Omega-3 Supplementation for Dry Eyes and Ocular Rosacea

Research highlights the exciting potential to improve symptoms of ocular rosacea and dry eyes with increased dietary intake of omega-3 fatty acids and underscores the significance of dietary factors in skin diseases.

Rosacea is a common inflammatory skin condition of the face that is commonly characterized by redness, skin sensitivity, and even bright red and pus-filled bumps that are often confused with acne. Dermatologists divide rosacea into four different subtypes based on the patient’s symptoms. These subtypes include erythematotelangiectatic (redness and flushing), papulopustular (acne-like bumps), phymatous (skin thickening especially of the nose), and ocular rosacea.

Although erythematotelangiectatic and papulopustular rosacea subtypes are most common, ocular rosacea can be especially difficult to treat. It can cause significant physical and psychosocial stress and dry, irritated eyes that can even lead to blindness.

 

What Is Ocular Rosacea?

Ocular rosacea is rosacea with inflammation of the eyes. Patients with ocular rosacea often complain of swelling, and redness around the eyes and in the eyes themselves. It may feel as if something irritating or gritty is stuck in their eyes. If the cornea of the eye becomes involved, which occurs in a large proportion of people with ocular rosacea, patients may even begin losing their eyesight.[1]

Dry eyes

Many people with ocular rosacea have dysfunctional meibomian glands, which are special oil glands found on the rims of the eyelids. People with and without rosacea who have meibomian gland dysfunction complain of dry and itchy eyes and inflamed eyelids with crusting and scaling.

Current ocular rosacea treatments

Based on the severity of ocular rosacea, treatments may include warm compress, lubricating eye drops, and topical and systemic antibiotics.[2]

 

Do Omega-3 Fish Oil Help Ocular Rosacea and Dry Eyes?

Recently, there is evidence showing supplementation with omega-3 fatty acids may reduce inflammation in ocular rosacea and improve symptoms.[3] Omega-3 and omega-6 fatty acids are types of polyunsaturated fatty acids derived from our diet. They are important in cell membrane structure, brain function, regulating inflammation in the body, and many other functions throughout our body.[4]

Sources of omega-3 for ocular rosacea

Omega-3 fatty acids are derived from fish, flaxseed, and walnuts, while omega-6 fatty acids are predominately derived from plant oils such as olive oil, canola oil, and peanuts.

Research shows that omega-3 improves dry eyes

In a recent clinical trial in people with rosacea and dry eyes, patients were randomized to one of two different treatments: omega-3 fatty acid supplementation or olive oil placebo capsules.[5] After 6 months of treatment, the patients who received the omega-3 fatty acid supplementation had significant improvement in dry eye symptoms compared to those in the placebo group. Four out of 130 participants complained of stomach intolerance caused by the omega-3 supplement, but no other side effects were reported.

In a separate study, patients with dry eyes were randomized to receive either 6,000 mg flaxseed oil or placebo each day for one year.[6] Those in the flaxseed group had significant improvement in dry eye symptoms, meibomian gland function, and even had a significant increase in omega-3 fatty acids in their meibomian gland secretions.

 

Omega 3 vs Omega 6 Supplements

It is believed that omega-3 consumption decreases inflammation, while a higher ratio of omega-6 fatty acids revs up the inflammatory cascade in our bodies. Therefore, maintaining a delicate ratio of higher omega-3 to omega-6 fatty acid consumption is ideal to decrease inflammation, which is a major component in the pathogenesis of ocular rosacea.

This research highlights the exciting potential to improve symptoms of ocular rosacea and dry eyes with increased dietary intake of omega-3 fatty acids and underscores the significance of dietary factors in skin diseases.

 

Concluding Remarks

Omega-3 supplementation can have a blood-thinning effect, so people with bleeding disorders, liver disease, and those on blood thinners such as Warfarin may be at increased risk for bleeding. In addition, many omega-3 supplements are derived from fish oil and should be avoided in people with fish allergies.

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References

  1. Vieira AC, Mannis MJ. Ocular rosacea: common and commonly missed. J Am Acad Dermatol.2013;69(6 Suppl 1):S36-41; PMID: 24229635 Link to research.
  2. Wilkin JK. Rosacea. Pathophysiology and treatment. Arch Dermatol.1994;130(3):359-362; PMID: 8129416 Link to research.
  3. Oltz M, Check J. Rosacea and its ocular manifestations. Optometry.2011;82(2):92-103; PMID: 21276570 Link to research.
  4. Wiktorowska-Owczarek A, Berezinska M, Nowak JZ. PUFAs: Structures, Metabolism and Functions. Adv Clin Exp Med.2015;24(6):931-941; PMID: 26771963 Link to research.
  5. Bhargava R, Chandra M, Bansal U, et al. A Randomized Controlled Trial of Omega 3 Fatty Acids in Rosacea Patients with Dry Eye Symptoms. Curr Eye Res.2016;41(10):1274-1280; PMID: 27050028 Link to research.
  6. Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Trans Am Ophthalmol Soc.2008;106:336-356; PMID: 19277245 Link to research.