Contact Lens & Anterior Eye 38 (2015) 206–210 Contents lists available at ScienceDirect Contact Lens & Anterior Eye jou rnal h om epa ge : w ww.e l sevier.com/locate/clae Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye Rahul Bhargava a,∗ , Prachi Kumar b , Hemant Phogat c , Avinash Kaur c , Manjushri Kumar d a Laser Eye Clinic, Noida 201301, India b Department of Pathology, Santosh Medical College and Hospital, Ghaziabad 201301, India c Department of Ophthalmology, Rotary Eye Hospital, Maranda, Palampur 176102, India d Department of Microbiology, Narayan Medical College, Sasaram, India a r t i c l e i n f o Article history: Received 5 May 2014 Received in revised form 3 December 2014 Accepted 26 January 2015 Keywords: Computer vision syndrome Dry eye Goblet cell density Tear film break up time Omega 3 fatty acids (O3FAs) a b s t r a c t Purpose: To assess the efficacy of dietary consumption of omega-3 fatty acids (O3FAs) on dry eye symp- toms, Schirmer test, tear film break up time (TBUT) and conjunctival impression cytology (CIC) in patients with computer vision syndrome. Setting and design: Interventional, randomized, double blind, multi-centric study. Methods: Four hundred and seventy eight symptomatic patients using computers for more than 3 h per day for minimum 1 year were randomized into two groups: 220 patients received two capsules of omega- 3 fatty acids each containing 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA) daily (O3FA group) and 236 patients received two capsules of a placebo containing olive oil daily for 3 months (placebo group). The primary outcome measure was improvement in dry eye symptoms and secondary outcome measures were improvement in Nelson grade and an increase in Schirmer and TBUT scores at 3 months. Results: In the placebo group, before dietary intervention, the mean symptom score, Schirmer, TBUT and CIC scores were 7.5 ± 2, 19.9 ± 4.7 mm, 11.5 ± 2 s and 1 ± 0.9 respectively, and 3 months later were 6.8 ± 2.2, 20.5 ± 4.7 mm, 12 ± 2.2 s and 0.9 ± 0.9 respectively. In the O3FA group, these values were 8.0 ± 2.6, 20.1 ± 4.2 mm, 11.7 ± 1.6 s and 1.2 ± 0.8 before dietary intervention and 3.9 ± 2.2, 21.4 ± 4 mm, 15 ± 1.7 s, 0.5 ± 0.6 after 3 months of intervention, respectively. Conclusion: This study demonstrates the beneficial effect of orally administered O3FAs in alleviating dry eye symptoms, decreasing tear evaporation rate and improving Nelson grade in patients suffering from computer vision syndrome related dry eye. © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. 1. Introduction Dry eye syndrome is public health problem affecting vision related quality of life. Recently, there have been significant advances in our understanding of the dry eye pathogenesis; ocular surface inflammation is now considered to be an integral part of dry eye disease [1]. Ocular surface health may be influenced by hormones, contact lens wear, refractive surgeries, humidity, medications, smoking and computer work [2–5]. ∗ Corresponding author at: B2/004, Ananda Apartments, Sector-48, Noida 201301, India. Tel.: +91 9999055223; fax: +91 1772801202. E-mail address: brahul 2371@yahoo.co.in (R. Bhargava). Role of personal computers has increased exponentially in all spheres of life (school, office and home). Almost everyone including children, college students, software professionals and the elderly are hooked on to the computers every day, ranging from 2 to 12 h; use of mobile phones further add to the overall burden. Prolonged visual display terminal tasks reduce blink rate, blink amplitude and blink quality leading to tear film instability [6,7]. People experience one or more symptoms referred to as computer vision syndrome; these include eye strain, tired eyes, headache, burning of eyes, redness, foreign body sensation, blurring of vision, sometimes accompanied by backache and neck pain; visual symp- toms predominate in 64–90% patients [8–10]. Artificial tear supplements are commonly used to treat dry eye in computer users; although, these supplements provide symp- tomatic relief, they do alter the pathophysiology of dry eye [11–13]. http://dx.doi.org/10.1016/j.clae.2015.01.007 1367-0484/© 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.