My PRK Experience: Six Month Postop

I had my six month post op appointment yesterday. On the visual acuity test, I tested 20/20 in both eyes and with both eyes open I could read the 20/15 line without difficulty. In fact, they didn’t test my eyes individually at 20/15, but I believe I could have easily passed. Incredible results – I was actually surprised since my last check-up, several months ago, had me testing at 20/25.

My night vision is crystal clear without halos or other distortions. I haven’t had any other complications like dry eye or floaters. Overall the results are better than I could have imagined. Strangely, I still have intense pain when I get an eyelash stuck on the ablated area of the cornea. My surgeon explained that this is due to the epithelium and it may take up to a year to heal thoroughly. Its a minor issue and I’d say the surgery was worth it.

I have another appointment in 6-months to mark the 1-year check-up. My vision has been stable for three months, and I don’t expect that to change.

My PRK Experience: Over a Month Postop

Left Eye: post-op day 47
Right Eye: post-op day 33

I had another check-up Monday and it went well. I’m currently -0.25 diopters (20/20) in my left eye and somewhere between -0.25 and -0.5 diopters (20/25) in my right eye. Visual acuity is mostly stable with some (almost imperceptible) fluctuations in my right eye. Both eyes continue to appear healthy with no signs of haze or other complications. While I’m disappointed that my right eye is not 20/20, I understand that I  really need to reevaluate at the 6-month mark, because these subtle changes will continue until then. I’ve also completely discontinued using eyedrops (including steroid drops) and its possible that my right eye is asymptomatically dry, reducing visual acuity.

Still, 20/20 and 20/25 is nothing to complain about. I find myself starting at signs in the distance and expecting to read them no matter how small the text is. When I can’t read the text I start to worry that my vision is deteriorating – fortunately its all in my head.

My PRK Experience: Right Eye Day 3

Left Eye: post-op day 17
Right Eye: post-op day 3

Just a quick update on my right eye. Its going much like the left eye did – the worst day being yesterday accompanied by lots of pain, blurriness, and ghosting. Today its been mostly pain free, but the blurriness still remains. Hopefully if my eye is healed enough, I’ll get the bandage contact lens removed tomorrow and I should be seeing very clearly by the end of this week. I also get to reduce the application of Pred Forte in my left eye to two drops per day tomorrow.

It will be interesting to see if my right eye reaches 20/20. My surgeon had to make a decision on how to treat my right eye because my optical perscription determined with the phoropter differed from wavescan data by 0.34 diopters. He decided to under correct by 0.25 diopters, opting to trust the wavescan machine. Either way, its better to be under corrected than overcorrected and I should know where I stand by the end of the week.

My PRK Experience: Right Eye Treated (No More Monovision)

Left Eye: post-op day 15
Right Eye: post-op day 1

After two weeks of suffering monovision, yesterday I finally had a PRK performed on my right eye. The procedure went much as it did for the left eye with the only difference being my immediate post-op vision was blurry and smudged with an almost grayish glow. The staff in the surgery room assured me that every eye is different and my vision would clear up soon. They were right. A few hours after the procedure, the blurred vision was gone. Strangely, the ice-cold eye drops didn’t cause as much pain this time, while my post-operative pain was much greater than the left eye. On my way out of the surgery center yesterday, I threw my crazed, scratched glasses in their trash. You have no idea how good that felt!

This morning I had my day 1 post-op doctor visit while en route to the FIRST Robotics Competition in Portland. Amazingly, my visual acuity was 20/25 and it has remained very sharp throughout the day. My surgeon noted that my epithelium had healed about 30% and again asked me to take the Pred Forte and Zymar four times per day. I also have some Bromday drops for pain, though these drops apparently slow the healing process so they are to be used sparingly. While my right eye vision was excellent throughout the day, I am starting to see my visual acuity worsen significantly, both for distance and near vision. As with the left eye, the healing epithelium causes a sharp but temporary decline in vision as it slowly covers the surface of the cornea.

I had my visual acuity checked for my left eye this morning and it was still at 20/20, though just barely. This is not an unexpected result since my visual will continue to fluctuate for the next few months.

My PRK Experience: Day 11 Doctor Visit

Yesterday I had my one week post-op appointment, although it was day 11 after the surgery.  The vision in my left eye tested to 20/20 +2 (Meaning I had 20/20 vision but was able to read two of the characters from the 20/15 line). They told me that my visual acquity is excellent given that my eye is early in the healing process. This is welcome news although I understand PRK has a very long healing process and my vision will continue to fluctuate in the coming months. These visual changes can be attributed to both the steroid eye drops and dryness. Apparently, toward the end of the day, the eye tends to dry out creating subtle disturbances in vision. I haven’t experienced any symptoms of dry eye, however if I treat with preservative-free drops, my vision becomes crystal clear again (at least temporarily).

My surgeon didn’t notice any signs of haze or infection and asked me to discontinue taking the antibiotic eyedrops. He asked me to taper my dose of the steroid drop. Three times per day this week, two next week, etc. He was still able to see the gray-colored collection of cells where the epithelium fused, though I am not experiencing any visual disturbances. Early on, this created some ghosting and a smudge-like blur effect.

I’m scheduled to have my right eye lasered this Thursday and if all goes well I’ll be free of glasses.

