Many patients with dry eye ask whether fish oil is worth taking. A clinical primer in Optometry Times reviewed how omega-3 fatty acids may help the eye surface and why studies have not always agreed.
How omega-3s may help
The article describes three main roles:
- They change the oils made by the meibomian glands in the eyelids, so the oil stays more fluid at body temperature, helping prevent clogged glands and reducing tear evaporation.
- The body turns them into anti-inflammatory compounds, such as resolvins and protectins.
- They are structural parts of cell membranes.
The balance with omega-6
Omega-6 fats, found in vegetable oils, nuts, seeds, poultry, and eggs, have important roles too. The article notes that the historical ratio of omega-6 to omega-3 was roughly 1:1 to 2:1, while Western diets now run from 10:1 to 20:1, an imbalance linked to inflammation. The author emphasized restoring balance mainly through omega-3 supplementation rather than adding omega-6.
What the trials say
A 2016 placebo-controlled trial found that re-esterified omega-3s improved tear osmolarity, tear breakup time, and symptom scores. The large Dry Eye Assessment and Management study, however, found no significant difference from placebo over 12 months. The primer points out that the placebo there was olive oil, which has its own anti-inflammatory properties, and that baseline omega-3 levels were not measured.
Form matters
- EPA and DHA from fish, shellfish, and algae are more potent than ALA from plant oils, and the body converts ALA to EPA and DHA only to a limited degree.
- Most supplements use the ethyl ester form, of which only about one-third is absorbed.
- Triglyceride and re-esterified triglyceride forms are absorbed about 51% better than ethyl esters, though the article notes the difference mainly affects the rate of absorption rather than the final effect.
My advice
Omega-3s may help some people, especially those with oil-gland dysfunction, but they are one piece of dry eye care. Check with your physician before starting any supplement, and keep treating the eyelids and eye surface as directed. For more eye-health reading, see encinolasik.com.
Source: A primer on oral omega-3s and dry eye disease (Optometry Times, 08/20/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.