Dry eye disease and cataracts are two of the most common age-related eye conditions, and many people experience them at the same time. The way these conditions interact becomes especially important when planning for cataract surgery and understanding this relationship can help you prepare for surgery, manage symptoms, and achieve the best long-term vision outcomes.

The Effect of Dry Eye Before Cataract Surgery

1. Dry Eye Can Interfere with Accurate Cataract

Measurements Before cataract surgery, your surgeon carefully measures your eyes to choose the best artificial lens (IOL) for your eye. A stable tear film is essential for accurate
measurements, and dry eye can disrupt that stability. When the tear film is unstable:

• Vision fluctuates during testing
• Eye measurements become inconsistent
• IOL power calculations may be less precise

2. Dry Eye Can Make Cataract Symptoms Feel Worse

Cataracts cause blurry or hazy vision, glare, and difficulty seeing at night. Dry eye contributes its own set of symptoms: burning, gritty sensation, fluctuating vision, and intermittent blur.
When both conditions are present, the combined symptoms can make vision feel worse than what the cataract alone would cause. Many patients don’t realise how much dry eye is contributing until it is treated.

3. Inflammation From Dry Eye Can Slow Visual Recovery

Dry eye is often associated with ocular surface inflammation. A chronically irritated eye
may:

• Heal more slowly after surgery
• Have a higher risk of postoperative discomfort
• Be more prone to fluctuating vision in the early recovery period

The Effect of Dry Eye After Cataract Surgery

Cataract surgery is one of the safest and most successful procedures, but it can temporarily disrupt the tear film. Here’s how.

1. Surgery Can Temporarily Worsen Dry Eye

It’s very common to experience increased dryness for weeks, or even a few months, after surgery. This happens because:

• The incision affects corneal nerves involved in tear production
• Surgery causes short-term inflammation
• Tear film stability changes as the eye heals

For most people, this improves as the nerves regenerate.

2. Post-Operative Drops Can Irritate a Dry Eye

After cataract surgery, patients typically use a combination of antibiotic, anti inflammatory, or steroid drops. While these medications are essential for preventing infection and controlling inflammation, they can also aggravate an already dry or sensitive ocular surface.

3. No Glasses After Surgery Can Make Dry Eye More Noticeable

Many people are pleasantly surprised after cataract surgery to discover that they rely less on glasses – or in some cases, don’t need them at all. However, glasses can act as a mild protective shield for the eyes, reducing airflow and exposure.
After surgery, when a patient suddenly stops wearing glasses:

• The eyes are more exposed
• Airflow can increase evaporation of tears
• Dryness symptoms can become more noticeable

4. Dry Eye After Cataract Surgery Can Cause Fluctuating Vision

One of the most common post-surgery concerns is fluctuating or intermittent blurry vision throughout the day This is most often due to an unstable tear film rather than a problem with the lens implant.

• When the tear film is unstable:
• Vision appears sharp at times and blurry at others
  Reading vision can come and go
• Light sensitivity and glare may feel worse

Our Approach at Nexus Eyecare

Dry eye can become more difficult to manage for up to three months following cataract surgery, which is why early identification and treatment are essential.

At Nexus Eyecare, we take a proactive strategy to optimize the ocular surface before and
after cataract surgery:

Before Surgery:

• Every patient is assessed for dry eye and tear film stability.
• All patients are pretreated with medicated or lubricating drops before
  performing measurements to ensure accuracy.
• Patients with more severe dry eye are referred to our specialised Dry Eye Clinic
  for targeted therapy before surgery.

After Surgery:

• We continue dry-eye management
• We monitor healing and tear-film stability closely to ensure comfort and the best possible visual outcomes.

With Good Management, Cataract Surgery Can Improve Dry Eye Symptoms

This surprises many people. When the surgical plan includes optimising the tear film before and after surgery, patients often end up with:

• A more stable tear film
• Less irritation
• A clearer, smoother optical surface

In some cases, treating dry eye as part of the surgical process leads to better comfort and better vision than before.

A healthy tear film is one of the most important factors for excellent cataract surgery outcomes. If you have both conditions, our cataract surgeons will discuss a tailored dryeye treatment plan to optimise your vision, improve comfort, and ensure the best possible results from surgery.