{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:48:14Z","timestamp":1788482894745,"version":"build-2803163510"},"reference-count":78,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T00:00:00Z","timestamp":1587513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Melbourne International Research Training Scholarship","award":["PhD research scholarship"],"award-info":[{"award-number":["PhD research scholarship"]}]},{"name":"Australian Government Research Training Program Scholarship","award":["PhD research scholarship"],"award-info":[{"award-number":["PhD research scholarship"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>This study investigated optometrists\u2019 attitudes and self-reported practice behaviors towards omega-3 fatty acids for eye health, and knowledge and understanding of their potential risks and benefits. An anonymous online survey was distributed to optometrists in Australia and New Zealand. Questions included practitioner demographics and practice modality; self-reported practices and recommendations relating to diet, nutritional supplements, and omega-3 fatty acids for age-related macular degeneration (AMD) and dry eye disease (DED); and practitioner knowledge about omega-3 fatty acids. Of 206 included surveys, most respondents (79%) indicated recommending for their patients to consume omega-3 fatty acids to improve their eye health. Sixty-eight percent of respondents indicated recommending omega-3-rich foods for AMD management, while 62% indicated recommending omega-3 supplements. Most respondents (78%) indicated recommending omega-3-rich foods or supplements for DED. For DED, recommended omega-3 supplement dosages were (median [inter-quartile range, IQR]) 2000 mg [1000\u20132750 mg] per day. The main sources of information reported by respondents to guide their clinical decision making were continuing education articles and conferences. In conclusion, optometrists routinely make clinical recommendations about diet and omega-3 fatty acids. Future education could target improving optometrists\u2019 knowledge of differences in the evidence for whole-food versus supplement sources of omega-3 fatty acids in AMD. Further research is needed to address uncertainties in the evidence regarding optimal omega-3 dosage and formulation composition in DED.<\/jats:p>","DOI":"10.3390\/nu12041179","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T10:46:22Z","timestamp":1587638782000},"page":"1179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Omega-3 Fatty Acids and Eye Health: Opinions and Self-Reported Practice Behaviors of Optometrists in Australia and New Zealand"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-2870","authenticated-orcid":false,"given":"Alexis Ceecee","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3519-7037","authenticated-orcid":false,"given":"Sumeer","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8297-5319","authenticated-orcid":false,"given":"Jennifer P.","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland 1023, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1596-2259","authenticated-orcid":false,"given":"Laura E.","family":"Downie","sequence":"additional","affiliation":[{"name":"Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC 3053, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lawrenson, J.G., and Downie, L.E. (2019). Nutrition and Eye Health. Nutrients, 11.","DOI":"10.3390\/nu11092123"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1038\/sj.ejcn.1601478","article-title":"Polyunsaturated fatty acids, inflammation and immunity","volume":"56","author":"Calder","year":"2002","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s11745-005-1440-y","article-title":"Dietary alpha-linolenic acid increases brain but not heart and liver docosahexaenoic acid levels","volume":"40","author":"Collison","year":"2005","journal-title":"Lipids"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0005-2760(94)00054-9","article-title":"Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males","volume":"1213","author":"Emken","year":"1994","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_5","first-page":"159","article-title":"Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)?","volume":"68","author":"Gerster","year":"1998","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S0002-8223(21)01118-4","article-title":"Omega-3 fatty acids: Comparison of plant and seafood sources in human nutrition","volume":"91","author":"Nettleton","year":"1991","journal-title":"J. Am. Diet Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.plipres.2013.10.002","article-title":"Long-chain polyunsaturated fatty acids (LCPUFA) from genesis to senescence: The influence of LCPUFA on neural development, aging, and neurodegeneration","volume":"53","author":"Janssen","year":"2014","journal-title":"Prog. Lipid Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0753-3322(02)00253-6","article-title":"The importance of the ratio of omega-6\/omega-3 essential fatty acids","volume":"56","author":"Simopoulos","year":"2002","journal-title":"Biomed. Pharmacother."