The PRK Recovery Experience

I did PRK laser eye surgery on September 24th, 2015, at Bochner Eye Institute in Toronto. In this blog post, I’ll document what I’ve discovered. Hope it helps someone out there!

Why PRK and not LASIK?

The most important thing to know about PRK is that the recovery process for it is much, much longer than LASIK. So why the hell would anyone choose it?!

PRK-vs-LASIK

PRK is actually the “original” LASIK. It’s very straightforward – shave off some thickness from the surface of your cornea to correct the refraction of light into your eye. The problem is that it’ll take several months to regrow the surface of your cornea a.k.a. the epithelial layer of the eye. LASIK was invented specifically as a way to eliminate this lengthy healing process. By cutting a thin flap in the cornea, the thickness can be shaved from beneath, and no need to regrow the epithelial layer! Unfortunately, LASIK doesn’t work for a lot of people because there is not always enough thickness in the cornea for both (a) the flap and (b) the corrective shaving. And thus, PRK remains a staple in the laser vision correction industry despite the obvious advantages of LASIK. Okay, so if you have a bad prescription and/or thin corneas, your doctor may have recommended PRK to you. So, how bad is the recovery for it, really? Should you do it? Keep reading below to get the full picture. The explanations that even the best surgeons give are incomplete and there is no substitute for a full length testimonial.

My Experience

Day 1 – The Surgery

I found that the surgery was actually very entertaining! It’s kinda like your eyes are going through a car wash. After popping a Valium, you relax and just lay on your back while the surgeon does everything. Thanks to plenty of freezing drops, you can’t even tell when the surgeon touches your eye – you just watch it all unfold like a movie.

buffing-toolShe starts the surgery by clamping your eyelids open. Every 30 seconds or so she’ll spray some water on your eye to keep it moist. She uses this polishing tool to rub the epithelial layer off (much like a buffer for your car’s waxing job, shown to the right). More water spray. Then before you can blink, the laser correction is done. Really fast - maybe 20 seconds. You can’t even see it happen, and how could you – if you could see the laser that would mean it’s cutting your retina, not your cornea. She now squeegies your eye to remove any debris from the laser. More water spray. Apply bandage contact lense. Remove the clamps. Done. Next eye. After both eyes are complete, you sit in the waiting room just long enough to make sure you feel okay and for a quick checkup with the doctor. When all is well, you’re free to go until the next checkup!

For the record, my surgeon was Dr. Albert Cheskes, who is great. We even took a glamour shot outside the operating room right after the surgery was complete!

Dr. Albert Cheskes and Anson Kao

Day 2 - Regrowing the epithelial layer

The same day of the surgery, I didn’t experience any pain. In fact, on the way home from the clinic, I was comfortable enough to drop by the grocery store with my girlfriend to stock up on snacks. There was a haziness over my vision, but I was able to read text at all distances, which felt great.

It was only on the evening of the next day that I started to experience pain. The reason for the pain is that the cells in your epithelial layer are slowly replicating and spreading back over your cornea. As the cells grip onto your cornea, it’s kinda like your eye is literally poking itself. This was really painful, very similar to the stinging feeling you get when cutting open onions in the kitchen or perhaps getting pepper sprayed, except it doesn’t go away for maybe 48 hours. There’s no way around it – just take the pain killers provided, try to sleep it off. Think of it like the muscle soreness/pain in the days after a workout – no pain, no gain. Visualizing the surface of my eye being healed back to normal definitely helped me get through it. By the morning of day 4, the pain had mostly subsided. I would experience only occasional stings throughout the rest of the day (presumably, the last few cracks in my epithelial layer being filled in).

Day 5 - Learning to live away from the keyboard

By day 5, it was pretty obvious that the epithelial layer had regrown. It seems like the surgeons have figured out that it usually heals within 5 days, because they had prescheduled my followup appointment for day 5. When I got to the clinic, the surgeon took out my bandage contact lenses. We did a quick look at the Snellen chart, and I was able to distinguish characters on the 20/40 line, but not without a some real difficulty which I’ll explain below.

