Lasik is an incredible procedure, within a matter of minutes, a laser can correct your vision. But after lasik, there are a few precautions that must be taken in order to ensure that the procedure works the best.
It is optimal to wait a few weeks after lasik before washing the eyes after lasik. This is to prevent getting excess water in the eyes that can lead to an infection or irritation of the eyes. This is also to avoid causing the lasik flap to dislocate out of position.
But by being careful and with the right technique, it is possible to wash the eyelids a little earlier than that - and get all that eyelid "gunk" off. But let's first figure out what absolutely needs to be avoided and why.
The Problem With Water In The Eyes After Lasik
During lasik, a flap is created just beneath the surface of the cornea. This flap creates a potential space for bacteria to enter, spread out and grow.
But it's very rare to actually develop an infection after lasik. Lasik is a very clean procedure. All the instruments used are sterilized thoroughly and the antibiotic drops used afterwards can prevent any bacteria from gaining a foothold.
But probably the biggest reason why an infection is so rare after lasik (aside from sterilized instruments) is because lasik heals up very quickly. Immediately after the procedure there is a gap between the lasik flap and the rest of the cornea. This gap creates a possible entryway for bacteria. But this gap closes within the first 2-3 hours after lasik. The very top most layer of your cornea, called the epithelium, heals over this gap to close it off (and also to start to secure the lasik flap in place).
Having this gap alongside the lasik flap is like having a scratch on the eye. With a scratch on the eye, you have pain and well... scratchiness. You have these same symptoms for the first hours after lasik. As soon as these symptoms go away, it means that the scratch or gap has healed over by the epithelium.
Thus, by the next day, quite a bit has already healed over from lasik. But we want to be extra cautious when it comes to our eyes.
Despite the fact that epithelium has healed over the gap, it isn't quite as strong yet. There can still potentially be "micro-breaks" that can allow for bacteria to slip by.
Where does most bacteria come from? Unless you are putting dirt in your eyes, it comes from water!
Until the cornea and epithelium fully heal up, we want to avoid getting water in the eyes.
Washing Can Irritate The Eyes
But aside from just the bacteria in the water, there are other issues with getting water in the eyes. Water typically isn't pure water. There are other things and chemicals in the water.
This is especially the case when washing the eyes. Getting soap in the eyes will irritate the eyes. Granted, getting soap in the eyes will always irritate the eyes. But things are different after lasik.
Everyone after lasik will have extra dry eye for the short term. Within the cornea are tiny little nerves. These help us to produce natural tears to keep our eyes hydrated. But the lasik flap and treatment disrupt these nerve connections. Thus, until these nerves re-grow, everyone will have some increased dry eye.
Dry eye can lead to the build-up of inflammation on the surface of the eye. It's important to treat dry eye aggressively to prevent this inflammation from building up. Why? Because if inflammation starts to develop, this inflammation will in turn actually cause MORE dry eye.
But dry eye isn't the only thing which can cause inflammation on the surface of the eye. Anything that irritates the eyes, such as soap, can also create inflammation as the eye tries to respond to the irritant. This can create more irritation in the short term and set the eye back as it tries to recover from lasik.
Washing Can Rub The Eyes
Lastly, washing poses another issue with the lasik flap - the possibility of disrupting the flap and causing it to dislocate.
This is a key reason, especially within the first week out after lasik, that it is best to avoid washing the eyes. When you wash your eyes, you can have a tendency to rub the eyes.
Rubbing of the eyes soon after lasik puts friction on the lasik flap and can push it out of position.
This is one of the main reasons why during the first week out after lasik that eye make-up should be avoided. Removing the make-up involves rubbing of the eyes.
The risk that rubbing can cause the lasik flap to move is highest within the first week (and especially the highest during the first 24 hours after lasik; see also Everything You Need To Know About Flap Dislocation After Lasik). Gradually over time, the lasik flap becomes more secured in place and this becomes less and less of an issue - not that you should intentionally try to rub the eyes.
Safely Washing The Eyes Eyelids
So to be safe, during the first few weeks after lasik, it is generally recommended to avoid washing the eyes. But what if you have eyelid “gunk" or “crustys" that you just need to get off?
With the right technique, it is possible to safely wash just the eyelids after lasik (although I would still wait beyond the first 24 hours).
- You want to be standing in front of a mirror while you are washing the eyelids - that way you can see exactly where you are cleaning.
- With one finger, pull the eyelid away from the cornea - this reduces the chance that you will end up rubbing the cornea and lasik flap.
- Don't splash water onto the eyes and eyelids, instead use a wet washcloth without any soap. This avoids getting any water onto the cornea and lasik flap.
- Lightly dab the eyelids with this washcloth - don't rub the eyelids. Dabbing the eyelids will help clean the crustiness. Dabbing also ensures that you aren't rubbing the eyes.
By following this technique, you can clean around the eye while still avoiding getting any excess water in the eye and also avoiding rubbing the eye.
Summary
Washing the eyes can potentially create issues after lasik eye surgery. It's best to wait a few weeks after the procedure to avoid any problems with your eyes. It is possible, however, to clean the eyelashes with the proper technique that avoids excess water and rubbing.
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