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Role of Omega-3 and Omega-6 supplements in management of aqueous-deficiency dry eye disease: a systematic review

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Session Details

Session Title: Special Cases

Session Date/Time: Sunday 14/09/2014 | 14:30-16:00

Paper Time: 15:18

Venue: Boulevard B

First Author: : B.Teh UK

Co Author(s): :    P. Tyagi   A. Reddy           

Abstract Details


To determine the evidence base for the use of Omega-3 and Omega-6 supplements in the management of symptoms and signs of aqueous deficiency dry eyes.


Aberdeen Royal Infirmary


A systematic review of clinical interventional reports of supplementation of Omega-3 and Omega-6 Essential Fatty Acids (EFAs) in the management of aqueous deficiency dry eyes was performed.Ovid MEDLINE (1948 to Dec 2013) CINAHL, and EMBASE were searched using the medical subject headings ‘dry eye Syndrome’, ‘dry eyes’, ‘ocular surface disease’ and ‘omega 3’ (n-3 fatty acids), ’omega 6’ (n-6 fatty acid), ‘polyunsaturated fatty acids or PUFA’. In addition medical subject headings ‘meibomian gland disease’, 'meibomian gland dysfunction', blepharitis, meibomitis and ‘meibomianitis’ were also included as the authors realised that published reports on dry eyes often reported on both evaporative and aqueous deficiency dry eyes. Text words as docosahexaenoic or DHA, eicosapentaenoic or EPA, alpha-Linolenic or ALA, linoleic acid or LA, gamma linoleic acid or GLA were also included in the search. Animal studies, unpublished abstracts/conference proceedings were excluded. Only articles/studies published in English language were included. Two independent reviewers analysed the search results and the corresponding full text articles.


Sixteen studies chosen were analysed for demographic characteristics, supplement used and efficacy outcomes. All studies were prospective, randomized clinical trials except one being a cross-sectional study. All had female preponderance with variable age range. Only three studies had explicitly recruited patients with aqueous-deficiency dry eyes. Six studies included both evaporative and aqueous-deficient dry eyes. Others were evaporative, contact-lens related or photorefractive keratotomy related dry eyes. Five studies used Omega-3, six used Omega-6 and four had both Omega-3/6 supplements for intervention. One study included dietary intake of Omega-3 and Omega-6. Most studies have assessed outcome measures such as improvement in Schirmer’s test results.


Most trials suggested some improvement in symptoms and signs of aqueous-deficiency dry eyes. However, there was no consensus on type of supplement and treatment duration. Larger studies on patients with aqueous-deficiency dry eyes with predetermined outcome measures are needed.

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