Common LASIK Side Effects and How to Manage Them

1. Dry Eye (Most Common)

Frequency: 60-95% in first month, 5-8% beyond 1 year

Why it happens: LASIK temporarily disrupts corneal nerves that signal tear production. Healing takes 3-6 months for most patients.

Symptoms: Burning, gritty sensation, intermittent blurred vision that improves with blinking, watering (paradoxical).

Management: - Preservative-free artificial tears 4-6 times daily - Warm compresses for 10 minutes daily - Omega-3 supplements (1-2g daily) - Avoid AC blowing directly on face - Humidifier at home/office - Limit screen time, take frequent breaks - For persistent cases: prescription drops (cyclosporine, lifitegrast), punctal plugs, IPL therapy

Resolves: Most patients fully recover in 3-6 months.

2. Halos, Glare, Starbursts at Night

Frequency: 30-50% in first month, 5-10% beyond 6 months

Why it happens: Healing cornea and slight pupil-reshape interaction with light at night. More common with higher prescriptions and large pupils.

Symptoms: Bright halos around streetlights, oncoming headlights causing starbursts, ghosting at night.

Management: - Time — most cases resolve within 1-3 months as the brain adapts - Lubricating drops at night - Avoid night driving for the first 1-2 weeks, or longer if halos are still bothering you - Wavefront-guided LASIK and Contoura Vision have lower rates than standard LASIK - For persistent cases: night-driving prescription glasses, low-dose pilocarpine drops

Resolves: Most cases within 3 months; a small number persist beyond 6-12 months.

3. Light Sensitivity

Frequency: 30-50% in first 1-2 weeks

Why it happens: Healing corneal surface temporarily more sensitive to bright light.

Management: - Wear sunglasses outdoors - Avoid bright fluorescent lights - Dim screen brightness - Lubricating drops

Resolves: Within 1-3 weeks for most patients.

4. Under-correction or Over-correction

Frequency: 1-3% of patients

Why it happens: Individual healing variation can sometimes leave residual prescription.

Symptoms: Vision not as sharp as expected at distance or near.

Management: - Wait 3-6 months for full healing before assessing - Mild residual prescription often improves over time - For persistent residual error: enhancement procedure (touch-up LASIK) — ask whether it is included in the original surgery cost - Reading glasses may be needed for residual minor near-vision needs

Resolves: Most patients achieve good vision after enhancement, though results can't be guaranteed.

5. Regression

Frequency: 2-5% over 5 years, slightly higher for high prescriptions

Why it happens: Cornea slowly returns toward original shape. More common in high prescriptions (above -8 D), young patients (under 25), or those with continued near-work strain.

Management: - Annual eye exams catch regression early - Mild regression may not need treatment - Significant regression: enhancement LASIK can correct it (check your centre's enhancement policy) - Lifestyle factors (excessive near work, eye strain) may contribute

Resolves: Usually correctable with enhancement if it occurs.

Rare but Serious Side Effects

Less than 1% combined:

• Flap dislocation: Rare, usually from trauma in first weeks. Surgical repositioning required.
• DLK (Diffuse Lamellar Keratitis): Inflammation under flap. Treated with steroid drops.
• Epithelial ingrowth: Cells growing under flap edge. May need minor surgical removal.
• Infection (microbial keratitis): Less than 1 in 5,000. Aggressive antibiotic treatment.
• Ectasia (corneal weakening): Less than 1 in 10,000. Treated with corneal cross-linking and ICL.

These rare complications are why proper screening (rejecting unsuitable candidates) and choosing an experienced surgeon matters so much.

What Are the Side Effects of LASIK Surgery? What's Normal and When

The usual side effects of LASIK are short-lived: watering, grittiness and light sensitivity for a day or two, then dryness, fluctuating vision and night-time halos that fade over weeks to months. It helps to know what to expect at each stage.

First 24-48 hours (normal): - Watering, burning or a scratchy, eyelash-in-the-eye feeling for the first few hours - Light sensitivity and hazy vision - A bright red patch on the white of the eye (subconjunctival haemorrhage) from the suction ring used during surgery — it looks alarming but is harmless and fades over 1-2 weeks - Mild swollen eyelids

First weeks (normal): - Dryness and gritty eyes, worse in AC and at screens - Vision that varies through the day - Halos, glare and starbursts around lights at night

First months (normal, gradually fading): - Dryness that needs drops less and less often - Night-time halos that become less noticeable

Not normal — contact your clinic the same day: - Pain that increases rather than settles after the first day - Vision that gets worse instead of better - Increasing redness, discharge or sensitivity to light after the first few days - A sudden change in vision after rubbing or a knock to the eye

Does LASIK Affect Night Vision? Halos, Glare and Night Driving

Yes, at first. Halos, glare and starbursts around lights are common in the first weeks after LASIK and usually fade over 1-3 months, as described above. In most patients, night vision returns to roughly what they had with glasses or contact lenses.

