Post-Refractive Surgery Dry Eye

One of the most common complaints among patients with refractive surgery complications is dry eye. The FDA mentions severe dry eye syndrome as a complication on their LASIK information site.

“Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.”

Resources for dealing with dry eye

There are numerous over-the-counter drops and ointments, nutritional supplements, as well as prescription drugs and drops that are useful in alleviating the symptoms of dry eye. There are also many products that are helpful in providing relief for the acute symptoms of dry eye. However, it is important to determine the cause before it can be treated successfully. While LASIK can induce or exacerbate dry eye, there is no one, simple pathology that that can be pinpointed as the cause, which means that there is no one, simple, one-size-fits-all remedy.

Reversing Dry Eye Syndrome, by Steven Maskin, MD, is an easily understandable volume that explores the many factors that can contribute to dry eye disease, and discusses diagnosis and various treatments, many of which dry eye patients can do on their own. He also presents tips on how to find and work with a dry eye specialist. The book may be purchased through Dr. Maskin’s website is a good resource for dry eye information.

Another excellent source of information about dry eye pathology, treatments and surgeries, is the website of Scheffer Tseng, MD, PhD, who specializes in treating and researching dry eye disease. Dr. Tseng understands the specific needs and frustrations of post-RS patients.

Patient support, as well as information on over-the-counter treatments and products that can help to alleviate dry eye issues can be found at Dry Eye Zone. The Dry Eye Shop offers helpful information about products to alleviate dry eye.

A presentation on dry eye, by the esteemed Dr. Frank Holly, of the Dry Eye Institute, is available here. Dr. Holly has developed a newer drop, Freshkote, which, while pricey, has proven beneficial to many dry eye patients. These drops and others are available through the The Dry Eye Shop, Amazon and other online stores.

Finally, many patients benefit from lid therapy, described below.

Lid therapy is designed to eliminate surface debris and infection from the lids and improve the quality and flow of the oily secretion from the meibomian glands.
It is important that the entire procedure is performed twice daily for a period of three weeks.

Hold a hot washcloth (as hot as you can tolerate) over the eyes for 1 minute. Alternatively turn the water in your shower up as high as you can tolerate and have the hot water run over your eyes for 1 minute.

Gently rub the lid margin with the washcloth 2-3 times.
Put 1 drop of Baby Shampoo into 5ml of water. Dip a Q-tip into the solution and scrub the lid margin gently for 20 seconds. Rinse the eye with an eyebath.

The index finger is rolled up the lower lid to the lid margin. Pressure is applied inwards as the finger is rolled up to express the secretion from the gland. Lid massage should be done 20 to 30 times on each eye.
• There are 23 glands in each eye, running upwards to the lid margin, behind the eyelashes. Ensure that you do 3 rolls to cover the entire lower lid and all of the glands. Research has shown that as few as 2 glands blocked can have a detrimental effect on tear film performance.
• Think of your finger being like a steam roller. Pressure must be kept in against the eyeball to keep the gland blocked as your finger rolls up the lid and the fluid inside is pushed out.