LASIK Surgery and Headaches

Introduction to LASIK Complications

• The American Academy of Ophthalmology Refractive Surgery Guidelines do not list headache as a recognized complication, but LASIK can indirectly cause headaches through several mechanisms, including corneal neuralgia, dry eye-related eye strain, and visual disturbances that trigger headaches 1, 2

Direct Neurologic Complications

• Corneal neuralgia is a documented post-LASIK complication that can manifest as chronic pain requiring multimodal local and systemic treatment beyond standard dry eye therapies, according to the American Academy of Ophthalmology 1, 2

Indirect Mechanisms Leading to Headaches

Visual Disturbances

• Quality of vision under low-light conditions is reduced after LASIK, with halos and glare particularly in patients with smaller treatment zones or high refractive corrections, which can trigger headaches through sustained accommodation effort and visual stress 1
• Less than 1% of patients report difficulty performing usual activities due to visual symptoms, as reported by the American Academy of Ophthalmology 3

Clinical Approach

• When evaluating post-LASIK headaches, it is essential to assess for corneal complications such as flap striae, epithelial ingrowth, and diffuse lamellar keratitis, as recommended by the American Academy of Ophthalmology 1, 2

Treatment Approach

• For dry eye-related symptoms, the American Academy of Ophthalmology recommends supplemental lubrication, topical cyclosporine, and punctal occlusion 1
• For visual disturbances, ensuring refractive stability and considering enhancement only after stable refraction is crucial, as suggested by the American Academy of Ophthalmology 4