The People's Perspective on Medicine

No Study Support for Fish Oil Soothing Dry Eyes

Although fish oil has a reputation for soothing dry eyes, a recent randomized controlled trial found that placebo capsules of olive oil worked just as well.

Fish oil is one of the best sources of omega-3 fatty acids. These compounds have anti-inflammatory activity, and doctors have hoped that fish oil supplements would prove useful against a wide range of chronic conditions, including heart disease and dementia. Sadly, most studies have failed to provide evidence that fish oil can work these miracles. Controlled trials have shown that fish oil doesn’t prevent heart rhythm abnormalities, postpartum depression, macular degeneration or cognitive decline. Some eye doctors still prescribe it for soothing dry eyes, however. How well does it work?

Is Fish Oil Good for Soothing Dry Eyes?

Q. My husband and I are taking cold-processed salmon oil, two pills a day, not for our hearts but for soothing dry eyes. We have both had cataract surgery and each of our doctors (an optometrist and an ophthalmologist) has recommended fish oil supplements. We also eat fish once or twice a week. Are there any studies on omega-3s and dry eyes?

The DREAM Study:

A. A recent study showed that fish oil supplements were no more effective than placebo for easing dry eye symptoms. The research was published online in The New England Journal of Medicine on April 13, 2018. The study was named the DRy Eye Assessment And Management trial (DREAM), but it was not a dream come true.

The scientists assigned more than 500 people with dry eye disease either 3,000 mg fish oil or olive oil as a look-alike placebo. Their eyes were assessed before the study started and after six months and a year. There was no difference between the groups on a number of objective measures of dry eye disease. Both groups improved significantly. As a result, it is impossible to conclude that fish oil was helpful in soothing dry eyes.

Soothing Dry Eyes:

If you are happy with the results you are getting taking fish oil on your doctors’ recommendations, we don’t see a good reason to change. But eye doctors may be less enthusiastic about this approach after they have read this report.

One very important–and inexpensive–tactic for soothing dry eyes is to blink frequently, especially when reading from a computer screen. People looking at a screen tend not to blink as often as they do when looking elsewhere.

Another simple approach to soothing dry eyes is to use a warm compress. Some people find this inexpensive tactic very helpful.

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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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This is not as simple as it seems. “Dry eye” can have various causes. From increased age, medications, or disease such as Sjogren’s or Rheumatoid arthritis. Or a combination of the above. Thats why some of these solutions work for some but not all people. If dry eye is somewhat severe, then a combination of things can be helpful.

Lifestyle changes such as keeping TV and computer lower than your eyes, improved humidity and avoiding air vents can be very helpful. There are many more things as well. Quality supplemental oils such as fish oil and flax seed are helpful to many. Warm eyelid compresses (bruder mask) and the proper eye lubrication with the correct type of eye drops are important. There are more things that can help which means you should research and consult a good optometrist or ophthalmologist but keep in mind that many are not knowledgeable about dry eye.

Look up dry eye solutions and at the Sjogrens.org website you can use some of their ideas even if you do not have Sjogrens (an autoimmune disease that can cause dry eye). Finally, if you use eye drops more than 4 times a day, go preservative free. Those drops that say the preservatives disappear on your eye when applied may in fact be causing eye irritation. So be aware that different people react differently to different formulations, etc because we are not all the same and the cause of dry eye is not all the same.

About 15 years ago I was told by an ophthalmologist to take flaxseed oil capsules for my severe dry eye condition. It did not take long to work. I noticed that when I had to stop taking it for about a week prior to some surgery that my eyes were notably worse, then got better when I returned to my regimen. I have continued to take 1200 mg twice per day.

Since both fish oil and the placebo, olive oil, improved dry eyes significantly, aren’t both helpful?

It seems so.

I have found that discomfort from dry eyes is directly related to the amount of water I drink during the day. A minimum of 3-4 full glasses eases this condition. Eye drops seem to do little to help.

Fish oil most definitely helps my dry eye problem. From the first week 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. It does matter the brand.

My opthalmologist also recommended fish oil capsules and I found no benefit from a 2400 mg daily dose. However, a second opthalmologist said that my eyes would be the last organ to receive the oil and I should try increasing the dose if I could tolerate it. I gradually went up to 3 2400 mg capsules and I have gone from using eyedrops about 20 times a day to 5-6 times a day. As a retired statistician I can assure you that is a statistically significant difference!

I have been taking fish oil for years. I never considered it to treat my dry eyes. Apparently it didn’t!

I went to a health food store and purchased castor oil(hexane-free). I rub it on my eyelids morning and evening. No more dry eyes. My eye doctor told me about Refresh P.M. I put just a little in my eyes before going to bed.

I hope this helps.

When I developed dry eye, a rhuemetologist I saw told me to use flaxseed oil capsules, one 1,000mg capsule per day. I’ve found this really helpful. I can tell the difference if I run out of the flaxseed oil and don’t replace right away. I also use warm compresses which also help.

Warm compresses and fish oil are my lifesavers for lasik induced dry eyes. I have stopped and started fish oil enough times to know that it makes a huge difference.

For dry eyes, I started taking Lutein with Zexanthin and it has stopped the dry eyes almost immediately.

Have been taking 5 gram fish oil since 2006 to replace the statins. were killing me.
The fish oil has done NOTHING for my dry eyes.
I take Gell eye drops and even that doesn’t work.

I get “bullets” in my tearduckts.

Hmm. Let’s see… The patient has dry eyes (because the Meibomian glands in the eyelids which produce a natural oily lubricant have clogged). So if he consumes more oil, the eyes will have more oil?

This is the same kind of simplistic, ridiculous thinking that produced the “If you don’t eat fatty foods, you won’t form cholesterol in your arteries and get atherosclerosis.” theory. That theory is obviously flawed: cows are mammals which eat only vegetation and they produce loads of cholesterol. People are also mammals and produce cholesterol on a vegetarian diet.

“Dry eyes” are painful because of a lack of lubricant. We produce salt-water tears in the absence of the glandular lubricant but they are a poor substitute.

The lubricant stops simply because as we age the glands become clogged when the lubricant becomes waxy. You can reverse this situation by simply applying hot compresses to your closed eyes a few times each day. Start out with four times, and once things are working well, cut back to two times per day.

Maybe that is what happened to you. I was in my early 20s when I was first told that I had dry eyes. It really didn’t bother me until sometime in my 40s. I take fish oil and my eyes let me know when I run out and forget to buy more.

Any studies on flaxseed oil for dry eye? I’ve been taking it for some months and it seems to help. Take one in the morning with breakfast, took a few weeks before I noticed a change.

It is always good to know wha kind of fish oil capsules was used in the study (brand name, etc) and who paid for the study. I found eye relief from taking fish oil in the morning, flax oil at bedtime and using saline drops in my eyes morning and evening. They are so much better. I always use a good quality fish or Krill oil.

Interesting, as I received very fast and positive results shortly after starting Omegas. Eyes had been burning and itchy for months. I will definitely continue taking it.

If both groups improved significantly, then obviously olive oil helps dry eyes and so does fish oil. So why are not both of these recommended?

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