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Meyer, B.J. (2016). Australians are not Meeting the Recommended Intakes for Omega-3 Long Chain Polyunsaturated Fatty Acids: Results of an Analysis from the 2011\u20132012 National Nutrition and Physical Activity Survey. Nutrients, 8.","DOI":"10.3390\/nu8030111"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/ICU.0b013e3283477d23","article-title":"Nutritional supplements for dry eye syndrome","volume":"22","author":"Rand","year":"2011","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.preteyeres.2004.06.002","article-title":"The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina","volume":"24","author":"SanGiovanni","year":"2005","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II Epidemiology Report","volume":"15","author":"Stapleton","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jtos.2015.11.002","article-title":"Economic and Humanistic Burden of Dry Eye Disease in Europe, North America, and Asia: A Systematic Literature Review","volume":"14","author":"McDonald","year":"2016","journal-title":"Ocul. Surf."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1185\/03007995.2011.566264","article-title":"Work productivity loss in patients with dry eye disease: An online survey","volume":"27","author":"Patel","year":"2011","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jtos.2017.05.008","article-title":"TFOS DEWS II Definition and Classification Report","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jtos.2017.05.011","article-title":"TFOS DEWS II pathophysiology report","volume":"15","author":"Bron","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/978-1-4615-0717-8_62","article-title":"Correlations between nutrient intake and the polar lipid profiles of meibomian gland secretions in women with Sjogren\u2019s syndrome","volume":"506","author":"Sullivan","year":"2002","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1167\/iovs.16-19131","article-title":"\u03c9-3 Tear Film Lipids Correlate With Clinical Measures of Dry Eye","volume":"57","author":"Walter","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1093\/ajcn\/82.4.887","article-title":"Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women","volume":"82","author":"Miljanovic","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1056\/NEJMoa1709691","article-title":"n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease","volume":"378","author":"Asbell","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ophtha.2016.09.023","article-title":"A Randomized, Double-Masked, Placebo-Controlled Clinical Trial of Two Forms of Omega-3 Supplements for Treating Dry Eye Disease","volume":"124","author":"Deinema","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1097\/ICO.0000000000000940","article-title":"Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes","volume":"35","author":"Epitropoulos","year":"2016","journal-title":"Cornea"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1016\/j.ophtha.2013.04.006","article-title":"Short-term Consumption of Oral Omega-3 and Dry Eye Syndrome","volume":"120","author":"Kangari","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/ICO.0b013e3181f22e03","article-title":"Pilot, prospective, randomized, double-masked, placebo-controlled clinical trial of an omega-3 supplement for dry eye","volume":"30","author":"Wojtowicz","year":"2011","journal-title":"Cornea"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Downie, L.E., Ng, S.M., Lindsley, K.B., and Akpek, E.K. (2019). Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease. Cochrane Database Syst. Rev., CD011016.","DOI":"10.1002\/14651858.CD011016.pub2"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.preteyeres.2018.04.006","article-title":"A new perspective on lipid research in age-related macular degeneration","volume":"67","author":"Emri","year":"2018","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_27","first-page":"78","article-title":"Effect of dietary fish oil on acute light-induced photoreceptor damage in the rat retina","volume":"35","author":"Reme","year":"1994","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"799","DOI":"10.2353\/ajpath.2009.090089","article-title":"A high omega-3 fatty acid diet reduces retinal lesions in a murine model of macular degeneration","volume":"175","author":"Tuo","year":"2009","journal-title":"Am. J. Pathol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/jnc.13487","article-title":"Synthesis of docosahexaenoic acid from eicosapentaenoic acid in retina neurons protects photoreceptors from oxidative stress","volume":"136","author":"Agnolazza","year":"2016","journal-title":"J. Neurochem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/archophthalmol.2009.76","article-title":"Dietary fatty acids and the 10-year incidence of age-related macular degeneration: The Blue Mountains Eye Study","volume":"127","author":"Tan","year":"2009","journal-title":"Arch. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.ophtha.2016.12.033","article-title":"Dietary Intakes of Eicosapentaenoic Acid and Docosahexaenoic Acid and Risk of Age-Related Macular Degeneration","volume":"124","author":"Wu","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_32","first-page":"CD010015","article-title":"Omega 3 fatty acids for preventing or slowing the progression of age-related macular degeneration","volume":"4","author":"Lawrenson","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ophtha.2018.08.006","article-title":"Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The EYE-RISK Consortium","volume":"126","author":"Merle","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lawrenson, J.G., and Evans, J.R. (2013). Advice about diet and smoking for people with or at risk of age-related macular degeneration: A cross-sectional survey of eye care professionals in the UK. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-564"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Downie, L.E., and Keller, P.R. (2015). The self-reported clinical practice behaviors of Australian optometrists as related to smoking, diet and nutritional supplementation. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0124533"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/cxo.12216","article-title":"Optometry Australia Entry-level Competency Standards for Optometry 2014","volume":"98","author":"Kiely","year":"2015","journal-title":"Clin. Exp. Optom."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/opo.12353","article-title":"What do patients think about the role of optometrists in providing advice about smoking and nutrition?","volume":"37","author":"Downie","year":"2017","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Age-Related Eye Disease Study Research Group (2001). A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch. Ophthalmol., 119, 1417\u20131436.","DOI":"10.1001\/archopht.119.10.1417"},{"key":"ref_39","unstructured":"Australian Government Department of Health (2020, February 01). Health Workforce Data: Optometrists 2017 Factsheet, Available online: https:\/\/hwd.health.gov.au."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.clae.2009.04.002","article-title":"Optometry and optics in Europe","volume":"32","author":"Naroo","year":"2009","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.clae.2019.02.008","article-title":"Is there scope for expanding the optometrist\u2019s scope of practice in Singapore?\u2014A survey of optometrists, opticians in Singapore","volume":"42","author":"George","year":"2019","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1001\/jamaophthalmol.2017.5081","article-title":"Access to Ophthalmologists in States Where Optometrists Have Expanded Scope of Practice","volume":"136","author":"Stein","year":"2018","journal-title":"JAMA Ophthalmol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1080\/03036758.2019.1587476","article-title":"The changing scope of Optometry in New Zealand: Historical perspectives, current practice and research advances","volume":"49","author":"Black","year":"2019","journal-title":"J. R. Soc. N. Z."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/opo.12262","article-title":"Scope of practice of optometrists working in the UK Hospital Eye Service: A national survey","volume":"36","author":"Harper","year":"2016","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_45","unstructured":"Optometry Board of Australia (2020, February 01). Optometry Board of Australia Registrant Data: Reporting Period: 01 October 2019 to 31 December 2019. Available online: https:\/\/optometryboard.com.au."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1001\/archopht.126.9.1274","article-title":"The relationship of dietary omega-3 long-chain polyunsaturated fatty acid intake with incident age-related macular degeneration: AREDS report no. 23","volume":"126","author":"SanGiovanni","year":"2008","journal-title":"Arch. Ophthalmol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ajo.2018.09.036","article-title":"Intake of Vegetables, Fruit, and Fish is Beneficial for Age-Related Macular Degeneration","volume":"198","author":"Buitendijk","year":"2019","journal-title":"Am. J. Ophthalmol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/archopht.126.6.826","article-title":"Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: A systematic review and meta-analysis","volume":"126","author":"Chong","year":"2008","journal-title":"Arch. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Zhu, W., Wu, Y., Meng, Y.F., Xing, Q., Tao, J.J., and Lu, J. (2016). Fish Consumption and Age-Related Macular Degeneration Incidence: A Meta-Analysis and Systematic Review of Prospective Cohort Studies. Nutrients, 8.","DOI":"10.3390\/nu8110743"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1001\/jama.2013.4997","article-title":"Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial","volume":"309","author":"SanGiovanni","year":"2013","journal-title":"JAMA"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1001\/jama.1994.03520180037032","article-title":"Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group","volume":"272","author":"Seddon","year":"1994","journal-title":"JAMA"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2147\/VHRM.S50464","article-title":"Steady-state bioavailability of prescription omega-3 on a low-fat diet is significantly improved with a free fatty acid formulation compared with an ethyl ester formulation: The ECLIPSE II study","volume":"9","author":"Offman","year":"2013","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.plefa.2010.06.007","article-title":"Bioavailability of marine n-3 fatty acid formulations","volume":"83","author":"Dyerberg","year":"2010","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/OPX.0000000000000285","article-title":"Nutrition and age-related macular degeneration: Research evidence in practice","volume":"91","author":"Downie","year":"2014","journal-title":"Optom. Vis. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/opo.12280","article-title":"Comparing self-reported optometric dry eye clinical practices in Australia and the United Kingdom: Is there scope for practice improvement?","volume":"36","author":"Downie","year":"2016","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/opo.12349","article-title":"A comparison of the self-reported dry eye practices of New Zealand optometrists and ophthalmologists","volume":"37","author":"Xue","year":"2017","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1097\/ICO.0000000000000874","article-title":"Influence of Omega 3 and 6 Fatty Acids on Human Meibomian Gland Epithelial Cells","volume":"35","author":"Liu","year":"2016","journal-title":"Cornea"},{"key":"ref_58","first-page":"336","article-title":"The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis)","volume":"106","author":"Macsai","year":"2008","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jtos.2017.05.006","article-title":"TFOS DEWS II Management and Therapy Report","volume":"15","author":"Jones","year":"2017","journal-title":"Ocul. Surf."},{"key":"ref_60","first-page":"e673","article-title":"Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association","volume":"140","author":"Wilson","year":"2019","journal-title":"Circulation"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1159\/000502652","article-title":"International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major Depressive Disorder","volume":"88","author":"Guu","year":"2019","journal-title":"Psychother. Psychosom."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1167\/iovs.18-24758","article-title":"Modulating Contact Lens Discomfort With Anti-Inflammatory Approaches: A Randomized Controlled Trial","volume":"59","author":"Downie","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jtos.2019.11.004","article-title":"An artificial tear containing flaxseed oil for treating dry eye disease: A randomized controlled trial","volume":"18","author":"Downie","year":"2020","journal-title":"Ocul. Surf."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"4474","DOI":"10.1167\/iovs.04-1394","article-title":"Systemic Omega-6 Essential Fatty Acid Treatment and PGE1 Tear Content in Sjogren\u2019s Syndrome Patients","volume":"46","author":"Aragona","year":"2005","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ajo.2018.01.004","article-title":"Relation Between Dietary Essential Fatty Acid Intake and Dry Eye Disease and Meibomian Gland Dysfunction in Postmenopausal Women","volume":"189","author":"Ziemanski","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/00003226-200303000-00002","article-title":"Systemic linoleic and gamma-linolenic acid therapy in dry eye syndrome with an inflammatory component","volume":"22","author":"Barabino","year":"2003","journal-title":"Cornea"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e591","DOI":"10.1111\/j.1755-3768.2011.02196.x","article-title":"A multicentre, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients","volume":"89","author":"Baudouin","year":"2011","journal-title":"Acta Ophthal."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.plefa.2016.01.003","article-title":"Conducting omega-3 clinical trials with cardiovascular outcomes: Proceedings of a workshop held at ISSFAL 2014","volume":"107","author":"Rice","year":"2016","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Zhang, A.C., and Downie, L.E. (2019). Preliminary Validation of a Food Frequency Questionnaire to Assess Long-Chain Omega-3 Fatty Acid Intake in Eye Care Practice. Nutrients, 11.","DOI":"10.3390\/nu11040817"},{"key":"ref_70","unstructured":"National Health and Medical Research Council (2006). Nutrient Reference Values for Australia and New Zealand including Recommended Dietary Intakes."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.plefa.2006.05.013","article-title":"Metabolism of \u03b1-linolenic acid in humans","volume":"75","author":"Burdge","year":"2006","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"592s","DOI":"10.3945\/jn.111.155259","article-title":"Mechanisms of action of (n-3) fatty acids","volume":"142","author":"Calder","year":"2012","journal-title":"J. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"35c","DOI":"10.1016\/j.amjcard.2006.11.020","article-title":"Safety considerations with omega-3 fatty acid therapy","volume":"99","author":"Bays","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Villani, A.M., Crotty, M., Cleland, L.G., James, M.J., Fraser, R.J., Cobiac, L., and Miller, M.D. (2013). Fish oil administration in older adults: Is there potential for adverse events? A systematic review of the literature. BMC Geriatr., 13.","DOI":"10.1186\/1471-2318-13-41"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.plefa.2018.01.001","article-title":"Safety and tolerability of prescription omega-3 fatty acids: A systematic review and meta-analysis of randomized controlled trials","volume":"129","author":"Chang","year":"2018","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/OPX.0000000000000550","article-title":"Attitudes and barriers to evidence-based practice in optometry educators","volume":"92","author":"Suttle","year":"2015","journal-title":"Optom. Vis. Sci."},{"key":"ref_77","unstructured":"Optometry Australia: Clinical Practice Guide for the Diagnosis, Treatment and Management of Age-Related Macular Degeneration (2020, February 01). Optometry Austraia. Available online: https:\/\/www.optometry.org.au."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.jtos.2017.08.003","article-title":"TFOS DEWS II Report Executive Summary","volume":"15","author":"Craig","year":"2017","journal-title":"Ocul. 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