Dealing with Dry-eye

Written by John Taylor

Dry-eye is perhaps the most common complication of laser-assisted refractive surgery, impacting up to nearly a third of all patients. Although the condition can be uncomfortable, in many cases it isn't permanent, but if it is there are a variety of treatments for dry-eye.

Dry-eye is a fairly common condition among people who haven't had laser-assisted refractive surgery, particularly among people who wear contact lenses. People who already have dry eyes as a condition pre-existing to laser-assisted refractive surgery should report it to their doctor. Dry-eyes most likely won't preclude you from having the surgery, but it is an issue that you and your doctor need to address prior to surgery.

If you think you have dry eyes, there are two tests your doctor can conduct to determine whether you do and how severe the condition is. These tests are called the Tear Break-Up Test and the Schirmer test. The TBUT determines tear quality, the Schirmer determines tear quantity. Getting these conditions assessed prior to surgery will help you get treatment for them that's covered under insurance.

Dry-eyes are most commonly associated with with LASIK surgery and its derivatives, although PRK also has a high rate of dry-eye complaints. LASEK and Epi-LASIK have substantially fewer complaints of dry-eye. In fact, just about every patient who undergoes LASIK will have dry eyes to some degree, but in many cases this condition will subside within a few days after the surgery. Dry eyes are more common to LASIK because this procedure involves more disruption of the corneal nerves.

The level of disruption to these nerves caused by LASIK results in a decrease in the ability of the tearing system to intuit when tears are necessary. This reduction of the flow of information between the cornea and the tearing system may cause the patient to blink less or not to produce enough or the righ kind of tears, or even make the patient feel like he or she doesn't have enough tears even when he or she does.

Prevention is the best cure, and there are some things patients can do to prevent dry eyes. The most important step is picking the right procedure to undergo. If you're prone to dry eyes prior to your surgery, you will likely want to select a surgery that is less likely to result in dry eyes. Patients with pre-existing dry eyes will likely want to chose LASEK or Epi-LASIK, or perhaps even pick an alternate method of improving their vision such as CK, RLE or corneal implants that are less likely to cause dry-eye. Another important step is to chose the right physician. If you think you're likely to get dry-eye, pick a doctor who is experienced in laser-assisted refractive surgery and in dealing with complications such as dry-eye.

Most patients who suffer from dry eyes will see their condition resolve itself within half a year after their surgery. The small minority of patients who will have long-term problems with dry-eye from LASIK surgery have a number of treatment options they can avail themselves of.

Some basic lifestyle changes may help with your dry-eye problem. For example, you should be sure to drink enough water, because if you're dehydrated your body will not be able to produce sufficient tears. Also, you should try to avoid dry areas, as this will dry out your tears. It may also be advisable to purchase a humidifier. This can help keep the air around you wet, and reduce the need for tear production. Eating fish may also help produce more tears.

A more aggressive approach may be the use of artificial tears. You should consult with your doctor regarding which brand of artificial tears is right for you.

There are also a variety of nutritional supplements that can help with dry-eye. Flax seed oil is a supplement available at most vitamin and health food stores. Taken once per day, flax seed oil can help increase the quantity and quality of tears. Flax seed oil has an unpleasantly strong flavor, so you may want to take it with something pleasantly flavored to make it more palatable. Other good supplements include TheraTears nutrition, Hydrate Essential and Hydroeye.

Anti-inflammatory drugs such as steroids or restasis can also help. Restasis can help reduce swelling around the channels that carry vital tear ingredients to the eyes. Restasis currently is the only medication approved by the FDA for treating the long-term effects of dry-eye.

Dry-eye can be uncomfortable and annoying, but it doesn't have to be the fly in the ointment regarding your successful laser-assisted refractive surgery. With proper care and support, you can overcome the impact of dry-eye.