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Dry Eyes After LASIK (Part One)

By Joel Hunter, MD | 8/19/15 8:00 AM
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One of the most common questions I get when someone is deciding on whether or not they want to get LASIK is whether or not they will get dry eyes afterwards. I’m always glad when someone asks me because it means they’ve been doing some research on the idea, and more research is always better when people are feeling stressed about whether or not laser vision correction will be safe and/or effective.

There’s a reason that “dry eyes” comes up as a result when searching for LASIK complications. Namely, it’s one of the known complications. But in a larger sense, that’s not as accurate as we can be about it with the current information available to us. Because it’s also true that infection is a known complication of ear piercing, but in that example, most people already know it’s a much different level of risk to get your ears pierced by a professional in a controlled environment vs. doing it yourself with a staple in middle school. Incidentally, I know someone who did that and while I won’t give his name, I will say he works here and his office is by mine and his name is Josh Hunter.

We know a lot about dry eyes after LASIK at this point—tons more than we knew about it in the 1990s. I actually attended lectures at conferences while theories were still being posited on what caused dry eyes. It turns out almost all of the answer is nerves. The corneal nerves send information saying the eyes need more tears, and then you make more tears. When you do LASIK, a percentage of those nerves are shut down from sending that information, and then your eyes get dry. We learned some of that from good, old-fashioned bench-in-a-lab research, and we learned more and confirmed more about it with the ever-vanishing incidence of dry eyes with modern LASIK. It’s a rare problem these days, and one that I’ve always been able to fix when it happens, because of the big leaps in technology—both laser and pharmacologic —that have occurred in recent years.

It’s worth laying out a little more about how that has happened, but this entry will get too long if I try to add it now. So until next time… I don’t know what to write to end this with an “until next time.” To be continued? That seems dramatic. Maybe I should go with a cool catch phrase: Until next time… keep on blinkin’. Yeah that’s perfect.

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