Why Omega-3 is Important for Dry Eyes

Why is Omega-3 Important?

Omega-3 oil, celebrated for its innate anti-inflammatory qualities, has demonstrated its efficacy in relieving inflammation and associated symptoms in Dry Eye Disease [1]. Beyond its benefits for eye health, Omega-3 also contributes to cardiovascular well-being, cognitive function enhancement, mental health support, bolstering bone and joint health, and provides numerous other systemic advantages [2]. With a variety of Omega-3 supplements on the market, it becomes important to choose the most appropriate supplement tailored to your individual needs. Factors such as component ratios, daily dosage, and formulation can vary significantly, making informed selection crucial for optimal results.



rTG omega-3 soft gells compared to Ethyl Ester Omega-3




What is Re-Esterfied Triglyceride Form Omega-3?

   The term “Re-Esterified Triglyceride Form” refers to the production process. While fish oils naturally exist in triglyceride form, the oil extracted from fish must undergo purification. Ethyl ester alcohol is used to remove toxins. To reduce expenses, many companies end the process here, while the companies we recommend go one step further, converting the ethyl alcohol form into a purified omega-3, essentially replicating its natural state. Product labels may not specify if the oils are in the ethyl ester form or have undergone additional processing.

The rTG form of Omega-3 is more digestible, enabling improved absorption [4] and utilization of Omega-3 by the body, thereby reducing common side effects associated with ethyl ester forms.



The process of extracting rTG form Omega-3 from fish oil



Does Omega-3 interact with other medications?

   While Omega-3 supplements are generally safe, consulting with your physician or pharmacist is always recommended before starting any supplement. Certain Omega-3 brands contain synthetic Vitamin E, which may elevate the risk of bleeding and prostate cancer. Moreover, Omega-3 itself can also thin the blood, making it incompatible with other blood-thinning medications [5], and certain chronic health conditions.



I eat a lot of fish, do I need to take a supplement too?

   The recommended dosage of Omega-3 for alleviating dry eye symptoms is significantly higher than one might anticipate. To attain the equivalent amount, one would need to consume seven servings of salmon or thirty-seven cans of tuna weekly. However, processed fish products contain elevated levels of mercury, which could be harmful or even lethal at such high consumption rates [6].



rTG Omega-3 compared to salmon and tuna consumption



Why fish oil?

   Omega-3 sourced from cold water fish has proven the most successful in relieving symptoms of dry eye . These fish oils contain “long-chain” omega-3s (EPA and DHA). Conversely, plant-based omega-3s are classified as “short-chain” omega-3s (ALA). The body converts ALA into EPA and DHA, but the conversion rate is limited. This means that a significant amount of plant-based omega-3 sources would need to be consumed in order to absorb equivalent amounts of long-chain omega-3s [7]. For those unable to consume fish due to allergies or dietary restrictions, algae supplements can serve as an excellent alternative, provided they contain both EPA and DHA.



What about Omega-6 and Omega-9? Isn’t taking more omegas better?

Omega-6 and Omega-9 oils are found in commonly consumed foods such as fried foods, corn, vegetable oil, poultry and more. Excessive intake of these oils can lead to pro-inflammatory effects, exacerbating dry eye symptoms. Typically, our diets here in Alberta already provide sufficient levels of Omega-6 and Omega-9 essential for the body, making supplementation unnecessary and potentially counterproductive [8] unless specifically recommended by a healthcare professional.


How do I choose the best Omega-3 Supplement?

  1. Opt for a 3:1 EPA & DHA Ratio: Clinical studies have shown that a 3:1 ratio of EPA to DHA holds statistical significance in effectively treating dry eye disease. [1][3]
  2. Ensure a Minimum Daily Dose of 2000mg: To activate anti-inflammatory benefits, it’s essential to meet or exceed a daily serving of at least 2000mg. [1][3]
  3. Choose Re-esterified Triglyceride (rTG) Form: Opt for supplements in the re-esterified triglyceride (rTG) form, as they are more efficiently metabolized and absorbed by the body compared to ethyl ester form Omega-3 supplements. [4]


1 – Calder, Philip, Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clinical Pharmacol 2013.
2 – Ajmera, Rachael, Gans, Keri, 6 Health Benefits of Omega-3 Fatty Acids. Forbes Health 2024
3 – Epitropoulos, Alice T., Donnenfeld, Eric, D., Effect of Oral Re-esterfied Omega-3 Nutritional Supplementation on Dry Eyes. Cornea 2016.
4 – Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010 Sep;83(3):137-41. doi: 10.1016/j.plefa.2010.06.007. PMID: 20638827.
5 – Gross BW, Gillio M, Rinehart CD, Lynch CA, Rogers FB. Omega-3 Fatty Acid Supplementation and Warfarin: A Lethal Combination in Traumatic Brain Injury. J Trauma Nurs. 2017 Jan/Feb;24(1):15-18. doi: 10.1097/JTN.0000000000000256. PMID: 28033135.
6 – Mercury in Fish – Questions and Answers. Health Canada 2019
7 – Nettleton JA. Omega-3 fatty acids: comparison of plant and seafood sources in human nutrition. J Am Diet Assoc. 1991 Mar;91(3):331-7. PMID: 1825498.
8 – Simopoulos, A.P., The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine and Pharmacotherapy, vol. 56, no. 8 2002.
* Based on PRN DE Omega-3

Written & Researched by Holly, our Ocular Hygienistprofile photo of Ocular Hygienist