Dry eye: symptoms and treatment options
The tear film is unstable or insufficient, so the surface of the eye is uncomfortable and the vision can fluctuate. It matters before surgery because it is also one of the things refractive surgery can temporarily make worse.
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Quick answer
The tear film is unstable or insufficient, so the surface of the eye is uncomfortable and the vision can fluctuate. It matters before surgery because it is also one of the things refractive surgery can temporarily make worse.
General educational information about a subject, not an assessment of your own eyes. Suitability and treatment decisions are made by a qualified ophthalmologist who has examined you.
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Dry eye
The tear film is unstable or insufficient, so the surface of the eye is uncomfortable and the vision can fluctuate. It matters before surgery because it is also one of the things refractive surgery can temporarily make worse.
Also known as dry eye, dry eyes, dry eye disease, ocular surface disease, dryness
Questions about Dry eye
Each answer below is the short version; the question links to the page that carries it in full, with sources.
- What is dry eye?
Dry eye is a condition in which the tear film is unstable or insufficient, either because too few tears are produced or because they evaporate too quickly, which leaves the surface of the eye irritated rather than adequately lubricated.
- What causes dry eyes?
Dry eyes are caused by a mix of tear production, tear quality, eyelid and blinking behaviour, medication, general health and environment. In most people several of those contribute at once.
- Can dry eye be treated?
Dry eye can usually be improved, though it is often managed rather than cured. Treatment depends on which part of the tear system is failing, which is why an assessment of the surface comes before a recommendation.
- How is dry eye diagnosed?
Dry eye is diagnosed from the history together with an examination of the ocular surface, which usually includes how quickly the tear film breaks up, how the eyelids and glands look, and sometimes a test of tear production.
- Can LASIK cause dry eyes?
Dryness is a recognised side effect of LASIK, particularly in the early months, because the procedure affects the corneal nerves that contribute to tear production. It usually improves as the surface heals.
- Can SMILE cause dry eyes?
Dryness can occur after SMILE, as it can after any corneal procedure. Research comparing procedures suggests differences in the degree of early surface disturbance, and that research describes averages rather than predicting an individual.
- How long should dry eye be treated before laser surgery?
There is no single period that applies to everyone. What matters is whether the surface has stabilised enough for the measurements to be reliable and for healing to be predictable, and that is judged from repeat examination.
- Can SMILE Pro cause dry eyes?
It can. Any refractive procedure involves cutting corneal nerves, which affects the feedback loop that keeps the ocular surface comfortable and moist. Published evidence suggests early dry-eye signs and symptoms are generally less pronounced after SMILE than after flap-based LASIK, but the literature is not unanimous and many patients still experience dryness.
- Can dry eye prevent LASIK?
Significant dry eye can make LASIK a poor choice, because surgery itself can worsen dryness in the short term and an unstable tear film makes the measurements less reliable and the healing less predictable.
- Which procedure is suitable if I have dry eyes?
All of the corneal procedures can affect the tear film, and the honest answer is that dryness is assessed and treated before any of them is planned. Where dryness is significant, a lens-based option may be discussed instead.
- What should I choose if I have dry eyes?
Treat the dryness first, then reassess. Dryness is a treatable finding in many people, and what is available to you afterwards may be different from what it looks like now.
- Can screen time cause dry eyes?
Screen time can contribute to dry eyes because people blink less often and less completely when concentrating on a screen, which allows the tear film to break up between blinks.
All 23 Dry eye questions, searchable
Where this is covered in full
- The eye examination before surgery
What each test measures, and why a refraction on its own is not enough.
- Am I a candidate for SMILE Pro?
The factors an assessment settles, and why no page can decide suitability for a particular eye.
- Risks and side effects
A balanced account of what can go wrong, from the common and temporary to the rare and serious.
- The vision knowledge base
Every question the site answers about eyes and vision, grouped by subject, with a search box.
Related subjects
- Eye infections, allergies and injuries
Conjunctivitis, styes, allergic eye disease and injury to the surface of the eye. Most are not refractive questions, and some of them need to be seen urgently rather than booked.
- Dryness and grittiness
A burning, scratchy or gritty feeling at the front of the eye. It can make vision fluctuate through the day, and it is one of the reasons a surgeon examines the tear film before operating.
- LASIK vs SMILE
A flap procedure against a flapless one. The difference readers care about is what happens to the surface of the eye, not which laser is better.
- Dubai
The emirate where most of the UAE refractive surgery capacity is, and the one most international patients travel to. Licensing, clinic choice and what a quote should contain are the local questions.
