(I-MED Pharma)
Did you know that most North Americans don’t get enough omega-3 from their diet[1]? Because these fatty acids play a key role in fighting dry eye disease, some turn to supplements to make up the difference and ensure they’re getting the recommended amount. However, when it comes to choosing the best omega-3 supplement for dry eyes, quality matters. In this article, we’ll explore the nutritional role of omega-3, what exactly rTG omega-3 means, and what ultimately makes a good omega-3 supplement, especially when used as part of a dry eye management toolkit.
Dry Eye Disease
Dry eye disease (DED) is a multifactorial disease characterized by an imbalance in the tear film, the protective layer covering the surface of the eye, accompanied by discomforting symptoms as well as ocular surface inflammation and damage[2]. When it comes to dry eye, complexity is the nature of the beast, so understandably, the recommended approach to managing and treating it is multifaceted. One of the recommendations made in the TFOS DEWS II Report, a comprehensive report on the consensus around dry eye management and treatment, is to supplement the diet with omega-3 fatty acids.
The Science Behind Omega-3 and Dry Eye
Omega-3s are considered essential fatty acids, so named because they are essential for healthy metabolic processes. Since the human body is unable to produce them, it’s important to get these fatty acids through our diet[3]. Two of the most important omega-3s, EPA and DHA, are predominantly found in fish and shellfish. However, even if you eat a large quantity of oily fish, it is still difficult to meet the recommended intake through your diet alone[4], which makes nutritional supplements an important method to meet these dietary recommendations.
Omega-3 fatty acids have been recognized for their overall anti-inflammatory effects, with research indicating that they reduce inflammatory markers that contribute to dry eye disease. What’s more, studies found that omega-3 intake improved the function of the meibomian glands[5]. These glands in the eyelids produce the oily outer layer of the tear film, which prevents tears from evaporating too quickly and helps keep the eye hydrated.
Benefits of Omega-3
Omega-3s play a key role in fighting dry eye disease and improving discomforting symptoms. In patients who suffer from dry eye associated with meibomian gland dysfunction (MGD), one study noted expressly that taking omega-3 supplements improved both physical and mental symptoms over the course of the treatment, leading to an overall improvement in health-related quality of life[6]. Ingesting omega-3 in the rTG form has been shown to support the tear film and improve overall symptoms of dry eye[7], and taking rTG omega-3 supplements has also been shown to improve the comfort levels of patients experiencing dry eye as a result of cataract surgery[8].
What is rTG Omega-3?
So what exactly does rTG omega-3 mean? Omega-3 in the rTG (re-esterified triglyceride) form has been specially processed to make it easier to absorb into the bloodstream. While EPA and DHA are found primarily in fish, fish often contains mercury and carcinogens. To make it safe for consumption, most fish oil is subjected to a detoxification process that involves adding alcohol. However, this alcohol changes the form of the natural triglycerides in the fish oil, making them difficult for the human body to digest. Some fish oil is sold at this stage, in this ethyl ester form, but to improve the potency, it can be put through the process of re-esterification. This additional step removes the alcohols from the purified fish oil, turning the triglycerides back into the more bioavailable rTG form for easier digestion and better absorption[9].
Choosing the Right Omega-3 Supplement for Dry Eyes
For patients looking for the best omega-3 supplement for dry eyes, ensure the product you choose contains omega-3 in the rTG form for better overall quality, and that it contains the right kinds of omega-3s. For those in Canada, I-VU® OMEGA-3 PLUS is an ideal solution: this Health Canada-licensed nutritional supplement is formulated specifically for dry eyes. While many products contain little, if any, EPA or DHA, these softgel capsules provide a high daily dose of EPA, DHA, and DPA in the rTG form vs. the ethyl ester form. Another option is the I-VU® OMEGA-3 liquid supplement with added vitamin D3 and the omega-6 essential fatty acid GLA. The capsules are available in both 30-day and 60-day formats, and the liquid is available in a 48-day format, with both supplements containing the same high-quality omega-3s. Make sure to consult your health professional before adding any nutritional supplements to your dietary regimen.
To reap the full benefits of an rTG omega-3 supplement, ensure you’re regularly taking the right dosage and maintain these supplements as part of your dietary regimen over time. Studies have shown improvement over periods of 3 months, or 12 weeks[10], [11], so stick with it for the best results!
Further Steps toward Comfort
An omega-3 supplement is one step in a systemic approach to finding relief from the symptoms of dry eye. Regular use of preservative-free artificial tears and maintaining good ocular hygiene are also of critical importance, but especially when combined with some simple lifestyle changes – like staying hydrated, getting enough sleep, and being mindful of your environment – adding a nutritional boost to supplement your multi-step dry eye routine can help make all the difference in your comfort!
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[1] Langlois, Kellie, and Walisundera M N Ratnayake. “Omega-3 Index of Canadian Adults.” PubMed, U.S. National Library of Medicine, Nov. 2015, https://pubmed.ncbi.nlm.nih.gov/26583692/.
[2] Craig, Jennifer P., et al. TFOS DEWS II Report. Tear Film & Ocular Surface Society, 2017, https://www.tfosdewsreport.org/report-management_and_therapy/147_36/en/#A153. Accessed 11 Mar. 2025.
[3] Craig, Jennifer P., et al. TFOS DEWS II Report. Tear Film & Ocular Surface Society, 2017, https://www.tfosdewsreport.org/report-management_and_therapy/147_36/en/#A153. Accessed 11 Mar. 2025.
[4] “Omega-3 Fatty Acids.” NIH Office of Dietary Supplements, U.S. Department of Health and Human Services, https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/#h3. Accessed 11 Mar. 2025.
[5] Craig, Jennifer P., et al. TFOS DEWS II Report. Tear Film & Ocular Surface Society, 2017, https://www.tfosdewsreport.org/report-management_and_therapy/147_36/en/#A153. Accessed 11 Mar. 2025.
[6] Oleñik, Andrea, et al. “Benefits of omega-3 fatty acid dietary supplementation on health-related quality of life in patients with meibomian gland dysfunction.” Clinical Ophthalmology, Dove Press, 30 Apr. 2014, https://doi.org/10.2147/OPTH.S62470.
[7] Epitropoulos, Alice T., et al. “Effect of oral re-esterified omega-3 nutritional supplementation on Dry eyes.” Cornea, vol. 35, no. 9, Sept. 2016, pp. 1185–1191, https://doi.org/10.1097/ico.0000000000000940.
[8] Park, Jongyeop, et al. “Effects of the Re-Esterified Triglyceride (RTG) Form of Omega-3 Supplements on Dry Eye Following Cataract Surgery.” British Journal of Ophthalmology, BMJ Publishing Group Ltd, 1 Nov. 2021, https://bjo.bmj.com/content/105/11/1504.
[9] Epitropoulos, Alice T., et al. “Effect of oral re-esterified omega-3 nutritional supplementation on Dry eyes.” Cornea, vol. 35, no. 9, Sept. 2016, pp. 1185–1191, https://doi.org/10.1097/ico.0000000000000940.
[10] Epitropoulos, Alice T., et al. “Effect of oral re-esterified omega-3 nutritional supplementation on Dry eyes.” Cornea, vol. 35, no. 9, Sept. 2016, pp. 1185–1191, https://doi.org/10.1097/ico.0000000000000940.
[11] Oleñik, Andrea, et al. “Benefits of omega-3 fatty acid dietary supplementation on health-related quality of life in patients with meibomian gland dysfunction.” Clinical Ophthalmology, Dove Press, 30 Apr. 2014, https://doi.org/10.2147/OPTH.S62470.