Causes of dry eyes after LASIK and methods of treatment and prevention

Welcome to Dalili Medical website. Many people who have undergone LASIK suffer from dry eyes, which is a common symptom associated with this procedure. In this article, we will discuss dry eyes after LASIK, including its causes, symptoms, and treatment methods. LASIK surgery is one of the most common laser surgeries to correct vision problems, and it is a potential alternative to glasses or contact lenses. It is common for patients to experience a temporary decrease in tear production during the first six months after the procedure, leading to an annoying feeling of dry eyes, which may negatively affect the quality of vision. What are the causes of dry eyes after LASIK? And what are the solutions available to deal with this problem?

 What is LASIK?

LASIK is known as a surgical procedure that aims to correct vision defects such as nearsightedness, farsightedness, and astigmatism. This technique relies on the use of different types of laser beams to reshape the cornea, which is the surface responsible for receiving light and directing it to the inner parts of the eye to form images. Therefore, any impact on the cornea can significantly affect vision.

When does dry eye end after LASIK?

Reports indicate that dry eye symptoms may appear in up to 60% of patients one month after the procedure. These symptoms usually peak in the first few months, and then begin to improve in most patients within a period ranging from 6 to 12 months after surgery.

 Is dry eye curable?

To date, there is no permanent cure for dry eye, but there are many options available that can help maintain eye moisture and relieve symptoms, which contributes to protecting vision.

 What are the causes of dry eye after LASIK?

Dry eye after LASIK is a common side effect that many patients may experience. In some cases, this problem may worsen if it was previously present before the procedure. Recent studies have shown some hypotheses that explain the relationship between LASIK and dry eye.

One of the main explanations is the effect of laser beams on the nerve endings responsible for the tear ducts, which leads to a decrease in their activity. Some other hypotheses indicate that dry eyes may be the result of inflammation of varying severity in different parts of the eye after the procedure.

**How ​​long does dry eye treatment last?**

Dry eyes can be treated and their symptoms eliminated using medical drops over a period ranging from several weeks to months.

**Do tears affect the LASIK eye procedure?**

If you notice excessive tear secretion after LASIK, this may be a sign of an allergy, inflammation or infection, so it is advisable to consult a doctor immediately. It is also important to adhere to post-operative instructions and use eye drops known as artificial tears regularly to keep the eyes moist after the procedure.

**How ​​can I know if LASIK has failed?**

Vision should be clear and stable within six months of LASIK. If abnormal symptoms appear after following the recommended instructions, this may be an indication of a failure of the procedure.

**Can I wear makeup after LASIK eye surgery?**

One of the tips that doctors give after LASIK surgery is to avoid wearing eye makeup or any cosmetics such as eyeliner for two weeks. It is also preferable not to use lotions or creams near the eye, and to be careful when using some products such as shaving cream and hair spray.

**Are lubricating eye drops safe?**

Lubricating eye drops are generally safe to use and can be used as needed. Some of these drops contain preservatives, which are chemicals that prevent the growth of bacteria in the medication, but these substances may cause irritation in some people, especially if they suffer from severe dry eyes. Therefore, many ophthalmologists recommend not using drops containing preservatives more than four times a day. As for preservative-free drops, they are usually preferred for people who suffer from moderate to severe dry eyes, and are often the best choice for those who need to use drops more than four times a day.

**When can eyeliner be applied after LASIK eye surgery?**

You can apply eyeliner one to two weeks after the surgery, after consulting your doctor to ensure the healing process and the absence of infection or inflammation in the cornea, while adhering to the use of moisturizing eye drops.

**When does the cornea heal after LASIK surgery?**

The cornea usually heals within four to five days after the surgery, provided that you adhere to the post-surgery instructions and do not rub the eye during this period.

**Do all types of LASIK surgeries cause the same amount of dryness?**

Of all the possible side effects of LASIK, dry eye is the most common. About 95% of patients who have undergone this procedure suffer from symptoms of dry eye syndrome to some extent immediately after the surgery.

What is the difference between surface LASIK, detailed LASIK, and regular LASIK?

Detailed LASIK is also known as (Ultra-Lasik), and is characterized by its high accuracy and safety in vision correction surgeries. This type helps in reshaping the cornea by creating a very thin flap, which reduces the risks associated with traditional flaps that may lead to complications.

The advantages of detailed LASIK compared to surface LASIK include:

- Reduced potential risks during the cutting of the corneal flap.

- Lower likelihood of infection, inflammation and dry eyes compared to other types of lasers.

