Dry eye after cataract surgery or LASIK: why it happens and how long it lasts

Dry, gritty or blurry eyes are a common part of healing after cataract surgery and laser vision correction, and for most people they ease with time. Here’s why surgery dries the eye, how long it usually lasts, what helps, and the signs that mean calling your surgeon right away.

By Symvana EditorialUpdated 12 min readHow we research
On this page
  1. Why eye surgery can dry the eye
  2. After cataract surgery: how long it lasts
  3. After LASIK: how common it is and how long it lasts
  4. Dry eye after SMILE and PRK
  5. If you already have dry eye, treat it before surgery
  6. What helps while you heal
  7. Warning signs that can’t wait
  8. Common questions

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The short version

  • Cataract surgery and laser vision correction cut some of the nerves that tell your eyes to make tears, so some dryness afterward is expected.
  • After cataract surgery, those nerves generally heal in about three months. For some people dryness lasts longer.
  • After LASIK, most people improve over the first months. A small number still have symptoms more than a year later.
  • Dry eye you already have can get worse after surgery, so it’s worth finding and treating it first.
  • Use your prescribed drops exactly as directed, and ask your surgeon before adding anything else, from new drops to warm compresses.
  • Severe or worsening pain, vision that gets worse, flashes of light or a shadow in your side vision need a call to your surgeon right away.

Why eye surgery can dry the eye

Nerves on the surface of your eye are part of a feedback loop that tells your eyes to make tears. Cataract surgery cuts a small number of them where the surgeon makes the incisions. Until they heal, your eye may not feel when it’s dry, and it may make fewer tears1 American Academy of Ophthalmology, 2026 (opens in a new tab). 10 Cataract Surgery Side Effects, and How to Cope..

Laser vision correction also cuts nerves in the cornea, the clear front of the eye. A 2023 review describes this as the main cause of dry eye after LASIK, SMILE and PRK: it disturbs both tear production and the reflex that makes you blink. How much nerve damage there is depends on the procedure2 Nair et al., Indian Journal of Ophthalmology, 2023 (opens in a new tab). Refractive surgery and dry eye: an update..

In LASIK, the surgeon cuts a flap in the cornea, folds it back, reshapes the tissue underneath with a laser and puts the flap back3 US Food and Drug Administration, 2018 (opens in a new tab). LASIK: what to expect before, during and after surgery.. Cutting the flap severs the nerves deeper in the cornea, at their trunks where they enter the eye, while in PRK the damage is to nerve endings nearer the surface4 Bower et al., Journal of Cataract & Refractive Surgery, 2015 (opens in a new tab). Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: manifestations, incidence, and predictive factors..

Nerves aren’t the whole story. Cataract surgery can also damage the eye’s surface, disturb the tear film, cause inflammation and cause problems with the oil glands along the eyelids5 Ta et al., BMC Ophthalmology, 2025 (opens in a new tab). Dry eye post-cataract surgery: a systematic review and meta-analysis.. People blink less after cataract surgery, which may leave the tear film less stable5. After laser surgery, inflammation as the cornea heals adds to the dryness2.

Preservatives in eye drops, such as benzalkonium chloride, may make dry eye worse6 Gomes et al., The Ocular Surface, 2017 (opens in a new tab). TFOS DEWS II iatrogenic report.. That’s no reason to skip the drops you were prescribed. After cataract surgery7 American Academy of Ophthalmology, 2025 (opens in a new tab). Cataract Surgery: Risks, Recovery, Costs. and after LASIK3, they help prevent infection and inflammation, so use them as directed, and ask your surgeon if you think they’re irritating your eyes.

After cataract surgery: how long it lasts

According to the American Academy of Ophthalmology, almost everyone has some dryness after cataract surgery, and the cut nerves generally heal in about three months. If you had dry eye before surgery, you may have even more dryness afterward. The sandy, scratchy feeling many people notice at first comes from the small incision and should heal within a week or so, although with dry eye it may last up to three months1.

