LASIK MYTH #6 - LASIK Causes Dry Eye

FACT: Dryness is Reduced Over Time After LASIK. MESSAGE FROM THE SPEAKER: Thank you for all of your comments. It is important to recognize the multiple factors that are involved in ocular dryness. LASIK gets a lot of attention, but it is low on the list of causative agents involved in Dry Eye Disease. I would like to clear up any confusion that my video may have created. The intention was to explain a very common experience that happens when people trade in contact lenses for LASIK. Contact lenses promote inflammation by resting chronically in the eye, chaffing the cornea and inhibiting tear flow to the surface of the eye. At the same time, they mask the symptoms of ocular dryness by protecting the sensitive corneal nerves from the environment. This condition can progress unknowingly until the corneal surface begins to break down. In this situation, the person often feels fine with their contact lenses on but is uncomfortable when they are taken off. Ocular inflammation caused by contact lenses requires the lenses to be removed long term in order to allow the eye to heal. Transitioning out of contacts or glasses is a very important turning point in a person’s visual journey. Depending on the severity of the contact lens damage, it may require an extended period of time before LASIK can be considered. There may even be instances where people are not recommended to have the surgery at all. The mechanism of action of decreased dryness post LASIK is linked to the reduction of contact lens associated dryness. LASIK, in itself, will not promote ocular hydration. However, when substituted for contact lenses in someone suffering from contact lens associated dryness, the symptoms improve by contrast. There are many other factors that affect ocular dryness that are not mentioned here and it is important when talking about dryness that we look at the big picture. The prevalence of Dry Eye Disease is large and increases 4 fold between ages 17-50. It is also 2-3 times more common in women than men. Causative factors include hormone status, autoimmune disorders, thyroid imbalance, meibomian insufficiency, medications, and poor hydration to name a few. Through the course of life, it is not uncommon for people to encounter these issues, whether they have had LASIK in the past or not. Dry Eye Disease is often confused with a disorder called Neuropathic Pain. This is a corneal disorder similar to phantom pain which people sometimes experience after other surgeries. One important differentiator is the presence of pain. Dry eye is consistent with ocular irritation, however, if a person is experiencing pain after corneal surgery, Neuropathic pain is more likely the culprit. The treatment for these two entities is different. Refractive Surgeons, myself included, have dedicated our lives to helping people to see. The thing that we cherish most is the ability to make a positive impact in people’s lives such that they are able to experience the confidence and freedom that comes from clear unaided vision. It is very concerning when someone experiences a problem or is dissatisfied following surgery. For anyone suffering from dry eye disease, please reach out to a corneal specialist in your area. There are many therapies available, and I do not want you to have to suffer unnecessarily. Thank you for being a part of this conversation. I think that the more input we have, the closer we all get to the truth. Find out more from Refractive Surgery Alliance Members at www.RefractiveAlliance.com and at www.EverywakingMinute.com.