Cataracts, Surgery, and Chronic Dry Eye

Reviewed by: HU Medical Review Board

Chronic dry eye, or simply “dry eye,” is a disease of the surface of the eye that can happen when your eye does not make enough tears or there is an issue with the tears that are made. Chronic dry eye may also be called dry eye syndrome (DES), dry eye disease (DED), or keratoconjunctivitis sicca.1

Recent studies have estimated that more than 16 million adults in the United States have been diagnosed with chronic dry eye. Plus, about 6 million more people have symptoms but have not been diagnosed.2

Cataracts are also common conditions of the eye. Cataracts often occur with dry eye disease. Educating yourself about cataracts and their connection to dry eye disease can help you get the right care for your symptoms.

What are cataracts?

A cataract is simply a clouding of the lens inside the eye. The lens is usually clear at birth. It helps to focus light onto the retina, located at the back of your eye. Cataracts develop slowly over time and usually do not cause noticeable vision changes until age 60 or older. Certain conditions, such as diabetes, can cause cataracts to form earlier.3,4

You may not notice a cataract at first. However, over time the cataract may cause blurry, hazy, or less colorful vision. Other symptoms of cataracts may include:4

  • Difficulty seeing at night
  • Sensitivity to light
  • Seeing a halo or streaks around lights
  • Seeing double or multiple “ghost” images
  • General issues with seeing well

Who gets it?

Over time, cataracts occur in everyone as part of the normal aging process. The degree of cataracts can vary widely, ranging from no symptoms to severe vision loss. More than half of all Americans over the age of 80 either have cataracts or have had surgery to remove cataracts.4

While cataracts normally get cloudier with age, sometimes, a cataract can form earlier if you have diabetes, use steroids, or a history of eye injury or eye surgery. Cataracts can occur in 1 or both eyes, and sometimes 1 cataract may be more advanced than the other.4

Can cataract surgery cause dry eye?

Cataract surgery involves removing the cloudy lens inside the eye and replacing it with a clear artificial lens that stays inside the eye for the rest of your life. Those undergoing the procedure may wonder: does cataract surgery cause dry eyes? The answer is that some people can develop dry eyes, or existing dry eye symptoms may worsen following surgery. The reasons for this include:5,6

  • The surgery requires an incision (surgical cut) to the surface of the eye
  • Most people having the surgery are older, with an increased risk of developing dry eye disease
  • Older adults tend to be more sensitive to the drugs given during and after cataract surgery, which can increase damage or irritation to the surface of the eye
  • Blurriness related to dry eye may be more noticeable after a cloudy cataract is removed

It is estimated that about 20 percent of those who have cataract surgery have underlying dry eye disease.6

What does this mean to you?

If you have cataracts, talk to your doctor about any dry eye symptoms you may have. Doctors may miss dry eye symptoms if you do not describe how these are impacting your daily life. Treating dry eyes before cataract surgery may help soothe your eyes and prevent further damage to the surface of your eyes.

You may want to see if there are any treatments you can have before surgery to improve your results after surgery.6

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