Research reviews add some numbers, but they’re less certain about how long it lasts:

  • How common. A 2022 review pooled nine studies of 775 people who didn’t have dry eye before cataract surgery. Of them, 37.4% developed it afterward. In most of the studies it reviewed, dry eye signs and symptoms hadn’t returned to where they were before surgery by the time the study ended8 Miura et al., Ophthalmology and Therapy, 2022 (opens in a new tab). Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis..
  • How long. A 2025 review of 20 studies covering 1,694 eyes found some evidence that tears broke up faster than before surgery, both in the first week and, by a smaller amount, from one week to three months after. Results for symptoms and the other tests were too inconsistent between studies to combine. Its conclusion was that dry eye may last up to three months after cataract surgery, and that more research is needed to know whether it returns to normal after that5.
  • When it starts. Some people may not notice dryness straight away. The authors of the 2025 review note that symptoms could begin about a month after surgery, around the time steroid drops are tapered off, although the timing of the studies they reviewed made this hard to check5.
  • Who’s more likely to get it. Reported risk factors include older age, being female, existing dry eye, oil gland problems, other health conditions, some medicines and preservatives in eye drops8. Don’t stop any medicine because of your eyes without asking the doctor who prescribed it.

Dry eye is also one of the reasons vision can stay blurry after cataract surgery. Blur in the first days usually comes from normal swelling. If it hasn’t eased after a week, check in with your ophthalmologist1.

After LASIK: how common it is and how long it lasts

Dry eye is the most common complication of laser vision correction, and almost all LASIK patients have some degree of it in the period right after surgery2.

The PROWL studies, which asked 262 Navy personnel and 312 civilians about their symptoms before and after LASIK, found a mixed picture. Many participants had dry eye symptoms before surgery, and overall these became less common afterward. But of the people whose symptom scores were normal before surgery, about 28% had mild, moderate or severe dry eye symptoms three months later9 Eydelman et al., JAMA Ophthalmology, 2017 (opens in a new tab). Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies..

Most of this settles with time, though reviews describe the timeline differently. One says the symptoms and signs usually last about a month, and that a small number of people still have symptoms more than a year after surgery10 Toda, Investigative Ophthalmology & Visual Science, 2018 (opens in a new tab). Dry Eye After LASIK.. Another says they typically peak in the first week and ease gradually over 6 to 12 months, and that while most cases clear within the first year, a small number may go on to chronic dry eye2.

The FDA’s patient information spells out the worst case: some people may develop severe dry eye after LASIK, it may be permanent, and they may need intensive drop treatment, plugs or other procedures11 US Food and Drug Administration, 2018 (opens in a new tab). LASIK: the risks, and how to find the right doctor..

Having dry eye before surgery is the biggest risk factor for dry eye after laser vision correction. Women and contact lens wearers also have a higher risk2.

Pain that outlasts the dryness. Some people have ongoing eye pain after LASIK that’s thought to be a different problem from dry eye, possibly because nerves grew back abnormally or the nervous system became oversensitive10. With this nerve-related pain, called neuropathic ocular pain, the usual signs of dry eye are often missing2. If pain rather than dryness is your main problem, tell your surgeon or eye doctor.

Dry eye after SMILE and PRK

SMILE (small incision lenticule extraction) doesn’t use a flap. A laser shapes a small lens-shaped piece of tissue inside the cornea, and the surgeon removes it through a curved cut of 3 to 4 millimeters, much shorter than the edge of a LASIK flap. The approach was meant to spare more corneal nerves12 Shen et al., PLOS ONE, 2016 (opens in a new tab). Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis..

A 2016 analysis of six studies (291 eyes after SMILE, 277 after femtosecond LASIK) found symptom scores and tear stability were worse after LASIK at one, three and six months, while two other tear tests, including tear production, didn’t differ. The authors judged the two procedures broadly similar on the objective tests, found dry eye after both was usually temporary, and concluded that SMILE may bring milder symptoms12.

