By Mr Aris Konstantopoulos, Consultant Ophthalmologist & Corneal Specialist
One of the questions that often comes up during my laser eye surgery consultations is:
“Will LASIK give me dry eyes?”
It is a very reasonable question.
Dry eye is a recognised side effect of laser vision correction, particularly during the early stages of recovery. But the subject is more nuanced than simply saying that LASIK “causes dry eyes”.
Most patients will notice very little.
Others will experience grittiness, tiredness of the eyes or fluctuating vision for a few weeks following the procedure.
And a much smaller group may require treatment for longer-lasting symptoms.
What matters most is understanding your eyes before surgery, recognising risk factors and treating any existing ocular-surface problems before we operate.
At ClarisVision, this is an important part of deciding not only whether laser eye surgery is appropriate, but which procedure is most suitable for you.
What Does Dry Eye Actually Feel Like?
People sometimes imagine ‘dry eyes’ simply means that their eyes feel dry.
In reality, patients can describe it in many different ways.
You might notice:
- burning or stinging sensation of the eyes
- a gritty or sandy feeling
- tired or heavy eyes
- intermittent blurred vision
- vision that clears after blinking
- sensitivity to wind or air conditioning
- discomfort during prolonged screen use
- increased awareness of your eyes
One symptom that occasionally causes concern is fluctuating vision.
You may see clearly, then less clear, then blink and notice the image looks clear again.
This can happen because the tear film is a very important part of the optical surface of the eye. If that tear film becomes unstable, the quality of vision can fluctuate even when the laser correction itself is accurate.
So fluctuating vision does not necessarily mean that the laser treatment has failed.
Often, it is the ocular surface telling us that it is still recovering.
If you are wondering what else to expect during those first days and weeks, our LASIK Recovery Timeline: What to Expect Day by Day explains how vision and comfort typically change during the early stages of healing.
Why Does LASIK Cause Dry Eye?
The answer largely comes down to the relationship between the cornea, its nerves and your tear film.
The cornea, the clear window at the front of your eye, has an extremely rich nerve supply. These nerves do much more than allow the eye to feel touch. They are involved in a feedback system that helps regulate blinking and tear production.
During LASIK, a thin corneal flap is created and the underlying corneal tissue is then reshaped with an excimer laser to alter the refractive properties of your cornea. Creating the flap temporarily interrupts some of the corneal nerve fibres. For a period afterwards, the cornea can therefore become less sensitive. The normal feedback mechanism between the cornea, blinking and the tear-producing glands also becomes temporarily disrupted.
That can lead to:
- reduced tear secretion
- a less stable tear film
- changes in blinking
- increased tear evaporation
- temporary ocular-surface inflammation
As the corneal nerves recover, these effects generally improve. This is why dry eye after LASIK is often most noticeable during the early recovery period rather than being a permanent problem.
For a broader overview of how LASIK fits alongside other treatments, you may find Laser Eye Surgery in the UK: Everything You Need to Know a useful place to start.
But LASIK Is Not the Whole Story
There is another important point that sometimes gets overlooked. Some patients considering laser eye surgery already have an unhealthy ocular surface.
They may not even know it.
Contact lens wearers, for example, sometimes assume that irritation towards the end of the day is simply part of wearing lenses.
People who work long hours at computers may accept tired or fluctuating eyes as normal.
Others have meibomian gland dysfunction, where the oil-producing glands along the eyelids do not function properly. This allows the tears to evaporate too quickly.
Blepharitis, allergies, certain medications and pre-existing dry-eye disease can all contribute.
Laser eye surgery may therefore reveal or temporarily aggravate a problem that was already present.
That is why, for me, the dry-eye conversation starts before surgery.
Screening for Dry Eye Before Laser Eye Surgery
One of the most valuable parts of a laser eye surgery assessment is examining the ocular surface properly.
I do not simply want to know whether your prescription can technically be treated.
I want to know whether your eyes are healthy enough to heal comfortably afterwards.
We start by listening.
Do your eyes burn?
Do they become uncomfortable after several hours of screen use?
