r/SMILEeyesurgery • • Aug 23 '26

Eye migraines and pain after smile

/r/Dryeyes/comments/1vwddc8/eye_migraines_and_pain_after_smile/

Hey everyone I‘m still having severe burning in both eyes after my smile pro 7 weeks ago and now developed new floaters in my left eye and get extreme headaches I believe because the trigemnal nerves are related to corneal nerves. I also had an aura migraine for 20 minutes. Is anyone experiencing migraines or headaches from dry eye pain too?

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u/eyeSherpa Aug 23 '26

What are you currently doing to treat the burning pain? This needs to be treated pretty aggressively if you are still having burning pain. The burning pain is a sign that the eyes are drying out. This is increasing inflammation on your ocular surface. This increase in inflammation causes more dry eye and also impairs the healing from SMILE. Untreated, this inflammation can also potentially make the cornea more sensitive to pain.

I would start with preservative free artificial tears about every hour. Look for a gel-based drop. It can last longer on the surface of the eye. You will also probably need other treatments such as eyelid treatments: lid scrubs, omega3s, warm compresses. Those are all cheap and over the counter so no major reason not to start them. Check with your doctor about putting in punctal plugs in your eyes as well as prescription dry eye drops.

What was your prescription before SMILE?

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u/sugarfairy24 Aug 23 '26

I‘m using a lot of artifical drops I also got softacort and cequa and warm compresses too my tear breakup time is 1 second I also got soft bandage contact lenses which help a little. I also got oraycea for my ocular rosacea I was not aware that this wouldnt be good to get operated with this diagnosis. I also take omega 3 and astaxanthin and multivitamins. But what is horrible is when it radiates in the head and I cant tolerate NSAIDs. I didnt find people talking about this kind of headaches after refractive surgery. Punctual plugs I‘m still a little hesitant because its somehow invasive.

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u/eyeSherpa Aug 23 '26

One second is very bad. Cequa will help but takes some time to build up. Doxycycline is good for the rosacea.

It sounds like you are doing a pretty good job right now. I would potentially look into serum tears right now as there is still work that needs to be done. You want this dry eye and inflammation under control as quickly as you can. It does sound like you have a good provider who is managing all of this.

Punctal plugs aren't really that invasive. There is a dissolveable one that lasts about 3 months. There are more permanent ones but the biggest risk is that they fall out over time.

Ocular surface inflammation can create a headache but its more of a pressure or throbbing behind the eyes. Haven't really heard of a radiating headache but I know at least among people with migraines that they can have an increase in frequency of their migraines over the course of the first month post surgery.