Dry eye is one of the most common conditions we see — and one of the most overlooked. It can cause blurry vision, irritation, burning, and fluctuating vision throughout the day, and it plays a much bigger role in your comfort and visual clarity than most patients expect.
This is especially true around cataract surgery and the Light Adjustable Lens (LAL) process. A healthy eye surface isn't just about comfort — it directly affects how accurately we can measure your eyes and how clear your final vision feels. Below is the same guidance I share with patients in clinic, so you have it to reference at home.
Common Dry Eye Symptoms
What You Should Be Doing Consistently
Even if your eyes don't feel dry — these habits help prevent problems before they start, especially in the weeks around cataract surgery or LAL treatments.
Scheduled Artificial Tears
Think of these as lotion for your eyes — not emergency treatment. Using drops only when your eyes feel dry doesn't prevent future dryness, it only helps in the moment. Use preservative-free tears at least 4 times a day (breakfast, lunch, dinner, and bedtime is a good starting place). Use more often if needed — there is no harm. Systane, Refresh, and Theratears are recommended, trusted brands — we generally steer away from generic or store-brand drops given recent sterility recalls.
Warm Compresses
Twice a day for 10–15 minutes. Use a warm washcloth held over closed eyes to help the oil glands flow more normally.
Scheduled, Frequent Lubricating Eye Drops
Artificial Tear Drops — 4 Times a Day
Most brands will work, but it often takes some trial and error to see which you prefer. Do not use anything that says "gets the red out." Using drops on a schedule before having symptoms is preferable. You can use liquid drops or gel tears, depending on your preference. If you wear contacts, check the bottle for compatibility.
A Note on Brands
We generally recommend sticking with well-established, name-brand artificial tears — Systane, Refresh, and Theratears are all good choices we're comfortable recommending.
We tend to steer patients away from generic or store-brand drops (the ones sold under a pharmacy's own label). In recent years there have been a number of FDA recalls of off-brand and store-brand artificial tears due to manufacturing issues and a lack of assurance of sterility — meaning the product couldn't be guaranteed free of bacteria or fungus. Spending a little more for a trusted, established brand is one of the simplest ways to lower that risk.
Preservative-Free Lubricant Eye Drops
Generally single-use vials or droppers. These are helpful if you need drops more than six times a day, or if you have an allergy to standard preserved drops. Refresh, Systane, and Theratears all make preservative-free versions — look for that on the label.
Artificial Tear Ointment at Bedtime
Squeeze a small amount of ointment into your lower eyelid and blink it into your eye. This may blur your vision, so it's best to use it at night right before you go to sleep.
Over-the-Counter Dry Eye Supplements
Flax seed oil (1000–1400mg), omega-3 fatty acids, omega-6 fatty acids, fish oil, or evening primrose oil. These are often available in a combined "dry eye formulation" and are thought to decrease inflammation. They may help relieve dry eye symptoms, in addition to other health benefits such as lowering blood pressure and reducing the risk of heart attack or stroke.
Warm Compress or Warm Eye Mask
Two or three times a day for 5–10 minutes. You can also fill a soft, clean sock with rice, tie the end, and heat in the microwave about 30 seconds until warm to the touch.
Eyelid Scrubs — Twice a Day
Use a pre-made eyelid scrub, or mix a few drops of Johnson's Baby Shampoo or Cetaphil face wash with a bit of water and gently scrub the base of the eyelashes with a cotton swab or soft washcloth.
Eye Allergies
For itchy, red eyes: Zaditor twice a day, Alaway twice a day, generic ketotifen twice a day, or Pataday 0.2% (olopatadine) once a day. You can also use tear drops four times a day to help relieve redness and itching, and cool compresses for comfort twice a day.
In-Office & Prescription Treatments
If dryness is still getting in the way of clear, comfortable vision, you are not stuck — and you are not doing anything wrong. Dry eye treatment often takes a step-by-step approach, and we adjust your plan as needed to help you move through the process as smoothly as possible.
Depending on your symptoms, we may recommend:
Punctal Plugs
Punctal plugs help keep your natural tears on the eye longer by temporarily or semi-permanently closing the tear drainage duct. Dr. Covey no longer uses silicone plugs, since many patients find them uncomfortable. Instead, we start with a temporary 3-day trial plug — if that goes well, we extend to a 90-day plug, which most insurance plans cover. Many patients come in on a regular schedule to have these replaced.
