Is a scratchy or gritty feeling normal after LASIK?

What's normal

The FDA says that immediately after the procedure your eye may burn, itch, or feel like there is something in it, and that both eyes may tear or water. The Academy says that for a few hours your eyes may feel scratchy or feel like they are burning. This is the flap edge and the cut corneal nerves, not something stuck in your eye.

The single most important response is what you do not do. The FDA says you will instinctively want to rub your eye, but do not, because rubbing your eye could dislodge the flap and require further treatment. Use artificial tears instead, which the FDA says you may be advised to use to help lubricate the eye, and wear the shield as instructed.

After the first day, a mild gritty or sandy feeling that comes and goes is usually dryness. StatPearls reports dry eye in roughly 85 to 98 percent of patients one week after surgery, falling to around 60 percent at one month, because the surgery interrupts the tear reflex.

Sharpest in the first few hours, much better within the first few days, then intermittent dryness-related grittiness for weeks to months.

When it stops being normal

A foreign body sensation that is getting stronger over the first day or two, especially with blurring, is a specific pattern worth acting on. StatPearls describes diffuse lamellar keratitis as presenting with blurriness and foreign body sensation, usually one to two days postoperatively, in as many as 1 in 50 cases, resolving with appropriate corticosteroid treatment after about a week. The surgeon needs to see it to treat it.

The FDA says contact your doctor immediately, and do not wait for your scheduled visit, if you experience severe pain or if your vision or other symptoms get worse instead of better. A sudden sharp scratchy feeling after rubbing, bumping, or getting hit in the eye should be treated as urgent because of the flap.