Can Dry Eyes Cause Pseudomyopia After Vision Correction Surgery?

Q: Can Dry Eyes Cause Pseudomyopia After Vision Correction Surgery?

Hello Ms. <br>Chen： Astigmatism caused by dry eyes is uncommon. <br>Astigmatism is due to irregularities in the cornea, so any factors that destabilize the corneal condition could potentially increase astigmatism. <br>A short-term increase in astigmatism is not common, and curren

Continuation: Can dry eyes cause astigmatism?

Hello, Doctor.
Last week, I inquired about experiencing significant dryness and some pain in my eyes after undergoing vision correction.
It has been four months since the surgery, but one of my eyes has shown a noticeable increase in astigmatism.
During today's follow-up, the doctor measured my astigmatism at 100 degrees, while previous measurements were consistently at 50 degrees (the last check three weeks ago was also 50 degrees).
This rapid change seems unusual.
My intraocular pressure and fundus examination were normal, but my cornea is very dry and shows signs of abrasion.
(The other eye previously measured 50 degrees of astigmatism but has now returned to 0 degrees.) I usually do not rub my eyes.
Could this situation potentially be caused by dry eyes leading to pseudomyopia? The doctor mentioned that a sudden increase in astigmatism is uncommon and provided lubricating artificial tears to see if it improves.
I couldn't find relevant information online, so I hope Dr.
Gao can help answer my questions.
Thank you!

Miss Chen, 20~29 year old female. Ask Date: 2021/01/26

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Chen: Astigmatism caused by dry eyes is uncommon.
Astigmatism is due to irregularities in the cornea, so any factors that destabilize the corneal condition could potentially increase astigmatism.
A short-term increase in astigmatism is not common, and currently, it should be monitored.
The ophthalmology department at Puzi Hospital in Taiwan is open on Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, and Wednesday afternoons from 2:00 PM to 4:30 PM.
Online responses should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
I hope to have the opportunity to serve you.
Gao Pilin

Reply Date: 2021/01/26

More Info

Dry eyes can indeed contribute to the phenomenon known as pseudomyopia, especially following vision correction surgery. Pseudomyopia refers to a temporary condition where the eye appears to be myopic (nearsighted) due to excessive accommodation, which can be exacerbated by dry eye symptoms.
After vision correction surgery, such as LASIK or PRK, patients often experience changes in their tear film and ocular surface, leading to dry eyes. This can happen for several reasons, including the disruption of corneal nerves during surgery, which can reduce tear production. When the eyes are dry, they may not focus light properly, leading to fluctuations in vision quality, including increased astigmatism or blurred vision.

In your case, the sudden increase in astigmatism from 50 degrees to 100 degrees in one eye, while the other eye returned to 0 degrees, is indeed unusual and concerning. The presence of corneal abrasions or friction marks suggests that your ocular surface is compromised, which can lead to further visual disturbances. Dry eyes can cause the cornea to become irregular, leading to changes in how light is refracted, which could explain the increase in astigmatism.

The use of artificial tears is a common first-line treatment for managing dry eyes. These lubricating drops can help restore moisture to the ocular surface, reduce friction, and improve overall comfort. They may also help stabilize the tear film, which can lead to improved visual clarity. It’s important to use preservative-free artificial tears, especially if you find yourself needing to apply them frequently throughout the day.

In addition to artificial tears, consider the following measures to manage dry eyes post-surgery:
1. Environmental Modifications: Avoid dry, windy environments and use a humidifier to maintain moisture in the air. Protect your eyes from wind and dust with sunglasses when outdoors.

2. Frequent Blinking: Make a conscious effort to blink more often, especially during activities that require prolonged visual focus, such as reading or using screens.

3. Warm Compresses: Applying warm compresses to your eyes can help stimulate tear production and relieve discomfort.

4. Dietary Adjustments: Ensure adequate hydration and consider omega-3 fatty acids, which may help improve tear quality.

5. Follow-Up with Your Eye Care Provider: Regular follow-ups are crucial to monitor your condition. If symptoms persist or worsen, your doctor may consider additional treatments, such as punctal plugs to reduce tear drainage or prescription medications to enhance tear production.

In conclusion, while dry eyes can lead to temporary changes in vision, including pseudomyopia and increased astigmatism, addressing the underlying dryness with appropriate treatments can help restore visual clarity. It’s essential to maintain open communication with your eye care provider regarding your symptoms and treatment progress. If your vision does not stabilize or improve with artificial tears, further evaluation may be necessary to rule out other underlying issues.

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