Had LASIK eight years ago and my eyes still get dry. Does that rule out upper eyelid surgery?

Hello all. I am 51, I had LASIK on both eyes at 43 and it was the best money I ever spent, no glasses since. The one thing it left me with is dry eyes. Not terrible, but I use drops most evenings, my eyes sting after a long day on the laptop, and in winter with the heating on they feel like sandpaper by bedtime.

Now my upper lids have gone properly hooded, the outer corners especially, and I would like to have them done. I have been reading the threads here about dry eyes after surgery and they have put the wind up me a bit. If eyelid surgery dries the eyes out, and mine are already dry, am I asking for trouble?

Is the LASIK itself a problem for the eyelid surgeon? Do I need to tell them? (I assume yes.) Has anyone here had both?

Not LASIK, but I can tell you what the dry eye bit felt like after uppers alone, since I posted about it at the time. Gritty, streaming and dry all at once for about three weeks, then fading to the odd dry morning by six weeks. I did not have dry eyes beforehand. If you already do, I would want the surgeon to know before anything else.

Having all four done in a couple of weeks and the tear test was a big part of my pre-op. Dye in the eye, timed blinking, strips of paper under the lower lid. Took about ten minutes and they asked a LOT about drops. So yes, tell them, they will ask anyway.

Corinne B. said:

If eyelid surgery dries the eyes out, and mine are already dry, am I asking for trouble?

Not necessarily, but it does mean the assessment and the plan need to account for it, so it is a good question to be asking now rather than afterwards. I have not examined you, so this is the general picture and your own surgeon will tailor it.

Previous laser vision correction does not by itself rule out blepharoplasty, and plenty of people who have had it go on to have eyelid surgery. The reason it matters is that both affect the surface of the eye. Laser treatment disturbs the corneal nerves that drive reflex tearing and blinking, and some people are left with a degree of dry eye long term, which sounds like your situation. Eyelid surgery then adds a few weeks in which the lids are swollen, the blink is less complete and the eyes commonly feel dry and gritty. An eye that starts with less reserve has less margin for that.

So the surgeon will want to look closely at your tear film, the surface of the cornea and how completely your lids close, which is the test kept_blinking describes. If the dryness is not well controlled, the usual approach is to treat it first and operate once the surface is comfortable. The operation itself is often planned more conservatively in this situation, removing enough skin to clear the hooding without leaving the lid tight, because a lid that closes well protects the eye. Many people with your history do well; the ones who struggle are usually those whose dry eye was not recognised beforehand. The site's guides to dry eyes after blepharoplasty and who is a candidate for eyelid surgery cover this in more depth.

Bring the name of your laser treatment, the year, and an honest account of how often you use drops. That history, more than anything else, is what shapes the plan.

Echoing the honesty point. I played my dry eyes down at my first consultation because I was worried they would say no. They did not say no to the next person I saw, who I told the truth, they just took a little less skin. I wish I had done it that way first time.

Thank you all. Booked a consultation for December and in the meantime I have been to my optician, who confirmed mild dry eye and put me on a proper routine with preservative free drops and warm compresses, so that I go in with it under control rather than flaring.

Also noticed the site has a new article on eyelid surgery after laser eye surgery which I have printed off to take with me, along with the list of questions at the bottom. Will report back.