Monday, April 18, 2011

Dry Eye and Eyelid Inflammation after Cataract Surgery

Question: I had cataract surgery in both eyes about 4 months ago with toric lens implants. My right eye now has supervision. The left has been extremely dry with blurry vision and is uncomfortable. The left eye actually feels larger than the right. I am on antibiotics (doxycycline), putting artificial tears in multiple times a day and the the left feels itchy. The doctor says it is a problem with my eyelids (which I never noticed pre-op). Any suggestions?

Answer: Dry eye, mild ocular surface irritation and eyelid inflammation can sometimes occur after uneventful Cataract Surgery-even if they were not present before your eye surgery. Modern Cataract Surgery, particularly with clear corneal incisions, is considered very safe for the cornea. However, several factors known to exacerbate dry eye can be present surrounding Cataract Surgery. These include the temporary disruption of corneal nerves from the tiny corneal incisions and the mild ocular surface toxicity of topical ophthalmic eye drop medications that are used before, during and after the Cataract operation itself. Further, it is entirely possible that you had "subclinical" eyelid inflammation-that was not bad enough to make you symptomatic-that became activated from the inflammatory factors mentioned above.

It is difficult to know whether you primarily have the eyelid problem causing the dry eye problem or the cataract procedure causing the eyelid problem and thus the dry eye problem-or which caused what. It appears as if your Cataract Surgeon is taking a pretty aggressive course of therapy for you. If you are not getting relief from the therapeutic approach being taken it would be worthwhile to first discuss this and ask about alternative therapeutic approaches with your Cataract Surgeon. If he or she is unwilling or unable to get you some relief, it might be worthwhile to seek a consultation with a Corneal Specialist who has a special interest in ocular surface and external disease. Sometimes these specialists will take a different therapeutic approach towards the inflammation, eyelid issues and ocular surface that you might have a better response to.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

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