Managing dry eye with fish oil supplements provides a low-cost, low-intervention solution.

Treating dry eye syndrome (DES) is an extremely important optometric practice today as functional tear film is essential to clinical outcomes. Though we have various treatments for this common disorder, oral supplements provide a new way to enhance patient comfort and improve this condition.

ProDHA Eye by Nordic Naturals combines
omega-3s with high levels of lutein and

Dry eye has been shown to be a chronic, low-grade inflammation of the meibomian and/or lacrimal glands. Diet rich in omega-3 fatty acids may help eliminate the signs and symptoms of DES, including improved Schirmer test scores, increased tear film breakup time, and a decrease in fluorescein and lissamine green staining. This is due to agents found in cold water fish and/or fish oil supplements called docosehexanenoic acid (DHA) and eicosapentaenoic acid (EPA), which suppress inflammation, decrease the “sandy, gritty feeling” patients often complain of, help to restore lacrimal gland function, and improve meibomian gland secretion.

While women are nine times more prone to have dry eye, as we age, both sexes have an increased incidence of the condition. Dry eye can lead to fluctuating refractive state, contact lens dropout, and an overall decrease in visual performance. Many patients do not present with typical symptoms, so it is important to keep the following groups in mind as they are at an increased risk:

•Women over 40
•Patients considering refractive surgery
•Those who work in dry environments or on computers
•Patients using systemic medications (beta-blockers, antihistamines)
•Contact lens wearers with intolerance
•Patients with systemic diseases (lupus, Sjögrens, diabetes, arthritis)

The common recommendation is that everyone should take 1,000mg of omega-3 fish oil per day, and this is increased to 3,000mg to 4,000mg for dry eye patients. Most practitioners prescribe a pharmaceutical grade, cold- water fish oil that has been independently tested for purity and concentration to increase absorption and decrease any unpleasant side effects. Brands that fit the bill include Nordic Naturals, PRN (Physician Recommended Nutriceuticals), and Pure Encapsulations.

Patients should be educated that quick results are not to be expected. I advise patients it could take a few weeks to feel an improvement, and up to a few months to see a significant improvement of symptoms. I explain that dry eye is often the result of a long-term inflammatory process, and since it was not a condition that appeared overnight, we cannot expect a “quick fix.” Once they understand this, they are more likely to stay the course for the duration of the treatment.

Our office stocks ProDHA Eye from Nordic Naturals. This way the patient can leave with their supply to start immediately, and not be confused or overwhelmed when trying to choose the right supplement. We usually send the patient home with enough of a supply to carry them until their next follow-up visit. We found this increases compliance and treatment success, and produces another revenue stream for the office.

Dry eye is one of the most common issues we face in our offices daily, yet it is still vastly underdiagnosed and undertreated. Adding omega-3 supplementation to a patient’s dry eye treatment plan can greatly improve their signs and symptoms, enhance their visual performance, boost practice revenue, and serve as a way to increase patient referrals.

Jennifer L. Stewart is in private practice at Norwalk Eye Care in Norwalk, CT.


Nordic Naturals •800-662-2544 •

PRN Physician Recommended Nutriceuticals • 800-900-2303 •

Pure Encapsulations •800-753-2277 •


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