Dry eye is a common occurrence following LASIK, but it doesn’t happen all the time. Dry eye experience also varies post-LASIK — from mild symptoms that don’t last long to persistent itching and burning requiring severe dry eye treatment. Nevertheless, the possibility of dry eye after LASIK shouldn’t hinder you from improving your vision with laser surgery.
Anyone considering LASIK and is worried about dry eye should take the time to learn the relationship between the two, the possible LASIK alternatives, and how to address dry eye issues after laser vision correction.
How LASIK Causes Dry Eye
In a LASIK procedure, a thin flap is created in the outer layer of the cornea. This flap is applied with laser to reshape the cornea and treat refractive errors such as nearsightedness. During the creation of the flap, certain nerves in the corneal surface are temporarily severed resulting in reduced sensation.
As a result, your eyes may have difficulty relaying information to your brain that it needs more moisture. This will eventually lead to inadequate tear production. In normal conditions, these injured nerves will regenerate and regain corneal sensation. However, it may take longer for these nerves to recover for individuals who have higher risks of developing dry eye.
Who is at Risk for Post-LASIK Dry Eye?
Finding out if you’re at risk is part of the screening process and is an essential step to reduce dry eye risk following LASIK. The following patients are more likely to develop post-LASIK dry eye:
- Individuals with nearsightedness or myopia, as stated in a study by researchers at the Cullen Eye Institute, Baylor College of Medicine
- Menopausal women who are undergoing hormone replacement therapy. Dry eye is heavily influenced by hormonal fluctuations.
- People with existing autoimmune problems like Sjogren’s syndrome and rheumatoid arthritis.
- Patients who live in areas with dry, arid climates or environments.
- Because dry eye prevalence increases with age, older patients are also at risk.
It’s worth noting that being diagnosed with dry eye before getting LASIK will not automatically disqualify you for LASIK candidacy. Your LASIK surgeon can perform further screenings, recommend that dry eye be treated first, or suggest laser vision correction alternatives that do not cause dry eye.
How is Dry Eye Screened Before LASIK?
Next to assessing risk factors, your dry eye screening before LASIK may include one or more of the following:
- Imaging tests such as the use of keratometers. A keratometers helps your eye surgeon identify dry eye risk by measuring the curvature of the cornea’s front surface.
- Schirmer testing to measure tear production. In this test, a thin strip of paper is positioned under the lower eyelid.
- Tear breakup time. A tiny amount of fluorescein dye is place on the eye’s surface to measure how they’re distributed and how long it takes for them to evaporate from the surface
- MMP-9 Testing. A small sample of your tears will be collected and tested for presence of MMP-9, a protein marker that is consistently elevated in tears of dry eye sufferers.
LASIK Alternatives for Individuals with High Dry Eye Risk
If you at high risk for dry eye and not eligible for LASIK, a PRK (Photorefractive Keratectomy) may be a good alternative. Dry eye is less likely to happen in PRK than LASIK because instead of going underneath the cornea to create a thin flap, it’s performed directly on the corneal surface. As a result, PRK will not sever the nerves involved in stimulating tear production. Moreover, regeneration of nerves may be faster in PRK than LASIK.
Visian Implantable Contact Lens (ICL) is also a great alternative to LASIK or PRK for patients who have high dry eye risk. Altering tear production is less likely to occur with Visian ICL because there’s no laser involved to treat the corneal surface. This procedure is also ideal for patients that aren’t eligible for LASIK because of extremely thin corneas.
How to Reduce Dry Eye Symptoms Post-LASIK
Although it’s impossible to completely eliminate dry eye symptoms following LASIK, taking the following steps will help prevent severe dry eye symptoms from occurring:
- Avoid caffeine, alcohol, and similar substances that increase your risk of dehydration. Increase your intake of foods rich in Omega-3. Omega-3 has been shown to have a beneficial role in helping reduce dry eye symptoms.
- Be more mindful of your hydration status and drink plenty of water daily.
- Adhere to surgeon instructions and recommendations before and after your eye laser surgery. In some cases, a punctal plug may be put in place following LASIK as treatment for dry eyes. It prevents the outflow of tears from your eye and helps retain lubrication.
To help you figure out if you’re more likely to develop dry eye following LASIK, schedule an appointment today. An in-person assessment and evaluation is the best way to gauge whether or not you have dry eye that could affect your LASIK candidacy.