Quick Guide to Dry Eyes and Laser Eye Surgery

Updated for 2024

Our eyes are among the most complex organs of the natural world. Often compared to cameras, when our eyes are working effectively, they provide us with crisp images of the world around us – images that many of us would be lost without. But our vision is far from straightforward; it requires the work of a huge number of separate components working together in harmony. 

With so many vital components, the eyes require appropriate defences to ensure smooth operation. Thankfully, evolution has provided us with a number of natural mechanisms to provide this protection, from eyelids to the tear film. In this guide, we’ll be walking you through the importance of these defences in preventing dry eyes, as well as some of the causes of this common problem. So, to kick off, let’s take a look at the tear film in a little more detail.

What is the Tear Film?

The tear film is made up of three layers: an oily layer, a watery layer, and a mucus layer. All of these layers work together to keep our eyes hydrated and prevent them from drying out. However, when these layers are out of balance, we can experience symptoms such as dry eyes.

Dryness can affect the eyes for several reasons, including systemic disease, menopause, medications, alcohol, the environment, and, as it happens, Laser Eye Surgery. 

What are the symptoms and causes of dry eyes?

Many of us will experience dry eyes from time to time. In many cases, this problem is temporary and can be resolved by following a few simple steps. On the other hand, millions of people experience dry, irritated, and itchy eyes daily – a problem that is not only extremely uncomfortable and inconvenient but can also be detrimental to your vision. It is therefore important to understand the causes of dry eyes and to be able to spot the symptoms when they occur.

Dry eyes can be a symptom of more serious conditions, such as Dry Eye syndrome (DES) or Keratoconjunctivitis Sicca (KCS). However, it is often a multifaceted issue which can make proper diagnosis difficult. For example, dry eyes can also occur as a result of drinking excessive amounts of alcohol, as a side effect of several medications, or after prolonged screen exposure.

When dry eyes are associated with screen use, it may be referred to as Digital Eye Syndrome, or Computer Vision Syndrome (CVS). Such eye dryness can be exacerbated by poor lighting, improper viewing distance, glare from the screen, poor seating posture, and decreased blink rate when using screens. Unfortunately, in a world where most of us increasingly rely on our screens, CVS is becoming an increasingly common problem.

Other factors that can cause dry eye syndrome include contact lens use, smoking, conditions like Sjogren’s syndrome, rheumatoid arthritis, Parkinson’s, and diabetes, and environmental conditions such as low humidity, and air conditioning.

According to the National Eye Institute, some of the most common symptoms of dry eye are:

• Stinging or burning sensation in the eyes;
• Episodes of blurred vision;
• A sandy or gritty feeling in the eyes;
• Decreased tolerance to reading, working on the computer, or other activities that require sustained visual attention;
• Episodes of excess tears following very dry eye periods;
• Eye fatigue
• Pain and redness in the eyes;
• A stringy discharge from the eyes;
• Heavy eyelids;
• Inability to cry when emotionally stressed.

As we mentioned, many of us will experience dry eyes from time to time – especially if we spend a lot of time on computers or other screen devices. However, with only around 20% of those suffering from dry eyes syndrome having received a correct diagnosis, it is worth visiting an eye doctor if you are regularly experiencing any of the symptoms outlined above.

Dry eye is also a factor that requires consideration when it comes to Laser Eye Surgery – both before and after the procedure.

How Dry Eye Affects Suitability for Laser Eye Surgery

In some cases, having severe dry eye syndrome can be a contraindication for Laser Eye Surgery. However, many people with DES are surprised to learn that they may still be eligible for treatment. This largely depends on the cause of your dry eyes.

Several factors, including the environment, can exacerbate the problem of dry eyes. At our Harley Street clinic, we provide an extensive review to determine the cause and severity of your dry eye symptoms to accurately evaluate your suitability for Laser Eye Surgery. If your dry eye is temporary or if it is possible to improve the health of the eye’s surface through treatment regimes, then it may be possible to move forward with treatment.

As our expert Laser Eye Surgeon, Mr Glenn Carp explains in the video above, we are often still able to offer treatment to patients with pre-operative dry eye.

Dry Eye as a Side Effect of Laser Eye Surgery

Dry Eyes can also be a common side effect following Laser Eye Surgery. This is why the screening process is so important – it allows us to ensure that every patient receives the appropriate treatment. For example, if a patient with a history of dry eye is found to be at an increased risk of prolonged symptoms after Laser Eye Surgery, an alternative treatment may be recommended.

But what exactly causes dry eyes after Laser Eye Surgery?

The nerves in the eye play an important role in the recovery process following Laser Eye Surgery. The corneal nerves in the surface of the eye are responsible for sending information to the lacrimal gland which, in turn, supplies a continual amount of lubrication to the eye. Following Laser Eye Surgery, this process is temporarily interrupted. As a result, the eyes receive a reduced amount of lubrication resulting in dryness.

This dryness can persist for several weeks to several months after the procedure; however, as the nerves heal, the eyes’ lubrication levels will return to normal. In a small number of cases – particularly in patients with pre-existing dry eye syndromes – this dryness can persist for longer and symptoms may be more significant. But for the most part, post-surgery dry eyes can be managed effectively with the use of artificial tears.

