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To investigate whether oral, long‐chain omega‐3 (ω‐3) essential fatty acid (EFA) supplementation, for 3 months, induces changes to the central corneal sub‐basal nerve plexus in dry eye disease and whether nerve alterations correlate with clinical findings.

This prospective, comparative study involved the final 12 participants enrolled in a randomised, double‐masked, placebo‐controlled clinical trial of 60 participants with moderate dry eye disease. Participants received either placebo (olive oil 1500 mg/day; n = 4) or ω‐3 EFA supplements (~1000 mg/day eicosapentaenoic acid + ~500 mg/day docosahexaenoic acid; n = 8) for 90 days. The main outcome measure was the mean change in central corneal sub‐basal plexus nerve parameters between days one and 90, quantified using in vivo confocal microscopy. Secondary outcomes included mean change in tear osmolarity, corneal dendritic …