Dry eye is common after LASIK vision correction surgery. Half the people who undergo LASIK have some degree of dry eyes after the procedure. The dry eye symptoms can persist for weeks, months, or even longer.
But to keep the problem in perspective, many people who seek LASIK already have dry eyes. Contact lens wearers who find their lenses uncomfortable because of dry eyes may investigate LASIK as an alternative because they do not want to wear eyeglasses.
Screening for LASIK has led to advances in dry eye detection and treatment. People wanting laser vision correction can solve their pre-existing dry eye problem before LASIK surgery.
Why LASIK Cause Dry Eyes?
LASIK causes some nerves in the cornea to be cut, which reduces corneal sensitivity. Your eye may not sense the need for lubrication, causing your body to produce fewer tears, leading to dry eye syndrome.
Dry eyes after LASIK can cause both discomfort and vision abnormalities. For this reason, many eye surgeons now recommend that you use lubricating eye drops or other therapies to help maintain eye moisture. As a precaution, you also may be given treatments to increase eye lubrication in advance of a LASIK procedure, even if you don’t have any sign of dry eyes.
PRK can be an alternative to LASIK when dry eyes are severe.
Screening for Dry Eyes before LASIK
Both the quality and the quantity of your tears produce are factors in the development of dry eyes, affecting healing after eye surgery.
Eye doctors now recognize that the best LASIK outcomes depend on controlling dry eyes. You will undergo screening in advance of a procedure.
Tests for detecting dry eyes include:
- Schirmer test. The eye doctor places a thin strip of paper under the lower eyelid to measure tear production.
- Tear breakup time – is where a small amount of dye is placed on the eye’s surface to monitor how tears distribute and when they “break up” on the eye’s surface. It measures the viscosity of the tears.
- Imaging. Keratometers or other instruments that provide a view of the tear film without touching the eye’s surface.
- MMP-9 Testing – will collect a small sample of your tears from the inside of your bottom lid will be collected. Within minutes, high levels of this protein mean you will have problems with inflammatory dry eye after LASIK.
Your assessment as a possible candidate for a LASIK procedure will include determining if you have an underlying condition that might be causing dry eyes.
Who Is Most at Risk of Dry Eyes After LASIK?
People with high degrees of myopia have a greater risk of dry eyes after LASIK than people with lesser degrees of nearsightedness before LASIK surgery.
- Older age, mainly if you are female and have undergone menopause.
- Allergy medications (antihistamines), certain blood pressure medications, and anti-depressants can decrease eye moisture.
- Autoimmune diseases such as Sjogren’s syndrome.
- Arid climates or environments, such as a room that is highly heated or air-conditioned.
Again, having dry eyes before a LASIK procedure will not automatically eliminate you as a candidate. But your eye doctor will need to consider the severity of your condition and the possibility of effective treatment before recommending a LASIK.
Dry Eye Treatment Before and After LASIK
Even if you have a pre-existing dry eye condition, the eye doctor may consider treating you before LASIK without eliminating you as a candidate.
Your eye doctor may also treat you for dry eyes before a LASIK procedure as a precaution, even if your tear production ordinarily is normal.
Your eye doctor may advise you to take flaxseed oil or fish oil orally before your vision correction surgery improves your tear film. You also may need to use lubricating eye drops before and after a LASIK procedure.
An oral dry eye treatment from TheraLife is also an excellent option for before and after LASIK. The oral treatment provides long-lasting, sustainable relief all day long—no more drops.
Your eye surgeon also might recommend prescription eye drops such as Restasis or Xiidra to reduce inflammation and help your body formulate more tears.
Other common dry eye remedies include:
- punctal plugs– which block tear drainage channels to increase moisture on the eye,
- anti-inflammatory medications – such as corticosteroids administered as eye drops.
Dry Eye Treatments after LASIK
When you consult with your LASIK surgeon for your assessment as a candidate, make sure you mention any eye symptoms that could indicate a dry eye problem. These dry eye symptoms could include a foreign body sensation or eye irritation. Even watery eyes can mean that you have dry eyes.
Eating taking omega-3 fish oil and eating food containing these “good fats,” such as salmon, can help maintain a healthy tear film. Drinking plenty of water also can help keep your body and your eyes adequately hydrated.
Also, make sure you have a frank discussion with your LASIK surgeon about the possibility of developing dry eyes following a procedure. Inquire about specific steps that can take for dry eyes to restore the eye’s tear film and comfort until healing is complete.
Many dry eye symptoms after a refractive LASIK surgery procedure are usually relatively mild and disappear in time. However, some LASIK patients have reported severe and ongoing problems with dry eyes.
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