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My PRK (photorefractive keratectomy) Recovery Experience

I read quite a few PRK recovery blogs before my own procedure, and hope that sharing my own experience helps someone else considering or preparing for PRK.

I was a great candidate for both LASIK and PRK, but chose PRK over LASIK since I didn’t like the idea of an unnecessary flap, which seemed to surprise at least one Dr I had a consult with.

I sail, so I had to schedule the procedure during the off-season.

The danger of a rope (line, on a boat) flying around and hitting me in the face and dislodging or moving the flap, however remote, wasn’t a thought I liked, so PRK it was.

I knew PRK would come with a longer recovery time, but I work for a company that allowed me to take a full week off of work to recover, no questions asked, and even was able to accommodate my location preference so that I would have more family support during my recovery instead of doing it all on my own or relying on friends.

I went to 3 consultations and felt very pushed toward LASIK at one, and the 2nd and 3rd both seemed surprised that I was so certain that I wanted PRK, but answered my questions about both procedures and the differences between them objectively.

I bought preservative-free eyedrops (day and nighttime versions) online before the procedure, minimizing the amount of things I had to worry about before the procedure or at the drug store while picking up my prescriptions.

PRE-PROCEDURE TIPS

Do your research. Look into the differences between LASIK, LASEK, PRK, and the other types of vision correction procedures your eyes are suited for. Don’t only trust the Dr’s word, look into things yourself.

Ask as many questions as you want. I asked questions about how long they’ve been doing these procedures, how many of my type of procedures they’ve done, how patients with my vision typically heal / react to my type of procedure, how big my pupils were compared to the laser treatment area (helpful for identification of possible side effects, more in LASIK than PRK but still good to know!), how the pre-procedure communication process would go, any recommended actions I should take before the procedure, what they’d prescribe me to help with pain / recovery, what laser technology they used and why they used it, and even how X laser compared to Y laser (another type of laser used by another place I was considering). If you have a question, ask it -- you’ll never regret asking too many questions.

Get more than one consultation. I went to three places and ultimately chose a Dr based on suggestions by many friends local to the area my family lives in -- that practice wasn’t even originally in my consideration set, and I’m glad I had multiple consultations to compare each practice against as it made me feel much more comfortable with the decision I made.

Don’t spend the first few days of your recovery alone. Seriously... just don’t. In my case I couldn’t see well enough to even order food off a delivery app, nevermind safely make food for myself or even a microwave meal.

The day-by-day breakdown is below...

Pre-PRK, my prescription was -2.75 in both eyes with no astigmatism in either eye. No dry eyes, either.

1 month pre-PRK: I started taking fish oil pills and Vitamin C daily, as while neither were explicitly recommended by my Dr., use of Omega-3 showed increased healing rates for the patients treated with it in this study, and based on the popularity of taking Vitamin C in other recovery blogs (and the fact that it’s not bad for you), I figured it couldn’t hurt.

2 weeks pre-PRK: I stopped wearing contacts and started wearing glasses full-time. These two weeks sucked and reminded me exactly why I was willingly paying thousands of dollars to have lasers shot onto my eyeballs in T-minus 14 days. I started trying to drink more water than I usually do on a regular basis, aiming for 72-80oz / day.

PRK day (Day 0): I was working until the very last minute before I had to leave for the appointment, and made sure to drink lots of water that day pre-procedure, as close to my 72-80oz goal as possible.

Once I arrived at the Dr’s office I took care of the normal check-in procedure which included payment in full, and was quickly ushered back to the LASIK / PRK waiting area, which was separate from the main office. They took photos of my eyes with their machine (WaveScan™ Wavefront®), which made a “fingerprint” of each eye, based on 5 (or so) photos of each eyeball.

As it turns out, my actual prescription in my left eye was -3.23, and my right eye was -2.84. After that, I took 2 Valium to calm my nerves and waited 30 or so minutes for the meds to kick in. The actual procedure started with my eyelashes being taped back, then a device placed around my eye to keep my eye open (right eye first), then numbing drops... and then the Dr took what I can best describe as a small toothbrush-like brush to my eyeball and brushed away my epithelial cells, using a small spatula to move them out of the way after he was done. This took about 30-45 seconds, perhaps more. The tech splashed my eye with water (cold, that I couldn’t feel until it hit my skin next to my eye), and more numbing drops. After that, I was directed to look at the laser (orange light, VISX® Star S4-IR™ laser), and the tech counted down in 5 second increments from 32 to 0 -- 32 seconds per eye. I could see the laser hitting my eyeball in various parts of my field of vision, but nothing hurt (then!). I was, like most people, nervous that I would shift my gaze, but I was assured that the laser would stop if I did... and it never did, so I suppose I didn’t!

