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Does Fish Oil Help With Dry Eye?

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Fish oil making the shape of a fish

Fish oil has been building a reputation as a nutrition mainstay for various health benefits, notably for its ability to help with dry eye. But it’s not actually the fish oil itself. Instead, it’s what’s in the fish oil, nutritious substances known as omega-3s.

The active ingredients in fish oil seem to benefit patients trying to overcome dry eye syndrome. Reno’s summer afternoons are notoriously hot and dry, so anything within your control might help you avoid the typical pain and itchiness. Starting with diet can help with dry eye.

What is Dry Eye?

Dry eye syndrome is a condition with many causes but a few familiar symptoms. It can include:

  • Stinging, burning, scratchy sensation
  • Stringy mucus in and around eyes
  • Light sensitivity
  • Redness in and around eyes
  • Feeling of having something in your eyes
  • Difficulty wearing contact lenses
  • Vision fluctuations, especially with nighttime driving.
  • Excessive tears

If you’re experiencing dry eye, you might be looking for relief. Treatments can range from over-the-counter eye drops to prescription ones and even to prosthetic inserts for your tears’ drainage system. It all depends on the type of dry eye you have. Different types of dry eye syndrome can affect different layers in your tear film.

The Tear Film

You don’t just get tears in your eyes when you’re crying. There’s a natural level of tears in your eyes, and they coat your eyes in something called the tear film. Your tear film is composed of 3 layers:

  • Mucin Layer: there’s a base of mucous coming from your conjunctiva, even your cornea, and it holds up the water layer.
  • Aqueous layer: water provides the moisture you need in your tears. Tears come from the lacrimal gland, giving much-needed hydration and oxygen to your cornea.
  • Lipid Layer: fatty oils cap the aqueous layer to prevent evaporation. Meibomian glands produce lipid oil within tiny shafts in your eyelids.

Aqueous-Deficient Dry Eye

Aqueous tear-deficient dry eye takes effect when your lacrimal glands just can’t produce enough tears. Water capable of hydrating and oxygenating your cornea doesn’t flow in the right volume, so your eyes get dried out. The causes are many, but they can include:

Evaporative Dry Eye

Evaporative dry eye (EDE) takes effect when your tears evaporate before they can hydrate your cornea. Oftentimes it’s due to a blockage in the oil glands, which unbalances the lipid layer. Some causes of EDE include:

  • Vitamin A deficiency
  • Skin conditions on or near the eye
  •  Overly frequent contact lens use
  • Toxins
  • Recovery from physical trauma to the eye

It can also set in as a side effect of certain oral medications.

Meibomian Gland Dysfunction

Meibomian gland dysfunction (MGD) is closely related to EDE, and it’s unclear whether one causes the other. But they can certainly play off one another. Sometimes, blockages in your meibomian glands can lead to atrophy, worsening your MGD and EDE, and may allow bacteria in. That inflammation and infection can lead to a condition called blepharitis.

With inflammation, infection with microorganisms, and further disruption of the lipid layer, your tears evaporate too quickly.

Treating MGD

pink and blue side by side comparison of illustrated cells affected by tear film and MGD

Fortunately, optometrists can utilize advanced systems for the treatment of dry eye. Our office uses LipiFlow, an FDA-approved device that can restore meibomian gland function.

Diet & Meibomian Gland Function

If you can produce tears sufficiently, but you’re struggling with the effects of evaporative dry eye, the workings of your meibomian glands are often to blame. Some research suggests that bolstering your diet with sufficient omega-3s from fish oil or other sources can relieve your dry eye. If your meibomian glands are straining to increase output, dietary changes might help.

In a study with a sample of over 32,000 women exhibiting dry eye symptoms, 5-6 servings of tuna per week provided a 66% decrease in dry eye compared with 2-3 servings per week. This study supported a few previous ones indicating the same thing: fish oil seems to help with evaporative dry eye consistently.

Fish Oil & Omega-3 Fatty Acids

Fish oil is a rich source of omega-3 fatty acids. These ingredients are the same that can help with dry eye. The 3 fatty acids that together form a group of the omega-3s are:

All omega-3 fatty acids, along with some omega-6 fatty acids, qualify as polyunsaturated fats. When doctors refer to omega-3 fatty acids, they mean: 

  1. Eicosapentaenoic acid (EPA)
  2. Docosahexaenoic acid (DHA)
  3. Alpha-linolenic acid (ALA)

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) nutrition often comes from fish. Alpha-linolenic acid (ALA) usually comes from vegetable oil, flaxseed, nuts, and leafy vegetables. For many, fish aren’t as sought after as poultry and red meats when dining or shopping for groceries, so you could easily lack a needed boost to your meibomian glands.

Omega-6 fatty acids are much more common in western diets, while omega-3 fatty acids can be a little harder to include, unless you know which foods to seek out. Omega-6 fatty acids often come from eggs, processed foods, cakes, salty snacks, and cured meats.

Fish Oil Sources & Alternatives

Fish itself (as a whole food) contains lots of fish oil, as you might expect. Tuna, Salmon, sardines, cod liver, menhaden, and herring have some of the highest omega-3-rich fish oil concentrations. In whole fish’s oil, you can get omega-3s in the form of free fatty acids, phospholipids, and triglycerides—all forms your body can break down and use.

Fish Oil Supplements

You can also get fish oil in supplements. Unless they’re concentrated, these supplements are about 30% omega-3 content in the form of triglycerides. That means the other 70% of the supplement’s oil can’t really help with dry eye.

Algal Oil & Alternative Supplements

Vegans and Vegetarians can look for supplements in the form of algal oil, made up of the triglycerides of algae. Algal oil is an even richer source of omega-3 triglycerides. Aside from algal oil, you can get various supplements rich in omega-3s, including krill oil, mammalian oil, and mussel oil.

Fish Oil & Omega-3s

Your health is more than just the sum of your different body parts. If you give it the right nutrition, it can definitely benefit more than one of your bodily functions. Nutrition can get overwhelming sometimes, but a few essential nutrients, easily shopped for, could make all the difference with dry eye relief.

It makes a lot of sense: if you bolster a gland that’s struggling, it can do its work more efficiently. Ask your optometrist for dry eye treatment, and you can find out what dietary changes you can make. Diet is a habit that you can take control of for yourself, reaping the benefits over time. A fish oil pill a day might keep the doctor away!

Written by Daniel Rowan

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