As soon as the pain had subsided on day 4, I started paying close attention to how well I was seeing. By looking at very distinct shapes, such as the time on an LED clock, it was easy to determine exactly what was happening with my visual acuity. Since I’m a photoshop wiz, I made some mockups so you can see for yourself.

led-clock

Shown is a pretty close approximation to what I was seeing with my right eye. As you can see, there’s double vision, which makes it very hard to read text without getting a headache. My left eye has the same amount of ghosting but without the double vision, which makes reading bearable. Presumably the double vision is because of a line that formed in the surface of the right eye. I’m praying that this problem will smooth over sooner rather than later, because it makes it very difficult to get anything productive done without getting a serious headache.

During this first week and possible through to the second week, you will most likely not be able to read or watch anything. Make sure you’ve prepared some audiobooks, stand-up comedy, or podcasts to tide you over until week 2. As a creator myself, I was INCREDIBLY bored during this first week. There’s only so much you can listen to before you feel like a prisoner in your own home. Just remember it’ll be worth it!

Day 9 - Smoothing the epithelial layer

On the morning of day 9, I woke up to find that the double vision in my right eye has finally disappeared!! Just some directionally ambiguous hazing, but this is MUCH more bearable than the ghosting. The funny thing is, I think it’s because I rubbed my eye the night before. One of the rules of laser eye surgery is that you must avoid rubbing your eyes at ALL COSTS for the first month. Tough luck with that! But I think rubbing my eye helped to smooth out the crack in surface of my right eye that caused the ghosting. How funny is that? I can tell the surgeons weren’t joking though – my right eye has gone back to feeling the way it felt on day 4, just after the pain subsided. Feels a bit raw again. Not gonna rub my eyes again, but I’m really happy with how this accident turned out, lol!

Just a note that prior to today, focusing on the computer screen has been too frustrating for me to do anything more than a couple hours of work before getting a headache. So if you’re a computer programmer like I am or something similar where you are sitting at the screen all day, be prepared for the possibility that you might have to take a second week off work. I know, it’s not cool – but remember it’ll be worth it!

For the second week, I ended up reducing the resolution of my computer monitors so that everything gets bigger, and that made it possible for me to be productive with anything except programming. I was forced to find ways to be productive without programming, e.g. getting as many of my errands out of the way as possible, and working on some presentation or design work that I had.

Day 20 – Final touches to the epithelial layer

On the morning of day 20, I realized that my ability to distance vision for street signs had gotten quite clear, so I reverted my computer monitor resolution back to normal, and to my surprise I was able to get by. I had to sit a bit closer to the monitor because there was still minor ghosting, but I could manage and be completely productive again. Thank goodness!

At night, there are still quite a bit of starbursts and glowing halos around lights, but it’s not too far off from what I experienced wearing contacts in the past. At this point, I am quite happy with the results and it’s clear to me now that the vision will reach 100% clarity in a few more weeks. I have to admit I was a bit worried that one eye would have better results than the other, which leads to one eye being dominant and and a very imbalanced feeling. In fact, the first few weeks were like this, with the left eye being dominant due to the double vision in the right eye. When the double vision went away, the right eye became dominant as there was actually still more ghosting in the left eye. And now, it seems that the ghosting has tapered off quite well in both eyes, leaving me with balanced vision. Wooot!!!

Day 28 – One Month, focusing on distance vision

Today is my 4 week mark. I’ve been working at full capacity for the past week, but just need to sit a bit closer to the computer screen in order to get past the ghosting. Really happy about that, since I’m a programmer lol. However, now I’m paying more attention to my distance vision, and it seems like my left eye has gone back to being the dominant eye. If I close it, I can see some slight double vision in my right eye in the far distance. So it feels like my right eye has gotten worse, but it might just be my left eye getting there faster and my expectations rising.

My Flarex steroid drops go down to a 2 drops per eye per day now. I’ve read in other blogs that the improvement really becomes profound after you stop taking the steroid drops – but my surgeon insists I follow his schedule until the 8 week mark.