After the laser was done doing it’s thing, the Doc placed a bandage contact on my eye and shifted on to the other eye. After they repeated the procedure on my left eye, the Dr. sat me up and walked me over to an exam room next to the procedure room, and checked my right eye by shining a light into it (the normal white light they shine when you get your vision checked every year), and declared me fit to leave the facility.

Other blogs mentioned a smell (from the laser hitting your eyeball + it being seared away), but either I inhaled only through my mouth or it was too subtle to notice for me... no smell! I was handed my “goody bag” by a tech, and everything in the bag was explained to my driver (my Mom, bless her), and we left right as dusk set in... me with sunglasses on already and my eyes tearing up due to the light, but not painful since the numbing drops were still in effect.

On the way home as the drops wore off I started having SEVERE pain in my right eye (my assumption is that the pain was due to the bright light they used right after the procedure to check things had gone well), and had my Mom run into the drug store with my card and ID to pick up hydrocodone, which is what they prescribed for post-op pain, and which I took as soon as I got home.

I stayed awake long enough to tearfully and quite messily stab at my dinner with my fork while wearing 2 pairs of sunglasses, put some anesthetic drops in my eyes, and then took a nap for a few hours, which helped with the pain in my right eye immensely, as well as the tears streaming down my face from both eyes.

I stayed awake for another few hours after the nap, took another pain pill and fell back asleep for the next 10 or so hours.

Day 1: I woke up quite early due to falling asleep so early the night before, and did have some pain in both eyes. I was also very light-sensitive, so much so that I took a shower that morning with only a night-light on in the bathroom... and it was enough. I started a regimen of 1 type of drops once a day (in the morning, so I knew I took them), another type of drop 4 times a day (morning, lunch, dinner, bedtime), and the anesthetic drops as often as I needed them, but no more frequently than every 30 minutes.

I went for a quick visit to my eye Dr and was pronounced to have “gotten a lot of healing done overnight” and clear to leave. He even said that I could back off of the drops I started taking that day 4 times / day to 2 starting the next day.

Once I got home, I used Siri on my Apple Watch in 30-minute increments pretty much this entire day, and couldn’t do anything more than relax / sort of sleep on the couch with my eyes closed for most of the day... always wearing sunglasses. I did also start using the re-wetting drops, but would alternate these and the drops that helped numb my eyes mostly due to my fear of dry eye rather than a feeling of dry eyes.

Focusing... when I was able to open my eyes without pain (from the light, in a dim room inside my parent’s house), I was completely unable to focus on anything closer to 15-20 feet to me. It felt like my eyes had been dilated, like they weren’t yet coordinated again for close-up sight. I slept for a total of about 15 hours that day, between daytime naps and other long night of sleep.

Day 2: More of the same, though I was less light-sensitive than Day 1. It was sunny out so we closed the blinds, and I took to my room with the blinds down and drapes drawn shortly after dinner, as my eyes were exhausted and it was painful to even keep them open, though I was able to keep my eyes open for 5-10 minute increments during the day (with sunglasses on at all times), and able to make my own food for lunch without fear of doing an appendage harm.

Pain pill and eyedrop regimen was still the same as day 1. Pain on both days 1 and 2 felt more like pain around the rim of my eyeball, back into my brain, rather than anything on the surface of my eye. that pain was pretty consistent in terms of intensity for the first 48 hours.

Day 3: Every single recovery blog said that day 3 was the worst day, but on day 3 my eye pain disappeared. I woke up and took my final pain pill, following the same drop regimen (with the modification to 2x / day for the drops I was using 4x / day on Day 1 and 2). I didn’t need the pain pills at all after that, and was even brave enough to venture outside of the house (in cloudy weather, with sunglasses on) for lunch. I couldn’t handle anything more than lunch, and returned to rest for the afternoon.

