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If you have dry eyes, you may wonder if it affects your eligibility for LASIK surgery. Dry eye conditions do not automatically disqualify you from being a candidate for LASIK, but they do require attention before the procedure. Proper treatment of dry eyes ensures the best possible outcome from the surgery, as untreated dryness can impact the accuracy of the results. At UELC, we offer a comprehensive range of treatments tailored to all levels of dry eye severity, ensuring your eyes are in optimal condition before undergoing LASIK.

How Dry Eyes Impact LASIK Candidacy

Dry eye conditions do not disqualify a patient from being a candidate for LASIK treatments. However, the condition needs to be treated before the surgery. Treating dry eyes is a prerequisite to ensure the best possible outcome from the procedure.

We offer a full range of treatments for dry eyes, whether mild or severe. Options include everything from eye drops made with your own blood, such as PRP (Platelet-Rich Plasma), to advanced technologies like dry laser treatments or LipiFlow. This ensures we can address all levels of dry eye effectively.

Why Treat Dry Eye Prior to LASIK?

Dryness affects the cornea, which is the surface where the laser is applied during LASIK. If there is dryness, it causes fluctuations in the refraction—the prescription—which makes it difficult to get accurate measurements. Severe dryness can interfere with the accuracy of the results. We recommend lubricating drops for mild to moderate dryness, and the patient can proceed with surgery. However, we cannot move forward with LASIK if I see dry eye spots on the cornea, such as punctate keratitis on the superior surface.

In these cases, we place the patient on a treatment plan, which may include eye drops, ointments, and sometimes eye masks. Depending on the severity, we will schedule a follow-up in one to two months. We can proceed with the surgery if the cornea clears up with no dry spots. However, if spots remain, treatment must continue to ensure the patient gets the best results from the procedure. Treating dry eyes before surgery is crucial, as untreated dryness can lead to less-than-ideal outcomes, leaving the patient unsatisfied with their vision improvement.

Post-LASIK Dry Eye Symptoms and Treatment Options

After LASIK, we typically recommend that all patients, not just those with dry eyes, continue using lubricating drops. In today's world, where most people spend long hours in front of screens, lubricating drops are beneficial for everyone. It is similar to moisturizing your skin—it is a good practice overall. We often advise using the drops twice or thrice a day or whenever their eyes feel dry. It is not mandatory, but it can be very helpful. Typically, we suggest using the drops for about a month post-surgery, and after that, they can continue using them as needed.

Other Factors that Affect LASIK Candidacy

Candidacy for LASIK treatments involves a comprehensive eye exam, similar to what an optometrist would conduct. We check the cornea, the back of the eye (fundus examination), refraction, and for conditions like dry eyes, lazy eye, or strabismus (a squint).

For example, if the cornea has dry eyes but not a severe case, LASIK can still proceed.

However, if dry spots are detected, we may place the patient on a treatment plan and follow up in two to three months to monitor improvement before booking surgery.

Next, we check the back of the eye by dilating the patient to examine the fundus. If everything is normal, they are cleared for LASIK. When assessing the cornea, we ensure there is no keratoconus, corneal dystrophy, or significant dryness. If any abnormalities are found, the patient is no longer a candidate. Dry eyes alone may still allow for LASIK, but conditions like keratoconus or Fuchs dystrophy disqualify the patient.

Regarding strabismus, some patients mistakenly think LASIK will correct this, but it only adjusts the glasses prescription. We make it clear that LASIK does not address strabismus, and we require consent for only the glasses prescription to be corrected. Strabismus requires a separate surgery.

Similarly, if the patient has a lazy eye with vision worse than 20/20—say, 20/40—we inform them that LASIK can only achieve a maximum of 20/40 in that eye. We have them sign a consent form acknowledging this before surgery.

Keratoconus, where the cornea is conical rather than spherical, also disqualifies patients from LASIK, though other technologies can treat the condition. Corneal thickness is another critical factor. If the cornea is too thin, even PRK may not be an option. In some cases, SMILE may still be considered, but conditions like keratoconus or Fuchs dystrophy rule out LASIK, PRK, or SMILE altogether.

The exam process is thorough, from the cornea to the back of the eye, and we review everything step by step to determine candidacy. Hyperopic patients (with a prescription of plus six or five) also undergo additional checks. Since hyperopia has a hidden number, we use drops to find the maximum correction possible, and we require consent acknowledging the potential return of some prescriptions due to the nature of hyperopia.

Conclusion

Having dry eyes doesn't mean LASIK is off the table. Many patients can proceed with LASIK and achieve excellent results with proper diagnosis and treatment. At UELC, we prioritize your eye health and take all necessary steps to ensure your eyes are in the best condition before surgery. By addressing dry eyes before LASIK, we help you achieve the clearest possible vision, minimizing potential complications and enhancing your overall satisfaction with the procedure.

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