LASIK is a surgical procedure that uses a laser to reshape the cornea, correcting vision issues like nearsightedness, farsightedness, and astigmatism. The procedure involves creating a thin, hinged flap on the cornea’s surface, which is lifted and then repositioned. The primary concern during immediate recovery is protecting this corneal flap from mechanical displacement and preventing infection from external sources.
The Critical First 48 Hours: Avoiding Tap Water
The period immediately following LASIK, typically the first two days, represents the highest-risk phase for water exposure. During this time, the corneal flap is most vulnerable to shifting or wrinkling if subjected to force, such as a direct splash or rubbing. Keeping the eye area completely dry is imperative due to this mechanical risk.
Tap water poses a specific risk because it is not sterile and may contain microorganisms like Acanthamoeba. This amoeba can cause Acanthamoeba keratitis, a severe infection that can lead to permanent vision loss. Since the eye’s natural protective barrier is compromised by the corneal flap, the risk of infection is temporarily increased.
Patients must completely avoid showering or washing their hair for the first 24 hours. Afterward, extreme precautions must be taken to prevent water from reaching the eyes. To clean the face, use only pre-moistened towelettes or a clean, damp cloth, carefully wiping around the eye area. Wearing the protective eye shields provided by the surgeon while sleeping is mandatory to prevent accidental rubbing or pressure.
Resuming Basic Hygiene: Showers and Face Washing
After the initial 24 to 48 hours, basic hygiene activities like showering can generally be resumed, but careful technique is required for at least the first week. The goal is to prevent non-sterile water, soap, and shampoo from entering the eye, which can cause irritation or introduce contaminants. Taking baths instead of showers during the first few days, or keeping the shower stream at a low pressure, is helpful.
When showering, tilt the head back slightly while washing hair to direct water flow away from the face. Keep the eyes tightly closed throughout the process to act as a physical barrier against splashes or soap residue. When drying off, gently pat the face with a clean towel, avoiding rubbing or pressure near the eyes.
Face washing should use a gentle, non-splashing technique. Apply cleanser and rinse the lower face with clean hands, consciously avoiding the forehead and orbital area. This prevents soap and water from trickling down into the eye socket. This cautious approach should be maintained for the entire first week until the corneal flap has had more time to seal.
Extended Restrictions: Swimming and Submerged Water
Activities involving submerged water require a significantly longer period of restriction due to the high risk of infection from bacteria, viruses, and chemicals.
Pools and Hot Tubs
Chlorinated pools typically require a minimum waiting period of one to two weeks before re-entry. The restriction for hot tubs is often extended to three to four weeks. This is because the warm, stagnant water creates an ideal environment for accelerated bacterial growth, increasing the concentration of potential pathogens.
Natural Bodies of Water
Natural bodies of water, such as lakes, rivers, and the ocean, pose the highest risk of infection and demand the longest restriction period, usually a minimum of one to three months. These environments contain uncontrolled levels of bacteria and microbes, including Acanthamoeba, which can cause severe infections if they penetrate the healing cornea. Even after the initial restriction period for pools, wearing tight-fitting swimming goggles is recommended to provide a protective seal against irritants and pathogens for at least the first month.
Accidental Exposure: Immediate Steps to Take
If a patient accidentally gets water in their eyes before the recommended timeline, the first step is to remain calm and resist the urge to rub the eyes. Rubbing can mechanically dislodge or wrinkle the corneal flap, which requires immediate surgical repositioning.
The eye should be immediately rinsed with the preservative-free lubricating drops or antibiotic drops prescribed by the surgeon. This helps flush out any potential contaminants from the non-sterile water source. Following the rinse, the patient should contact their eye surgeon’s office to report the incident, even if the eye feels fine. The surgeon can assess the risk based on the water source and time elapsed since surgery, and may advise a follow-up examination to check the flap’s integrity and look for early signs of infection.