Which Omega 3 Fatty Acid Supplements are Recommended by Most Eye Doctors for Dry Eyes

The Doctor Recommended Product Series

Do you have burning eyes and are looking for relief beyond artificial tears?  Have you heard omega 3 fatty acids can help with dry eye symptoms but don’t know which ones to buy because they all look the same? In this article we’ll explain the omega 3 fatty acids that help dry eye symptoms, research behind this claim, and the top recommended omega 3 fatty acid supplements by Ophthalmologists and Optometrists online.

Why do you need Omega 3 Fatty Acid Supplements?

If your eyes are burning, red and tearing, and your eye doctor has diagnosed you with dry eye disease, you may hear that omega 3 fatty acid supplements can help your symptoms (in addition to the artificial tears you’re already using).  The tear film that coats the eye is made of three components; water, mucin, and lipids.  If one of these components is deficient, your tears will rapidly evaporate leading to a sandy painful sensation.  Omega 3 fatty acid supplementation is thought to improve the quality of the lipid layer of your tear film expressed from the Meibomian glands that live in your eyelids.

The Research

The research on this topic is open to interpretation.  In 2018 the The Dry Eye Assessment and Management Study Research Group or DREAM Study showed that omega 3 fatty acid supplements did not significantly improve physical signs of dry eye compared to baseline (conjunctival staining score, corneal staining score, tear break-up time, and result on Schirmer’s test), however, patient’s felt significant improvement in their dry eye symptoms as rated on the OSDI scale compared to baseline.  That said, the placebo group who was taking olive oil supplements also had a significant improvement in their subjective symptoms measured by the Ocular Surface Dry eye Index (OSDI), and there was no difference when comparing the improvement experienced by patients receiving Omega 3 fatty acids versus olive oil.  However, given the subjective improvement in symptoms and low risks associated with fish oil supplements (as long as you do not have high lipids, cardiac disease, or bleeding disorders), many Ophthalmologists and Optometrists will incorporate the use of omega 3 fatty acid supplements in their treatment of dry eye. 

About Omega 3 Fatty Acids

So how much omega 3 fatty acids should you look for in a supplement and what separates the high quality from the low quality products?

Omega 3 fatty acids come in 3 forms: EPA, DHA, and ALA.  EPA and DHA are the beneficial omega 3 fatty acids found in the tear film, while ALA has other beneficial health properties but is not found on the ocular surface. Most eye doctors recommend taking 1000 to 2000 mg in a 2:1 or 3:1 EPA: DHA ratio in a re-esterified Triglyceride form which is better absorbed than an Ethyl-ester form.  So when we turn our supplement bottle around and look at the nutritional facts, look at the EPA: DHA ratio and look for the bottle to say Triglyceride or TG.  Additionally some studies have shown fish oil sourced from wild fish are higher quality than farm raised fish (https://pubmed.ncbi.nlm.nih.gov/25108414/ ).  And some studies show the liquid forms of medications have better absorption in the gut compared to capsules due to capsules delayed release due to their coating (https://ncbi.nlm.nih.gov/pmc/articles/PMC105699/ ).  Finally plant based omega 3 fatty acids from sources such as algae or flaxseed oil have not been as highly studied for dry eye treatment.  Where algae does contain high levels of EPA and DHA, flaxseed oil has a higher ALA content.

So now that we’ve covered the rationale behind omega 3 supplements, let’s find out which ones are highly recommended by eye doctors, and which ones just make your burps smell fishy.

Our search turned up 5 youtube videos created by an Ophthalmologist or Optometrist and 1 article reviewed by a board certified Ophthalmologist. Ultimately we looked at the 4 board certified Optometrists and 2 board certified Ophthalmologists's opinions to give you the top Omega 3 fatty acid supplements of 2024!

Number 2: Nordic Natural Ultimate Omega Fish Oil

The number 2 omega 3 fatty acid supplement was: Nordic Natural Ultimate Omega Fish Oil.  Recommended by 2 of 6 eye doctors, Nordic Natural Ultimate Omega comes in both a capsule and liquid form.  Ophthalmologists appreciated Nordic Natural’s EPA:DHA ratio of 2:1, lemon flavor, and 2 pill serving size delivering a total of 1280mg of omega 3 fatty acids.  According to the company, the fish oil is sourced from sustainable wild fishing sites and contains re-esterified triglyceride omega 3’s making it the better version for gut absorption. 