Do your contact lenses become difficult to tolerate?
Does your vision fluctuate?
Are your eyes worse in air-conditioned offices, heated rooms or on aeroplanes?
A symptom questionnaire based on the Ocular Surface Disease Index, or OSDI, can help us establish a baseline.
We can then examine the tears and ocular surface more closely.
Depending on the individual, this might include assessment of:
- tear-film stability / break-up time
- corneal and conjunctival staining
- tear volume / height
- eyelid health
- the meibomian glands
- tear production when clinically appropriate
Assessing both symptoms and clinical signs is very important, as symptoms and clinical findings do not always match perfectly.
Someone can have very noticeable symptoms with relatively subtle examination findings.
Another patient can have moderate ocular-surface changes but report little discomfort.
Both pieces of information matter.
If you are approaching your first appointment, our patient’s guide to preparing for laser eye surgery explains some of the other things to consider beforehand.
Treat the Surface First
If we identify significant dry eye before laser eye surgery, the answer is not necessarily:
“You cannot have LASIK or laser eye surgery.”
The better question is:
“Why are your eyes dry, and can we improve them before we consider laser eye surgery?”
Depending on the underlying cause, treatment over a few months might involve preservative-free lubricant drops, eyelid hygiene, warm compresses, management of meibomian gland dysfunction or treatment of ocular-surface inflammation.
On these occasions where significant dry eye is present, we simply postpone surgery until we have improved the ocular surface and symptoms.
This is not a setback.
A healthier tear film makes the eyes more comfortable, but it can also make our pre-operative measurements more reliable.
It is also why suitability cannot be decided by prescription alone. Our Laser Eye Surgery FAQs cover many of the other factors we consider before recommending treatment.
How Common Is Dry Eye After LASIK?
This is where information on the internet and studies need to be interpreted carefully. As explained previously, there is a varied definition of ‘dry eyes’ whether this is symptom based or clinical findings based.
Different studies use different definitions of dry eye. Some measure symptoms. Some measure tear production or tear-film stability. Others use corneal staining or clinical diagnostic criteria.
The timing matters too.
Dryness one or two weeks after laser eye surgery is very different from persistent dry-eye disease one year later.
One of the most useful sources is the FDA-supported Patient-Reported Outcomes With LASIK, or PROWL, programme.
Among patients with no dry eye before LASIK, only 4-5% reported moderate or severe symptoms, and symptoms generally became less common with time; approximately 27-28% reported at least mild dry-eye symptoms three months afterwards.
That number can sound worrying without context. Most of those symptoms were mild.
There is another finding in these studies that I think is particularly interesting.
Among patients who already had mild, moderate or severe OSDI dry eye scores before surgery, 59% reported normal OSDI scores three months afterwards.
This does not mean LASIK is a treatment for dry eye. What it does mean though is that with appropriate treatment, drops used following laser eye surgery, eliminating causes of meibomian gland dysfunction such as contact lens wear, dry eye symptoms can improve significantly.
What About Long-Term Dry Eye?
Early postoperative symptoms are, as can be expected, certainly more common than persistent chronic dry eye.
Another large US Army personnel study followed patients after LASIK or PRK for 12 months; it found that dry eye was present in 0.8% of LASIK eyes and 5% of PRK eyes. Importantly, patients who had dry eye at 12 months tended to have some dry eye signs before surgery.
These findings are consistent with the PROWL (Patient-Reported Outcomes With Laser In Situ Keratomileusis) and other studies.
What these studies do is they illustrate very well what we emphasise at ClarisVision:
- Persistent dry eye after laser eye surgery is uncommon
- The condition of your ocular surface before surgery matters
- Treating any dry eye prior to surgery is important
- Dry eye after surgery can be treated with appropriate care
If you would like a wider discussion of this and other potential complications, I have written separately about the risks and side effects of laser eye surgery.
Does SMILE Cause Less Dry Eye Than LASIK?
This is another common question.
SMILE differs from LASIK because it does not require creation of a conventional corneal flap. Instead, a small lenticule of tissue is created within the cornea and removed through a small incision.
