Can I play video games after LASIK?

I don’t know…can you? Should you? Don’t worry, you can enjoy playing video games after LASIK, watching TV after LASIK, and resuming computer use after LASIK! There’s no evidence that using your computer after LASIK causes any harm to your eyes. You may blink less frequently, which has been shown in a recent study to cause some dryness after 2 hours of screen time with an OLED screen of a smartphone, but not in an eINK screen like on a kindle. https://pubmed.ncbi.nlm.nih.gov/33202098/

I’ve read several opinions online to answer theses questions: Can I use my phone after LASIK?, Can you watch TV after LASIK?, and Computer use after LASIK?

Video games after LASIK

It’s like answering the question that my patients often ask: Can I blink? And sometimes, I reply jokingly, “ whatever you do, do not blink for the next two days!“ Silly, right? The same applies for using your phone, computer, or watching TV after LASIK. Of course you’re going to do it. But the good news is there is no evidence that this affects your vision long-term in any way. Typically your eyes will get dryer after laser vision correction for a temporary period of time from 1 to 6 months. I have performed over 80,000 LASIK procedures over 20 years, and I have observed that nearly everyone has some degree of dryness after laser vision correction surgery. It’s temporary, but there are some risk factors that increase the intensity and/or duration.

Risk factors for increased dryness after laser vision correction

• Female gender: There is really no doubt that women have more dryness than men. Before or after vision correction surgery, studies reflect increased dryness in women over men. After laser vision correction surgery, whether it’s LASIK or PRK they tend to have dryness much more than men. It is highly individual, but there is no doubt that women are affected more.
• About 95% of our patients will report some degree of temporary dryness or fogginess due dryness after LASIK or PRK surgery. 22% of people have symptoms of dryness preoperatively! Many people feel that dryness symptoms are improved after LASIK or PRK. Less than 3% feel they have dryness one year later.
• Medications: There are several categories of medication that can increase the risk for symptomatic dryness after laser vision correction surgery. One category is incontinence medications such as Detrol (tolterodine), which can cause dry mouth, dry eyes among other side effects.
• Medications: Medications for acne, such as Accutane or spironolactone can cause unexpected dryness in young people. This should be taken into consideration when determining the best procedure for a patient. I recently treated a young woman with ICL instead of LASIK due to spironolactone related dryness that had prevented this patient from comfortably wearing contact lenses. She had had multiple dry eye treatments with a specialist in dry eyes. She had a perfect result and felt amazing after not having contact lenses in her eyes.
• Lagophthalmos: This is a ten-dollar-word for incomplete eyelid closure. It can cause fairly severe dryness even in young people. In my practice I have specifically seen severe dry eyes in young Asian women. It can cause a very dry band in the space between the eyelids that can be totally normal above and below this space but severely dry in what’s called the interpalpebral fissure, the space between the eyelids. Sometimes a spouse or partner will confirm that the patient sleeps with her eyes slightly cracked open. This same condition can be caused are iatrogenically-another $10 word for “caused by the doctor“ in folks who have an aggressive blepharoplasty (a surgical lifting of the eyelids). It’s most often seen in women also, and naturally in older women who are at risk for dry eyes anyway. It can be quite severe and difficult to manage if their eyelids simply don’t close completely when the patient attempts to blink.
• Age: As we age, the ocular surface has a tendency to dry out more. We don’t produce as much volume of tears, the oil glands in our eyelids can potentially be plugged, inflamed, or both. The aqueous (water) component of our tears is decreased also. Our eyelids don’t work quite as well either. Dryness is extremely common as we get older, typically in our 50s. It’s especially noticeable in women 50 years old and older. It’s no coincidence that menopause occurs at an average age of 51.4 years old, and dryness increases at this same age. Women produce much less volume of tears after menopause. The hormonal changes likely also affect the production of oil in our eyelids at this age and older. Lid eversion or inversion (turning in or out from the surface of the eye) can also affect our ability to spread tears across the surface of our eyes. The medical term for this is ectropion (turning out) or entropion (turning in) so that the edge of the eyelid is malpositioned and the blinking doesn’t spread the tears over the surface of the eyes adequately. All of this combines to create a greater risk of dryness after Lasik as we get older. At SharpeVision Modern LASIK, we usually recommend lens-based surgery such as cataract surgery or refractive lens exchange surgery.