Day 4: I had my post-op appointment to take out the bandage contacts, where they tested my vision using the letter charts, took out the contacts, looked into both eyes with the bright light again, and pronounced me fit enough to stop all drops I was previously on and switch to the steroid drops I grabbed from the pharmacy pre-PRK... 4x / day until told otherwise.

Day 5: My light sensitivity has greatly decreased, though fluorescent lights still bother me quite a bit. I started back at work today, a few days earlier than expected, but only for a few hours... with my font size turned up to about 200%. I started the steroid drops 4x / day, and warning -- you can “taste” them in the back of your throat about 20-40 minutes after putting them in, so carry water with you! They taste awful!

I’m able to focus better closer to my face, though small type still bothers me at any distance. I also noticed a haze or starbursts around headlights while riding as a passenger, with older headlights appearing with a haze, like what appears around the moon before certain weather patterns hit, and other headlines appear with starbursts -- the newer ones seem to do this the most.

Despite this, I still think I can see at least as well as I could with contacts in, and I don’t notice any more or less starbursts / hazing than I’m used to when I drove with contacts in. Even on day 5, I can more clearly ready road signs in the distance, and my overall distance vision is sharper than it was when I was wearing contacts (likely as I was slightly under-prescribed, but I’ll take it!).

Day 6: For those who use VSP as their current vision insurance, I heartily recommend that you take advantage of their program benefits for PRK. My plan included a slight discount (5%, I believe) off the prices of the Dr I chose (just sheer coincidence that this particular Dr had a relationship with VSP, as I chose him before even calling VSP to ask about any benefits), AND VSP will add a benefit once your records in their system update to show that you have PRK which allows you to use your regular frame allowance for non-prescription sunglasses. This saved me about $170 in total on the sunglasses I chose, not to mention a bit off the surgery -- well worth the fee I’ve been paying for VSP to carry their insurance IMHO!

I did work for a few hours starting on Day 5 and continued this through Day 6, but my eyes quickly tired out around the 2-3 hour mark, and I didn’t push it.

I also noticed some slight dry eye sensations when I woke up on Day 6, which previous to this day I hadn’t felt before. The steroid drops got rid of that sensation, and I started using the lubricating drops about once an hour or so, even if my eyes didn’t feel dry, just in case. I do notice that just after I put the drops in my vision improves slightly, and that lasts for about 5 minutes or so each time. Encouraging!

Day 7: My week PRK-aversary! Today was my first full day back at work and by the end of the day, my eyes felt it. I started getting a headache around 3pm, even while wearing my blue light-blocking glasses (purchase as a precaution to take extra good care of my eyes while they healed post-PRK). Unfortunately there were a few very important things due at work by the end of the work day, so I powered through until they were done, then took a break from screens for pretty much the rest of the night.

My eyes held steady with regards to light sensitivity and vision quality over the last few days, and I still woke up with slight dry eye, so have continued my liberal use of lubricating drops both during the day, and the nighttime version as I go to sleep each evening.

Day 8: It snowed on Day 7 and Day 8 (boooo), and I finally felt comfortable enough to drive in it on Day 8, since it clearly wasn’t sticking to the ground. I did drive with sunglasses on, which helped me not to squint even while it was snowing, and I’ve been careful to wear sunglasses outside in every kind of weather since to protect my eyes from UV rays and block out some of the glare with my new polarized glasses. Since I sail and kayak 5/6 days a week for about half of the year, I’m used to wearing sunglasses outside in most conditions anyway, and don’t find it out of normal or too much to think about to just keep wearing them, even if I’m not on the water.

I did notice that the lights at Costco drove my eyes crazy, so I’m also wearing sunglasses indoors now if my eyes call for it.

The rest from screens really helped my eyes today, and I slept for a bit longer than usual the night of Day 7 into Day 8, I think as a result of my tired eyes from my first full day back at work.

Day 9: I decided to buy some additional “cheapo” sunglasses from Target, to serve as a backup for my usual “cheapo” pair (both “cheapo” pairs said 100% Uv protection and are polarized, though I’m not sure they’re as good of a pair as the expensive ones I bought earlier in the week).