A 2018 review says SMILE causes less dry eye than LASIK10, and a 2023 review describes dry eye after SMILE as less common, less severe and quicker to recover2.

PRK (photorefractive keratectomy) doesn’t use a flap either. The surgeon removes the cornea’s thin surface layer and reshapes the tissue beneath with the laser, and the surface grows back. In one study, that healing typically took four to seven days under a bandage contact lens4.

Without a flap, PRK is thought to spare more of the nerves. Several studies found that PRK and similar surface treatments caused less tear trouble and fewer dry eye symptoms than LASIK, although one found more dry eye symptoms after PRK at three months2. The overall picture is still unsettled:

  • A 2020 analysis of 14 studies found that tear stability and tear production fell significantly after LASIK, while the changes after PRK and SMILE weren’t statistically significant. The authors said more high-quality trials are needed before firm conclusions can be drawn13 Sambhi et al., Canadian Journal of Ophthalmology, 2020 (opens in a new tab). Dry eye after refractive surgery: a meta-analysis..
  • In a year-long study of 143 US Army personnel without dry eye before surgery, average age about 30, who chose either PRK or LASIK, chronic dry eye was uncommon after both: 6 of 120 eyes after PRK and 1 of 123 after LASIK. People chose their own procedure, so the study didn’t compare the two directly. In both groups, dry eye symptom scores stayed higher than before surgery for the whole year4.

If you have dry eye and are weighing these options, ask your surgeon how the condition of your tear film affects which procedure suits you.

If you already have dry eye, treat it before surgery

Many people come to cataract surgery with signs of dry eye or other surface problems they don’t know about. In a study of 120 people being evaluated for cataract surgery, 80% had at least one abnormal tear test suggesting a problem with the eye’s surface, and so did 85% of the 46 who had no symptoms. Many of them hadn’t been diagnosed14 Gupta et al., Journal of Cataract & Refractive Surgery, 2018 (opens in a new tab). Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation..

That matters for two reasons. Dry eye and other surface problems can blur vision and throw off the measurements surgeons use to plan cataract and laser surgery, and surgery can make them worse. An expert committee of the American Society of Cataract and Refractive Surgery says that treating them before surgery can improve vision and satisfaction afterward15 Starr et al., ASCRS Cornea Clinical Committee, Journal of Cataract & Refractive Surgery, 2019 (opens in a new tab). An algorithm for the preoperative diagnosis and treatment of ocular surface disorders.. For LASIK, the FDA lists dry eye among the conditions your doctor should screen you for, noting that LASIK tends to make it worse16 US Food and Drug Administration, 2018 (opens in a new tab). LASIK: when it may not be right for you..

Before your surgery:

  • Tell your surgeon if your eyes often feel dry, gritty or tired, if contact lenses get uncomfortable, or if you use eye drops regularly. Our three-minute dry eye quiz helps you put your symptoms into words before the appointment.
  • Tell them about every medicine you take, including ones you buy without a prescription3.
  • Ask whether your tear film and eyelid oil glands will be checked, and whether treating dry eye first could help your result.
  • If you know you have dry eye, find out which type it is. Treatment differs by type, and our evidence board grades the options.
Want help from a dry eye specialist before surgery?

Our directory lists practices whose own websites show dry eye care beyond drops. Search by ZIP code, starting in Florida.

Find a specialist

What helps while you heal

Your surgeon’s instructions come first. Most of what helps is simple, and anything beyond these basics is worth clearing with them.

