Managing Dry Eye Syndrome After LASIK: Tips and Treatment Options

Dry Eye Syndrome

I have been wearing contact lenses for a long time (about 18 years).
Last March, I underwent laser surgery to correct my vision (originally -750 diopters, now -150 diopters).
Since then, I have experienced dry and painful eyes, especially when I wake up in the morning or during the night; my eyes feel so painful that I can hardly open them.
The doctor diagnosed me with dry eye syndrome, and I have been using artificial tears for over a year.
I would like to know what other methods can improve my condition (preferably without using eye drops daily).
Can I use artificial tears (Artelac) long-term? Will it harm my eyes or affect my vision? Additionally, I experience allergic conjunctivitis every time the seasons change; is this related to my dry eye syndrome? Thank you.

aa, 30~39 year old female. Ask Date: 2004/06/08

Dr. Ke Meilan reply Ophthalmology

Hello,
1.
Were you diagnosed with dry eye syndrome prior to the LASK procedure?
2.
Generally, 3-6 months post-surgery, most patients will return to their pre-operative condition, and tear film tests can determine the severity.

3.
Waking up with eye pain can occur not only due to tear film issues but also if the eyes do not fully close during sleep.
In such cases, using breathable tape to secure the upper and lower eyelids may be considered, but it must be applied correctly to be effective.

4.
Additionally, occluding the puncta to prolong the retention of tears on the eye surface can also provide some improvement.

5.
Artelac still contains preservatives, but they are minimally harmful; however, if used in high quantities, it is best to use preservative-free artificial tears.

6.
Allergies are not related to dry eye syndrome, but dry eye can exacerbate allergic symptoms.

Sincerely, Dr.
Mei-Lan Ke, Ophthalmology Department

Reply Date: 2004/06/08

More Info

Managing Dry Eye Syndrome after LASIK surgery can be a challenging experience, especially for individuals who have a history of wearing contact lenses for an extended period. Your situation, where you have experienced persistent dryness and discomfort since your LASIK procedure, is not uncommon. Here’s a comprehensive overview of potential management strategies and treatment options for your condition.

Understanding Dry Eye Syndrome Post-LASIK
Dry Eye Syndrome (DES) occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. After LASIK surgery, many patients experience dry eyes due to the disruption of corneal nerves that are responsible for tear production. This can lead to symptoms such as dryness, burning, and discomfort, particularly upon waking or during the night.

Treatment Options
1. Artificial Tears: You mentioned using Artelac, which is a preservative-free artificial tear. Using artificial tears regularly can help alleviate dryness. It is generally safe to use artificial tears long-term, and they do not harm the eyes or affect vision. However, it is essential to choose preservative-free options to avoid irritation, especially if you are using them frequently.

2. Punctal Plugs: If artificial tears alone are insufficient, you might consider discussing punctal plugs with your ophthalmologist. These small devices are inserted into the tear ducts to block drainage, helping to retain moisture on the surface of the eye.

3. Prescription Medications: In some cases, your doctor may prescribe medications such as cyclosporine A (Restasis) or lifitegrast (Xiidra) to help increase tear production and reduce inflammation. These medications can be beneficial for chronic dry eye conditions.

4. Warm Compresses and Eyelid Hygiene: Regularly applying warm compresses can help unclog blocked meibomian glands, which are essential for producing the oily layer of tears. Additionally, maintaining eyelid hygiene can help reduce inflammation and improve overall eye comfort.

5. Environmental Modifications: Consider making adjustments to your environment. Using a humidifier, avoiding direct airflow from fans or air conditioning, and wearing sunglasses outdoors can help protect your eyes from dryness.

6. Dietary Changes: Increasing your intake of omega-3 fatty acids, found in fish oil or flaxseed oil, may help improve tear production. Staying hydrated is also crucial for maintaining eye moisture.

Allergic Conjunctivitis and Its Relation to Dry Eyes
You mentioned experiencing allergic conjunctivitis during seasonal changes. Allergies can exacerbate dry eye symptoms, as they often lead to inflammation and irritation of the ocular surface. It is essential to manage your allergies effectively, which may include using antihistamine eye drops or oral medications. Discussing this with your eye care provider can help tailor a treatment plan that addresses both your dry eyes and allergy symptoms.

Conclusion
In summary, managing dry eye syndrome after LASIK involves a multifaceted approach that includes the use of artificial tears, potential prescription medications, environmental adjustments, and dietary considerations. While artificial tears can be used long-term without harming your eyes, it is crucial to monitor your symptoms and consult with your ophthalmologist regularly to ensure that your treatment plan remains effective. If your symptoms persist or worsen, further evaluation may be necessary to explore additional treatment options. Remember, maintaining open communication with your healthcare provider is key to finding the best solutions for your eye health.

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