Using computer after LASIK

There is absolutely no reason why you cannot use your computer after Lasik. There are just a couple things I have always been true postoperatively regarding Lasik: use the medicated drops as directed by your doctor, and don’t get poked in the eye. Everything else you can do in my opinion.

Things that will increase your dryness after LASIK

There are several things that will most likely increase the dryness of your eyes after LASIK or PRK, but that do no long-term harm. Let’s face it, everyone is going to use screens after Lasik or PRK, but there will be no long term ill effects.

• Dehydration: If you feel your eyes burning and blurring, try drinking some water. It can improve the dryness quite quickly.
• Evaporation: Evaporation can rapidly cause loss of water from the surface of your eyes, which can cause blurring, burning, blinking and fogginess. Three causes of increased evaporation are:
  • Humidity: Places that are high altitude, or deserts (such as Santa Fe New Mexico) will dry out your eyes more quickly than low and humid places (like any tropical island). This is because less water is carried in less heat, less air (up high)
  • Heat: More heat causes more evaporation. Colder air can carry less water. Which is better for dryness? It depends, and this is why when we talk about humidity, we’re actually talking about “relative humidity” which means the percentage of moisture in the air relative to the heat of the air. Since hot air can carry more water, there is more moisture in warm air at 50% relative humidity than cold air at 50% relative humidity.
  • Volume of air: Your eyes will dry out more in the wind than inside with still air or with sunglasses where there’s less air flow over your eyes. I recommend sunglasses when outdoors even if there’s not a lot of sun.
• Screen time: Yes, using computer after LASIK may cause your eyes to dry out due to decreased blink frequency, and therefore less frequent rewetting of the surface. Your eyelids are amazing. They act like a windshield wiper with washer every time you blink. When you use your computer after LASIK, the surface of your eyes is more like a rock under the water-it Will dry out more quickly. Before LASIK, your eyes are more like a moss-covered rock-it takes longer to dry out. But that microscopic “moss” as described in this article https://onlinelibrary.wiley.com/doi/full/10.1111/j.1442-9071.2012.02758.x actually do exist and are temporarily reduced after LASIK.
• Can you use your phone after LASIK? Of course, just keep your eyes closed! Just kidding, the question is more like: Can I watch TV after LASIK? The answer is still “Yes.”  The surface of your eyes will dry out more quickly, but it won’t damage anything or significantly affect your healing time.
• I recommend the following when using your phone or regarding screen time after LASIK.
  • Take more frequent breaks as suggested in the 20-20-20 rule: take a break at least every 20 minutes to look at something 20 feet away for 20 seconds. It’ll give your eyes sometime to recover as you blink more frequently.
  • Hydrate well
  • Use artificial tears frequently
  • Move a bit farther away from the screen
  • Ask your doctor about additional therapy if dryness persists or is more severe than can be controlled with just artificial tears
• What about computer glasses after LASIK? The blue blocker filters that you may have seen certainly don’t seem to hurt anything, and if you feel like they help, then by all means, get yourself a pair. I discussed these in a previous post https://sharpe-vision.com/blog/digital-eyestrain-do-those-blue-filter-computer-glasses-work/
• What about reading glasses? Reading glasses will be necessary for anyone over the age of about 45 and up if and only if you have excellent distance vision in both eyes. Those who are nearsighted, or have monovision and are over the age of 45 should be ok without reading glasses. That said, it can and does take some of the strain off our focusing muscles even in younger patients who have excellent distance vision. So although I’ve also discussed presbyopia in a previous blog post https://sharpe-vision.com/blog/what-is-presbyopia/, you can wear blue blocking reading glasses and hopefully decrease the symptoms of dry eyes if you have them.