Essential fatty acids in the treatment of dry eye syndrome: A myth or reality?

January 1, 2014 Human Health and Nutrition Data 0 Comments

Essential fatty acids in the treatment of dry eye syndrome: A myth or reality?

Year: 2014
Authors: Al Mahmood, A.M. Al-Swailem, S.A.
Publication Name: Saudi J Ophthalmol
Publication Details: Volume 28; Issue 3; Pages 195 – 197


Dry eye is a common condition that can severely impair the quality of life. Systemic and topical omega 3 fatty acids and omega 6 fatty acids have been used as treatment for patients with dry eye disease and showed promising results. Further multicenter randomized controlled trials are required in order to establish a standardized protocol for the treatment of dry eye syndrome with those essential fatty acids. (Authors Abstract)
This paper provides a review of dry eye syndrome (DES) which leads to problems with sustained visual activities. These include problems during reading, using a computer, driving at night and carrying out professional work. DES manifests more in elderly people.  Essential fatty acids (EFAs) have been of interest in the area of dry eye disease treatment. Both topical and systemic EFAs have been evaluated in regard to alleviation of DES manifestations.  Many hypothesize that the cause of dry eye is inflammatory. The omega-3 fatty acid eicosapentaenoic acid (EPA) and the omega-6 fatty acid arachidonic acid (AA) act competitively as substrate for both enzymes cyclooxygenase and 5-lipoxygenase. The anti-inflammatory action is believed to result from the synthesis of prostaglandin E3 (PGE3) and of leukotriene B5 (LTB5 (from EPA that inhibits the conversion of AA to potentially harmful inflammatory mediators prostaglandin E2 (PGE2) and leukotriene B4 (LTB4). Multiple trials looked at the effect of oral supplement of omega-3 and omega-6 in the treatment of DES.  A proper balance of omega-3 and omega-6 essential fatty acids improves DES and  tear break up time and relieved patient symptoms. Levels of interleukin (IL)-1β, IL6, and IL10 in tears have been shown to be significantly lower in EFA treatments. Supplementation with omega-3 and omega-6 fatty acids can reduce expression of conjunctival inflammatory marker and may help improve DES symptoms. ALA treatment has also been associated with a significant decrease in CD11b cell number, expression of corneal Interleukin1α and Tumor necrosis factor (TNF) and conjunctival TNF. All these are important inflammatory mediators that are raised in DES patients. Most of the studies suggest a beneficial role of omega-3 and omega-6 supplement in reducing inflammation and improving DES symptoms. More studies are required in order to consider these supplements as part of an established protocol to treat DES. (Editors comments)

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