By the end of this trip -- about 30 minutes or so in length peering at small stickers on the lenses and then trying on various pairs -- I was completely wiped out and returned home to nap for a bit. The nap helped, and I spent the rest of the day relaxing and “watching” TV, letting my eyes see but not focus on the screen while I just relaxed and enjoyed.

Day 10: Today was my first official scheduled day back at work, though I did return earlier than expected due to my eyes being able to handle it (and me being slightly bored). My eyes became tired around 3pm, just like the previous week, and I knocked off of work for a few hours due to an oncoming headache I blamed on eye strain. After a few hours away from screens my eyes felt just fine again and my headache had gone away, so I was luckily in no pain and took my evening meeting with some colleagues in APAC just fine.

Slight dry eye upon waking, small starburts / halos around streetlights and headlights at night, and slight light sensitivity have all been holding steady.

Day 11: Today was follow-up appointment number 3, and I found out that I’m currently 20/25 in both eyes! Today’s appointment included a more thorough vision test than the appointment 4 days post-op where they removed my bandage contacts, and also included new photos of my eyeballs for the Dr to review (which, of course I saved to my phone so I could look at them as well... not that I really know what I’m looking at!).

I drove myself to and from my appointment, and while I’m shy about driving at night, I do feel more confident doing so now that I know I’m well within the legal limits (which are 20/40 in the state I’m in at the moment) to do so.

The Dr and his assistants (who both had LASIK at the same practice) assured me that my slight dry eye was totally normal, that the starburst / halos are totally normal, and that I’m healing well. My next follow-up appointment originally scheduled for next week was cancelled, and I was given the all-clear to drop my steroid drop use down to 3x / day for the next month, then 2x / day for the next 2 months after that. Other recovery blogs I read noted that their vision started to rapidly improve once they started tapering off the steroid drops, and I’m curious if I’ll see the same.

My computer screen is still at about 150% and my other side effects are still holding steady, just like they were over the previous few days.

Day 12: I was still dancing due to my 20/25 vision news so soon after the surgery, not to mention the birth of my nephew -- whom I was able to visit in the hospital without light sensitivity and with great clarity so I could see his little face! My eyes were a bit drier than they were on Day 11, but the humidity in the air also dropped very low, which may have something to do with it... maybe not. Either way, the re-wetting drops were still just fine, and per my Dr’s orders I officially started to wean off the steroid drops by using them only 3x / day. Progress! I still needed to knock off work a bit early (around 3:30-4ish), as my eyes were quite fatigued, but they didn’t give me a headache unlike previous days.

Day 13: I drove at night for the first time! I noticed that headlights, especially the new kind v. older cars, cause slight double vision if I look straight at them, whereas streetlights and older-style headlights only have halos. The double-vision isn’t too bad, really. Aside from being moderately annoying I can still tell how far away the car is, if they have their brakes on or not, etc -- I just see two outlines of them instead of one. I did feel completely comfortable driving at night with no dim vision, no significant glares or halos, and only the moderately annoying double brake light outlines on newer cars. Though, since my overall vision has improved so much, I dare say I felt more comfortable driving than I did at night when I depended on contacts or glasses as everything is generally more clear now. I did work a full day, and while I made sure to take a solid AM break, lunch break, and PM break, I did notice that this day was the first day that I was able to get through work without a headache or eye fatigue -- all the way until after 5pm -- success! My screen size is still between 125 - 150% depending on the program, and I’m still annoyed that services don’t do a better job of making their user experience pleasant (or even usable!) at larger resolutions, even slightly larger ones!

Days 14-32 (weeks 2-4): Not much to report these days, as thankfully they’ve all been very similar. I still don’t have a lot of light sensitivity (but wear sunglasses in pretty much every outside condition, including rain and snow), do still see mild halos and starbursts, still wake up with dry eyes, and still am using the same non-preservative eyedrops (day and night versions) that I bought in December and thought I’d plow through in less than a week. A month later and I still have about half of them left!

I do notice that some days, while watching TV for example, one eye is “better” than the other. When watching the new Star Wars on Christmas Day, for example, my right eye was a bit fuzzy and left eye was more clear. Enough to be annoying but not enough to ruin my sight. The opposite has been true when watching Mr. Robot or other shows at home, as I’ve noticed my left eye being slightly fuzzier than my right at points, and one my right fuzzier than my left. It seems to even out and this fuzziness is always gone either a few hours later or overnight, but it is something I’ve had to get used to.

