My vision and astigmatism are worse off, severe dry eye caused by meibomian gland dysfunction post LASIK, what do I do?

Question

Did LASIK and outcome is not good vision, one eye better than the other. Drops to treat dry eye are cumbersome and dont help much. Eyes dont feel good and vision isnt great. Not considering second surgery.

Joseph W. King, MD · Answer

Dry eyes and meibomian gland dysfunction (MGD) should be addressed first and foremost in this situation. There are several treatment other than dry eye drops that can be used to address MGD.  Some newer therapies for MGD include Lipiflow and IPL (a pulsed light) treatment.  You can talk about these treatments with your optometrist or ophthalmologist.

Amjad Khokhar, MD · Answer

I am sorry to here that you are having difficulty with your vision after lasik surgery.  It is very common for one eye to be corrected better than the other eye.  I tell all patients this in advance to expect this.  Just like one of our arms is longer than the other arm.  Our body is not symmetric.  One eye will usually be a little stronger or dominant compared to the other.
That being said, it is important for you to be satisfied with you vision as you complete your daily activities.  It sounds like your not there yet.  It is surprising to many patient to know how much dryness can affect your vision.  If you are being troubled with dryness, which is expected after LASIK, then that should be optimally controlled before considering any type of second surgery.  In fact, it can often be difficult to plan any additional surgery when struggling with dryness of the eyes.

The drops can be cumbersome.  There are many alternatives, none our perfect, to reduce your dependency on drops.  You may already be using Xiidra and/or Restasis.  You may have already have punctal plugs placed.  Using thicker drops can sometime reduce the number of drops your have to apply especially is you can place some ointment in you eyes at night.  Omega 3 Fatty Acids can help.  Sometime changes to work behavior especially is you spend hours staring at a computer need to be considered.  Also, if the cause of you dryness is not purely decreased tear production after LASIK but also evaporative tear loss from blepharitis or meibonitis, then that need to be addressed as well in somewhat different approach.

But you have to manage this dryness as your first priority.

My vision and astigmatism are worse off, severe dry eye caused by meibomian gland dysfunction post LASIK, what do I do?

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