- Keratoconus
The cornea thins and becomes irregular, so vision is distorted in a way glasses do not fully correct. It changes which refractive options are open, and it is usually the reason a laser procedure is ruled out.
- Blurred vision
Vision that is soft or unclear. It has many causes, from an uncorrected prescription to a change inside the eye, and only an examination can say which one applies.
- Light sensitivity
Discomfort in ordinary light. It is expected for a short period after refractive surgery and is also a sign of surface problems, so a sudden change is worth having looked at.
- Red or bloodshot eye
A red eye has many causes, most of them minor and self-limiting. Pain, light sensitivity, reduced vision or a red eye with a contact lens in place change the assessment entirely.
- Eye pain
Pain in or around the eye. Surface irritation, a foreign body, an infection and raised pressure feel different from one another, and the character of the pain is part of how it is triaged.
- Contact lenses
Lenses worn on the surface of the eye. They correct the same errors as glasses, and they change the shape of the cornea while worn, which is why wearing has to stop before a surgical measurement.
- SMILE Pro vs LASIK
The current lenticule platform against the flap-based standard: what the platform generation changes, and what having a flap changes for good.
- An eye consultation in Dubai
What happens at an assessment for laser eye surgery, how long to allow for it, what to bring, how to prepare, and what the visit should leave you holding when it ends.
This page describes what is generally true about dry eye. It is not a diagnosis, and it cannot say whether a treatment is suitable for you, because suitability depends on measurements taken during an examination.
Sources & further reading
We prefer primary sources. Where a claim comes from a manufacturer, a single study or a regulator, it is labelled as such below.
- Refractive surgery and dry eye: an update Peer-reviewed literature Peer-reviewed literature (via PubMed Central) · 2023
An update on how different refractive procedures affect the ocular surface, with attention to preoperative screening for dry eye.
Used for Why tear film assessment belongs in preoperative screening.
Link checked 22 September 2026
- Post-LASIK dry eye disease: A comprehensive review of the current literature Peer-reviewed literature Peer-reviewed literature (via PubMed Central)
A review of dry eye after LASIK, including the mechanisms involved and how other procedures compare in the published literature.
Used for Balanced comparison of dry-eye risk between procedures.
Link checked 22 September 2026
- Dry Eyes After SMILE Peer-reviewed literature Peer-reviewed literature (via PubMed Central)
A review of ocular surface changes after SMILE, including how dry-eye signs and symptoms are measured and how they change over the first postoperative months.
Used for Explaining why dry eye is a key preoperative consideration.
Link checked 22 September 2026
- Eye Health Information Patient information National Eye Institute, National Institutes of Health (US)
Condition-by-condition eye health information from a US government research institute, written for patients rather than for clinicians.
Used for Plain-language explanations of eye conditions and their symptoms; Healthy vision and screening guidance.
Link checked 23 September 2026
- EyeSmart: eye health information for the public Patient information American Academy of Ophthalmology
Patient-facing material from the largest ophthalmology professional body, covering conditions, tests and treatments outside refractive surgery.
Used for Cross-checking patient-facing explanations of non-refractive eye conditions; Describing what tests such as dilation and OCT involve.
Link checked 23 September 2026
- Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted In Situ Keratomileusis: A Meta-Analysis Peer-reviewed literature Journal of Ophthalmology (via PubMed Central) · 2016
A meta-analysis pooling several studies on dry eye after SMILE compared with femtosecond LASIK. It also documents where the included studies disagreed.
Used for The dry-eye discussion on the comparison and risks pages; Explaining that the evidence base is mixed rather than unanimous.
Link checked 22 September 2026
- Cataracts in adults: management (NG77) Clinical reference National Institute for Health and Care Excellence (UK) · 2017
Clinical guidance on when cataract surgery is indicated, what should be discussed before it, and what follow-up is expected.
Used for When cataract surgery is considered appropriate rather than cosmetic timing; What patients should be told before cataract surgery.
Link checked 23 September 2026
- Dry eye and corneal sensitivity after small incision lenticule extraction: a meta-analysis Peer-reviewed literature Peer-reviewed literature (via PubMed Central)
A meta-analysis of corneal sensitivity and dry-eye measures after SMILE compared with femtosecond LASIK, generally finding faster recovery of sensation in the SMILE group in the early postoperative period.
Used for Corneal sensation and dry-eye timing discussions.
Link checked 22 September 2026
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