Omega-3 has been the go-to supplement recommendation for dry eyes for decades. But the science is more complicated than most people realize — and there's a different kind of evidence worth knowing about.
If you've ever mentioned dry eye symptoms to a doctor, a pharmacist, or a wellness-minded friend, you've probably heard the same advice: take omega-3 supplements. It's one of the most widely given recommendations in eye health — and for many people, it has become a fixture of their supplement routine.
But when researchers conducted the largest randomized clinical trial ever designed specifically to test whether omega-3 supplements help dry eye, the result was surprising: they didn't outperform placebo.
That doesn't mean omega-3 has no role in eye health. It means the picture is more nuanced — and that for the specific problem of insufficient tear production, there may be a more targeted approach. This article walks through what the evidence actually says for both omega-3 and MaquiBright®, a standardized maqui berry extract studied specifically for dry eye and tear fluid production.
The recommendation has a reasonable scientific basis. Omega-3 fatty acids — particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) — have well-documented anti-inflammatory properties. Since inflammation plays a role in dry eye disease, and since omega-3s appear to support the meibomian glands (which produce the outer lipid layer of the tear film that prevents evaporation), the logic made sense.
Early observational studies supported the connection. A 2005 analysis of the Women's Health Study found that women with low dietary intake of omega-3s had a higher incidence of dry eye. Several smaller clinical trials showed positive results.
By the 2010s, omega-3 supplementation had become a standard recommendation for dry eye disease in many clinical settings.
In 2018, the National Eye Institute funded the DREAM study (Dry Eye Assessment and Management) — the largest, most rigorous randomized clinical trial ever conducted on omega-3 and dry eye. It enrolled 535 patients with moderate to severe dry eye at 27 clinical sites and ran for 12 months.
The result: no statistically significant difference between the omega-3 group and the placebo group on the primary outcome measure (OSDI score), or on most secondary measures including Schirmer's test, tear break-up time, or corneal staining.
Asbell PA, Maguire MG, Pistilli M, et al. — The DREAM study, funded by the National Eye Institute, found that omega-3 supplementation (3,000 mg/day EPA+DHA for 12 months) was not superior to placebo on OSDI score or on secondary endpoints including Schirmer's test, tear break-up time, and conjunctival staining.
N Engl J Med. 2018;378(18):1681–1690. DOI: 10.1056/NEJMoa1709691 ↗It's worth noting that the placebo used olive oil — which itself has anti-inflammatory properties. This may have narrowed the gap between groups. The study has been debated extensively in the clinical literature.
A 2023 systematic review and meta-analysis of 19 randomized controlled trials (Wang & Ko, Journal of Clinical Medicine) did find a positive overall effect of omega-3 on dry eye symptoms — but noted that efficacy depends significantly on formulation (higher EPA percentage), dose, and duration of supplementation, and that heterogeneity between trials was high.
The takeaway: omega-3 supplementation may offer benefit for some subtypes of dry eye — particularly evaporative dry eye associated with meibomian gland dysfunction — but its effects are inconsistent, and it does not have a direct mechanism for stimulating tear fluid production in the lacrimal glands.
MaquiBright® is a standardized extract of maqui berry (Aristotelia chilensis), sourced from wild harvesting communities in southern Chile and produced by Anklam Extrakt GmbH in Germany. It is standardized to ≥25% delphinidins and ≥35% total anthocyanins, with delphinidin-3,5-O-diglucoside (D3G5G) as its primary active compound.
The mechanism is distinct from omega-3. Rather than targeting the meibomian glands and the lipid layer, MaquiBright® targets the lacrimal glands — the glands responsible for producing the aqueous (water) layer of the tear film.
Pre-clinical research has shown that D3G5G suppresses oxidative stress-induced apoptosis in lacrimal gland acinar cells, helping restore their secretory function. This is a specific, documented mechanism — not a general antioxidant effect.
Nakamura S, Tanaka J, Imada T, Shimoda H, Tsubota K. — Delphinidin-3,5-O-diglucoside, the primary anthocyanin in maqui berry, was shown to restore tear secretion in a rat dry eye model by suppressing oxidative stress in lacrimal gland tissue.
J Funct Foods. 2014;10:346–354. DOI: 10.1016/j.jff.2014.06.027 ↗Hitoe S, Tanaka J, Shimoda H. — A clinical pilot trial demonstrated that MaquiBright® supplementation significantly increased tear fluid production as measured by Schirmer's test. Both 30 mg and 60 mg daily doses produced improvements versus baseline.
Panminerva Med. 2014;56(3 Suppl 1):1–6. PMID: 25208615 ↗Yamashita S, Suzuki N, Yamamoto J, Iio S, Yamada T. — A rigorous RCT in 74 visual display terminal workers published in the Journal of Traditional and Complementary Medicine reported significant improvements in tear fluid production (P=0.005) and reduced eye fatigue (P=0.047) in participants taking MaquiBright® 60 mg/day for 4 weeks versus placebo.
