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January 13, 2022 | Lasik

Are There Problems Getting Lasik When Sick?

By Barrett Eubanks, M.D.

Are There Problems Getting Lasik When Sick?

Cough cough; uh-oh. Feeling under the weather? But you have lasik scheduled just a few days away. What should you do? You’ve waiting so long to get your laser eye surgery. And now at the worst possible time you got sick.

Getting lasik done when you are sick can delay or cause problems with the recovery after lasik. This can especially be the case if you are taking multiple medications for symptom relief.

While most illnesses seem unrelated to the eyes, many illnesses and / or the medications used to treat them can affect the surface of the eye. To make lasik as smooth as possible, it is best to delay the procedure until you are healthy and off of any additional medications.

Medications can dry your eye out

You may feel just fine (other than your stuffed up nose), but the medication you are using to treat your cold or allergies can be drying you out.

Lots of over the counter medications have a side effect of causing dryness. If you have allergies, antihistamines are notorious for drying you out. Decongestants work by getting rid of water to clear your nose. This also includes medications used to treat reflux or an upset stomach. It’s actually quite a huge list including many you can get over the counter when you are sick. Few medications are free of any side effects and dryness is a very common one.

The trouble with these medications is that you can’t control where these medications work. You take a pill and then these medications work all around the body - including the eyes. The extra dryness that these medications cause will affect the eyes and cause the eyes to dry out more.

Popular OTC medications that can cause  dry eye

Illnesses can directly or indirectly dry your eye out

Even if you stop taking those medications, just being sick can lead to more dry eye.

Allergies

Along with medications, allergies can cause additional dryness to the eyes. Many people with allergies suffer with red, watery, scratchy eyes. This is called allergic conjunctivitis. This extra irritation on the surface of the eye from the allergens generates inflammation and causes more dry eye.

Note: If you have chronic allergies, it may actually be more beneficial to take a second-generation antihistamine like fexofenadine (Allegra), loratadine (Claritin), or cetirizine (Zyrtec). These cause less dry eye effects than first-generation diphenhydramine (Benadryl). Having controlled allergies will be better for the eyes than the drying effect of a second-generation antihistamine.

Cold

One of the most common causes of the cold is through a type of a virus called adenovirus. And similar to allergies, a cold can lead to extra dryness outside of just wanting to take a decongestant for your runny nose.

Adenovirus can cause more than just cold-like symptoms. It can also cause viral conjunctivitis or pink eye. This causes a red, watery eye with irritation (similar symptoms to allergic conjunctivitis). In severe cases, viral conjunctivitis can also cause some blurred vision. And again like allergies, there is extra inflammation on the eye and extra dryness. It will go away on its own; you just have to wait for it to run its course.

Stomach bug

If you have diarrhea or nausea with vomiting, you are losing excess water. You become more dehydrated than usual. When you become dehydrated, you develop more dry eye. It makes sense - when the body doesn’t have as much water as it needs, the eyes don’t get to be fully hydrated. As your GI upset goes away and as you replenish this lack of water, the dryness goes away.

The problem with dry eye after lasik

Lasik corrects vision by changing the shape or curvature of the cornea. To accomplish this, lasik creates a thin flap just underneath the surface of the eye. This flap is folded back to perform the treatment and then put back in place.

But this flap disrupts tiny nerves within the cornea. These nerves exists to monitor the state of the cornea and surface of the eye. If the surface dries out, these nerves tell the eyes to make more tears. But after lasik, because of the disruption, these nerves aren’t working at full capacity. The eye has a harder time responding to dryness and the eye dries out more (until these nerves regenerate).

Excess dry eye can prolong the recovery time after lasik. Dry eye builds up inflammation on the surface of the eye. Inflammation will actually cause you to produce less tears; which causes more dry eye and inflammation. The goal after lasik is to prevent as much dry eye until the eye heals up and prevent it from getting out of control.

Heading into lasik, we want to make sure dry eye is under control. Situations that cause excess unnecessary dry eye are best treated prior to getting lasik done. This includes being sick and taking drying medications.

If the eye is already irritated from conjunctivitis, than lasik will definitely want to be postponed.

When can lasik be done after being sick

The right time to get lasik done is when you recover from being sick. How do you know this is the case?

  • You no longer need any short term over the counter medications to manage symptoms.
  • The symptoms of your illness have resolved.
  • Your eye is no longer red, watery or irritated. Conjunctivitis, whether from allergies or virus needs to be resolved.

In general, it’s when you are back to feeling healthy. No need to rush into an elective surgery if you are still feeling under the weather.

Summary

Having healthy eyes before lasik allows for the best recovery after lasik. When you are sick, both the illness and medications you take for symptom relief can be causing extra dry eye. This extra dry eye interferes with the recovery after lasik. So do yourself a favor and allow your illness to go away before getting your vision corrected.

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