Short-Term Omega 3 Fatty Acids Treatment for Dry Eye in Young and Middle-Aged Visual Display Terminal Users.

OBJECTIVE: To evaluate the effect of an omega 3 fatty acid (O3FA) oral supplement (2,400 mg/day) for 45 days on dry eye symptoms, tear production, stability, and conjunctival cytology in young and middle-aged visual display terminal (VDT) users. METHODS: Institutional review board approval was obtained, and a randomized, double-blind, interventional study was done; eyes of 256 VDT users were randomized to receive 4 capsules twice daily for 45 days (O3FA group), each containing 180 mg of eicosapentaenoic acid and 120 mg docosahexaenoic acid. The O3FA group was compared with another group (n=266) who received 8 capsules of a placebo (olive oil). Patients were evaluated at baseline, 30 days, and 45 days. The primary outcome measure was an improvement in dry eye symptoms. Secondary outcome measures were improvement in the Nelson grade on conjunctival impression cytology, Schirmer test values, and tear film breakup time (TBUT). Means of groups (pretreatment, day 30, and day 45) were compared with repeated-measure analysis of variance. The relation between the outcome variables and VDT time was evaluated using linear regression. RESULTS: In the O3FA group, the mean symptom score differed significantly (P<0.005) (pretreatment, 30 days, and 45 days); the TBUT and Nelson grade also improved significantly but only after 45 days of intervention. Schirmer test values did not differ significantly after adjustment for multiple comparisons (P=0.010). The change was not significant in the placebo group. CONCLUSION: Consumption of 2,400 mg/day of O3FA supplement improves symptoms, tear stability, and conjunctival cytology but not tear production in symptomatic VDT users.

Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye.

PURPOSE: To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symptoms, Schirmer test, tear film break up time (TBUT) and conjunctival impression cytology (CIC) in patients with computer vision syndrome. SETTING AND DESIGN: Interventional, randomized, double blind, multi-centric study. METHODS: Four hundred and seventy eight symptomatic patients using computers for more than 3h per day for minimum 1 year were randomized into two groups: 220 patients received two capsules of omega-3 fatty acids each containing 180mg eicosapentaenoic acid (EPA) and 120mg docosahexaenoic acid (DHA) daily (O3FA group) and 236 patients received two capsules of a placebo containing olive oil daily for 3 months (placebo group). The primary outcome measure was improvement in dry eye symptoms and secondary outcome measures were improvement in Nelson grade and an increase in Schirmer and TBUT scores at 3 months. RESULTS: In the placebo group, before dietary intervention, the mean symptom score, Schirmer, TBUT and CIC scores were 7.5±2, 19.9±4.7mm, 11.5±2s and 1±0.9 respectively, and 3 months later were 6.8±2.2, 20.5±4.7mm, 12±2.2s and 0.9±0.9 respectively. In the O3FA group, these values were 8.0±2.6, 20.1±4.2mm, 11.7±1.6s and 1.2±0.8 before dietary intervention and 3.9±2.2, 21.4±4mm, 15±1.7s, 0.5±0.6 after 3 months of intervention, respectively. CONCLUSION: This study demonstrates the beneficial effect of orally administered O3FAs in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye.

Oral omega-3 fatty acid treatment for dry eye in contact lens wearers.

PURPOSE: The aim of this study was to evaluate the effect of dietary omega-3 fatty acid (O3FA) supplementation on dry eye symptoms, tear film tests, and conjunctival impression cytology in patients with contact lens wear-associated dry eye. METHODS: In this randomized, double-blind, multicentric trial, contact lens wearers (n = 496) were randomized to receive either O3FAs or placebo capsules (corn oil) twice daily for 6 months. Subjects underwent examinations at baseline, 3 months, and 6 months. At each visit, a questionnaire of dry eye symptoms and lens wear comfort was administered. Subjects further underwent measurement of tear film break-up time (TBUT) and a Schirmer test. Conjunctival impression cytology was performed by the transfer method. Improvement in symptoms and lens wear comfort were primary outcome measures. Changes from baseline in TBUT, Schirmer, and Nelson grade at 6 months were secondary outcome measures. RESULTS: The mean improvement in symptom score in the O3FA group was 4.7 ± 2 (2.0) as compared with 0.5 ± 2 (0.9) in the placebo group (P < 0.0001). Lens wear comfort levels improved significantly (P < 0.0001) from baseline. There was a significant increase in TBUT [3.3 ± 2 (1.5)] and Nelson grade [0.7 ± 2 (0.6)] in the O3FA group (P < 0.0001) as compared with 0.3 ± 2 (0.6) and 0.1 ± 2 (0.4) in the placebo group (P = 0.164 and 0.094, respectively). However, the magnitude of increase in Schirmer score [2.0 ± 2 (1.5)] was relatively small (P = 0.08). CONCLUSIONS: The results of this study point toward benefits of orally administered O3FAs in alleviating dry eye symptoms, improving lens wear comfort, and cytological changes in contact lens wearers.

A randomized controlled trial of omega-3 fatty acids in dry eye syndrome.

AIM: To evaluate the role of dietary supplementation of omega-3 fatty acids in dry eye syndrome. METHODS: A prospective, interventional, placebo controlled, double blind randomized trial was done at two referral eye centers. Two hundred and sixty-four eyes of patients with dry eye were randomized to receive one capsule (500mg) two times a day containing 325mg EPA and 175mg DHA for 3 months (omega-3 group). The omega-3 group was compared to a group of patients (n=254) who received a placebo (placebo group). There were 4 patient visits (at baseline, 1 month, 2 months and 3 months). On each visit, recording of corrected distance visual acuity (CDVA), slit lamp examination and questionnaire based symptom evaluation and scoring was done. A symptomatic score of 0-6 was mild, 6.1-12 moderate and 12.1-18 severe dry eye. Response to intervention was monitored by routine tear function tests like Schirmer I test, tear film break-up time (TBUT), Rose Bengal staining and most notably, conjunctival impression cytology. RESULTS: Sixty-five percent of patients in the omega-3 group and 33% of patients in placebo group had significant improvement in symptoms at 3 months (P=0.005). There was a significant change in both Schirmer's test value and TBUT values in the omega-3 group (P<0.001), both comparisons. However, there was a larger drift in TBUT values in omega-3 than the placebo group, in comparison to Schirmer's test values. The mean TBUT score was 2.54±2.34 in the omega-3 group and 0.13±0.16 in placebo group, respectively. The mean reduction in symptom score in omega-3 group was 2.02±0.96 as compared to 0.48±0.22 in placebo group (P<0.001). Despite a slight increase mean score, the Schirmer scores did not correlate well with symptomatic improvement. CONCLUSION: Omega-3 fatty acids have a definite role for dry eye syndrome. The benefit seems to be more marked in conditions such as blepharitis and meibomian gland disease. The role of omega fatty acids in tear production and secretion needs further evaluation.