Ophthalmologist Questions LASIK

My eyes feel very dry after LASIK. What could be the cause for this?

I underwent a LASIK surgery 10 days back. However, since the surgery although i have recovered well, my eyes feel exceptionally dry. What could be the reason behind this? Are there any medications that can help me maintain the moisture in my eyes?

13 Answers

This is not unusual and often frequent instillation of artificial tears without preservative over 6 months may help. If you have other hallmarks of ocular surface disease, your surgeon should be able to sort that out for you.
Dryness of the eyes occurs frequently after LASIK surgery. Many have LASIK because they have become less tolerant of their contact lenses due to underlying eye dryness. The procedure itself, cuts across nerves which are involved in the detection of surface eye dryness. Most regenerate but a certain percentage do not, and if the recovery is below your dryness threshold, you will experience dryness afterwards. Some will find improvement in this over a period of 3 months but dryness beyond that point can be long lasting. To start things out, try using Refresh or Systane (over the counter) eye drops as needed for your symptoms. There are other options which you can discuss with your LASIK surgeon. Hopefully you will be one of those that regenerates the proper amount of dryness detection nerves and will have no problem in the future.  
You may have decreased tear production and need testing as well as Punctal Occlusion, inceaed lubrucants, Restasis or Xiidra.
Dr. C
You are still quite early in the postoperative period and I would expect your symptoms to eventually improve. The LASIK procedure involves creating a flap of corneal tissue, either with a laser or a blade, which results in the 'disconnection' of the nerves which supply the surface of the cornea and are involved in the lubrication process. It is typical for these symptoms to show up around the 2 week mark but can take several weeks to months to recover.

Studies have shown that these nerves regenerate over a period of several months to sometimes as long as a year. This can be more sigfnicant if a patient had a dry eye problem to begin with so most LASIK surgeons will be diligent about identifying those patients with dry eye and treat them aggressively prior to the procedure in order to ensure an optimal outcome. Fortunately it is only a minority of patients who have a persistent, serious dry eye problem after LASIK.

Many cases of dry eye are actually due to an instability of the tear film due to a deficiency of oil due to meibomian gland dysfunction. This is often overlooked by eye doctors who don't specifically look for it. So in addition to using artificial tears - and I would recommend using preservative-free artificial tears for the first several weeks after surgery - you also want to promote adequate oil production from the eyelids.

Some things to try:
- preservative-free artificial tears
- moist heat on the lids (but avoid pressure on or rubbing of the eyelids for the first month)
- take fish oil, flaxseed oil, or black currant seed oil (the latter can be found in a supplement called HydroEye)
- cut wheat out of the diet =3D Paleo Diet. Wheat has been linked to inflammation and autoimmune disorders including dry eye due to decreased tear production
- limit omega-6 oils - these are found in fried foods and most processed foods and listed as hydrogenated oils and fats and are also linked to inflammation
- make sure you don't have a ceiling fan or AC duct blowing on you at night. Even a fan in the corner of your room can be blowing enough to dry your eyes out
- if fans or AC are not an issue, consider using a lubricating gel or ointment at night to keep the eyes from drying out while you sleep
- if you are still struggling, you might benefit from Restasis, a prescription eye drop that decreases inflammation and can increase tear production. Be aware that this medicine can take a few months to reach a therapeutic level.

Bottom line: dry eye is common early after LASIK and usually improves with time. But you should discuss your symptoms and concerns with your surgeon. Untreated dry eye is associated with regression which can lead to undercorrection of your refractive error. So your doctor will want to know so they can address it properly.
This is a very normal and expected consequence of LASIK surgery. It is caused by trauma to the nerves in the cornea. Dryness occurs to some extent to most LASIK patients. In most cases, considerable improvement can occur slowly over 6 months. Medications such as Restasis and Xiidra are available to help with this. Having 90 days or 180 day punctal plugs placed is a great temporizing measure to consider while you are waiting for your dryness to improve. I'm happy you are seeing well. All the best.
Amjad Khokhar, M.D., F.A.A.O.
One of the biggest side effects of lasik surgery is dry eyes. You need to come to continue lubricating your eyes for now. I would ask your doctor to think about placing punctual plugs also. This will help your eyes keep moisture better. Lastly there are medications to help improve tear production. Good news is you should get better with time.
After Lasik the eyes can feel dry, but we now have very good medications to treat dry eye. Xiidra eye drops and Blink preservative free can help alleviate dry eye. Please return to have a post op check with your surgeon. Please ask him or her whether these drops can help you.
Good luck.
LASIK generally makes everyone’s eyes dryer. This usually goes back to your baseline dryness over weeks to months sometimes up to 6 months. This happens because the flap cuts across the corneal nerves and desensitizes eyes till nerves regenerate. In the meantime nonpreservjed tears every few ours will help.There’s also xiidra and Restasis which need prescription abs well also punctual plugging may be of benefit.
It is very common for the eyes to be dry after LASIK surgery. Some of the small nerves in the cornea are disrupted when the LASIK flap is made. This decreases the amount of tears your eyes make. It often takes several months or even a year for the nerves to heal completely. Artificial tears are the best treatment. There are many good brands available over-the-counter. Systane and Refresh are examples. If you need to use the drops more than 4 times a day to keep the eyes comfortable, you
should get a Preservative-free version. If your symptoms persist despite using tears frequently, talk to your eye surgeon about other possible treatment options (such as punctal plugs or Restasis).
Luckily the dryness usually improves over time as your cornea heals.
Best regards,
Dr. Lindsey
There are many reasons for dry eyes. It would be my pleasure to examine you to determine and treat the root cause. Please call my office to schedule an appointment so we can get you feeling better.
The cutting of the LASIK flap causes damage to the corneal nerves which can decrease reflex tearing. Preservative free artificial tears can help. The majority of people see improvement with time
Lasik is associated with dry eyes due to corneal nerves transaction and usually recovers after several months when the nerves regrow.
Interim treatment with frequent use of artificial eye drops as lubricant and punctual plugs will help
It is very common to have worsening of dry eye after LASIK because some of the corneal nerves are cut to make the flap. It will improve. Restasis and or artificial tears can help.