Cataract surgery can disrupt the tear film in the eye, leading to dry eyes. The type of cataract surgery people have may also affect the severity of dryness. It may be temporary, and a person can use medications or home remedies to ease any pain from dry eyes.
Doctors can take certain measures during cataract surgery to reduce the possibility of a person experiencing dryness in their eyes afterward, including thoroughly irrigating the eye. A person can also make sure they stay well hydrated and get enough sleep to lessen dry eye symptoms.
Symptoms may include redness and irritation, the sensation of having grit in the eye, or mucus in or around the eye.
This article looks at the causes of dry eyes from cataract surgery, symptoms, prevention, treatment options, and when to see a doctor.
According to a
- prolonged use of antibiotic steroid eye drops
- the surgical incision that causes an irregular surface, which causes the layer of tears, or tear film, on the eye surface to break up more quickly
- reduced mucin production in the eye
- decreased tear secretion
- reduced tear film production due to inflammation of the eye and light exposure from operating microscope
The type of cataract surgery people have may also affect the severity of dry eye symptoms.
The above study looked at dry eye symptoms in 96 people undergoing manual small incision cataract surgery (SICS) or phacoemulsification surgery for cataract treatment. In total, around 64% of people experienced mild dryness after surgery.
About 53% of people had dry eyes in the SICS group one week after surgery, while approximately 22% had dry eyes in the phacoemulsification group. The SICS group also had more severe symptoms of dry eye.
Dry eye symptoms after cataract surgery
With treatment, people may find relief from dry eyes within a few months following surgery.
Recovery from dry eye after surgery may vary from person to person, depending on which treatment methods they use.
If people had pre-existing dry eye disease before cataract surgery, they might need to maintain their usual treatment to relieve symptoms.
Research from 2018 has shown that treating the eye both before and after surgery with 0.05% topical cyclosporine helps relieve dry eye symptoms, improve vision, and improve the overall satisfaction of people who have cataract surgery.
Doctors may also take steps during surgery to help prevent dry eyes or other complications to the eye after surgery, such as:
- using light filters over microscope lights and limiting exposure time
- thorough irrigation of the eye
- gentle manipulation of the surface tissue of the eye
Symptoms of dry eyes after cataract surgery may present as:
- stinging or burning
- need for artificial tears
- changes in vision
Other symptoms of dry eye include:
- a feeling of grit in the eye
- blurry vision, particularly when reading
- strings of mucus around or in the eye
- pain when wearing contact lenses
- excess tears in the eye
- increased sensitivity to light
Artificial tears are usually effective in treating dry eyes. These are eye drops that people can apply to the eye to add extra fluid.
People may find relief from over-the-counter or prescription eye drops.
Preservative-free eye drops are available for people who are sensitive to preservatives. If people are using artificial tears more than 6 times each day or have an allergy to preservatives, they can look for preservative-free eye drops.
If artificial tears do not relieve symptoms or dryness is severe, other treatment options for dry eyes after cataract surgery may include:
- using 0.05% cyclosporine twice a day to reduce inflammation in the surface of the eye
- using lifitegrast alongside a tapered course of topical steroids
- punctal plugs, which are tiny plugs people place in the tear duct to prevent tear drainage
A combination of punctal plugs and 0.05% cyclosporine may be more effective than using one or the other.
People can also talk to their doctor about taking an omega-3 fatty acid supplement to help relieve dry eyes.
People may be able to
- avoiding or protecting the eyes from factors that can dry the eyes further, such as:
- air conditioning
- hair dryers
- wearing wraparound sunglasses when outside to protect from sun and wind
- using a humidifier indoors, or placing a bucket of water by a radiator or heater
- limiting time staring at a screen
- blinking regularly
- taking regular breaks
- staying well hydrated by drinking around 8–10 glasses of water each day
- aim for 7–8 hours of quality sleep each night
Before any cataract surgery, people can inform their doctor of their medical history and any pre-existing dry eye symptoms.
If people think they may have dry eyes after cataract surgery, they can contact their doctor. A doctor may carry out a range of tests to check for dry eyes, such as:
- Slit lamp test: A doctor will add a drop of dye to the surface of the eye to show tears more clearly, shine a bright light into the eye, and examine with a microscope to check tear levels.
- Schirmer’s test: After applying numbing eye drops, a doctor will place a strip of paper next to the eye. People will close their eyes for
5 minutes, and a doctor will check how many tears people produce by how wet the paper becomes.
- Tear break up time test: A doctor will place a drop of dye onto the surface of the eye to show the layer of tears on the eye’s surface. People will then look straight ahead without blinking or closing the eye, and a doctor will check how long the tear film covers the eye without breaking up.
If people have low tear production or the tear film does not cover the eye for very long, people may have dry eyes.
Cataract surgery may cause dry eye or worsen existing symptoms due to disruption of the tear film. Antibiotic steroid eyedrops and microscope lights during surgery may also contribute to dry eyes.
Having dry eyes after cataract surgery is usually temporary, and people may find relief with artificial tears or medication, such as cyclosporine.
People can see their doctor for a diagnosis and treatment plan for dry eye after cataract surgery.