Dry eye after cataract surgery can vary based on the surgical technique used; for instance, a technique used more often in developing countries called small-incision cataract surgery is more likely to cause dry eye than phacoemulsification, which is used more in the United States.
This article will describe what dry eyes after cataract surgery are, as well as related symptoms, and offer prevention and treatment advice.
Why Do I Have Dry Eyes After Cataract Surgery?
There are several reasons why you may have dry eyes after cataract surgery. These include:
Changes to your tear film surface: These can be caused by the incision, or cut, made during surgery. Certain eye medications: After cataract surgery, your doctor will likely want you to use certain eye drops to help your eye heal and prevent infection. These may include antibiotics and steroid drops. The ingredients in these drops sometimes can irritate the eyes and cause dry eye symptoms. Lowered mucin production from the conjunctiva due to the surgical incision: Your conjunctiva is a clear covering of the eye’s front surface. Your conjunctiva may produce less of a protein called mucin after cataract surgery. Mucin helps to hydrate the surface of the eye. Lower tear film production: This can be caused by surgically induced ocular inflammation and exposure to light from the surgical operating microscope. The type of intraocular lens used: An intraocular lens, or IOL, is what an eye surgeon will place in the eye after removing your natural lens. One newer group of IOLs is called multifocal IOLs. These IOLs cost more than a standard IOL. Some of the newer multifocal IOLs are associated with higher incidences of dry eye. Having preexisting dry eye: Nowadays, many eye doctors will try to diagnose and treat dry eye before cataract surgery. Still, it’s possible for dry eye to go undiagnosed pre-surgery. Symptoms may emerge more strongly after surgery.
What to Expect From Dry Eyes After Cataract Surgery
Dry eye after cataract surgery may be temporary, lasting just a couple of months.
However, if you had dry eye before cataract surgery, you may continue to have related symptoms beyond these initial months. You also may need to continue any treatments for dry eye that you used before surgery.
Your eye doctor may make certain changes during the cataract surgery to lower your chance of experiencing dry eye. These include using:
Smaller incision sizes when possibleA special type of solution on the eye during surgery called a dispersive ophthalmic viscosurgical deviceA lower amount of surgical light exposure if possibleCareful handling of the tissue in the eye
Diagnosis
Many, but not all, patients with dry eye after cataract surgery will have symptoms that indicate they have dry eye. These symptoms include:
Blurred vision Burning and stinging of the eyes Changes in your vision Difficulty wearing contact lenses Eye irritation Having excess tears. Your eyes may want to make more tears because they feel dry.
You also can have dry eye without symptoms.
Testing
Some of the tests your eye doctor may use to diagnose dry eye after cataract surgery include:
A slit lamp exam: A slit lamp is a special microscope used to get a closer look at the eyes. Schirmer testing: This involves placing a thin paper strip under the eyes. It can help determine if the eye produces enough tears to keep itself moist. Tear breakup time: This is to measure how long the layers of tears remain on your eyes after you blink. Tear film staining: Applying a stain to the surface of the eye can reveal areas of damage or inconsistency.
Treatment
Treatments that your doctor may try to provide relief from dry eye symptoms include:
Over-the-counter artificial tears. There are many types of artificial tears, so ask your eye doctor what type they recommend. Many eye doctors favor preservative-free tears. Prescription medications that can improve the signs and symptoms of dry eye, including Restasis (cyclosporine) and Xiidra (lifitegrast) Topical steroids to help treat inflammation Punctal plugs, which will close your tear ducts and help preserve your tears
Summary
It’s not uncommon to experience dry eye after cataract surgery due to changes made in the eye during surgery. Sometimes the dry eye will be temporary; other times, you may have the symptoms longer-term. Symptoms of dry eye include vision changes and eye irritation. Your eye doctor can diagnose dry eye and recommend several treatments to try and soothe your symptoms.
Using a humidifier to provide more moisture to your environment Placing warm compresses over the eyes for 10 to 15 minutes at a time Wearing sunglasses to protect your eyes from wind Using omega-3 fatty acid supplements, such as fish oil
A Word From Verywell
If you find yourself experiencing dry eye after cataract surgery, you should let your eye doctor know. There are a variety of treatments that can help. Maintain any follow-up appointments so your eye doctor can monitor your dry eye and your eye health in general.