These lubricating eye drops will be provided by the clinic on the day of your surgery and are included in the cost of your treatment. Your Patient Care Coordinator and clinical team will help you to determine when and how often these should be applied.

In more severe cases of dry eye, your clinician may recommend punctal plugs. Also known as tear duct plugs or lacrimal plugs, these devices act like a plug in a sink, preventing the drainage of tears from your eyes. This can help to keep your eyes lubricated as they recover from the procedure. A clinician can remove the plugs at a later time if needed.

Managing and Preventing Dry Eye

While dry eyes are usually a temporary side effect of Laser Eye Surgery, there are many people for whom they are an irritating part of everyday life. Fortunately, there are some things you can try to reduce, and even eliminate dry eyes without medications, plugs, or even drastic lifestyle changes.

Controlling the weather

Don’t panic, we’re not really suggesting that you need to learn to control the actual weather. However, there are some things that you can do to help limit its impact on your eyes.

First of all, preventing wind or air from blowing directly into your eyeballs is a good place to start. For example, avoiding hair dryers (or at least being careful when using them around your eyes) can be helpful. Hairdryers don’t only produce a powerful airflow, but this air is also hot and dry – a poor combination for already dry eyes. It is also a good idea to turn down air conditioners and heaters in your home and car and make sure they’re not pointing directly at your face!

Next, try to protect your eyes from windy weather. Wearing sunglasses, a hat, or a scarf can help to protect your eyes in blustery weather – both from the wind itself and any debris that may be flying around.

Keeping the air moist

Just like windy conditions can dry out and irritate your eyes, so too can spending too much time in dry environments. For example, the drier the air around you, the faster any moisture on the surface of your eyes will evaporate. This can leave you with a familiar dry and itchy sensation.

Something as simple as investing in a humidifier for your home could help to prevent this pesky dryness; however, you should check with your Laser Eye Surgeon as these may not be recommended for a short time following your procedure. Air purifiers can also help prevent dust particles and other airborne allergens from irritating your eyes.

Giving your eyes a break

These days it’s hard to get through even one day without spending a prolonged period staring at a screen. Whether that be working at a computer screen all day at the office or unwinding with a television binge in the evening, all of these things can tire out our eyes. But it’s not just screens that we need to look out for. The fact is, any activity that puts a lot of strain, including reading and other close-up tasks, on the eyes can trigger dry eyes. Being sure to take a break every so often can help to prevent this.

Be sure to take a break when you begin to feel your eyes straining (or ideally before!). Simply take a few moments to stop what you’re doing, close your eyes, and gently massage your eyelids. If you’re working at a computer, ensuring your posture and viewing distance is optimised. This can be achieved by positioning the screen slightly below eye level and tilting it backwards. This can allow your eyes to be more relaxed, potentially slowing the onset of screen fatigue.

Adjusting the exposure of harsh overhead lights, using an ergonomic chair, sitting with the screen 20-26 inches away from you, and adjusting the contrast and brightness of your screen accordingly to your environment can also be extremely helpful.

Finally, employ the 20-20-20 method in your day. This trick involves looking away from your screen every 20 minutes to look at something 20 metres away for at least 20 seconds!

Shedding some fake tears

While there is nothing that can match the lubricating power of the healthy eye, artificial tears can be incredibly useful when tackling dry eyes. these can be bought over the counter from pharmacists and can be used as often as required. Furthermore, following Laser Eye Surgery, you will be provided with lubricating eye drops, free of charge!

However, eye drops are far from a permanent solution. The truth is, they can become something of a hassle when relied upon over a long period. Nonetheless, in times when your eyes need an extra hit of hydration, such as when you’re embarking on a long-haul flight or are working to meet a tight deadline, eye drops can offer some much-needed relief.

Seeing an eye doctor

It is easy to sweep the problem of dry eyes under the rug and put it down to screen fatigue or cold weather. But it is always better not to assume that it will go away on its own. While these factors can cause and exacerbate dry eyes, it is important to sit down with a doctor to accurately identify the cause of your symptoms.

Of course, it may also be the case that the cause of your dry eyes is nothing more serious than a few too many glasses of wine or a Netflix-binging habit; however, you may discover that prescription medications or an underlying condition are to blame. If this is the case, knowing can make you better able to manage your symptoms and maintain your eye and overall health.

Ditching the contact for Laser Eye Surgery

Contact lenses are a cause of dry eyes that can often go under the radar. While contacts are an effective solution to many refractive errors, they can also cause significant irritation and even infections in the eyes. Therefore, getting rid of the contacts could be one of the best things you can do to decrease your chances of experiencing irritation and dryness.

The good news is that you might not have to embrace glasses or sacrifice your clear vision to do so. If your dry eyes are down to your use of contact lenses, you may well still be suitable for Laser Eye Surgery.

Many people who experience dry eye and are also contact lens wearers may find that they don’t have dry eye syndrome. Contact lenses can suck up the tears on the surface of the eye, causing an imbalance in the tear film. So, once the contact lenses come out, your dry eyes may also resolve themselves! Therefore, the chances that you could be suitable for treatment are higher than you might think.

If you have any more questions about dry eye and Laser Eye Surgery, contact one of our friendly clinic coordinators today. Find out if you could be suitable for treatment by booking a consultation at London Vision Clinic.