Dry eye is one of the most common side effects that post LASIK patients experience during healing. Most doctors who work with LASIK patients will prescribe eye drops to help with eye lubrication during healing. The length of time that lubricant eye drops need to be used can vary. Lubrication drops are usually recommended for a minimum of one week. Some patients may need to use them for up to a few months after LASIK.
Many patients decide to have LASIK because their eyes are too dry to wear contact lenses comfortably. Dry eye can make a patient intolerant to contact lenses. Some doctors will recommend that patients be treated for dry eye prior to laser eye surgery. Additionally, some patients may be recommended to have PRK, SMILE, or an intraocular lens implant instead of LASIK.
PRK and SMILE procedures are laser eye procedures, similar to LASIK, known to lessen the risk of increased dryness for patients who already have dry eye.
PRK, or photorefractive keratectomy, is a type of refractive surgery where the thin outer layer of the cornea is removed prior to reshaping the underlying corneal tissue with an excimer laser. The fact that the procedure is done without a corneal flap reduces the risk of induced dryness.
SMILE is a laser eye surgery where a small lenticule of tissue is taken out through a tiny laser-created incision. Again, since the procedure does not involve a flap, the risk of inducing dryness is small.
Regardless of whether a patient has had LASIK, dry eye is one of the most common reasons that patients visit an eye doctor’s office. Dry eyes can be caused by many different conditions. A dry environment, uninterrupted screen time, and hormonal changes are just some of the reasons that patients experience dry eye.
Diagnosis of Dry Eye
There have been a lot of advances in the diagnosis and treatment of dry eye. In the past, only the Schirmer Test was available. The Schirmer test measures the volume of tears that your eye produces. But it doesn’t look at the quality of the tears produced by your eyes. More advanced practices use tools like the HD analyzer to get a feel for the quality of a patient’s vision. The HD analyzer is a tool that measures total optical quality, accounting for light scatter caused by pathologies like tear film instability. The HD analyzer measures a patient’s Optical Scatter Index (OSI). The HD Analyzer is the only diagnostic tool that can pre-diagnose the subtle forward light scatter that affects surgical outcomes for refractive patients.
The Causes of Dryness
There are also new treatments for dry eye patients. Meibomian gland dysfunction (MGD) may be one of the most common eye problems. Meibomian glands are particular glands within the eyelid. There are between 25 to 40 of these glands in the upper lid, and 20-30 in the lower. These glands secrete oil onto the ocular surface that keeps tears from evaporating too quickly. A blockage or dysfunction of these glands is referred to as Meibomian gland dysfunction (MGD). LipiView Ocular Surface Interferometer allows doctors to view your meibomian glands and oil layer of your tear film. Lipiflow Thermal Pulsation System is a tool used to cleanse and massage the glands, ultimately improving gland function.
Treatment of Dry Eye
Eye drops, like artificial tear drops, can be somewhat effective in treating dry eye. But the effect of eye drops tends to be fleeting. And, if your dryness isn’t caused due to a lack of tears, eye drops probably won’t be your long-term solution.
Xiidra is a prescription eye drop used to treat the signs and symptoms of dry eye. The drop works by blocking certain proteins on the surface of cells in your body. The protein can cause your eyes not to produce enough tears, or to produce tears that are not the correct consistency to keep your eyes healthy.
Restasis is another prescription eye drop for patients with dry eye. Restasis will lubricate your eyes and reduce inflammation associated with dry eye. You must use this drop for a minimum of 90 days to experience the full benefits of the drop.
Punctal Plugs are sometimes used in dry eye treatment to help tears remain on the surface of the eye longer. A punctal plug is a small device that fits into the puncta of tear drainage.
After the puncta have been plugged, tears can no longer drain through these ducts. It works very similarly to putting a drainage plug in a sink.
Warm compresses are recommended by some doctors who are treating patients for dry eye. This is particularly effective if a patient’s dry eye is caused by hardened meibum. But for this solution to be effective, patients need to keep the very warm compress on the eyelids for greater than 10 minutes at a time.
LipiFlow Thermal Pulsation System Is an in-office treatment for dry eye. A lot of doctors describe it as a massage for the eye’s glands.
The device fits over the eyelids. It applies heat to the eyelids, and it expresses the lids of any clogged meibum-the part of tears that is composed of oil. The treatment takes about 10 minutes per eye. The treatment is particularly effective for patients who have dry eye caused by MGD- Meibomian Gland Dysfunction.
Eyeliner and other eye makeup can clog the openings of the meibomian glands at the base of the eyelashes, leading to gland dysfunction and tears that evaporate too fast. Eyelid scrubs can be helpful in the ongoing maintenance of healthy lids and also in the treatment of lids with blepharitis.
Some doctors recommend a tablespoon of fish oil or flaxseed oil on a daily basis. Omega 3 fatty acids can decrease dry eye symptoms. Salmon, sardines, herring, and cod also are good sources of omega 3.
In summary, the causes of dry eye can be multifactorial. The best approach for treatment may be trial and error, and/or a multifaceted strategy. LASIK, contact lenses, environment, medications, and hormonal changes can cause dryness. There are better ways to diagnose and treat dryness today than ever before.
If you would like to learn more about dry eye then schedule an appointment at our dry eye clinics in Bedford or Brecksville today!