- Faster recovery.

- Rapid visual improvement.

- Ability to treat high refractive errors.

- Visual correction rate of up to 96%.

In the case of surface LASIK, the corneal flap is not lifted, butThe outer layer of the cornea is completely removed, and then the laser is used to reshape the cornea. The corneal healing process takes about 4 days, during which time the ophthalmologist provides the patient with soft contact lenses to protect the cornea until it heals completely. Surface laser is a procedure in which a laser is directed to remove the outer layer of the cornea and correct defects in it, and this layer heals within days. While regular LASIK is known to be a deeper procedure, as the laser is directed deeper into the cornea compared to surface LASIK.

**Is there a relationship between dry eye and hormonal disorders?**

There are many causes of tear film dysfunction, including hormonal changes.

**How ​​does the doctor diagnose dry eye before LASIK surgery?**

Diagnosing dry eye depends on two main factors: the first is to identify the symptoms that the patient may feel by reviewing the medical history, and the second is to conduct a set of medical tests that confirm the presence of dryness and determine its severity based on their results.

**Do all types of LASIK procedures cause the same degree of dryness?**

The incidence of dryness varies between different vision correction techniques. For example, surface LASIK (PRK) procedures rely on removing a smaller layer of the corneal surface, which is often half the actual area of ​​the cornea, which reduces damage to the nerve endings in the eye, thus helping to significantly reduce dryness. However, surface LASIK is not suitable for everyone, so choosing the appropriate procedure requires a visit to a specialist doctor and conducting the necessary tests.

**What are the most important tests that doctors perform to diagnose dryness?**

Doctors perform a set of medical tests that measure the amount of tears produced by the eye, in addition to using certain types of dyes to determine the amount and distribution of tears. There are also some tests that rely on radiological imaging to determine these data without the need to touch the eye. There are also tests that aim to measure the percentage of certain types of proteins in a person's tears by examining a sample of them, in order to determine the extent of eye inflammation or dryness after LASIK.

**What are the most prominent symptoms of dry eye?**

- A constant burning or itching sensation in the eye, or a tingling sensation.

- Extreme eye fatigue after reading or using the computer for long periods.

- Discomfort when wearing some types of contact lenses.

- The appearance of sticky fluids in the form of threads inside or around the eye.

- Difficulty or blurred vision after long hours of concentration or work.

- Excessive tearing throughout the day is also a common symptom.

**Does dry eye affect LASIK?**

There is a close relationship between dry eye and LASIK operations, as each affects the other. Dry eye affects the results of the medical examination of the eye before LASIK, which leads to inaccuracy of the numbers extracted from the corneal map. Dry eye also increases after the operation, so it is necessary to reduce dry eye before LASIK. Dry eye condition must be monitored after the operation, and the patient must be aware that dryness may increase for a period ranging from two to six months after LASIK. It is important to follow up on dry eye treatment after the operation. If the patient suffers from dry eye and wants to undergo LASIK surgery, he must inform the consultant doctor at "I Care" Center, the best eye center in Egypt, of the details of his condition. The doctor will help assess the condition of dry eye and guide the patient to reduce dryness before the operation, and will also provide him with steps to treat dry eye after LASIK to ensure the best results and avoid potential complications.

**How ​​do I take care of my vision after LASIK eye surgery?**

- Adhere to the post-LASIK care instructions.

- Use moisturizing drops to avoid dry eye.

- Avoid exposure to high temperatures, fumes, dust, and smoke.

- Stay away from direct sunlight and wear sunglasses.

- Do not strain the eyes by looking at phones and screens for long periods.

**Duration of wearing sunglasses after LASIK surgery**

After one to two weeks of LASIK surgery, it is recommended to wear sunglasses to protect the eyes from ultraviolet rays and bright light. It is important to keep your eyes safe from exposure to strong light during the first week after the procedure, and sunglasses can be used to reduce the discomfort caused by light.

**When can I use my phone after LASIK?**

The patient should avoid activities that cause eye strain, especially during the first twenty-four hours after LASIK surgery. Among the important instructions after the procedure, it is recommended to refrain from activities that cause eye fatigue, which include the following:

**Using a smartphone or tablet.**

**Using a computer, watching TV, or playing video games.**

**Reading short texts such as books, magazines, and newspapers.**

**Does vision correction surgery cause dry eyes?**

Dry eyes are a common problem that may occur after vision correction surgery, and it is one of the most common negative effects among other consequences that may affect the eye after the procedure. The relationship between LASIK surgery and dry eyes is due to the fact that this procedure aims to reshape the cornea and correct vision, which may affect the tear production centers in the eye, which ultimately leads to dry eyes after the procedure. The procedure involves removing tissue from the cornea to correct vision. This procedure affects the nerve fibers in the cornea, which play an important role in tear production, leading to dry eyes for two to six months after the procedure. Additionally, the use of eye drops or topical medications after the procedure may also contribute to dry eyes. When the patient relies on drops for lubrication, the body may gradually stop producing tears naturally.

