As quick as lasik heals up, it is still a procedure. The lasik flap creates a small scratch or injury in the cornea that must heal over. The eyelids can get more swollen after lasik due to the body’s own natural defense response to that “injury".
Fortunately, eyelid swelling after lasik is relatively short lived. Often nothing needs to be done except simply wait for the swelling to go away in a few days following the procedure. But there are a few different things you can do to help speed up that resolution of the swelling.
And none of these extra things are very complex. These treatments all target the exact reason why the swelling exists in the first place.
So How Does Swelling Happen?
Let's say twist your ankle. Ouch! Pretty soon you are going to develop swelling around that ankle. But what exactly is happening here?
The body has an injury response system. Injuries prompt the body to go into control and repair mode. This is good if there is a risk of infection that the body can fight against and also is designed to "repair" the injury as quick as possible.
Injury leading to swelling; image by Nason vassiliev, CC BY-SA 4.0, via Wikimedia Commons
When an injury is detected, blood vessels in our body release lots of white blood cells. This is our immune defense system. But with these white blood cells comes extra fluid. This fluid builds up in the injured tissue.
In some ways, this swelling actually may be helpful. For example, with a sprained ankle, this swelling stabilizes the ankle somewhat to prevent further injury. But while it may be helpful in the short term, swelling can still be annoying or potentially delay recovery.
How Does This Relate To Lasik
As smooth and precise as lasik is, lasik still causes an "injury" to the eye.
During lasik, a lasik flap is created just below the surface of the cornea. This lasik flap actually creates a break in the very surface layer of the cornea called epithelium. Fortunately it heals over very quickly (much of it heals over within the first 24 hours) but it is still an injury to the eye. As such, the body has to respond to this injury.
Next to your cornea (where lasik is performed) is the white part of your eye called conjunctiva. This is a loose semi-transparent layer with blood vessels. After lasik, this conjunctiva can get slightly swollen.
This conjunctiva is actually connected to the eyelids. In fact, the underneath of the eyelids IS conjunctiva. Thus, blood vessels in the eyelids can also respond to the injury on your eye and the eyelids can develop some swelling.
This is one of the main ways swelling can develop in the eyelids after lasik. But it isn't the only way.
Eyelid Holder During Lasik
To prevent you from blinking during a lasik procedure, a small device is placed underneath the eyelids. This pushes the eyelids off of the cornea to prevent the eyelids from getting in the way.
However, for some people this eyelid holder can squeeze the eyelids. (This will also happen if you intentionally or unintentionally squeeze down on the eyelid holder). If the eyelid holder squeezes the eyelids too much, it will cause a small amount of injury within the eyelid. This in turn can lead to some additional swelling of the eyelids.
What Can You Do About The Swelling?
Fortunately with lasik, if you do have any extra swelling of the eyelids, it usually doesn't last very long. As mentioned, that scratch after lasik heals up quickly within the first 24 hours. Beyond that the eye calms down; it no longer has to respond to any injury.
Thus, chances are you really don’t have to do anything extra to get rid of the eyelid swelling. It often quickly resolves on its own once you get further from the procedure.
But there are a few things you can do in the short term to help with the eyelid swelling:
- Continue to take your medication. After lasik, steroid eye drops are used to help reduce and control inflammation. This will help to reduce the swelling.
- Using artificial tears. While it may sound counterintuitive to use tears to reduce swelling, artificial tears will help wash away any built up inflammation on the surface of the eye and also provide a supportive environment for healing to prevent the development of any new inflammation.
- Take an NSAID such as ibuprofen. This particular type of medication can help to reduce swelling anywhere including the eyelids.
- Cool the eye. How can we stop the blood vessels from leaking out white blood cells and fluid? We can make the blood vessels cold and cause them to constrict.
- For any other injury what do you do? - you put an ice pack on the injury to reduce swelling. You could do that with lasik, but putting anything extra on the eyes isn't a good idea within the first few days and week after lasik. There is just too much of a risk of accidentally rubbing the eye putting something on the eyes.
- So what can you do instead? Refrigerate your artificial tears! Thus, you'll cool the eyes every time you put an eye drop in the eye.
Treating post lasik inflammation & dry eye
Once your epithelium heals up, you still can have some extra inflammation on the surface of your eye. This inflammation is caused by dry eye.
When the eye dries out, the epithelium on the surface of the eye can also dry out. This causes micro-injuries to this epithelium. Again, with injuries comes inflammation and the potential for some swelling.
After lasik, the eye is more prone to dry eye in the short term. Throughout the cornea are tiny nerves that sense when the eye is dry and signal to produce more tears. These nerves get disrupted during lasik when the lasik flap is created. Until these nerves regenerate, the eye can dry out more than usual.
So as the eye is healing up from lasik, it remains important to continue to treat this dry eye with frequent use of preservative free artificial tears. By keeping this dry eye and inflammation under control, you can reduce any eyelid swelling as well as make the eyes feel more comfortable and your vision crystal clear.
Summary
Eyelid swelling after lasik is simply a response to the scratch on the cornea that lasik created. Because that scratch heals up quickly, this eyelid swelling can resolve very quickly as well. No extra treatments are necessary but there are a few simple steps that you can do to help this swelling resolve quicker.
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