Dry eye is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. Tears can be inadequate for many reasons. For example, dry eyes may occur if you don’t produce enough tears or if you produce poor-quality tears.
Dry eyes feel uncomfortable. If you have dry eyes, your eyes may sting or burn. You may experience dry eyes in certain situations, such as on an airplane, in an air-conditioned room, while riding a bike or after looking at a computer screen for a few hours.
Although existing dry eye syndrome (DES) can worsen following Laser eye surgery, proper preoperative and postoperative management can allow patients with even significant dry eye to benefit from the surgery.

Symptoms

Signs and symptoms, which usually affect both eyes, may include:

A stinging, burning or scratchy sensation in your eyes
Stringy mucus in or around your eyes
Sensitivity to light
Eye redness
A sensation of having something in your eyes
Difficulty wearing contact lenses
Difficulty with nighttime driving
Watery eyes, which is the body’s response to the irritation of dry eyes
Blurred vision or eye fatigue

What causes dry eyes?

Dry eye can be caused by a lot of things. Some of the most common causes include:

The ageing processes
Hormonal changes in women related to pregnancy, menopause or the contraceptive pill
Extreme climatic environments
Environmental conditions, such as those experienced in the modern-day air-conditioned office combined with prolonged near visual tasks
Underlying medical conditions
Eye Surgery

How dry eye affects suitability for Laser Eye Surgery

If you suffer from dry eye and are interested in having Laser Eye Surgery, then you may be concerned that you’re not suitable for treatment — especially if you experience severe dryness.
However, many people who have DES are surprised to learn they do, in fact, have a high chance of being suitable for Laser Eye Surgery. All patients who are found to have preoperative dry eye will undergo through examination to evaluate the extent and underlying cause of the dry eye. This is important because suitability for Laser Eye Surgery depends on the cause and severity of dry eye. If the health of the surface of the eye can be optimised through treatment then it may be possible to move forward with laser eye surgery.

Dry eye as a side effect of Laser Eye Surgery

Dry eye is common after LASIK vision correction surgery. In fact, research shows that almost half the patients who undergo LASIK have some degree of dry eyes following the procedure, and symptoms sometimes can persist for weeks, months or even longer.
But to keep the problem in perspective, many people who seek Laser eye surgery already have dry eyes. As an example, contact lens wearers who find their lenses uncomfortable because of dry eyes may investigate Laser eye surgery as an alternative because they do not want to wear eyeglasses.

Corneal Nerves (those on the surface of your eye) play an important part in the Laser Eye Surgery recovery process. Because of the laser process, the nerves on the surface of the eye are momentarily interrupted. These corneal nerves send information to the lacrimal gland to supply a continual amount of lubrication to the eye. With the corneal nerves briefly disrupted, they can no longer supply the appropriate information, therefore decreasing the normal amount of lubrication to the eye.
Over the course of the weeks and months after Laser Eye Surgery, the nerves heal, and the lubrication level returns to normal. However, a small number of patients with pre-existing dry eye syndrome are at risk of prolonged and/or more significant symptoms.
In cases of severe dry eye, the clinician may use punctal plugs, also known as tear duct plugs or lacrimal plugs. A punctal plug is a plastic plug that prevents the drainage of tears from your eye. This device can raise the amount of lubrication on the surface of the eye, just like plugging the drain of a sink. A clinician can remove the plastic plugs months later if needed.

How to Manage dry eyes?

Most cases of dry eye are mild and can actually be easily managed with lubricating eye drops and other forms of medication. In some cases, hot compresses or lid wipes, plus Omega 3 supplements are of benefit. Therapeutic procedures, such as Lipiflow, a heat and massage treatment of the Meibomian glands of the eyelids can help the symptoms.

Tips for coping with dry eyes

Blink more frequently. Research has shown that people tend to blink much less frequently than normal when viewing a computer, smartphone or other digital display. This decreased blink rate can cause or worsen dry eye symptoms. Make a conscious effort to blink more often when using these devices. Also, perform full blinks — gently squeezing your eyelids together — to fully spread a fresh layer of tears over your eyes.

Take frequent breaks during computer use. A good rule of thumb here is to look away from your screen at least every 20 minutes and look at something that is at least 20 feet from your eyes for at least 20 seconds. Eye doctors call this the “20-20-20 rule,” and abiding by it can help relieve dry eyes and computer eye strain.

Clean your eyelids. When washing your face before bedtime, gently wash your eyelids to remove bacteria that can cause blepharitis and meibomian gland problems that lead to dry eye symptoms. Apply a warm, moist washcloth to your closed lids for at least 20 seconds. Then gently wash your lids and lashes with a mild cleanser, such as diluted baby shampoo or pre-moistened eyelid wipes sold in drugstores.

Wear quality sunglasses. When outdoors in daylight hours, always wear sunglasses that block 100% of the sun’s UV rays. For the best protection, choose sunglasses that also feature a wrap-style frame to protect your eyes from wind, dust and other irritants that can cause or worsen dry eye symptoms.

Medication adjustment. Many medicines — including antihistamines, antidepressants, birth control pills, certain blood pressure medications and more — can cause or worsen dry eye symptoms. Even over the counter (non-prescription) medications for allergies and other conditions can cause dry eyes. Be sure to discuss all medications you are taking with your eye doctor if you are experiencing dry eye problems. In some cases, adjusting the type and number of medications you are taking may help reduce dry eye symptoms without causing adverse health effects. However, never discontinue a prescription medication without first discussing the matter with your physician.

Moving from contacts to laser

Probably the most impactful thing you can do to decrease your chances of experiencing dry eye is to stop wearing contact lenses. A lot of people consider this as simply not an option as it means going back to relying on glasses. However, this is not the case. Contact lenses suck up the tears on the surface of the eye and can mess with the balance that we talked about earlier. So, most people that wear contacts and experience dry eye don’t actually have dry eye syndrome. They have contact lens induced dry eye. Laser eye surgery is then a great option as you no longer have to wear the contact lenses and the eyes feel better!

Dry Eyes and Laser Eye Surgery