. Over time, the patient may suffer from persistent dry eyes.

**Can dry eyes lead to blindness?**

Yes, severe dry eyes can lead to vision problems, and in rare cases, it may cause damage to the cornea, increasing the risk of vision loss. Good eye hydration is essential to protect tissues and ensure proper nutrition for the eye. When there is a lack of natural tear secretion or when tears evaporate quickly, the eye may dry out and become susceptible to injury and irritation. If dry eyes are not treated properly and in a timely manner, serious complications may occur, such as eye infections, corneal ulcers, and damage to sensitive tissues, which may lead to distorted vision. In rare cases, the patient may lose his sight if he delays treating dry eyes for a long time and does not receive appropriate medical intervention. If the patient suffers from symptoms of dry eyes such as itching, burning, a feeling of sand in the eye, and blurred vision, it is preferable to visit the "I Care" Center, which is considered one of the best eye centers in Egypt. There, a specialist consultant will examine the eye condition and provide an appropriate treatment program, in addition to follow-up if necessary.

Is dry eye after surface laser surgery normal?

Yes, dry eye after surface laser surgery or any LASIK surgery is normal. This is due to the effect of the procedure on the tissues responsible for tear secretion, as well as on the nature and mechanism of tear secretion in the eye. However, it should be noted that this effect does not necessarily occur to all patients, as about 20% of them may not have their tear secretion mechanism affected after the procedure.

How long does dry eye last after surface laser surgery?

In some cases, dry eye may last for up to 6 months or more after the procedure, and in most cases, dryness may last for life.

What are the harms of dry eye after surface LASIK surgery (PRK)?

Dry eye can cause some damage, as it first affects the efficiency of vision, leading to blurring. Continuous untreated dryness may also lead to inflammation of the eye and eyelids.

**How ​​to deal with dry eyes after surface laser surgery**

Dry eyes are a serious problem, but dealing with them and treating them is easy. The patient is required to commit to using moisturizing drops and artificial tears according to the doctor's instructions. These drops may continue to be used for several months or even years, and the patient may need them for life, but in smaller quantities.

**Factors affecting dry eyes after LASIK:**

These factors do not directly cause dryness after LASIK, but they are considered risk factors that may increase the likelihood of dryness to varying degrees depending on each case. The most prominent of these factors are:

- Many experts have noted that the incidence of dry eyes after LASIK increases proportionally to the degree of visual impairment before the operation, as the greater the degree of correction required, the greater the likelihood of dryness.

- The likelihood and severity of dryness increases based on the condition of the eyes before the operation and the level of pre-existing dryness, which the doctor determines through some accurate examinations.

- The incidence of dry eye after surgery is affected by the habits that the person followed before the operation, as using contact lenses for long periods may increase the likelihood and severity of dry eye after the operation.

- Some chronic diseases, such as diabetes, may affect the level of dry eye after LASIK, due to the effect of diabetes on blood circulation in the eye and some of the nerve endings associated with it.

Some statistics related to LASIK surgery have shown that women are more susceptible to dry eye than men. The incidence of dry eye depends largely on the level of humidity in the surrounding environment, and the likelihood of dry eye increases with age.

The basic tests that doctors perform to diagnose dry eye include a set of tests that help identify dry eye syndrome and rule out any other health conditions that may lead to this problem. The most prominent of these tests are:

**Schirmer's test**: This is the most common and basic test among dry eye tests. The ophthalmologist uses the Schirmer's test to determine whether your eyes produce enough tears to keep them moist. During this test, the doctor places a strip of medical paper inside the lower eyelid and asks you to close your eyes. The strip absorbs tears, indicating the amount of moisture in the tear film. After five minutes, the doctor checks the distance the tears have traveled on the paper, with travel of less than 15 mm indicating dry eye.

