You can get LASIK surgery if you already have dry eye. But because LASIK can aggravate eye moisture, surgeons will not typically operate on someone who has existing, uncontrolled dry eye syndrome.
LASIK, or laser-assisted in situ keratomileusis surgery, is a popular vision procedure that’s becoming more and more common as an alternative to corrective lenses. One of the most common complications for those having this procedure is dry eyes. but some people do wonder if they can have this type of surgery if they’re already experiencing dry eye.
This article will offer some detail about how LASIK can cause dry eye, how that eye condition can have an impact on LASIK surgery, and how your healthcare team and eye doctor may want to discuss other options because of this.
LASIK surgery can cause or worsen dry eyes. Research has found that getting LASIK if you have preexisting dry eyes can increase your chances of having complications after the procedure.
However, some people who are managing their dry eyes may be eligible for LASIK.
If dry eyes are not managed before LASIK, chronic dry eyes can lead to:
- eye infections
- vision problems
- decreased quality of life
- eye inflammation
- an abrasion of the corneal surface
- corneal ulcers
- vision loss, in some cases
When considering a patient for LASIK, a surgeon will determine if your dry eyes are managed or if the risks of complications would be too high.
Dry eye is a common condition that results from the eyes not making enough lubrication (tears) to stay wet or when tears do not work properly or are low quality.
When dry eye is not severe, it mostly makes someone feel uncomfortable, such as creating burning or stinging sensations. Severe cases of dry eye can cause vision problems or loss over time.
Dry eyes usually affect both eyes. The
- a consistent burning, stinging, or scratchy feeling in your eyes
- light sensitivity
- mucus around the eye
- bloodshot or red eyes
- feeling like you have something in your eyes
- an inability to put in contact lenses, or pain and pressure when you do
- difficulty driving at night
- eye fatigue
- eye pain
- blurred vision
Many things can cause dry eyes.
If the production and maintenance of your tear film is disrupted in any way, it can cause problems that include dry eyes. Your tear film consists of three layers: mucus, aqueous fluid, and fatty oils. These keep the surface of your eyes adequately lubricated and healthy.
Other possible causes of dry eye include:
- decreased tear production from hormonal changes
- autoimmune conditions such as Sjögren’s syndrome, rheumatoid arthritis, and lupus
- thyroid disorders
- allergic eye disease
- inflamed eyelid glands
- certain medications:
- antihistamines
- decongestants
- hormone replacement therapy (HRT)
- antidepressants
- medications for hypertension, Parkinson’s disease, and acne
- some birth control pills
Dry eyes can also occur situationally, such as in extremely dry environments like airplanes or after prolonged screen time. This leads to increased tear evaporation and thus, dry eyes.
Some people are
- assigned female at birth
- 50 years or older
- with low vitamin A levels
- with allergies
- living in areas with smoky or dry air
- who wear contact lenses
- who stare at screens for long periods of time
Situational or occasional dry eye improves with acute treatments or changes to your environment. Chronic dry eye is a long lasting condition where management is important to prevent worsening vision.
Managed dry eyes is crucial if you’re seeking LASIK. A surgeon will not operate on anyone with unmanaged chronic dry eye.
LASIK is a type of laser eye surgery that’s quick and straightforward. It’s done in an outpatient setting, meaning you do not need to stay overnight. You are completely awake and the procedure usually takes about 30 minutes or less to complete.
The procedure works by using a special type of laser to change the shape of the dome-shaped tissue (cornea) at the front of your eye.
When someone has 20/20 vision, their cornea refracts light precisely onto the retina. But when someone is either nearsighted, farsighted, or has astigmatism, the light is bent incorrectly, resulting in blurred vision.
Corrective lenses can fix this but actually changing the shape of the cornea itself through LASIK surgery is a more permanent solution.
Dry eye is common after LASIK surgery.
This is because the procedure temporarily reduces your tear production. This may last up to 6 months after surgery.
According to
Research in 2017 found that most cases of dry eyes from LASIK surgery resolve in 6 to 12 months. However, up to 20% of people have dry eyes for longer.
In most cases, dry eyes can be treated with eye drops. In severe cases, you may need a follow-up procedure where a surgeon puts special plugs into your tear duct to prevent your tears from draining from the surface of your eyes. This is a more permanent fix.
Other risks of LASIK include:
- halos, glare, and double vision
- vision undercorrection
- vision overcorrection
- flap problems
- astigmatism
- regression
- vision loss (although this is rare)
After LASIK surgery, you won’t have perfect vision immediately, although some people start to see improvements in as little as 24 hours.
After the procedure:
- Your eyes may burn or itch and your vision will initially be blurry.
- Your eye doctor will likely prescribe some eye drops to manage any dry eyes.
- Wear sunglasses or a protective shield to protect your vision from harsh light.
- Avoid any contact sports, swimming, going into hot tubs, wearing contact lenses, and using makeup while your eyes continue to heal.
After a few days, you’ll have a follow-up appointment with your doctor to check on the progress of your healing.
It typically takes a few months for your eyes to completely heal after surgery and for your vision to fully correct itself. While the process does take time, it is often worth it for most people.
If you start having painful, itchy, or burning eyes several months after LASIK surgery, reach out to your doctor as soon as possible. They can check to see if you’ve developed any complications, including dry eyes.
Addressing what’s the cause of your dry eyes — if it’s known — is the best way to quickly resolve symptoms and make sure they don’t return.
However, there are still many treatments available for dry eyes even when the underlying cause is not known or cannot be addressed. Treatments that can help relieve dry eyes include:
- over-the-counter eye drops
- prescription eye drops, like Restasis (cyclosporine) and Xiidra (lifitegrast)
- medications to stimulate tear production, including cholinergics like pilocarpine
- avoiding wind and smoke
- using a humidifier
- using a warm compress over the eyes
- taking breaks from screens
- surgery to plug tear ducts (in severe cases)
Some people are able to get LASIK surgery if they have dry eyes. If you have dry eyes that are well-managed ahead of time, you may be eligible for this eye surgery. But because LASIK can affect eye moisture, many surgeons will not typically operate on anyone with unmanaged dry eye syndrome.
If not addressed, chronic dry eyes can affect your quality of life and lead to eye infections and vision problems. While there is currently not cure, the symptoms can be managed with eye drops, warm compresses, certain medications, and in severe cases, surgery.
Discuss your specific situation with a healthcare professional to help you weigh the pros and cons and see if you’re eligible for LASIK.