Guide to Dry Eyes and Laser Eye Surgery

The eyes are the body’s natural cameras that capture light, convert it to waves of electrochemical signals, and magically conjure up the images we see. Technically, it’s up there with the most complex parts of the human body, and for that matter, the known universe is the eye.

With so much complexity, the eye requires an ultra-precise arrangement of components in order to function correctly. And, like a pearl sitting in a clamshell, such a delicate design needs appropriate protection.

For the eye, one barrier of protection is the tear film. The tear film consists of three layers: The oily layer, the watery layer, and the mucus layer.

When the tear film is out of balance we start to experience things like dry eyes. Dry eye can occur for a lot of reasons, including systemic disease, menopause, medications, alcohol, the environment, and, as it happens, Laser Eye Surgery.

In this brief guide and video on dry eye and Laser Eye Surgery, we’re going to explore everything from symptoms, how it affects laser eye surgery and treatment.

Watch the Dry Eye Video

Do you recognise any of these symptoms of dry eye?

Irritated, itchy, and dry. That’s how millions of people around the world would describe the condition of their eyes on a daily basis.

If this sounds familiar, then you may not only have an inconvenient and uncomfortable situation on your hands but something a bit more detrimental to your vision.

What I’m talking about is dry eye syndrome (DES) or keratoconjunctivitis sicca (KCS). The difficulty in proper diagnosis comes from the fact that it’s a multifaceted issue. Meaning there’s more than one cause or contributing factor. For example, dry eyes can occur as a side effect of certain medications, as a result of drinking too much alcohol, or after prolonged screen use.

Dry eye, as a result of spending too much time staring at screens and reading blog articles, has its own name – digital eye syndrome or computer vision syndrome (CVS) and may be caused by poor lighting, glare from the screen, improper viewing distance, poor seating posture, or decreased blink rate.

Without going into too much detail, some other causes of dry eye syndrome include contact lens use, smoking, Sjogren’s syndrome, rheumatoid arthritis, Parkinson’s, diabetes, low humidity, and air conditioning.

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

  • Episodes of blurred vision
  • Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention
  • Stinging or burning of the eye
  • A sandy or gritty feeling as if something is in the eye
  • Episodes of excess tears following very dry eye periods
  • Eye fatigue
  • A stringy discharge from the eye
  • Pain and redness of the eye
  • Heavy eyelids
  • Inability to cry when emotionally stressed

As you can see, all of us may experience the symptoms of dry eye at some point — particularly if you’re part of the modern, digital lifestyle. With only 20 per cent of those actually suffering from dry eye syndrome being diagnosed correctly, if any of the above sound familiar to you it’s worth going to see an eye doctor and having a routine checkup.

How dry eye affects suitability for Laser Eye Surgery

If you suffer from dry eye and are interested in having Laser Eye Surgery then you may be concerned that you’re not suitable for treatment — especially if you experience severe dryness.

However, many people who have DES are surprised to learn they do, in fact, have a high chance of being suitable for Laser Eye Surgery

Dry eye can often be temporary and is greatly influenced by conditions and your environment. This is important because suitability for Laser Eye Surgery depends on the cause and severity of dry eye.

All patients at the London Vision Clinic who are found to have preoperative dry eye undergo an extensive review whereby we evaluate the extent and underlying cause of the patient’s dry eye. If the health of the surface of the eye can be optimised through treatment regimes then it may be possible to move forward with laser eye surgery. In the video above, Mr Carp explains how patients with dry eyes undergo extensive review system at the London Vision Clinic to help with treatment.

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Dry eye as a side effect of Laser Eye Surgery

Nerves play an important part in the Laser Eye Surgery recovery process. I’m not talking about the jitters, although they can too — I’m on about a different set of nerves: those on the surface of your eye.

Because of the laser process, the nerves on the surface of the eye are momentarily interrupted. These corneal nerves send information to the lacrimal gland to supply a continual amount of lubrication to the eye. With the corneal nerves briefly disrupted, they can no longer supply the appropriate information, therefore decreasing the normal amount of lubrication to the eye.

Over the course of the weeks and months after Laser Eye Surgery, the nerves heal and the lubrication level returns to normal. However, a small number of patients with pre-existing dry eye syndrome are at risk of prolonged and/or more significant symptoms.