I also noticed that when coming back to my home location (since I had the procedure elsewhere), it’s the small things I notice more... like that I can see the “subway line arriving in” signs much more clearly now than before, or that the buildings outside my apartment windows in the distance are much more clear (Including Lady Liberty! Always a great sight.), and that it’s really nice to be able to see waking up and going to bed -- I feel like I’m getting used to things being crisp rather than blurry and my brain is finally starting to accept that I can’t see due to contacts being in, but rather because my eyes are that good again!

I’m taking reading slowly, as the first book I tried to pick up looked like it had VERY small typeface (my Mom assured me it was normal, as did a few other friends), and I do get mild headaches if I read more than a chapter at a time.

I’m still taking steroid drops 3x / day and use my daytime drops twice per day on average, and the night-time drops once as I’m going to bed. I don’t take any other painkillers, and I have kept up my Omega-3 (fish oil) and Vitamin C pill daily habits, as I promised myself I would do until 3 months post-PRK.

My next check-up is in about 2 weeks, and in between now and then I’ll be heading into really, really cold weather (-F temperatures!), so I’m making sure to call my Dr to see if there’s anything I need to do for such extreme cold... and of course bringing my sunglasses.

Days 32-41 (weeks 5 & 6): The last week has brought small but very noticeable improvements in my sight. Due to the weather, I’ve been working from home more often than I usually would during a typical week, but when I’m in the office and people are projecting onto a screen across the room, I’ve noticed that I can see the small fonts almost perfectly, and the larger fonts are crystal clear.

This is very noticeable for me, as even when I was wearing contacts I had trouble seeing smaller fonts (or even larger ones!) due to (I think) wearing contacts slightly too weak for my prescription, so between being able to see more clearly for further distances plus being able to read what’s up on the screen so well, I’m constantly being reminded of how much my vision has changed in only a short 6 (or so) weeks.

Reading is still a bit tough for me, and print seems harder than on a screen for some reason. I’ve also had to make a few small repairs to clothes (sew buttons back on, etc.), and I still feel practically cross-eyed when I try to focus on small things with very little color differentiation up close.

My next check-up is in 8 days, and I’m looking forward to my next vision test to see if my vision has improved any since the 20/25 it was measured at about a month ago, and also I’m looking forward to asking my Dr. when my close-up vision should become easier for me and not feel so strenuous! I’ve been trying to acclimate my eyes and have been making a point to read things in print on a daily basis... I’m not sure if it makes a difference, but at least it’s something I feel like I’m doing to help.

As of today I’m only on 2x daily steroid drops, which will continue for the next 2 months.

My eyes are still slightly dry when I wake up, but they’re less dry some days compared to others, which is an improvement from very dry every morning. I’m still using the same box of preservative-free overnight drops I bought pre-PRK, and I have about a box left of the preservative-free daytime drops (I bought 2 to start with), so I anticipate those lasting me another month or two before needing to switch to the regular “in the bottle” eyedrops. Right now I’m only using drops a few times a day, more at night when it seems like I’m more sensitive to a dry eye feeling than during the day.

I still have halos and starbursts, and those have remained largely unchanged since I first noticed them after the procedure.

Days 42 - 51 (week 7 - some of week 8 post-op): I officially have perfect / better than perfect vision! My eyes are both independently 20/20, and working together I passed the test at the 201/5 level with flying colors. YYYEEESS! I did mention my continuing morning dry eyes to my Dr and he told me about an OTC medication I could buy (Refresh PM Ointment), which I bought that day but only could find the generic for. So far, so good, as I’ve used it for 2 nights and have so far not had a single dry eye morning yet.

Starbursts and halos are holding steady at “just like when I was wearing contacts”, so solved as far as I’m concerned. I haven’t had to sew any buttons lately, but I’m officially back down to 100-110% on my computer, tablet, and other screens, which indicates to me that my close vision is still continuing to improve. It’s not perfect yet, so I do plan on bringing this up at my 3-month post-op appointment in about 6 weeks or so if it’s not back to normal. Right now, that’s my biggest worry about my recovery.

Going forward I’ll be using X weeks instead of days, since days are getting awkward to count!

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