What is the recommended treatment protocol for dry eyes before LASIK?

Doctor's Answers 1

Dry eye syndrome can span a spectrum from mild to moderate and severe. Treatment protocols also may vary from clinic to clinic, but it is worth mentioning the goals of treatment and the general principles that can be used to alleviate the problem.

Among the problems associated with dry eyes is the development of punctate corneal epithelial erosions (little dry spots on the cornea). If a large number of these appear and if they develop in the centre of the cornea, vision will become blurred. In the worst cases, some amount of scarring can also develop. Treatment aims to minimize or eliminate these erosions, as well as to minimize eye irritation and feelings of eye dryness/discomfort.

Treatment for dry eyes with any protocol always starts with frequent artificial tear use, and in the case of moderate to severe dry eye conditions, preservative free preparations are used. If significant inflammation is noted, topical steroids or cyclosporine can be added as well. This is done in conjunction with general measures such as stopping contact lens wear and frequent breaks from computer use, as well as treatment of any contributing eyelid condition such as blepharitis.

If a dry eye state persists and requires very frequent eyedrop use, but where the inflammation is under control or is not a significant factor, then punctal plugs are very useful.

These methods are used to achieve a state where there are minimal punctate erosions, and where there are minimal symptoms, before a patient would be considered for surgery.

If a patient has severe dry eyes that require more intensive treatment than this, or where it is associated with an underlying systemic disease, most doctors would advise against laser refractive surgery.

Similar Questions

Should I delay LASIK if I suffer from symptomatic dry eyes and Epithelial Keratopathy?

When there are symptoms suggestive of any potential eye disease, I would recommend addressing the underlying problems first before embarking on any form of surgery, refractive surgery included. Complaints such those you described are suggestive of dry eye and refractive error instability which would warrant caution prior to making any decision for surgery. Should you have any concerns, it would be perfectly appropriate for you to raise them with your surgeon. Work closely with a trusted surgeon to decide on the best course forward. Otherwise, a second opinion could help allay your worries.

How does LASIK cause dry eyes?

During a LASIK operation, a thin superficial layer of cornea is created and temporarily peeled back to allow laser treatment of the underlying tissue. This is called the ‘lasik flap’, and is what provides the quick and painless recovery after LASIK. Some nerve endings that go into the flap are ‘disconnected’ at the time, and this reduces the feedback that our tear glands get that stimulate tear production.

Photo of Human

Answered By

Human

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox