Is LASIK Surgery Safe for Dry Eyes?

If you’ve been thinking about laser eye surgery but you already suffer from dry eyes, it’s completely natural to wonder whether LASIK is safe for you. Many people worry that LASIK will make their dryness worse, that they won’t be suitable for the surgery at all, or that recovery will be uncomfortable. You’re definitely not alone dry eyes are one of the most common concerns people mention during a LASIK consultation.

I want to help you understand how LASIK affects dryness, what surgeons look for before recommending the procedure, and what dryness you can realistically expect during healing. My goal with this guide is to give you a clear, honest picture of the full process, so you know what’s normal, what’s manageable and what might make LASIK less suitable for certain eyes. By the end, you’ll feel far more confident about whether LASIK could be right for you.

Why Dry Eyes Matter in LASIK

Before we talk about safety, it helps to understand why dry eyes are such an important factor in LASIK.

– During LASIK, a small flap is created on the cornea.
– This temporarily affects some of the nerves that help regulate your tear film.
– As a result, almost everyone yes, even people without dryness experiences temporary dry eye symptoms after LASIK.

These symptoms typically include:

  • Mild burning
  • Slight gritty sensation
  • Temporary blurred vision
  • Light sensitivity
  • Feeling like you want to blink more

– This dryness is normal, expected and usually short-lived.

– The real question is: what if you already have dry eyes before surgery?

– That’s where careful screening becomes essential.

Is LASIK Safe If You Have Dry Eyes?

The short answer is: yes, LASIK can be safe for many patients who have dry eyes, as long as their dryness is:

  • Mild
  • Well controlled
  • Properly treated before surgery
  • Caused by a reversible issue

But LASIK may not be ideal if your dryness is:

  • Severe
  • Chronic and unresponsive to treatments
  • Linked to autoimmune conditions
  • Causing corneal surface damage

Surgeons never rush into LASIK if dry eyes appear significant. Instead, they treat the dryness first, reassess the eye surface and only proceed if the cornea is healthy and stable.

How LASIK Affects the Tear Film

LASIK affects the tear system in temporary but predictable ways.

Here’s what happens:

Corneal nerves are temporarily disrupted

– These nerves help tell your eyes to produce tears.

– While they regenerate, tear production may decrease slightly.

Your eyes may feel more exposed

– Because your cornea has been reshaped, your tear layer may need time to rebalance.

Post-surgery inflammation can cause dryness

– This is normal and settles as healing progresses.

Tear evaporation may temporarily increase

– Because blinking patterns change immediately after surgery.

Good news:

Most patients’ tear function returns to normal within a few weeks to a few months.

Who Is a Good LASIK Candidate If They Have Dry Eyes?

Surgeons assess several factors to decide whether LASIK is a good option.

You’re likely a suitable candidate if:

  • Your dryness is mild
  • Your tear layer improves with treatment
  • Your corneal surface is smooth and healthy
  • You don’t rely heavily on contact lenses
  • Your dryness does not cause fluctuating vision
  • You hydrate well and blink normally
  • You are willing to use lubricating drops during healing

Many people with dry eyes still go on to have excellent LASIK results.

Who Is Not a Good LASIK Candidate with Dry Eyes?

You may not be suitable if:

  • You have severe untreated dry eye disease
  • You have significant corneal staining
  • Your Schirmer’s test shows very low tear volume
  • You have meibomian gland dysfunction that hasn’t been treated
  • Your tear film breaks up extremely quickly
  • Your dryness is linked to an autoimmune condition (e.g., Sjögren’s)
  • You cannot tolerate lubricating drops

In these cases, surgeons often recommend treating the dryness first or suggest alternative procedures.

Alternatives If You’re Not Suitable for LASIK

If your dryness makes LASIK less ideal, your surgeon may suggest:

PRK (Photorefractive Keratectomy)

– PRK affects fewer tear-producing nerves and may be more comfortable for dry eye patients.

SMILE (Small Incision Lenticule Extraction)

– SMILE uses a smaller incision than LASIK, disrupting fewer nerves.

– This often results in less dryness post-surgery.

Treating dryness first

– Once controlled, you may still become suitable for LASIK later.

LASIK is not the only option and sometimes alternatives are simply a better match.

The Most Common Dry Eye Symptoms After LASIK

Even if you don’t have dry eyes before surgery, it’s normal to develop temporary symptoms afterward.

These may include:

  • Scratchy feeling
  • Slight stinging
  • Blurred vision that improves after blinking
  • Watering (a sign of irritation ironically linked to dryness)
  • Sensitivity to light
  • Discomfort in windy or air-conditioned areas

These symptoms usually improve rapidly during the first few weeks. For most people, they settle completely within three months.

How Surgeons Check Whether LASIK Is Safe for You

Your consultation includes several tests that help assess dryness.

The most important ones include:

Tear Break-Up Time (TBUT)

Checks how quickly your tears evaporate.

  • Normal: 10+ seconds
  • Dry: below 7–8 seconds
  • Severe dryness: below 5 seconds

Schirmer’s Test

Measures tear quantity with filter paper.

  • Normal: 10+ mm
  • Borderline: 5–10 mm
  • Dry: below 5 mm

Meibomian Gland Examination

These glands produce the oily layer of your tears. Blockages cause quick evaporation.

Corneal Staining Test: Shows surface dryness or inflammation.

Imaging of the Tear Film: Modern clinics use topography and meibography to assess dryness precisely. These tests help the surgeon understand the true severity of your dry eyes.

How Dry Eyes Are Treated Before LASIK

If your surgeon sees dryness, they may treat it first. This improves safety and results.

Common treatments include:

  1. Artificial tears: Used regularly before surgery to hydrate the eye.
  2. Punctal plugs: Small plugs inserted into your tear ducts to retain moisture.
  3. Omega-3 supplements: Help strengthen the oily layer of your tears.
  4. Warm compresses: Improve meibomian gland function.
  5. Eyelid hygiene: Helps restore natural tear quality.
  6. Prescription anti-inflammatory drops: Useful in cases of inflamed dry eye.
  7. LipiFlow or intense pulsed light (IPL) treatment: Advanced options for more resistant dryness.

What to Expect With Dry Eyes After LASIK

Most people experience dryness for:

  • 2–4 weeks (mild cases)
  • 6–12 weeks (moderate cases)
  • 3–6 months (if they had dryness beforehand)

During this time, you’ll likely use:

  • Lubricating drops
  • Preservative-free artificial tears
  • Ointment at night (temporary)
  • Anti-inflammatory eye drops (as prescribed)

Most symptoms improve steadily with each week.

How Long Does Dryness Last After LASIK?

Most people return to normal tear function within:

  • 1–3 months if they had no dryness
  • 3–6 months if they had mild dryness
  • 6+ months if they had significant dryness

But the vast majority recover fully.

How Age Affects LASIK Dry Eye Risk

Age plays an important role.

You may have a higher dryness risk if:

  • You’re over 45
  • You use reading glasses
  • You experience hormonal changes
  • You use devices heavily (reduced blinking)

Your surgeon will consider all these factors during screening.

How to Minimise Dry Eye After LASIK

Here’s what you can do to support healing:

  1. Use lots of lubricating drops – Your surgeon will tell you how often.
  2. Blink often, especially on screens – Screen use is a major drying factor.
  3. Avoid fans and air conditioning – Air flow increases evaporation.
  4. Use a humidifier at home – Moist air is easier on your eyes.
  5. Reduce screen time for the first week – This helps your tear film stabilise.
  6. Stay hydrated – Your tear film needs moisture.
  7. Wear sunglasses outdoors – Wind and sun can dry out your eyes.

These steps make a big difference in comfort.

FAQs:

  1. Will LASIK make my dry eyes permanently worse?
    Not usually. Most people experience temporary dryness after LASIK because the corneal nerves responsible for tear production take time to recover. If your dryness is mild or well managed before surgery, the symptoms you feel afterward normally settle as the nerves heal. Surgeons carefully assess your tear film and treat any dryness beforehand to make sure you’re in the safest category. As long as your corneal surface is stable and your eye responds well to treatment, there’s no reason to expect long-term worsening.
  2. Can I still get LASIK if I already have dry eyes?
    Yes, you can depending on how severe your dryness is. LASIK is completely fine for many people with mild or well-controlled dry eyes, especially if the dryness improves with artificial tears or simple treatment. Your surgeon will evaluate your tear quality, tear quantity and gland function before making a recommendation. If your dryness is severe or causing surface damage, they’ll help you treat it first or guide you toward a safer procedure.
  3. How do surgeons decide if my dry eyes are too severe for LASIK?
    Your suitability is based on several clinical findings, but the most important is how healthy and stable your corneal surface looks. If your tear film breaks up very quickly, your Schirmer’s test shows extremely low moisture, or there is staining on your cornea, these signs suggest that LASIK could worsen symptoms. Surgeons also consider whether your dryness improves with treatment, whether your glands are functioning properly and whether inflammation is present. All of these details help determine if LASIK can be done safely.
  4. What if I have dry eyes because of contact lens use?
    If your dryness is linked to contact lens wear, you may still be an excellent LASIK candidate. Many contact lens users develop irritation, reduced tear quality and meibomian gland issues simply from long-term lens use. Once you stop wearing contacts for a short period and treat the dryness, your tear film often improves significantly. Surgeons see this all the time, and most patients go on to have successful LASIK with no long-term dryness afterward.
  5. Is PRK safer than LASIK for someone with dry eyes?
    PRK can sometimes be a better choice if dryness is one of your main concerns. This is because PRK disturbs fewer corneal nerves, which means the temporary dryness you experience afterward may be milder or settle faster. That said, PRK has a longer initial recovery, so the overall experience depends on what matters most to you. Your surgeon will guide you based on your dryness level, lifestyle and the condition of your corneal surface.
  6. How long should I expect dryness to last after LASIK?
    Most people notice dryness gradually improving over the first month, with significant relief between the two- to three-month mark. If you had dryness before surgery, it may take a little longer sometimes up to six months for your tear film to feel completely normal again. This timeline varies from person to person, but the vast majority recover fully with the right aftercare.
  7. What can I do if my eyes feel very dry during recovery?
    The most important thing is to use your lubricating drops exactly as recommended by your surgeon. These drops soothe the surface, protect the healing nerves and refresh your tear film. You should also blink more frequently, especially while using screens, and avoid air-conditioned or windy environments when possible. Staying hydrated, using a humidifier at home and wearing sunglasses outdoors can also make your eyes feel significantly more comfortable.
  8. Can hormonal changes affect how dry my eyes feel after LASIK?
    Yes, hormones play a big role in tear production. If you’re going through perimenopause, menopause or experience hormone-related dryness, you may notice slightly longer healing times after LASIK. This doesn’t necessarily make you unsuitable, but your surgeon will factor in your hormone history when planning your treatment. With proper management, most patients still achieve very comfortable long-term results.
  9. Will computer use make my dryness worse after LASIK?
    It can, especially during the first few weeks. When you use screens, your blink rate drops significantly, which means your tears evaporate faster and your eyes feel drier. Your surgeon will usually recommend reducing screen time for a few days after the procedure and taking frequent blink breaks when you return to work. This simple habit helps your tear film stabilise faster and keeps discomfort to a minimum.
  10. What happens if my dry eyes don’t improve before LASIK?
    If dryness doesn’t improve even after consistent treatment, your surgeon may advise delaying LASIK until your corneal surface becomes healthier. This is simply to protect your long-term comfort and vision quality. In some cases, they may suggest an alternative like PRK or SMILE, which may be more suitable for dry-eye-prone patients. The goal is always to choose the safest option for your specific eyes not to rush into surgery that may compromise comfort.

Final Thoughts: Is LASIK Safe for Dry Eyes?

Deciding whether LASIK is safe when you already deal with dry eyes really depends on understanding how healthy and stable your tear film is. Once you know what’s causing your dryness, how severe it is and how well your eyes respond to treatment, it becomes much clearer whether LASIK is the right choice for you. A thorough pre-surgery assessment isn’t just routine it’s there to make sure your eyes stay comfortable, your vision stays stable and your long-term results remain as good as possible.

If your dryness is mild, treatable or linked to something temporary like contact lens use, LASIK can still be a very safe and successful option. And even if LASIK isn’t the best fit right now, alternatives such as PRK or SMILE often work beautifully for people with dry-prone eyes. What matters most is getting honest guidance so you can make a confident, informed decision about your vision.

If you’re considering Lasik surgery in London and want to know if it’s the right option, you’re welcome to reach out to us at Eye Clinic London to book a consultation.

References:

  1. Kanellopoulos, A.J., 2020. Long-term safety and visual outcomes following LASIK surgery. Journal of Clinical Medicine, 9(5), p.1432. https://www.mdpi.com/2077-0383/9/5/1432
  2. Padmanabhan, P. et al., 2021. Tear film changes following LASIK and SMILE procedures. Journal of Personalized Medicine, 11(3), p.190. https://www.mdpi.com/2075-4426/11/3/190
  3. Salomão, M.Q., Ambrósio Jr, R. & Wilson, S.E., 2009. Dry eye after LASIK: incidence, time course and outcomes. Journal of Cataract & Refractive Surgery, 35(10), pp.1752–1756. https://pubmed.ncbi.nlm.nih.gov/19781471/
  4. De Paiva, C.S. & Pflugfelder, S.C., 2004. Corneal epitheliopathy after LASIK and its relation to tear dysfunction. Ophthalmology, 111(9), pp.1813–1819. https://pubmed.ncbi.nlm.nih.gov/15350328/
  5. Toda, I., 2018. Dry eye after LASIK and PRK: mechanisms, evaluation and treatment. Clinical Ophthalmology, 12, pp.1801–1810. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120378/