Because less of the anterior cornea is disturbed, SMILE can preserve more corneal nerve function during the early recovery period. Several studies have found better early corneal sensitivity and some measures of tear-film function after SMILE compared with LASIK.
However, the story becomes interesting when we ask patients how their eyes actually feel.
In a 2022 Stanford study, 40 patients underwent LASIK in one eye and SMILE in the other. LASIK eyes did show greater loss of corneal sensitivity during the first six months.
But the patients’ dry-eye symptom scores were not significantly different between LASIK and SMILE at any follow-up visit. By 12 months, corneal sensitivity had returned to baseline in both groups.
As per many other studies, average dry-eye symptom scores improved from their pre-operative values in both LASIK and SMILE eyes. Again, that does not mean either procedure treats dry-eye disease.
In my personal clinical experience with both LASIK and SMILE, I have not noticed any meaningful difference in dry eye between the two procedures.
If you are deciding between these procedures, our detailed LASIK and SMILE comparison goes through their differences in more detail.
What About Surface Laser Treatment?
For some patients, neither LASIK nor SMILE is the most suitable approach.
Advanced Surface Ablation, or ASA, sometimes known as LASEK or PRK depending on the technique, reshapes the cornea without creating a LASIK flap or SMILE pocket.
It can be particularly useful when corneal anatomy, thickness or other factors make a surface treatment preferable.
Recovery is different from LASIK or SMILE and tends to take longer, so this needs to be considered alongside your work, lifestyle and expectations.
There is no single “best” laser procedure.
The question is which procedure is most appropriate for your eyes and the aims of laser surgery.
Our article What Laser Eye Surgery Procedure Is Better for Me? explores this decision in more detail.
And What If You Are Over 40?
The conversation changes slightly once presbyopia, the age-related need for reading glasses, begins.
Presbyopia is the gradual loss of near focusing ability that typically becomes noticeable during our 40s. If you find yourself holding your phone further away or suddenly needing reading glasses, this is often the reason.
Our guide Presbyopia Explained: Why Your Vision Changes Around 40 and What to Do explains what is happening inside the eye.
For suitable patients, PRESBYOND laser blended vision may reduce dependence on both distance and reading glasses.
This is one reason people in this age group increasingly explore their options, something I discuss in Why Laser Eye Surgery Should Be on Every 40-Something’s Wishlist.
For others, particularly when early cataract starts developing, refractive lens replacement may be a more appropriate option.
Our article comparing lens replacement and laser eye surgery explains why we might choose one approach over another.
And when cataract itself becomes the main cause of reduced vision, the appropriate treatment is cataract surgery rather than corneal laser vision correction.
Again, the principle is the same.
We assess the eye first, then recommend the treatment.
How Do We Manage Dry Eye After LASIK?
For most patients, management is straightforward.
Preservative-Free Lubricant Drops
Artificial tears support the ocular surface while the natural tear film and corneal nerves recover.
We generally prefer preservative-free preparations when frequent lubrication is required.
The amount you need varies considerably from person to person, so this is something we tailor during follow-up. We generally recommend using lubricant drops for a minimum of 3 months following the procedure.
Look After Your Eyelids
If meibomian gland dysfunction is contributing to the problem, treating the eyelids may improve the oily layer of the tear film and thus its stability. This can include warm compresses and eyelid hygiene when appropriate.
Occasionally, a more prolonged course of antibiotic and steroid drops may be required.
Think About Your Environment
Air conditioning, central heating, wind and aircraft cabins can all accelerate tear evaporation.
Avoid having fans or vents blowing directly into your eyes and keep your lubricants with you when travelling.
This is particularly useful to remember when flying after recovery. If travel is a big part of your life, our article on travelling after laser eye surgery and life without glasses looks at some of the practical benefits patients notice once they are fully recovered.
Take Breaks From Screens
When we concentrate on computer work or our phone, we do not blink as often as when we chat socially. In addition, we may not close our eyes fully. That means the tear film is refreshed less frequently and spread less well over the cornea.
