Skip to content
Winnowleaf home

Does fish oil help dry eye?

Probably not much. In the largest and best trial, 535 people with moderate to severe dry eye took 3,000 mg of fish oil a day or an olive oil placebo for a year, and their symptoms improved by about the same amount (grade B for no clear benefit). Pooled smaller trials suggest a small, uncertain gain at most. High doses of fish oil raise the risk of an irregular heartbeat.

Last reviewed

How we grade evidenceEditorial policy

What the studies found

  • Grade B. The DREAM trial gave 535 people with moderate to severe dry eye either fish oil (3,000 mg of EPA and DHA daily) or an olive oil placebo for 12 months. Symptom scores fell by about the same amount in both groups (13.9 and 12.5 points on a 100-point scale), and tear tests and eye-surface staining did not differ either. (Asbell 2018)
  • Grade C. When 43 of those people who had taken fish oil for a year were switched at random to keep taking it or to take placebo, the ones who stopped did no worse over the next 12 months. (Hussain 2020)
  • Grade C. Pooled results are uncertain. In the 4 trials that compared long-chain omega-3 with placebo on symptoms (677 people), a Cochrane review found little to no reduction, and a slight rise in tear production that was too small to matter. A 2026 review found that marine omega-3 changed the symptom score by 4.4 points in 6 trials, below the 7 points that count as a real difference to patients. (Downie 2019, Alamoudi 2026)

Who should be careful

  • In 7 heart trials (81,210 people), fish oil supplements made atrial fibrillation (an irregular heartbeat) more likely, more so in trials that used more than 1 g a day. (Gencer 2021)
  • If you take a blood thinner such as warfarin, or an antiplatelet medicine, ask your doctor or pharmacist before you start fish oil.
  • Pregnant or breastfeeding, or under 18: ask a clinician first.
  • See an eye doctor soon for eye pain, sensitivity to light, a change in vision, or a red eye with discharge. Dry eyes together with a dry mouth or aching joints can be a sign of Sjögren's disease, an autoimmune condition, and are worth a check.
  • Don't stop or change prescribed eye drops on your own.

Try first

  • Over-the-counter artificial tears. A Cochrane review of 43 trials (3,497 people) found they may be a safe and effective way to treat dry eye, and most types seem to work about as well as each other. (Pucker 2016)
  • An eye exam to find the cause (too few tears, tears that evaporate too fast, a medicine side effect, or a condition such as Sjögren's), since the right treatment depends on it.

Sources

  1. Asbell PA, et al. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018. PubMed 29652551 · doi:10.1056/NEJMoa1709691
  2. Hussain M, et al. The Dry Eye Assessment and Management (DREAM) extension study - A randomized clinical trial of withdrawal of supplementation with omega-3 fatty acid in patients with dry eye disease. Ocul Surf. 2020. PubMed 31425752 · doi:10.1016/j.jtos.2019.08.002
  3. Downie LE, et al. Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease. Cochrane Database Syst Rev. 2019. PubMed 31847055 · doi:10.1002/14651858.CD011016.pub2
  4. Alamoudi A, et al. Oral Nutritional Supplements for Dry Eye Disease. A Systematic Review with Pairwise and Exploratory Network Meta-Analysis of Randomized Controlled Trials. Semin Ophthalmol. 2026. PubMed 42949566 · doi:10.1080/08820538.2026.2753569
  5. Gencer B, et al. Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation. 2021. PubMed 34612056 · doi:10.1161/CIRCULATIONAHA.121.055654
  6. Pucker AD, et al. Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Database Syst Rev. 2016. PubMed 26905373 · doi:10.1002/14651858.CD009729.pub2