Clinic’s that use advanced screening techniques, such a case is extremely unlikely, and if patients with a history of dry eye are at risk of prolonged symptoms, they are typically picked up during the screening process and other available treatment options may be discussed.

In general, the use of artificial tears is a staple during the recovery time after Laser Eye Surgery. Talking with your Patient Care Coordinator and clinical team both before and after surgery will help you determine how often and how much lubrication is required.

In cases of severe dry eye, the clinician may use punctal plugs, also known as tear duct plugs or lacrimal plugs. A punctal plug is a plastic plug that prevents the drainage of tears from your eye. This device can raise the amount of lubrication on the surface of the eye, just like plugging the drain of a sink. A clinician can remove the plastic plugs months later if needed.

Managing and even eliminating the dry eye in your life

There are many things you can do to help manage, reduce, or avoid dry eyes that don’t involve drugs, plugs, or even drastic lifestyle changes. The guidelines below are easy to follow and, in many cases, instantly bring some clarity and comfort to your eyes.

Seeing an eye doctor

First and foremost, don’t assume dry eyes is something minor that will go away with a little conscious effort on your part.

Although lifestyle changes can work wonders for calming down the condition, it’s important to have a sit down with a doctor and determine, for instance, if any of your prescription medications could be the cause of the irritation.

It’s also often the case that dry eyes are nothing more serious than a few too many glasses of wine each week or a Games of Thrones habit.

Controlling the weather

No one expects you to be able to control the weather, but there are some other simple things you can do to cut down on the amount of air being blown onto your eyeballs.

Firstly, try to avoid hair dryers (or at least close your eyes when using them). Not only do they have a powerful airflow but the air is also hot and dry — a deadly combination for already dry eyes. Secondly, make sure that the heating and air conditioning vents in your car are set to low and are positioned to blow on the floor, instead of directly on your face. And if the weather happens to be windy out, or perhaps you live in the North, hats, scarves, and wrap-around sunglasses all work well to help protect your eyes from the wind and the debris it can carry.

Keeping the air moist

The moisture level of your environment can also have a significant impact on the condition of your eyes. The dryer the air, the faster any moisture on the surface of the eyes will evaporate.

Invest in a humidifier for your home to keep a good amount of moisture in the air (check with your surgeon if you are having eye surgery as this may not be allowed for a short time after treatment). You could also consider an air purifier, which will help prevent dust particles and other airborne allergens from irritating your eyes.

Giving your eyes a break

The eyes get tired on a typical day in the 21st century, particularly if you work in an office. So, whether you do a lot of reading or are on the computer for hours at a time, it’s essential you give your eyes a break every so often.

It’s as simple as when you start to feel your eyes straining, take a few moments to close them and massage their lids gently. If you’re working at a computer monitor, be sure to position it slightly below eye level. Being able to look slightly down at the screen can allow your eyes to stay slightly more relaxed and mean they’re less likely to quickly fatigue.

Other ergonomics best practices include adjusting harsh overhead lights, using an ergonomic chair, sitting with the screen 20-26 inches away from you and tilted slightly backwards, and adjusting the contrast and brightness of your screen accordingly to your environment.

Another trick to combat eye fatigue is to incorporate the 20-20-20 method into your day. This method is basically stopping every 20 minutes to look at something which is 20 metres away for at least 20 seconds.

Shedding some fake tears

There’s no substitute for the real thing, but lubricated eye drops come closer than anything else and can be really handy. What’s best about lubricated drops is that they’re available for anyone over the counter at the local pharmacy and can be used as often as needed. It is important to note, however, they’re far from a permanent solution and can often be a hassle when relied upon in the long-term. But they will provide immediate relief when needed most — e.g. when doing overtime at work or on a long-haul flight.

Moving from contacts to laser

Probably the most impactful thing you can do to decrease your chances of experiencing dry eye is to stop wearing contact lenses. A lot of people consider this as simply not an option as it means going back to relying on glasses. However, this is not the case. Contact lenses suck up the tears on the surface of the eye and can mess with the balance that we talked about earlier. So most people that wear contacts and experience dry eye don’t actually have dry eye syndrome. They have contact lens-induced dry eye.

Laser eye surgery is then a great option as you no longer have to wear the contact lenses and the eyes feel better!

Have another question about dry eye and Laser Eye Surgery? Give one of our friendly clinic coordinators a call on 020 7224 1005.