The familiar 20-20-20 rule can help: every 20 minutes, look approximately 20 feet away for at least 20 seconds. For my patients, for the first month after surgery I recommend a 5 min break every 20-30 minutes if work is computer based.
And something even simpler helps too. Blink consciously!
Treat Inflammation When Necessary
Dry-eye disease can involve inflammation. In selected patients, prescription anti-inflammatory treatments such as steroids or immunomodulatory agents may be appropriate.
How Long Does Dry Eye After LASIK Last?
For many patients, symptoms are most noticeable during the first few weeks or months and improve as the ocular surface and corneal nerves recover. The exact timeline varies. As detailed above, a quarter of patients may experience some dryness of the eyes in the early period following laser eye surgery, but this settles rapidly; it is rare for dry eyes to be present 12 months following the procedure.
Your eyes may already be seeing extremely well while the tear film and corneal sensation are still settling. That distinction is important. Visual recovery and biological healing are not always happening at exactly the same speed. You can read more about this in our guide to taking care of your eyes after LASIK.
Getting Back to Everyday Life
Once the early recovery period has passed, patients tend to stop thinking about their surgery and start noticing what has changed in everyday life.
Sometimes it is as simple as waking up and seeing clearly before reaching for glasses.
That small moment inspired our article Morning Routines Without Glasses: What Changes After Laser Eye Surgery.
For others, the difference is most obvious during exercise.
Glasses no longer slip during a run, contact lenses do not become uncomfortable on a long cycle ride, and activities such as climbing become easier to approach without thinking about eyewear. You can read more in Cycling, Running and Climbing Without Lenses: What Active People Should Know.
And for people who have spent years managing glasses or contacts, the change can affect how they feel as well as how they see. I discuss this in Vision & Confidence: The Surprising Link in My Laser Eye Surgery Patients.
What Do Patients Say Months Later?
The first few weeks understandably receive a lot of attention.
But when I speak to patients months later, their focus is usually somewhere else entirely.
They are not thinking about their postoperative drops.
They are talking about holidays, work, exercise, family life and all the small situations where glasses or contact lenses are no longer part of the equation.
That longer-term perspective is explored in Life After Laser Eye Surgery: What Patients Say Months Later.
Laser eye surgery can also reduce the ongoing dependence on disposable contact lenses and associated packaging. If the environmental side of vision correction interests you, we have explored that perspective in Sustainable Laser Eye Surgery: A Clearer, Greener Way to See.
What Do Patients Say About LASIK Overall?
Dry eye deserves a proper discussion because informed consent means discussing both benefits and risks.
But the statistics should also be kept in perspective.
In the FDA PROWL programme, more than 95% of participants were satisfied with their vision after LASIK. And months after the procedure eyes can feel more comfortable than prior to surgery.
At the same time, PROWL demonstrated something very useful for us as clinicians: patients were more than twice as likely to report visual symptoms through a questionnaire than to mention them directly during an appointment.
That is a good reminder.
We have to ask.
And patients should feel comfortable telling us.
Successful laser eye surgery should not simply mean achieving a good number on an eye chart.
It should mean achieving comfortable, useful vision that works in everyday life.
When Should You Contact Your Surgeon?
Some dryness, grittiness and visual fluctuation can be part of normal recovery.
But not every symptom following laser eye surgery should automatically be assumed to be dry eye.
Contact your surgical team if you experience:
- significant or increasing pain
- worsening vision
- increasing redness
- marked sensitivity to light
- new discharge
- symptoms that are becoming worse rather than gradually improving
If you are worried, I would always rather you contact us.
Knowing what is normal and what requires review is one of the reasons postoperative care matters just as much as the surgery itself.
The Most Important Part Happens Before the Laser Procedure
Dry eye should be part of the conversation when you are considering laser eye surgery.
But it should not automatically frighten you away from treatment.
For most suitable patients, dry eyes following laser eye surgery is temporary and treatable.
The patients we need to identify carefully are those with dry eyes before the procedure or who may be at greater risk of persistent symptoms.