  • Your prescribed drops, exactly as directed. Anti-inflammatory drops after cataract surgery should be used as your surgeon directs1. After LASIK, your drops help prevent infection and inflammation3.
  • Preservative-free artificial tears Good evidence. For mild dryness after cataract surgery, the American Academy of Ophthalmology suggests nonprescription preservative-free tears, put in 5 minutes after your prescription drops so they don’t dilute the medicine1. After laser vision correction, a 2023 review says, artificial tears, preferably preservative-free, are the first treatment for dry eye, and they’re routinely prescribed for about four to six weeks2.
  • No eye rubbing. After cataract surgery, don’t rub or press on your eye7. After LASIK, rubbing could move the flap and mean more treatment3.
  • After LASIK, no contact lens in the operated eye. The FDA’s advice is not to go back to wearing one in that eye, even if your vision is blurry3.
  • Screen breaks with full blinks. People blink about 17 times a minute at rest but only around 4.5 times a minute while reading17 Bentivoglio et al., Movement Disorders, 1997 (opens in a new tab). Analysis of blink rate patterns in normal subjects.. Our Eye Break Timer reminds you to look away every 20 minutes.
  • Warm compresses and lid care only with your surgeon’s OK. When blocked oil glands or inflamed eyelids add to dryness after laser surgery, a 2023 review recommends treating them with measures such as lid hygiene and a heated eye mask2. Once you’re cleared, our warm compress guide explains how to do it properly.
  • The next steps if tears aren’t enough. Your ophthalmologist can suggest other ways to get you through the dry period1. For dry eye after laser surgery, the options include anti-inflammatory drops, punctal plugs Mixed evidence that slow tear drainage and, for harder cases, drops made from your own blood serum2. For dry eye in general, a Cochrane review of 18 trials found the evidence on plugs inconclusive18 Ervin et al., Cochrane Database of Systematic Reviews, 2017 (opens in a new tab). Punctal occlusion for dry eye syndrome..

The grades come from our evidence board and rate each treatment for dry eye in general, not specifically after surgery.

Two preservative-free drops from our Relief Kit are below. In the weeks after surgery, check with your surgeon before adding any drop. Our guide to the best eye drops for dry eyes explains the other types.

Water-layer drop, preservative-free vials

Refresh Plus

A plain carboxymethylcellulose drop in single-use vials. Nothing clever, which is exactly why it suits sensitive eyes.

Worth knowing. Wears off faster than thicker drops. Some people prefer it by day and a gel at night.

Good evidence$
See price on Amazon for Refresh Plus (opens in a new tab)

Water-layer drop, preservative-free bottle

iVizia Lubricant Eye Drops

Povidone with hyaluronic acid and trehalose, preservative-free in a multi-dose bottle. Gentle enough to use many times a day.

Worth knowing. Water-layer drops alone often fall short if your oil glands are the real problem.

Good evidence$$
See price on Amazon for iVizia Lubricant Eye Drops (opens in a new tab)

Evidence grades are for the type of product, not the brand. Amazon links are affiliate links. If you buy through them we may earn a commission, at no extra cost to you. Disclosure.

Warning signs that can’t wait

Ordinary dryness is uncomfortable but not urgent. These are different. Call your surgeon or ophthalmologist right away, without waiting for your next appointment, if you notice any of these:

  • Severe pain, or pain or other symptoms that get worse instead of better3.
  • Vision that gets worse instead of better3.
  • A red eye together with pain, light sensitivity or a change in vision1.
  • Extreme light sensitivity, which can be a sign of infection1.
  • A burst of new floaters, flashes of light, or a shadow or curtain in your side vision. After cataract surgery, these are signs of a retinal detachment, a rare complication that needs a call to your ophthalmologist immediately1.

More broadly, the FDA advises contacting your eye doctor immediately about any new, unusual or worsening symptom at any point after LASIK, since it could signal a problem that may lead to vision loss if it isn’t treated early3.

Common questions

How long does dry eye last after cataract surgery?

The American Academy of Ophthalmology says the nerves cut during surgery generally heal in about three months, and until then your eye may make fewer tears. A 2025 review found dry eye may last up to three months, and how long it lasts beyond that hasn’t been well studied. If you had dry eye before surgery, you may have more dryness. Tell your eye doctor if it isn’t improving.

Is dry eye after LASIK permanent?

Usually not. Most people improve over the first months, but a small number still have symptoms more than a year later, and the FDA warns that some people may develop severe dry eye after LASIK that may be permanent. If it lingers, ask your eye doctor about treatments, from prescription drops to punctal plugs.

