Dry Eye and LASIK Surgery

LASIK, and other vision correction surgery, can cause dry eye.  LASIK is a great procedure for improving your vision and lifestyle without glasses or contacts, but did you know that LASIK can cause dry eye?  This article is part of our recognition that July is Dry Eye Awareness Month.

About 50% of patients who undergo LASIK vision correction surgery will develop some degree of dry eye after the procedure, lasting for weeks, months or longer.  

Many patients who choose to have LASIK have already been diagnosed with dry eye.  Contact lens intolerance (due to dryness) is a common reason to consider LASIK.

Other patients, however, are unaware of they have pre-existing signs and symptoms of dry eye prior to undergoing vision correction or that LASIK can cause dry eye.

During our initial consultation, we look for any signs and symptoms of dry eye.  Pre-operative diagnosis improves your visual outcome and satisfaction.

How LASIK Causes Dry Eye

LASIK involves the creation of a corneal flap.  In creating the flap, corneal nerves are cut, thus decreasing corneal sensitivity.  This decrease in sensitivity may decrease your ability to sense dryness, thus leading to decreased tear production.

In cases where postoperative dryness is a concern, PRK may be a suitable option.

Other patients who use certain medications, have environmental allergies, blepharitis or autoimmune disease may be more prone to developing problems from dryness.  Older patients, especially post-menopausal women may be more susceptible.

Symptoms of Dry Eye

Symptoms of dry eye include:

• Tearing
• Redness
• Blurry vision
• Scratchiness
• Gritty feeling
• Tired Eyes

The cornea and tear film are responsible for most of the focusing power of the eye.  

If the corneal surface is not smooth and lubricated, blurry vision can develop from the dry uneven surface.  Also, any measurements we take for use in the calculations for your vision correction surgery may be inaccurate.

In addition, some of the symptoms of dry eye can be quite debilitating and aggravating...all leading to frustration and dissatisfaction.

Pre-Operative Testing

Fortunately, we have an arsenal of diagnostic tests which may aid in the diagnosis of dry eye.  During your examination, we can use:

• Special dyes to examine your tear film
• Special agents to examine your cornea
• Schirmer tests, to accurately measure tear production
• Testing for protein markers (MMP-9) associated with dry eye
• Tests for meibomian gland dysfunction (e.g. LipiScan)

Treatment of Dry Eye

There are various treatments ranging from artificial tears, prescription anti-inflammatory drops and medicines, pulse stimulation, punctal plugs and others.

The importance of diagnosing and treating pre-existing dry eye is essential to achieving your visual goals.

The importance of recognizing that dry eye may develop after LASIK is essential to your understanding that treatment may be required for weeks, months or longer in order to maintain your comfort and satisfaction.