That is why in clinic we:
- Ask you about your eye comfort, health and lifestyle
- Assess the ocular surface
- Treat problems first
- Postpone decisions and surgery when required
- Wait until the eye is ready
- Choose the most appropriate procedure
- Then look after you while the eyes are healing
If you already experience dry-eye symptoms or have struggled with contact lenses, please tell us during your consultation.
It does not necessarily mean you cannot have laser eye surgery.
It simply means we need to understand and treat your eyes properly before deciding what comes next.
To explore the wider options available at ClarisVision, visit our Laser Eye Surgery page.
Our aim is not simply to help you see clearly.
It is to help you see clearly and comfortably.
Let’s Talk
If you are considering laser eye surgery and wondering whether this is the right time for you, we offer free, no-obligation screenings at ClarisVision.
We will assess your eyes, talk through your lifestyle, and help you understand which option is most suitable for you.
📍 Book your appointment at clarisvision.co.uk
📞 Or call 02381 812281
Because sometimes the best decision is not about changing your life completely.
It is about removing what has been quietly holding you back.
Choosing the Right Surgeon
At ClarisVision, our procedures are personally carried out by myself. I am a consultant ophthalmologist who specialises in laser eye surgery, lens replacement surgery and corneal surgery. We prioritise precision, safety, and personal care at every step.
When choosing a clinic, we recommend checking the surgeon’s credentials, including:
- Fellowship of the Royal College of Ophthalmologists (FRCOphth)
- Inclusion on the GMC Specialist Register for Ophthalmology
- Subspecialty Fellowship level training in corneal and/or refractive surgery
- Proven track record in performing a range of vision correction procedures
Why Choose ClarisVision?
When it comes to your eyes, you want care that’s not only expert, but personal.
At ClarisVision, we provide:
- 👁️ Care led by Consultant Ophthalmologist and Corneal Specialist, Mr. Aris Konstantopoulos
- 🧬 Advanced diagnostics and laser technology for superior precision
- 🫶 A personalised approach to your vision correction
- 🌍 A warm, patient-first experience trusted by hundreds in the UK
We’re more than a clinic – we’re your partner in clear vision for life.
Start now with a free, no-obligation suitability screening.
Real Stories, Real Impact
“Aris has treated members of my family who want to be free from glasses. Everyone is very happy with the results.”
— Liz, 41, Teacher
“Aris and his staff were excellent. I was nervous on the day of the surgery but they were all so kind and reassuring. I cannot recommend him and his team enough!”
— Jenny, 38, Architectural Technician
Read more about what our patients had to say about their experience.
References
- Eydelman M, Hilmantel G, Tarver ME, et al. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmology. 2017;135(1):13-22. doi:10.1001/jamaophthalmol.2016.4587.
- Bower KS, Sia RK, Ryan DS, Mines MJ, Dartt DA. Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: Manifestations, incidence, and predictive factors. Journal of Cataract & Refractive Surgery. 2015;41(12):2624-2634. doi:10.1016/j.jcrs.2015.06.037.
- Ma KK, Manche EE. Corneal Sensitivity and Patient-Reported Dry Eye Symptoms in a Prospective Randomized Contralateral-Eye Trial Comparing Laser In Situ Keratomileusis and Small Incision Lenticule Extraction. American Journal of Ophthalmology. 2022;241:248-253. doi:10.1016/j.ajo.2022.05.010.
- Sambhi RDS, Sambhi GDS, Mather R, Malvankar-Mehta MS. Dry eye after refractive surgery: a meta-analysis. Canadian Journal of Ophthalmology. 2020;55(2):99-106. doi:10.1016/j.jcjo.2019.07.005.
- Ahluwalia A, Manche EE. Comparing femtosecond LASIK and small-incision lenticule extraction (SMILE). Current Opinion in Ophthalmology. 2025;36(4):276-281. doi:10.1097/ICU.0000000000001145.
- Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. American Journal of Ophthalmology. 2025;279:289-386. doi:10.1016/j.ajo.2025.05.039.