PurposeTo evaluate the incidence and severity pattern of dry eye after phacoemulsification.SettingKing Chulalongkorn Memorial Hospital, Bangkok, Thailand.DesignProspective descriptive study.MethodsSamples were collected from ninety-two uncomplicated cataract patients who were 18 years old or older. Dry eye incidence and pattern were analyzed at days 0, 7, 30 and 90 after phacoemulsification using (1) Ocular Surface Disease Index (OSDI) questionnaire, (2) tear break up time (TBUT), (3) Oxford ocular surface staining system, and (4) Schirmer I test without anesthesia.ResultsSeven days after phacoemulsification, the incidence of dry eye was 9.8% (95% confidence interval; 3.6–16.0%). The severity of dry eye peaked seven days post-phacoemulsification and was measured by OSDI questionnaire and all three clinical tests. Within thirty days and 3 months post-surgery, both the symptoms and signs showed rapid and gradual improvements, respectively. However, dry eye post-phacoemulsification was not significantly associated with sex and systemic hypertension (P = 0.26, 0.17 and 0.73, respectively).ConclusionsThe incidence of dry eye after phacoemulsification was 9.8%. Symptoms and signs of dry eye occurred as early as seven days post-phacoemulsification and the severity pattern improved over time. We recommend that ophthalmologists should evaluate patients both before and after phacoemulsification to prevent further damage to the ocular surface and able to manage the patient promptly and effectively so the patient will not have a poor quality of life and vision due to dry eye syndrome.