Dry Eye After LASIK or Vision Correction? What No One Warns You About
If you wear glasses or contact lenses, getting a vision correction procedure like LASIK can be life changing. But as with all surgeries, it’s not free of potential side effects. The most common complication? Dry eye.
However, as it happens so frequently, it can be hard to know what’s normal and what’s not. It also doesn’t help that symptoms can sometimes persist or appear long after surgery.
To make sure you’re prepared, we asked eye care professionals to explain the link between vision correction and dry eye, along with how to protect eye comfort as you heal.
Why vision correction can affect tear function
“Vision correction procedures can temporarily disrupt corneal nerves that play a key role in signaling tear production,” explains Ksenia Goman, MD, ophthalmologist at Northwell’s Manhattan Eye, Ear and Throat Hospital. “In the short term, this often leads to irritation, burning, or fluctuating vision.” It’s also super common, with 95% of people experiencing dry eye right after refractive surgery and 60% of people having symptoms one month later.
For most people, their symptoms get better as nerves regenerate over the next few months. But for some folks, especially those with pre-existing dry eye, symptoms can become chronic, says Goman.
In some cases, dryness can show up weeks or months later. “Dryness is a subjective feeling that’s experienced differently by everyone,” points out Danielle Orr, OD, MS, FAAO, assistant clinical professor at OSU College of Optometry.
And dry eye symptoms, especially burning or sensitivity to wind and light, are typically connected to changes in the nerve pathway between the cornea and the brain, says Orr. These changes can take time, potentially delaying symptoms.
What’s normal after surgery & what’s not
In general, you should expect some dryness during the healing window, though it should improve over time.
But how do you know your dry eye is becoming chronic? It’s a red flag if your symptoms don’t get better with the recommended post-surgery therapies, which usually include OTC artificial tears, according to Orr.
Likewise, if you have severe dry eye symptoms that interfere with daily activities, you’ll want to take note.
Why some people are more vulnerable
Though dry eye is a common complication, some people are more likely to have long-term symptoms.
Risk factors include:
- Pre-existing dry eye: This is the biggest risk factor1 for post-surgery dry eye. If you already have dry eye, vision correction surgery can exacerbate your symptoms.
- Women: “Women and individuals over 40 are also more susceptible due to natural tear changes,” says Goman. That’s because women have lower levels of androgen2, a hormone that plays a role in tear secretion.
- Underlying conditions: Hormonal changes, like those caused by menopause, can reduce tear production. Similarly, autoimmune conditions can affect the eye, causing tear film instability and inflammation.
- Heavy screen use: Constant screen exposure reduces your blink rate, increasing the risk of dry eye. This can get worse after surgery, especially if you continue to frequently look at screens.
- Contact lens use: Wearing contact lenses3 can trigger dry eye, especially if you don’t take care of them or switch them out. If you have pre-existing dry eye caused by contact lens, it’s important to manage it before surgery.
Protecting long-term eye comfort after vision correction
If you’re concerned about post-surgery dry eye, don’t hesitate to chat with your eye care provider. This is especially important if you have a history of dry eye or certain risk factors.
Plus, your eye care professional needs to know if you have dry eye (and your response to any therapies) before considering you as a candidate for refractive surgeries like LASIK, says Orr. This will ensure a successful procedure, along with a healthy healing process.
Fortunately, there are many ways to support tear quality and lid health, both before and after surgery. According to Goman, this may include:
- Regular use of OTC preservative-free lubricating drops
- Conscious blinking and breaks during screen use
- Proper hydration
- Warm compresses and lid hygiene (for healthy oil gland function)
- Omega-3 supplements (for improved tear quality)
- Prescription drops
- In-office treatments
On that note, you’ll want to avoid overusing OTC eye drops. The habit won’t treat the root cause (i.e., inflammation, poor tear production, or tear quality), which can increase the risk of eye damage. Eye drops with preservatives can also cause irritation, making your symptoms worse.
The takeaway
Vision correction surgery can disrupt healthy tear production, potentially triggering dry eye. This can be super frustrating, and it might even feel like you’ve traded eye comfort for 20/20 vision. But it doesn’t need to be that way.
By communicating with your eye care provider, you’ll be able to lower the risk of post-surgery dry eye and prevent it from becoming chronic.