My PRK Experience: One Week Post-op Recovery

Its been a week and a few days since my PRK surgery, and my eye is healing quickly. I don’t have any near vision blurriness anymore and I’m guessing my distance vision is at least 20/20 since my left eye’s visual acuity is equal to my right eye with the corrective lens. In just 48-hours the initial post-operative farsightedness has resolved itself. In fact, because the vision in my left eye is so superior to my right, I recently became left-eye dominant at all distances. In the past few days, when I was experiencing post-op hyperopia, I had difficulty reading a computer screen with my left eye. Even at that near distance, the text on the screen was almost unreadable, so I resorted to covering my left eye in order to work without a headache. Now that I’m left-eye dominant, my right eye is seeing blurry text, while my left eye is sharp. In order to focus with my right eye, I have to cover my left and then concentrate on focusing with my right. Just crazy. My solution is simply to wear my old glasses with the left lens removed. This way, both eyes have the same prescription.

The optical aberrations seem to have abated as well. I don’t have ghosting issues anymore, in any lighting condition. I still see very faint halos and starbursts in my left eye, but they are significantly less intense than my right eye with corrected vision. My glasses, for some reason, create very large starbursts from bright light sources (e.g. headlights of oncoming traffic). Even without correction, my untreated right eye still produces more visible optical distortions than my left. Perhaps this is due to the wavefront technology of the Visx laser.

I’ll learn my exact visual acuity on Monday. Fortunately, my vision is fluctuating much much less throughout the day. I find that my left eye is at its worst in the evening. This may be due to the steroid drops, as I’ve read that eyesight tends to stabilize once the drops are discontinued. For now, I can’t wait until next Thursday when I have the right eye done. I don’t know how much longer I can stand such lopsided vision!

My PRK Experience: Day Six

Today marks a significant improvement in my recovery. I woke up this morning with my distance vision very sharp and my near vision improved, but still blurry. What a difference a few hours makes! I suppose most of the healing happens during sleep, emphasizing the need for uninterrupted rest during recovery. While my vision did fluctuate again today, the ups and downs were not as drastic, though my near vision degraded as the day wore on. When I put my glasses on (with one lens removed), I could see that my distance vision is not yet 20/20, but close (I’d guess 20/30 or 20/40).

I drove home from work in twilight and didn’t notice any night-time optical abberations that many post-op PRK patients complain about. I do still see halos around lights, but they are very faint and diffused, and not at all distracting. Strangely, my glasses were responsible for creating large starburts in my untreated right eye, clearly visible in the headlights of oncomming traffic during my drive home. I attribute this to the fact that my glasses are partially crazed from heat exposure.

I addressed two concerns to my surgeon in a quick phone call earlier today: possible over correction in my left eye and the fact that my pupils are different sizes. He alleviated both concerns, explaining that pupil size can vary as much as one millimeter in healthy people, and that variation is actually quote common. He also said my near vision should improve with time, and it is probably not due to over correction because it would be difficult to accidentally over correct an eye with such a low myopic prescription. Given the fact that I made such significant progress in the past 24 hours, I’m going to wait a bit before I become alarmed. They will also test my near vision at my next post-op appointment on Monday, so that should put to rest any questions about over correction. I was also asked to pour on the preservative-free lubricating drops, even though my eye doesn’t feel dry. Apparently the cornea can dry out easily after surgery and that can affect vision and slow healing. These drops are insanely expensive, but its my eye after all.

My PRK Experience: Day Five

My distance vision has been fluctuating all day with significant changes occurring every hour. It changes from slightly worse than my untreated eye to significantly better. My close vision has been consistently blurry though. I haven’t had any pain or symptoms of dry eye and I haven’t needed the lubricating drops today.

My PRK Experience: Day Four

My vision has fluctuated quite a bit today from blurry in the morning to less blurry in the afternoon. Now its back to “more” blurry but roughly equal to my uncorrected, un-lasered right eye. This greatly reduces the feeling of dizziness from the past few days. I didn’t experience any pain today either, so I’m definitely on the mend. I have noticed that my eye tends to worsen after an application of steroid eye-drops, but I can’t discontinue these drops since they slow the healing process and prevent scar tissue from forming.

Earlier today, at my post-op checkup, my surgeon removed the bandage contact lens after convincing himself that I had healed enough. He explained the epithelium had mostly regrown except for a small spot of opaque cells in the center. I should expect the healing trend to continue and these cells to smooth out and become more transparent in the next few weeks. At the appointment, my vision tested to 20/60, a definite improvement from the day before.

As for the optical aberrations, I don’t notice the star bursts or ghost-images anymore, although the halos persist. Rather than a solid ring of light, they appear as a soft, warm glow around light sources. I also notice that my distance vision is much crisper than my near vision, though both are blurry. This may be a sign that I had some mild presbyopia that was hidden by my nearsightedness, or it could mean that I was slightly over corrected by the laser. Hopefully this will also resolve during the healing process.

My PRK Experience: Day Three

My surgeon suggested that the worst day would be yesterday (day three) and he was right. I had very little pain today. In the morning I had some dryness that was quickly alleviated with some drops. I don’t feel the sand-in-eye pain at all now, its quite comfortable. Tomorrow I’ll be visiting the clinic again to have the bandage contact lens removed. Its possible that I’ll feel the scratchy pain again since the lens is providing protection for my eye as it heals.

While that was the good news, the bad news is my vision hasn’t improved at all. Its still incredibly blurry with a 9 o’clock ghost image and large halos around all lights (even during the day). I definitely cannot drive like this and I find it difficult to walk without feeling dizzy. I almost want to wear an eye patch and do the pirate thing for a few days since this just isn’t working. I’ve been told this is normal and I should expect blurry vision for another few weeks. Again, I’m glad I did one eye at a time!