Number 1: PRN De3

The number 1 omega 3 fatty acid supplement was: PRN De3.  Recommended by 4 of 6 eye doctors, PRN De3 also comes in capsule and liquid form.  Optometrists appreciated PRN De3’s higher 3:1 EPA:DHA ratio, 2000mg per serving size with 3 pills per serving, and re-esterified triglyceride formulation.  

Of note PRN also created a vegan algae alternative called PRN Omega-V benefits, however, it has a 1:2 EPA:DHA ratio and again there are not large scale studies looking at the effects of algae based omega 3 fatty acids on dry eye in the literature.

Conclusion:

So there you have it: the literature behind eye doctors recommending omega 3 fatty acid supplements for dry eyes, the attributes to look for in a high quality supplement, and the two top Ophthalmologist and Optometrist recommended omega 3 fatty acid supplements on the market.  We hope your choice in omega 3 fatty acid supplement keeps your eyes feeling refreshed and happy, and we hope the use of these high quality supplements reduces the awful fishy burps users of lower quality fish oil supplements experience!

Nordic naturals ultimate omega 3 capsule - https://amzn.to/3Lvks9b

Nordic naturals ultimate omega 3 liquid - https://amzn.to/3WsA2Zj 

PRN De3 capsules - https://amzn.to/3YdExs7

PRN De3 liquid - https://amzn.to/4cKSiCV

PRN Omega V - https://amzn.to/4c6gD5n 

Sources

1. Dry Eye Assessment and Management Study Research Group; Asbell PA, Maguire MG, Pistilli M, Ying GS, Szczotka-Flynn LB, Hardten DR, Lin MC, Shtein RM. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 May 3;378(18):1681-1690. doi: 10.1056/NEJMoa1709691. Epub 2018 Apr 13. PMID: 29652551; PMCID: PMC5952353.
   

2. Cladis DP, Kleiner AC, Freiser HH, Santerre CR. Fatty acid profiles of commercially available finfish fillets in the United States. Lipids. 2014 Oct;49(10):1005-18. doi: 10.1007/s11745-014-3932-5. Epub 2014 Aug 10. PMID: 25108414.

3. Barone JA, Moskovitz BL, Guarnieri J, Hassell AE, Colaizzi JL, Bierman RH, Jessen L. Enhanced bioavailability of itraconazole in hydroxypropyl-beta-cyclodextrin solution versus capsules in healthy volunteers. Antimicrob Agents Chemother. 1998 Jul;42(7):1862-5. doi: 10.1128/AAC.42.7.1862. PMID: 9661037; PMCID: PMC105699.

4. https://www.youtube.com/watch?v=UQfD2mdKAl0 Dr Eye Health. 5/3/23. Joseph J Allen OD, FAAO, Dipl ABO.

5. https://www.youtube.com/watch?v=-f3ZHbbnOSQ Eye Channel by Eye Surgeon. 3/25/22 Audrey Tai, MD.

6. https://www.youtube.com/watch?v=irhim6JjbTI Dr. Brandon Walley 5/26/23. Dr. Walley OD.

7. https://www.youtube.com/watch?v=zDSNwTyJzMo Eye School with Dr. D. 2/1/2023. Melanie Denton, OD

8. https://www.youtube.com/watch?v=rOG5zQOGR6g Stone Canyon Eye Show. 9/2/2022. Aaron Smith OD.

9. https://www.livestrong.com/article/13778572-fish-oil-for-dry-eyes/ Livestrong By April Benshosan, Medically reviewed by Julián Saavedra, MD, FEBO. Nov 27, 2023.
   

Disclaimer:

Links in the article are affiliate links and the authors of this article as well as the authors of the articles and videos sited may receive compensation from the products featured. This article is not personalized healthcare. You should always speak with your healthcare provider to ensure any products you purchase are right for you.