What are the best eye drops for dry eyes after cataract surgery?

Keep using the drops your surgeon prescribed, exactly as directed. They help prevent infection and inflammation. For mild dryness, the American Academy of Ophthalmology says nonprescription preservative-free artificial tears can help. Wait 5 minutes after your prescription drops before putting them in, so the medicine isn’t diluted. Ask your surgeon before adding anything else in the weeks after surgery. Our eye drop guide explains the types.

Can I use a warm compress after cataract surgery or LASIK?

Ask your surgeon first. Heat and lid massage can help blocked oil glands, but after cataract surgery the American Academy of Ophthalmology advises not to rub or press on your eye, and a healing eye needs your surgeon’s OK before you put heat or pressure on it. Once you’re cleared, our warm compress guide shows how to do it properly.

Can I have LASIK if I have dry eye?

It depends on how severe it is. The FDA notes that LASIK tends to make dry eye worse, and dry eye before surgery is the biggest risk factor for dry eye after it. Surgeons can treat it first and, in more severe cases, may suggest a different procedure. Ask yours what suits your eyes.

Why does my eye feel gritty after cataract surgery?

A scratchy, sandy feeling is normal at first. It comes from the small incision and should heal within a week or so, though with dry eye it may last up to three months. Pain that’s severe or getting worse is different: call your surgeon.

Sources

  1. 10 Cataract Surgery Side Effects, and How to Cope (opens in a new tab). American Academy of Ophthalmology, 2026.
  2. Refractive surgery and dry eye: an update (opens in a new tab). Nair et al., Indian Journal of Ophthalmology, 2023.
  3. LASIK: what to expect before, during and after surgery (opens in a new tab). US Food and Drug Administration, 2018.
  4. Chronic dry eye in photorefractive keratectomy and laser in situ keratomileusis: manifestations, incidence, and predictive factors (opens in a new tab). Bower et al., Journal of Cataract & Refractive Surgery, 2015.
  5. Dry eye post-cataract surgery: a systematic review and meta-analysis (opens in a new tab). Ta et al., BMC Ophthalmology, 2025.
  6. TFOS DEWS II iatrogenic report (opens in a new tab). Gomes et al., The Ocular Surface, 2017.
  7. Cataract Surgery: Risks, Recovery, Costs (opens in a new tab). American Academy of Ophthalmology, 2025.
  8. Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis (opens in a new tab). Miura et al., Ophthalmology and Therapy, 2022.
  9. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies (opens in a new tab). Eydelman et al., JAMA Ophthalmology, 2017.
  10. Dry Eye After LASIK (opens in a new tab). Toda, Investigative Ophthalmology & Visual Science, 2018.
  11. LASIK: the risks, and how to find the right doctor (opens in a new tab). US Food and Drug Administration, 2018.
  12. Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis (opens in a new tab). Shen et al., PLOS ONE, 2016.
  13. Dry eye after refractive surgery: a meta-analysis (opens in a new tab). Sambhi et al., Canadian Journal of Ophthalmology, 2020.
  14. Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation (opens in a new tab). Gupta et al., Journal of Cataract & Refractive Surgery, 2018.
  15. An algorithm for the preoperative diagnosis and treatment of ocular surface disorders (opens in a new tab). Starr et al., ASCRS Cornea Clinical Committee, Journal of Cataract & Refractive Surgery, 2019.
  16. LASIK: when it may not be right for you (opens in a new tab). US Food and Drug Administration, 2018.
  17. Analysis of blink rate patterns in normal subjects (opens in a new tab). Bentivoglio et al., Movement Disorders, 1997.
  18. Punctal occlusion for dry eye syndrome (opens in a new tab). Ervin et al., Cochrane Database of Systematic Reviews, 2017.

This guide is for education and doesn’t replace advice from your surgeon or eye doctor. Always follow the instructions you were given for your own surgery.

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