Amniotic Membranes
For more significant corneal irritation or a surface that needs extra help healing, we may recommend a bandage amniotic membrane placed directly on the eye in the office. These membranes contain natural healing and anti-inflammatory factors that can calm the ocular surface and support faster, more comfortable healing — often used for a short course when other treatments haven't been quite enough.
Prescription Eye Drops
For more significant or persistent dry eye, Dr. Covey can prescribe medicated drops. This may include a short course of steroid drops to reduce inflammation, or longer-term prescription drops such as Restasis, Xiidra, Tyrvaya, or Cequa, depending on what's driving your symptoms.
Serum Tears & IPL
For select patients, we coordinate with trusted local optometric partners for autologous serum tears or IPL (intense pulsed light) therapy — additional treatment options for more advanced or stubborn dry eye.
Pterygium
A pterygium is a growth of tissue on the surface of the eye, often related to sun and wind exposure, that can cause irritation, redness, and dry-eye-like symptoms — and in some cases can affect vision as it grows toward the cornea. When a pterygium is causing significant symptoms or growing enough to be a concern, Dr. Covey performs surgical excision in the operating room, typically using a conjunctival autograft or amniotic membrane graft to help reduce the chance of it growing back.
Why Dry Eye Becomes More Noticeable After Cataract Surgery
Dry eye becomes more apparent after cataract surgery because it often exists silently beforehand. Surgery temporarily cuts some of the corneal nerves that regulate tear feedback, natural tear production decreases, and patients become more visually aware of subtle changes.
It typically takes 6–12 months for corneal nerves to regrow and tear function to return to baseline. This is expected, temporary, and does not mean something went wrong.
A Closer Look at Dry Eye & the Light Adjustable Lens
If you're going through the Light Adjustable Lens process, the health of your eye surface plays an especially important role in your results. Here's what to know.
Why the Eye Surface Matters So Much
Immediately after surgery, you will still need reading glasses. Reading vision is increased gradually through the light adjustment process, usually by fine-tuning the nondominant eye. Together, we work toward clear, functional vision that lets you live most of your day-to-day life without needing glasses — roughly 95% glasses-free. This includes reading your phone or a menu in normal lighting, working on a computer, and driving.
No current technology can provide perfectly clear vision at all distances without any glasses, so occasional reading glasses are still expected for very fine print, dim lighting, or close-up hobbies such as sewing, embroidery, cross-stitching, or fly-tying. While some patients may need to pause briefly between adjustment visits, the full Light Adjustable Lens process is typically completed and permanently "locked in" within six months of surgery.
Tailoring your vision involves balance. Our goal is excellent distance, intermediate, and near vision together — but there is a natural tradeoff, since increasing near vision beyond a certain point can reduce distance clarity. We can intentionally shift the balance toward more near vision if that aligns with your priorities, and we'll make that decision together.
Clarity vs. Prescription
This is one of the most important things to understand about Light Adjustable Lens outcomes. The Light Adjustable Lens allows us to change your prescription, but it does not change the health of the eye's surface.
In most cases, we can successfully adjust the lens to reduce or eliminate your need for glasses. However, how clear your vision feels depends largely on the cornea — the clear front surface of the eye, which provides about two-thirds of your eye's focusing power. When the cornea is dry, vision can feel less clear, with symptoms such as blur, glare, or fluctuation, even when the prescription is correct.
No amount of light treatments can fix dryness or restore clarity without treating the eye surface. If your vision fluctuates between blinks or changes throughout the day, this is almost always due to dryness — not a failed treatment. Many patients say, "I never had dry eyes before surgery," but dry eye was usually present and simply became more noticeable afterward.
Before each light treatment, we carefully measure how much glasses correction your eyes still need in the clinic. These measurements let us place that "glasses prescription" directly onto the lens itself. For this process to work well, the eye surface must be stable. When dryness is present, measurements and clarity can fluctuate, making progress feel slower or less crisp — even when adjustments are working appropriately. Patients who treat dryness consistently tend to complete the process sooner and feel more satisfied with their final vision.
If Your Vision Fluctuates or Doesn't Feel as Clear as Expected
Patience and consistency truly matter — and we'll guide you through every step.
Questions about dry eye or your treatment plan?
Call or text our office — we're happy to help.