J Tradit Complement Med. 2019;9(3):172–178. DOI: 10.1016/j.jtcme.2018.11.001 ↗Kundu G, et al. — A 2023 study published in the Indian Journal of Ophthalmology was the first to demonstrate reduction of inflammatory biomarkers in lacrimal fluid following maqui berry extract supplementation, providing molecular-level evidence for the mechanism of action in human subjects.
Indian J Ophthalmol. 2023;71(2):441–447. DOI: 10.4103/IJO.IJO_2909_22 ↗→ Explore the full list of peer-reviewed studies at mnl-group.com/en/clinical-studies
| Omega-3 (EPA/DHA) | MaquiBright® | |
|---|---|---|
| Primary mechanism | Anti-inflammatory; meibomian gland support (lipid layer) | Antioxidant; lacrimal gland support (aqueous layer) |
| Tear layer targeted | Lipid (outer) layer | Aqueous (middle) layer |
| Best studied for | Evaporative dry eye (meibomian gland dysfunction) | Aqueous-deficient dry eye; screen-induced dry eye |
| Largest RCT result | No significant difference vs. placebo (DREAM, 2018) | Significant increase in tear volume vs. placebo (P=0.005) |
| Schirmer's test evidence | Inconsistent across trials | Consistent improvement in pilot and RCT |
| Lacrimal biomarker data | Not available | Demonstrated in human subjects (Kundu et al., 2023) |
| Active compound | EPA, DHA (long-chain polyunsaturated fatty acids) | Delphinidin-3,5-O-diglucoside (D3G5G) |
Because they act through non-overlapping mechanisms — one targeting the lipid layer, the other the aqueous layer — combining them is physiologically rational. There is no known interaction between omega-3 fatty acids and maqui berry anthocyanins, and the two ingredients address complementary aspects of tear film stability.
For individuals with mixed dry eye (both evaporative and aqueous-deficient components), a combination approach may be worth discussing with an eye care professional.
When leading nutraceutical brands choose an ingredient, it signals trust, scientific validation, and market demand. MaquiBright® has earned exactly that, with recognized U.S. brands incorporating it into their eye health formulations:
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Is omega-3 effective for dry eye?
The evidence is mixed. The DREAM study — the largest RCT ever conducted on this topic (535 patients, 12 months) — found no significant benefit of omega-3 over placebo for moderate-to-severe dry eye. A 2023 meta-analysis of 19 trials did find positive results, but noted that efficacy depends significantly on formulation (higher EPA percentage), dose, and duration. Omega-3 may be more effective for evaporative dry eye driven by meibomian gland dysfunction than for aqueous-deficient dry eye.
What makes MaquiBright® different from omega-3 for dry eye?
They act through completely different mechanisms. Omega-3 primarily targets the meibomian glands and the lipid layer of the tear film, reducing evaporation through anti-inflammatory effects. MaquiBright® targets the lacrimal glands and the aqueous layer — its active compound (delphinidin-3,5-O-diglucoside) suppresses oxidative stress in lacrimal gland tissue, helping restore natural tear fluid production. In clinical trials, MaquiBright® showed statistically significant improvements in Schirmer's test (tear fluid volume) versus placebo.
What is the DREAM study?
The DREAM study (Dry Eye Assessment and Management) was a 12-month, randomized, double-blind, placebo-controlled trial funded by the National Eye Institute. It enrolled 535 adults with moderate-to-severe dry eye disease at 27 U.S. clinical sites and tested whether omega-3 supplementation (3,000 mg/day EPA+DHA) improved dry eye outcomes versus placebo. The study found no statistically significant difference between groups on the primary or most secondary endpoints. It remains the largest and most methodologically rigorous trial on this question to date.
Can omega-3 and MaquiBright® be taken together?
Yes. They work through non-overlapping mechanisms and address different layers of the tear film. There is no known interaction between omega-3 fatty acids and maqui berry anthocyanins. For individuals with mixed dry eye presentation, a combined approach may be discussed with an eye care professional.
What is MaquiBright®?
MaquiBright® is a patented, standardized extract of maqui berry (Aristotelia chilensis), produced by Anklam Extrakt GmbH in Germany from berries wild-harvested in Patagonia, Chile. It is standardized to ≥25% delphinidins and ≥35% total anthocyanins and is GRAS affirmed in the United States. MaquiBright® is a B2B ingredient developed by MNL Group and used in finished supplement products by brands including Life Extension, NOW Foods, and Swanson Health.
How long does it take for MaquiBright® to show effects?
In the 2019 RCT (Yamashita et al.), statistically significant improvements in tear fluid production were observed after 4 weeks of supplementation at 60 mg/day. The clinical pilot (Hitoe et al., 2014) also showed improvements within a similar timeframe. Individual results may vary.