Research Article
The Role of Omega-3 Essential Fatty Acids in Dry Eye Disease
William J Faulkner*
Published: 12/22/2017 | Volume 1 - Issue 1 | Pages: 055-059
Review
One of every four visits to eye care professionals is for dry eye disease which affects an estimated 7-34% of Americans [1].Knowledge regarding etiology and treatments has advanced exponentially in the last 20 years. As recently as 1997, in the mega textbook Cornea, it was stated “The mechanism for lacrimal gland dysfunction in this condition is unclear” [2]. A recent study entitled “The Dry Eye Workshop ll Report”, defines dry eye as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms in which tear film instability and hyperosmolarity, ocular surface inflammation, and damage and neurosensory abnormalities play etiological roles” [3]. A 2003 study regarding the morbidity ratings of dry eye showed utility assessments for moderate and severe dry eye were parallel to historical reports for more severe (class lll/ lV) angina [4]. The tear film is responsible for the greatest optical power of any ocular surface, since the greatest change in the index of refraction occurs between the air and the tear film [5]. Double pass retinal imaging shows increased light scatter in dry eye patients which can decrease retinal image quality 20-40% [5]. Ophthalmologists now understand the critical necessity to normalize the ocular surface prior to cataract surgery; otherwise, they risk an unhappy patient with a less than ideal visual result. Increased use of electronic devices, such as smart phones, tablets, and computers, by youth in the last ten years has resulted in a broader age range of dry eye patients, to now include adolescents and teens. A study of urban school age children showed that 8.2% had dry eye (vs 2.8% in a rural group), presumably due to high incidence of smart phone use.6 In fact, with cessation of phone use for four weeks, dry eye resolved completely in 100% of subjects [6]. Only two FDA approved dry eye medications are available: cyclosporine ophthalmic emulsion, 0.05%, (approved in 2003) and lifitegrast, 5%, (approved in 2016), both of which require chronic treatment. The focus of this discussion involves an emerging paradigm in treating ocular surface disease: a nutraceutical containing omega-3 essential fatty acids.
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References
- Murphy, John J. Dry Eye Inflammation: A Discussion with Dr. Michael Lemp, MD Linx.com. 2017.
- Cornea, Vol II, Krachmer, Mannis, Holland. 1997; 647.
- Sullivan DA, Daniel Nelson J, Jennifer Craig P, Esen Akpek K, Dimitri Azar T, et al. TFOS DEWS II Introduction. 2017; 15: 269-275. Ref.: https://goo.gl/A6QsFp
- Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, et al. Utility assessment among patients with dry eye disease. Ophthalmology. 2003; 110: 1412-1419. Ref.: https://goo.gl/P7Dexj
- Farid M. The contribution of the tear film to vision and ocular comfort. Eyeworld. September, 2016: 6.
- Moon JH, Kim KW, Moon NJ. Smartphone use in a risk factor for pediatric dry eye disease according to region and age. a case control study. BMC Ophthalmol. 2016; 16: 188. https://goo.gl/bUbcHc
- Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of Aqueous deficient and Evaporative Dry Eye in a clinic Based patient Cohort: A retrospective Study. Cornea. 2012; 31: 472-479. Ref.: https://goo.gl/ywiKyj
- Simopoulos AP. Evolutionary aspects of diet, essential fatty acids and cardiovascular disease. Eur Heart J Supplements. 2001. Ref.: https://goo.gl/t7VxEh
- Tribole E. The Ultimate Omega-3 Diet.
- Boerner CF. Dry Eye successfully treated with oral flaxseed oil. Ocular Surgery News. 2000.
- Bucci F, Kislan T. A Comparison of Omega-3 RBC Saturation for PRN-Dry Eye Omega Benefits V. Theratears Nutrition V. Nature Made. 2011.
- Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 acid formulations. Prostaglandins leukotrienes essential fatty acids. 2010. 83: 137-141. Ref.: https://goo.gl/RpJrSL
- Siscovick DS, Raghunathan TE, King I, Weinmann S, Wicklund KG, et al. Dietary Intake and Cell Membrane Levels of Long Chain Omega-3 Polyunsaturated Fatty Acids and the Risk of Primary Cardiac Arrest. JAMA. 1995; 274: 1363-1367. Ref.: https://goo.gl/9WC4JA
- The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007; 5: 75-92. Ref.: https://goo.gl/Zxzocb
- Nichols KK. The International Workshop on Meibomian gland Dysfunction. Invest Ophthalmol Vis Sci. 2011: 52: 1917-1921. Ref.: https://goo.gl/yr5m1t
- Swanson D, Block R, Mousa SA. Omega-3 fatty acid EPA and DHA: Health Benefits throughout life. Adv Nutr. 2012; 3: 1-7. Ref.: https://goo.gl/fupSE4
- Deckelbaum RJ, Torrejon C. The Omega-3 fatty acid nutritional landscape: Health Benefits and sources. J Nutr. 2012; 142: 587-591. Ref.: https://goo.gl/PUkswP
- Pinna A, Blasetti F, Zinellu A, Carru C, Solinas G. Meibomian Gland Dysfunction and Hypercholesterolemia. Ophthalmology. 2013; 120: 2385-2389. Ref.: https://goo.gl/1dVLfu
- Sala-Vila A, Díaz-López A, Valls-Pedret C, Cofán M, García-Layana A, et al. Dietary Marine Omega-3 Fatty Acids and Incident Sight Threatening Retinopathy in Middle Aged and Older Individuals with Type 2 Diabetes. JAMA Ophthalmol. 2016; 134: 1142-1149. Ref.: https://goo.gl/AjtE4s
- Abelson MB, McLaughlin J. “Resolving” The effects of Fish Oil on the eye. Rev. Ophth. 2012; 74-77.
- Epitropoulos AT, Donnenfeld ED, Shah ZA, Holland EJ, Faulkner WJ, et al. Effect of Oral Re-Esterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea. 2016; 35: 1185-1191. Ref.: https://goo.gl/P6apTE
- Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. The Preventable Cause of Death in the United Sates: Comparative Risk Assessment of Dietary, Lifestyle and Metabolic Risk Factors. PLOS Med. 2009. Ref.: https://goo.gl/Cd2fBE
- Brasky TM, et al., Nutr Cancer, 2011, doi: 10.1080/01635581.2011.553022
- White D, Study sends wrong message about Omega-3 fatty acids and prostate cancer. Ocular Surgery News, 3/25/2014, 8.
- Chinnery HR, Naranjo Golborne C, Downie LE. Omega-3 supplementation is neuroprotective to corneal nerves in dry eye disease: a pilot study. Ophthalmic Physiol Opt. 2017; 37: 473-481. Ref.: https://goo.gl/EwvBXW
- Bhargava R, Mini Chandra, Utsav Bansal, Divya Singh, Somesh Ranjan. A Randomized Controlled Trial of Omega 3 Fatty Acids in Rosacea Patients with Dry Eye Symptoms. Current Eye Research. 2016. https://goo.gl/oH5PzU
- Gatell-Tortajada J. Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study. Clin Interv Aging. 2016; 11: 571-578. Ref.: https://goo.gl/8JUrAL
- Molina-Leyva I, Molina-Leyva A, Bueno-Cavanillas A. Efficacy of nutritional Supplementation with omega-3 and omega-6 fatty acids in dry eye syndrome: a systematic review of randomized clinical trials. Acta Ophthalmol.2017; 95: 677-685. Ref.: https://goo.gl/FhTnfj
- Age-Related Eye Disease Study Protocol.
