Why halos happen: At night your pupil widens. Light passing through the edge of the treated zone, the healing cornea and a dry eye surface scatters, which creates rings and rays around bright lights. Dry eye makes them noticeably worse, so treating dryness often reduces halos too.

Who is more likely to notice them: People with higher prescriptions, larger pupils, or significant dry eye. Your pre-operative scans measure your pupil and corneal shape so the surgeon can plan an adequate treatment zone and choose the right technology; customised treatments such as Contoura Vision or wavefront-guided LASIK aim to reduce these effects.

Can LASIK improve night driving vision? For some people, yes, compared with how they managed before. Glasses at night add reflections, rain and fog on the lenses, and frame edges; soft contact lenses can dry out and smear late in the day. Removing those problems helps many patients feel more confident at night. But LASIK cannot promise sharper night vision than your best glasses, and early on night vision is often slightly worse. If night driving is central to your work, say so at the consultation.

Managing it: Avoid night driving for the first 1-2 weeks, use lubricating drops before driving, keep your windscreen and any glasses clean, and give it time. Persistent halos beyond 6 months should be assessed, as they can often be helped.

Can LASIK Improve Contrast Sensitivity?

Usually not beyond what you had with your best glasses or contact lenses. LASIK's goal is to give you the same quality of vision without them. Contrast sensitivity — how well you see grey on grey, faces in dim light or road markings at dusk — is often slightly reduced in the first weeks and then generally recovers as the eye heals and dryness settles.

There are a few situations where people notice an improvement in their everyday experience:

• High minus powers: Thick minus glasses make the world look smaller. After LASIK, images are normal-sized, which many people describe as crisper.
• Problems with lenses: People whose contacts dried out or whose glasses were scratched or smudged often feel their vision is cleaner.
• Customised treatments: Topography-guided (Contoura Vision) and wavefront-guided treatments are designed to reduce certain corneal irregularities that lower visual quality. Whether this gives a noticeable improvement varies by person and is something your surgeon can discuss using your own scans.

If you already have reduced contrast from another eye condition, such as early cataract or retinal disease, LASIK will not fix that.

Eye Drops After LASIK: What Is Used and For How Long

Most patients use three kinds of eye drops after LASIK: an antibiotic, an anti-inflammatory (usually a steroid), and lubricating drops (artificial tears). The exact brands and schedule vary; the ones on your own prescription are the right ones for you.

• Antibiotic drops prevent infection while the flap edge seals. A fluoroquinolone such as moxifloxacin is commonly used. Typically about 1 week.
• Steroid or anti-inflammatory drops control healing inflammation. Examples include prednisolone, loteprednol or fluorometholone. Usually 1-2 weeks, sometimes tapered over a few weeks. Don't extend or stop them on your own — prolonged steroid use can raise eye pressure, which is why your doctor checks it at follow-ups.
• Lubricating drops (artificial tears) keep the surface comfortable while corneal nerves recover. Use them frequently in the first weeks, typically for 1-3 months, then as needed. Some people need them for 3-6 months or longer.

What are the best eye drops after LASIK? The best lubricating drops are preservative-free artificial tears, usually in single-use vials or preservative-free multi-dose bottles, because you will use them often and preservatives can irritate the surface with frequent use. Common bases include carboxymethylcellulose, hyaluronic acid (sodium hyaluronate) and hydroxypropyl guar. A thicker gel at night helps if you wake with dry eyes. Avoid 'redness relief' or decongestant drops, and don't use leftover or shared drops from someone else.

How to Use Your Eye Drops Correctly After LASIK

Using drops correctly matters as much as using the right ones. A few habits make them work better and keep the eye safe:

1. Wash your hands before every use.
2. Tilt your head back, look up, and gently pull down the lower eyelid — never press on the eyeball or the upper lid.
3. Don't let the bottle tip touch your eye, eyelashes or fingers.
4. Close your eye gently for a minute after each drop; don't squeeze or blink hard.
5. Wait about 5 minutes between different drops so the second doesn't wash out the first.
6. Use set times with phone reminders for the antibiotic and steroid; use lubricants whenever the eyes feel dry, in addition.
7. Shake suspension drops (many steroid drops are milky) before use.
8. Discard opened multi-dose bottles as the label directs, usually after a month, and never share drops.

If you miss a dose, use it when you remember and carry on — don't double up. If drops sting badly, cause swelling of the lids or a rash, contact your clinic.