**TearLab**: The TearLab is used to assess the osmolarity or salinity of tears. A low, stable osmolarity in both eyes ensures that the eyes are healthy and moist. Healthy tears are made up of a balanced mixture of salt, water, and oil. If the quality or quantity of tears is low, or if the osmolarity is too high, the surface of the eye may be damaged, leading to dry eye syndrome. Additionally, a large difference in osmolarity between the eyes may indicate the presence of this syndrome. During this test, the eye doctor collects a small sample of tears, and the TearLab assesses the osmolarity and tear components to provide accurate diagnostic information.

**Phenol Red Thread Test** This test aims to assess the total amount of tears to determine if the aqueous layer of the tears has decreased. When this happens, it can cause your tears to not spread enough over the surface of your eye, leading to dry eyes. During this test, your eye doctor will place a thin red string over your eyes to monitor the amount of tears your eyes produce over a few seconds. Your doctor will then compare the results between each eye.

**Tips to reduce dry eyes after LASIK:**

- Make sure to eat a balanced diet that contains the essential nutrients for the health of your body and eyes, including:

Highlighted by Omega-3, which is recommended by many doctors to reduce dry eyes.

- Make sure to drink enough water and fluids throughout the day, which helps moisturize your body and eyes.

- Follow your doctor's instructions after the operation, and use the medical drops he may prescribe for you regularly to help moisturize the eye and relieve the symptoms of dryness.

- Make sure to rest your eyes periodically when using computer screens, televisions, or other sources of radiation for long periods, as this is one of the main causes of dry eyes due to its effect on the natural blink rate.

- Avoid smoking or being in places where smokers are present, as the chemicals in cigarettes may cause eye allergies, in addition to the negative effects of smoking on the rate and composition of tear drops.

**The negative impact of lack of sleep on eye hydration and tear duct function**

Lack of sleep negatively affects eye hydration and tear duct function. Therefore, it is recommended to get enough sleep daily, ranging from 6 to 8 hours.

**Factors associated with dry eye syndrome**

There are several factors that may increase the risk of dry eye, including:

- **Computer use**: When working on a computer or using smartphones or other digital devices, we tend to reduce the number of times we close our eyes, which leads to greater tear evaporation and an increased risk of dry eye symptoms.

- **Wearing contact lenses**: Although it is difficult to determine the extent to which contact lenses affect dry eye, the discomfort resulting from dry eye is the main reason that prompts many people to stop using them.

- **Aging**: Dry eye syndrome can occur at any age, but it becomes more common with age, especially after the age of fifty.

- **Menopause**: Postmenopausal women are at a greater risk of dry eye than men of the same age.

- **Closed environment**: Air conditioning systems, fans, and heating systems can reduce indoor humidity or accelerate tear evaporation, causing dry eye symptoms.

- **Open environment**: Dry and windy weather conditions increase the risk of dry eyes.

- **Frequent flying**: The air in airplane cabins is very dry, which can lead to dry eye problems, especially among frequent flyers.

**Smoking and dry eyes** Smoking is linked to serious eye problems, including macular degeneration, cataracts, and uveitis, in addition to dry eyes.

**Health conditions** Certain systemic diseases, such as diabetes, thyroid-related diseases, lupus, rheumatoid arthritis, and Sjögren's syndrome, contribute to dry eyes.

**Medications** Many medications, both prescribed and over-the-counter, such as antihistamines, antidepressants, some blood pressure medications, and birth control pills, increase the risk of dry eye symptoms.

**Eyelid Problems** Incomplete closure of the eyelids during blinking or sleeping, a condition known as glaucoma, can lead to severe dryness of the eye, which can lead to corneal ulcers if left untreated. This condition can occur as a result of aging, after cosmetic eyelid surgery, or for other reasons. LASIK and some other refractive corneal surgeries can also cause dry eye, but in most cases, this discomfort is temporary and goes away within a few weeks after the procedure. If you have dry eye before LASIK, your eye specialist may recommend a preoperative dry eye treatment program to ensure the best possible results.

**What Vitamin Treats Dry Eye?**

There is no single vitamin that can completely treat dry eye, but some vitamins that are good for eye health may help relieve symptoms. These vitamins include:

- **Vitamin A**: Plays an essential role in eye health and tear production, and can be found in carrots, pumpkin, turnips, sweet potatoes, liver, fish, and fish oils.

Vitamin C: Fights inflammation and protects eyes from UV damage. Vitamin C is found in oranges, lemons, potatoes, strawberries, and bell peppers. Vitamin E: Helps protect eyes from oxidative damage and promotes blood flow to the eyes. Vitamin E can be found in nuts, seeds, vegetable oils, avocados, and spinach.