The Omega-3 revolution
Until now the approach to dry eye has been a topical one by, lowering elevated tear film osmolarity and providing an electrolyte-matched tear solution the problem has been effectively managed. Now we are seeing a new approach to dry eye treatment, with Omega-3 dietary supplements. |
 | What are Essential Fatty Acids?
Omega-3 & 6 are essential fatty acids. "Essential" means that, because they cannot be produced by the body, their inclusion in the diet is essential for good health.
The two best sources of Omega-3's are dark, oily, cold-water fish, and flaxseed. They are known to have a multitude of health benefits. |
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| However, most of us are Omega-3 deficient. Conversely we tend to obtain an excess of Omega 6 through consumption of beef, dairy and vegetable cooking oils (via fried food). Unfortunately, while the recommended ratio of Omega-3 to Omega-6 is 1:2.3, the existing ratio of consumption has been estimated to be as low as 1:10. |
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The Research about Omega-3's
New research, presented for the first time at the 2003 Annual meeting of the Association for Research in Vision and Ophthalmology has found that high dietary intake of Omega-3 essential fatty acids decrease the risk of dry eye. Using the Women's Health Database at the Harvard School of Public Health, the investigators examined the dietary intake of essential fatty acids in 32,470 female health professionals. They found that the higher the dietary ratio of Omega-3 to Omega-6 essential fatty acids, the lower the likelihood of dry eye, and the higher the dietary Omega-3 intake, the lower the likelihood of dry eye. Conversely, they found that the lower the ratio of Omega-3s to Omega-6s the higher the likelihood of dry eye. |
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Omega-3's decrease inflammation
There is an abundance of clinical evidence that ingestion of Omega-3's decreases the inflammation seen in the joints in rheumatoid arthritis and in the skin in dermatitis. These anti-inflammatory effects go a long way to explain why Omega-3's have been useful in helping patients with symptoms of posterior blepharitis or meibomitis. They may have a place in replacing the use of systemic tetracyclines for such conditions. |
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Omega-3's decrease cell death
Certain chemicals, TNF-a (tumor necrosis factor alpha), in the body lead to cell death in the lacrimal gland and on the corneal surface. Omega-3's are thought to have a dual effect. EPA (eicosapentaenoic acid) helps to suppress the production TNF-a and DHA products cells from the effects of TNF-a. |
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 | Omega-3's stimulate tear secretion
TNF-a also impairs tear secretion in lacrimal gland disease-based dry eye. This is probably the main mechanism by which tear secretion decreases in dry eye. Therefore, the ability of EPA to suppress TNF-a is one way that tear production is helped. |
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| DHA may help in a complementary way because it helps improve age-related decline in nerve synapse function. This makes it more difficult for TNF-a to block the normal cell function. Omega-3s affect the lacrimal gland in another way by helping boost the natural anti-inflammatory properties and stimulating aqueous tear secretion. |
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Omega 3's and the meibomian gland oils
Meibomian glands use essential fatty acids to synthesize oil (meibum). Dietary intake of Omega-3's (especially EPA and DHA) have recently been shown to affect the lipid profiles of meibum. Although further studies are needed, it may man that they improve the oil layer and retard evaporation. |
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What about Omega-6?
There have been some attempts to treat dry eye with the Omega-6's. However, they show this is not effective and there are risks in long-term Omega-6 supplementation. |
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 | Summary
While not a panacea, by decreasing inflammation and augmenting the oil and water layers of the tear film, Omega-3 supplementation promises to provide the foundation for a broad spectrum of dry-eye treatment regimens.
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