Exploring the Cataract Surgery Link to Chronic Dry Eye

Cataract surgery is a topic that frequently comes up in the chronic dry eye community. Most often, the community member had cataract surgery and has since developed chronic dry eye. The question for them is whether the cataract surgery caused their symptoms to appear.

Getting told to have cataract surgery

I was first diagnosed with chronic dry eye four years ago. The optometrist explained that I have meibomian gland dysfunction. There were other factors contributing to my dry eye symptoms, including cataract surgery.

During an annual eye exam, my optometrist told me I had cataracts and should consider surgery. I had noticed a halo around headlights when driving. My vision wasn't as sharp as it had been. My optometrist referred me to an ophthalmologist that performs cataract surgery.

He briefly explained the procedure and scheduled me for surgery. I am sure the tiny print consent form I signed covered possible side effects, but the doctor mentioned none of them to me. Like most patients, I trusted the doctor and didn’t ask questions.

Overlooking possible side effects

In hindsight, I should have asked questions about possible side effects.

Now I know that cataract surgery carries potential side effects, including dry eye symptoms. For many patients, the dry eye symptoms go away in time. Unfortunately I was among those that developed chronic dry eyes.¹

After a few months, I noticed my vision was cloudy. I returned to the doctor and learned that I had developed scar tissue sometimes referred to as a secondary cataract. Now I needed another procedure, a YAG (yttrium-aluminum-garnet) laser to remove the scar tissue. Once again, the doctor failed to mention any potential side effects for the procedure.²

Worse vision

The YAG procedure, like other laser treatments, can cause dry eye symptoms. After having the procedure, my dry eye symptoms worsened. I also became light sensitive. Even on cloudy days I wear sunglasses and use a visor when outdoors.

I recently saw my retinal specialist for my bi-annual visit for macular degeneration. My wonderful doctor is also happy to discuss my chronic dry eye, which my previous doctor refused to do. My vision was noticeably worse than it was at my last visit. My doctor reassured me that my macular degeneration was stable. He said the chronic dry eye was the likely cause, in addition to floaters. He said mine were so numerous they were impacting my vision. The floaters may require surgery at a later date.

As usual, I began exploring a reason for the floaters. I found two potential reasons for floaters that pertained to me: cataract surgery and YAG laser treatment.^3,4

Wishing I had known the risks

Both cataract surgery and the subsequent YAG procedure were probably necessary in my case. I wish I had known the risks before having the treatments. My cataracts were not having a huge impact on my daily life, and surgery might have been delayed a few years.

Hindsight is 20/20, and in this case can’t help me. My hope is that my experience may enlighten others.