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Dry eye after cataract surgery

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  • Dry eye after cataract surgery

    This is my first post and I’m writing in the hope of finding other people who, like me, were catapulted into fairly severe dry eye disease by cataract surgery.
    My eyes were fine before the surgery although, thinking back, they were pink and sore sometimes and I was beginning to suffer from photophobia. But I took little notice of it and had certainly never heard of dry eye syndrome. And my surgeon did not check me for incipient dry eye before the surgery – as I now know that he should have done.
    The post-surgery scratchiness never went away and, at the follow-up appointments, my surgeon advised me to use artificial tears as often as needed. Within a couple of weeks, I was confined to bed with my eyes shut. Opening my eyes felt like slicing them open with razor blades. And then we went into Covid lockdown. My surgeon’s consulting rooms were closed and my doctor was unable to make referrals.
    I stayed in bed for almost ten weeks, suffering from increasing anxiety. I had panic attacks, was unable to eat and lost almost two stone in weight (and I’m a fairly thin person anyway). Very gradually the pain levels began to decrease and now, eight months after the surgery, I am much better although, even on good days, my eyes are never comfortable. I use artificial tears every hour, wear moisture-chamber glasses, and go to bed fairly early in the evening.
    Like so many of you, I am now on a merry-go-round of ophthalmologists, all of whom have diagnosed MGD (posterior blepharitis). The most recent one uses TearLab (USA) diagnostic equipment and has put me on doxycycline. The treatment I am most scared of is cyclosporine (Ikervis in the UK, Restasis in US) because, having had so much pain, I am a bit of a wimp about the stinging and burning. I am in awe of those of you who suffer from worse symptoms and manage them with stoicism.
    As a historian, I am an accomplished researcher. And I researched cataract surgery in depth, both in books and on the internet. And none of the websites I found (including the NHS in the UK) mentioned dry eye. It wasn’t listed in the indices of the books I read and – most important – was not included on the consent form for surgery. But after the surgery, when I googled “dry eye”, I found a large number of sites, all saying things like “it is well known that cataract surgery can exacerbate, or even cause, dry eye disease”. And one of my ophthalmologists wrote: “Cataract surgery can cause abnormalities of the tear film and dry eyes. Typically this tends to resolve within a few months. However, it is possible, although fairly rare, to have a severe dry eye reaction to intraocular surgery, like you experienced, despite the cataract surgery being otherwise uneventful and successful.”
    So why, I ask, is dry eye never mentioned as a possible complication of cataract surgery? If I had known the risk, I would have researched dry eye and made sure that my eyes were checked before surgery and, if necessary, had treatment before the operations. I should therefore be very interested to know if anyone else on the forum has had a similar experience.
    Finally, huge thanks to Rebecca for setting up this forum. I have spent hours on it since my problems began and it’s been enormously helpful. Every time something new crops up, my first thought is to look it up on the forum and see what other people have to say. Without it, I would have felt much more alone.

  • #2
    I faced same problem of dry eye and light flashes after cataract surgery. My doctor gave me some additional eye drops. After a 15 days my eyes get normal.

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    • #3
      Hi Jenny. I have been suffering from dry eye disease not attributed to any procedure but know all too well that this can happen. I want you to know that cyclosporine might be worth trying. The stinging effect can be combated by putting in artificial tears about 15 minutes before you instill cyclosporine drops so don’t let that deter you from trying. I personally did not have much luck but who’s to say you won’t? Everyone is different. Moisture chamber glasses are a life saver. I’m glad you mentioned them in this post. Hang in there with this dry eye thing. It’s a challenge but you will eventually find something that works for you.

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      • #4
        Thanks for replying and for your advice about cyclosporine. So far I've not been prescribed it. I've got MGD, not aqueous deficiency, and cyclosporine's anti-inflammatory effects seem to help only a small proportion of people with MGD. At least that's my reading of the information I've read so far - but I might be wrong. After reading your comment, I've been wearing moisture chamber glasses every day. They certainly help with symptoms - just wish they were more comfortable to wear! Good luck with your own dry eyes - and thank you for your support.

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        • #5
          Your doctor should have prescribed eye drops for you. Check with them

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