommended a long daily warm eye soak, and (not simultaneously) a daily eyelid cleanse with a strong tea tree oil product (Cliradex pads). After a few weeks, there is a noticeable reduction in dry-eye and much less itching and eyelash pulling. A very positive result.

Larry’s post is very interesting. I hate fish oil; have tried krill oil also for the easier digestion. But it didn’t seem to help my dry eye. Hot compresses make sense! Also, I use a q-tip of castor oil like an eye-liner, after my morning shower; that does it for me. I still use eye drops a couple times a day.

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