Treating Dry Eye Before Your Cataract Surgery

In continued recognition of Dry Eye Awareness Month, this article focuses on the association and importance of recognizing dry eye syndrome in patients considering cataract surgery.  

It is common that the symptoms of pre-existing dry eye are overlooked or overshadowed by the symptoms of cataracts:  blurry vision, need for more light, glare, etc.

In this article, we’ll discuss why it is so important to assess our patients for symptoms of dryness before anticipated cataract surgery.

Cataracts and Dry Eye

The chance that you will develop a cataract increases with age.  So, too, is the chance you will develop dry eye.

Because both cataracts and dry eye commonly occur in the same patient population, it is as important to look for signs of dry eye when performing a cataract evaluation.

Various testing might be used to assess a patient with potential dry eye.  Thorough examination at the slit lamp is essential. Certain dyes may be placed on the ocular surface looking for characteristic signs of dry eye.  Measurements of tear production can be helpful in making the diagnosis if dry eye.

Causes of Dry Eye

There are various causes of dry eye.  Most dry eye is either due to insufficient tear production or meibomian gland dysfunction, where the oily lipid coating the tear film is of poor quality and allows faster evaporation of the tears.

Identifying the actual cause of dry eye is important to determine the correct treatment.  Patients with meibomian gland dysfunction may be treated with hot compresses, oral supplements (e.g. fish oils) or direct stimulation (e.g. LipiFlow) of the diseased glands.  

Patients with dry eye due to poor tear production may benefit from artificial tears and/or anti-inflammatory medications.

Ocular Surface

Treating the ocular surface before cataract and after cataract surgery is essential to patients with definite signs of dry and eye even those with borderline conditions.

The corneal surface is responsible for most of the focusing ability of the eye.  An irritated dry cornea can cause irregular measurements, persistent symptoms and a disappointing outcome.  

With all of our patients who are considering cataract surgery, we are looking for signs of dry eye and prefer to start treatment prior to anticipated cataract surgery.