A Dry Eye Question

Post your questions and start your research in this forum if more than three months ago you had any type of surgery to reduce the need for glasses and contacts.

A Dry Eye Question

Postby dan1966 » Tue Jun 30, 2009 9:22 pm

Why are some people left with dry eyes after Lasik surgery? Is there any way to predict this? It would seem to me that it's often a crap shoot. I know age and pre-surgery dryness are factors but often the results are not what would have been predicted by those factors.

Relevant factors for me:

Age: 42
Pre-surgery Schirmer Test: 10 mm

Possibly relevant factor:

Eyes started burning even during the surgery and were burning so bad on the way home that I couldn't open my eyes without the tears flowing. It was as though salt water had been put in my eyes. Within a few minutes of being home, though, my eyes felt much better.

Whatever the case, it's been over a year since I had the surgery and my eyes have never returned to what they were. I had a Tear Breakup Time test about a month ago and the break up was instant in the right eye and 1 second in the left. One bright spot is that despite my dry eyes, I seldom feel any burning or discomfort; it does affect my vision, though.

When I did use artificial tears, my vision would fluctuate a great deal and often create what I would call a soap bubble, funhouse effect on the outer periphery of my left eye. So I was damned if I did and damned if I didn't. Every blink was an adventure. Blink, now it's clear, blink again, it's blurry again, blink, blurry, blink, clear, blink, clear, blink, clear, blink blurry, blink clear, blink blurry, blink blurry. When I didn't use the drops, my vision was more stable. I never felt any real relief from artificial tears. Even when I used them every hour, by the end of the day my eyes were just as dry as if I hadn't used any. And by nighttime, the halo effect was even worse than if I hadn't used anything.

When I was having my eyes scanned prior to the surgery, which required keeping the eyes open for a certain length of time, at some point, it would become difficult because the burning would make me want to blink. I forced myself to keep my eyes open for the required time, anyway. I was a little worried about this but figured the people there knew what they were doing. I wonder if this affected the results of the orbscans and wavefronts. I can keep my eyes open without feeling the need to blink just as long now as I could before the surgery.

My right eye weakens during the course of the day. My left eye does not. Yet another mystery, given that they are both dry. The right one is the slightest bit drier than the left but I wouldn't think that would account for such a difference in vision as the day progresses.

Why did my eyes respond in this way? Was it inevitable? Any help would be appreciated. Thank you.

My surgeon is certified by USA Eyes, btw.

Signed most respectfully,

One Man Crying in the Wilderness
Posts: 26
Joined: Tue Jun 09, 2009 11:56 pm

Re: A Dry Eye Question

Postby dan1966 » Tue Mar 16, 2010 9:05 pm


Please answer my post, a post that I left quite awhile ago. Thank you.
Posts: 26
Joined: Tue Jun 09, 2009 11:56 pm

Re: A Dry Eye Question

Postby PRKorIntacs » Wed Mar 17, 2010 8:28 am

The lasik flap cuts into the cornea and severs the nerves responsible for tear production. PRK burns off surface nerves, but causes less drying than lasik. Those who already had dry eyes to begin will find their eyes more dry, especially after lasik. Google lasik dry eyes. Hope this helps.
Posts: 90
Joined: Thu Feb 25, 2010 5:43 am

Re: A Dry Eye Question

Postby dan1966 » Fri Mar 19, 2010 12:38 am

I was given the Schirmer test before the surgery and scored 10 mm, which apparently is considered mild dry eye. I was still told by the resident optometrist at the Lasik Center that I was an "ideal candidate". After reading a bit more about this test, I now believe that most of the tears formed were a result of reflex tear secretion. In other words, my eyes were tearing up because of irritation. The basic tear production, on the other hand, was such that I should have been diagnosed with eyes too dry for the procedure. This is only my theory, though. Just keeping my eyes open long enough to have them scanned wasn't easy and they would burn by the end of this process, which probably should have been some kind of a tipoff.

From what I've gathered from what I've read, the only real explanation for dry eyes after the procedure is that you had dry eyes before the procedure, as you mentioned. What good does this knowledge do me now? Not much. I'm trying Restasis now and so far I've seen little to no improvement. I'm only on day 6, though.

My dry eye doesn't lead to much pain, luckily. It does keep my vision from being what it could be, though. Moisturing eye drops haven't helped in the past. Will Restasis? I doubt it. It's as though my eyes are impervious to moisture. Actually drops lead to distortion in my left eye, a fun house, soap bubble effect that affects my peripheral vision.

Thanks for any help you might have. Thank you very much.

P.S. Sorry to repeat some of the things that I mentioned in my first post.
Posts: 26
Joined: Tue Jun 09, 2009 11:56 pm

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