Dry Eyes After Cataract Surgery

Cataract surgery can change the tear film in the eye, frequently leading to dry eye symptoms. Sometimes these symptoms are temporary. Other times, they become chronic.

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.

Mature man with gray hair inserting eye drops into one eye.

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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.

Dry Eye Due to Surgical Technique

The surgical technique used during cataract surgery also can make a difference in the incidence of dry eye. Phacoemulsification is a common surgical approach in the United States. An approach called small-incision cataract surgery, or SICS, is used more often in developing countries. A 2019 study compared dry eye after cataract surgery in 100 eyes having SICS or phacoemulsification. Researchers found more dry eye and more severe dry eye symptoms in the patients who had SICS vs. phacoemulsification.

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 possible
  • A special type of solution on the eye during surgery called a dispersive ophthalmic viscosurgical device
  • A lower amount of surgical light exposure if possible
  • Careful 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.

Let your eye doctor know if you are experiencing the symptoms of dry eye. They can conduct certain tests to check for dry eye and try one or more treatments that may help you. Sometimes it takes trial and error to find the right treatments for you.

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

Are There At-Home Remedies?

There also are some things you can do at home to help provide relief for dry eyes. These home remedies for dry eye include:

  • 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

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.

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.

Frequently Asked Questions

  • Can you have cataract surgery if you have dry eyes?

    Yes. Unless you have severe dry eye, you can have cataract surgery. Even with a severe case, your eye doctor will likely try to improve your dry eye signs and symptoms before the procedure so you can have cataract surgery.

  • Does dry eye get worse after cataract surgery?

    Yes, for some people. This happens due to changes made to the eye during surgery or because of the use of certain medications post-surgery. However, it is also possible that the worsening of dry eye is only temporary as your eyes heal.

  • Is it OK to use lubricating eye drops after cataract surgery?

    Yes. Lubricating eye drops, also called artificial tears, provide moisture to the eyes and can feel good. Try to use preservative-free lubricating eye drops.

  • How long does it take for my eyes to feel normal after cataract surgery?

    It could take anywhere from one to three months. Your vision should start to become clearer within hours or a couple of days after cataract surgery.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Vanessa Caceres
Vanessa Caceres is a nationally published health journalist with over 15 years of experience covering medical topics including eye health, cardiology, and more.