LASIK (Laser-Assisted In Situ Keratomileusis) is a widely performed procedure to correct vision, reducing the need for glasses or contact lenses. A common temporary side effect following this surgery is dry eyes. While this condition can cause discomfort, it typically resolves as the eyes heal.
Why Dry Eyes Occur After LASIK
Dry eyes after LASIK are primarily due to the temporary disruption of corneal nerves during the creation of the corneal flap. These nerves play a role in signaling the lacrimal glands to produce tears, and their severance can lead to reduced tear secretion and altered tear film stability. The tear film, which normally coats the eye surface, may become imbalanced in its oil, water, and mucin layers.
The healing process can also involve inflammation, which further impacts tear gland function and can worsen dry eye symptoms. Patients commonly experience sensations such as grittiness, burning, or stinging, along with redness, irritation, blurry vision (especially after prolonged screen use), and sensitivity to light.
How Long Do Symptoms Last
Most patients experience some degree of dry eye immediately following LASIK, with symptoms often peaking in the first few months after surgery. For many, symptoms significantly improve within three to six months as corneal nerves regenerate and tear production stabilizes.
While improvement continues for most, a small percentage may still experience mild dryness up to a year after surgery. Persistent dry eye beyond one year is less common, but symptoms can, in rare cases, last for two years or longer, sometimes requiring ongoing management.
Treatments for Dry Eye Relief
Managing dry eye symptoms after LASIK involves various strategies, starting with over-the-counter options. Artificial tears and lubricating eye drops are often the first line of defense, providing immediate moisture and soothing irritation. Preservative-free drops are generally recommended for frequent use.
Lifestyle adjustments can also help alleviate discomfort. Using a humidifier, particularly in dry environments, adds moisture to the air and can reduce tear evaporation. Avoiding exposure to smoke, dust, and strong air currents is also beneficial, as these irritants can worsen symptoms. Regular blinking exercises and taking breaks from screens during prolonged focus activities help distribute tears evenly across the eye’s surface.
For more persistent or severe cases, an ophthalmologist may recommend prescription medications. These can include anti-inflammatory eye drops, such as cyclosporine or lifitegrast, which work to reduce inflammation and promote tear production. Punctal plugs are another option, inserted into the tear ducts to slow down tear drainage and keep more moisture on the eye’s surface. Intense Pulsed Light (IPL) therapy, originally used in dermatology, has also shown promise for dry eye by addressing underlying issues like meibomian gland dysfunction, which contributes to tear film instability.
Factors Increasing Dry Eye Risk
Several individual factors can increase the likelihood of experiencing more severe or prolonged dry eyes after LASIK. A significant risk factor is having pre-existing dry eye disease before the surgery, as this condition can worsen post-procedure. Patients with a history of dry eyes should discuss this with their surgeon during the pre-operative evaluation.
Certain systemic conditions also contribute to increased risk. Autoimmune diseases like Sjögren’s syndrome and diabetes can affect tear production and the eye’s healing capacity, potentially leading to complications if not well-controlled. The use of specific medications, such as antidepressants, antihistamines, decongestants, and antihypertensive agents, can also elevate the risk of dry eyes.
Other contributing factors include higher levels of myopia (nearsightedness) requiring greater ablation depth during surgery, which may affect corneal nerves more extensively. Age can also play a role, with older patients potentially experiencing a longer recovery due to naturally reduced tear production. Women are also four times more likely to experience dry eye symptoms post-surgery compared to men, with post-menopausal women facing a higher risk.