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Dry eye syndrome after LASIK, causes and treatment options - A State of Sight #128

Dry eye syndrome is one of the more common potential side effects from LASIK, but it is usually one of the more temporary side effects. Watch this episode of A State of Sight with Isaac Porter, MD to learn more about the causes of dry eyes after LASIK and some of the treatments that can be used for improvement.




Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain dry eye syndrome which can occur after LASIK. This is one of the more common side effects following LASIK, sometimes up to half or even more of the patients who have LASIK can develop some degree of dry eyes.


Patients may initially notice eye irritation, scratchiness or the feeling that something is in their eye when their eyes are dry. Also, dryness can cause vision to be inconsistent and not as clear as it should be. Sometimes, those with dry eyes may have to blink in order to see more clearly due to a poor tear film over the surface of the eyes.


We know that LASIK affects the nerves in the cornea in the front of the eye where the operation is performed. Because of this, PRK and other advanced surface laser treatments that affect the corneal nerves less may have less risk for dry eyes afterwards. When the sensory nerves are affected, the brain does not receive the signal that the eye is feeling dry. This causes tear production to be lower because the brain is not trying to treat the dryness since it is not getting signals indicating the eye is dry.


A lot of times this resolves or improves over the first three to six months after laser eye surgery as the nerves regenerate and the dryness improves. Some people may have symptoms longer, but usually dry eyes are one of the more temporary side effects, even though it is one of the more common side effects.


Fortunately for the patients who notice dryness after LASIK, we have several treatments available. First, we usually begin with artificial tear drops for extra lubrication. Early after LASIK, patients will use frequent medicated drops to heal from surgery including steroid and antibiotic drops. As these drops are slowly tapered after the procedure, dryness may become more noticeable and there may be more need for artificial tears.


Beyond tears, we have other options with medicated drops, medicated ointments, or even oral pills that can help treat dry eye syndrome. Also, omega-3 supplements, either from fish oil, flaxseed oil, or other sources, can help improve symptoms of dryness.


One of the most effective treatments that I like to use for dry eyes after LASIK are plugs that are placed in the natural tear drains in the eyelids. This can be done in the office, and patients are usually pleasantly surprised how little discomfort there is with this procedure. By placing a plug in the tear drain, the patient’s natural tears and artificial tear supplements stay around longer to have a greater effect.

Generally, these plugs can stay in for an extended period of time without problems. My wife had dry eyes after LASIK and she was much more comfortable after she had these punctal plugs placed. If you have had LASIK or are thinking about it and you have dry eyes please post and we will be happy to answer any questions. Hopefully we’ll see you again soon next time on A State of Sight.