Does LASIK cause dry eye?

LASIK reshapes the cornea to correct nearsightedness, farsightedness or astigmatism. The cornea is densely supplied with nerves, and those nerves are part of the feedback loop that tells your eye to produce tears. Creating the flap and reshaping the tissue affects some of them, so tear production drops until they recover.

It is well recognised, and it is why eye surgery sits on the list of contributing factors to dry eye alongside cataract surgery.

Having dry eye does not automatically rule you out. It means the pre-operative assessment matters more: your surgeon will judge how severe it is and may recommend treating it first to improve tear quality before going ahead.

Sometimes an alternative such as PRK is suggested instead, as it may carry a lower risk of making dry eye worse. Newer approaches such as custom wavefront-guided LASIK can also reduce the risk by preserving more of the corneal nerves responsible for tear production. Either way, a clear post-operative plan is part of doing it well.

Have your tear film and meibomian glands assessed beforehand. Untreated dry eye tends to be more troublesome after surgery than before it, and settling the lid margin and the glands first gives you a better starting point.

It can also affect the measurements the surgery is planned from — an unstable tear film makes for less reliable readings.

Dry eye afterwards is common and treatable. Preservative-free artificial tears give immediate relief and can be used as often as needed. Omega-3 improves tear quality and reduces inflammation. For more stubborn cases there are prescription anti-inflammatory drops, and punctal plugs — tiny devices placed in the tear ducts to keep tears on the eye for longer.

Symptoms that persist well beyond the expected recovery are worth assessing rather than waiting out, particularly if your glands are also blocked. Surgery affects tear production; it does not clear a meibomian gland that was blocked before you went in, and the two problems add together. The treatments we offer address the oil side of the tear film, which is often the part that can still be improved after surgery.