The case report shows how tear film affects the quality of vision after laser refractive surgery. The patient saw 6/6 after LASIK but still complained of blurred vision. Routine dry eye examinations, Schirmer test, corneal staining, and Meibography showed no problems other than the truncated BUT. He was then examined on an HD Analyzer, analyzing the quality of vision. Vision quality in OD and BUT were pathological. Thus, dry eye impairs OD vision, even though the patient is already being treated. What next? The Meibomian glands were treated with the LipiFlow device, which combines heat and mild pressure on the eyelids in the Meibomian glands. Three months after the Lipiflow treatment, the quality of the tear film and vision improved.
Conclusion: dry eye can impair the vision quality after Lasik, and intensive treatment is needed to resolve the problem.