Month 2 – “Forgetting” and Beyond

UPDATE: March 7th, 2016. Was reminded that I need to update this blog post by a comment notification from Emily below. It’s been half a year, and for the past few months I’ve completely forgotten about my past life where glasses and contacts were a concern. I guess it first occurred to me around the 2 month mark that I could go several days without thinking about the surgery and that I was fully recovered! It’s a pretty freakin awesome feeling.

How is my vision today? I’m very satisfied – no glasses/contacts, no dry eyes (except when I first wake up in the morning), and no more hesitations to go about my regular day life. But, if I HAD to complain about one thing, it’s that my right eye never fully caught up to my left eye – it still sees slightly worse. It’s not noticeable when I’m working up close or outside in the brightness of the sun, but it is a bit bothersome when I am in a modestly-lit + far distance situation (such as looking at price signs in a grocery store). In those situations, my right eye sees the numbers ever so slightly blurrier, and it’s a bit annoying. However, if your eyes were as bad as mine before the surgery, this is not nearly as bad as what we were used to from before with glasses getting foggy/sliding down your nose etc. My surgeon and I agree that it’s not worth it to do a touch-up surgery, as I am mostly happy with the result, but should I decide I want it, he’ll do it for free (with no time limit). So make sure you find a surgeon that has lifetime guarantee as part of their policy.

I think that’s it, the end of my story. I’m 99% satisfied, and just going to go on with my life now. Hope this helped someone out there :)

Cheers!
Anson

See Also

I found these testimonials from other people really helpful when I was researching PRK:

  • http://alextran.me/ Alex Tran

    Good to see someone else documenting their journey! Hope your recovery is quick and side effect free.

    • Anson Kao

      Cheers, Alex! Would you mind linking back to my post from yours? Thanks!

  • Rickard B

    Hi there! Hope you will recover well! Have patience ! I am soon at 7 months and everything is good except I still have a bit dry eyes. I did the version of PRK that doesn’t exist in US yet though, transPRK – the laser both removes the epithelium and reshapes the cornea in one go. Check my story here:

    http://mytransprkstory.blogspot.ch

    I will create a link to your story if ok also?

    • Anson Kao

      Absolutely! Thanks!

  • Emily Young

    Blogs like yours seem to be the only way I can find detailed information about PRK recovery. Thanks for taking the time! I had PRK on a Friday and was told I could return to my 100% computer based job by Tursday. When I couldn’t even pretend to read by then I essentially when into full what have I done panic mode.

    Today I’m on day 11 and back at work. I bumped up the text size and can read with my left eye, but it takes work to do so. My right eye is still very very fuzzy and it’s hard to make out any words with my left eye closed.

    Based on your entry, I shouldn’t be panicked that I will forever be hazy, and that clarity is still on its way. It’s baffling to me that I can see houses way down my street, but that ny own reflection in a mirror is hazy. At what point do you feel you could work at your computer with “normal” sharpness and clarity? Thanks calmjng my nerves!

    • Anson Kao

      Hi Emily!

      It seems like everyone that has PRK goes through the same panic experience, but don’t worry – you’ll be fine. I agree that it would be better if the surgeons were more up-front with how difficult the recovery process is, although most of us tend to end up quite satisfied in the end anyway. I am :)

      As I mentioned in the post above, I only managed to turn the text size back to normal on day 20. At this point, it was still not perfect but it was finally bearable with sitting a little bit closer to the screen than usual. So looks like your progress is on par with mine. Have patience, keep yourself hydrated and you’ll be fine :)

      It’s been about half a year, and I guess around the 2 month mark was when I realized that I had forgotten about the surgery for the first time (and of my intention to keep updating this blog post) which was an amazing revelation. I’ll update this post now. Hope this helps. Cheers!

    • Alex S

      I’m in a similar situation where I work on a computer all day 100% of the time. How many days off did you take from work after the surgery? My surgery is this Friday and if I can’t at least be able to work a few hours in front of the computer by Tuesday then I will probably opt out of the surgery.

    • Anson Kao

      Hey Alex – everyone is slightly different but in my case I didn’t start feeling like I could make meaningful work contributions until day 9, and full work contributions on day 20. So… it might not be for you. Good luck

    • Lana Williams

      I am 4 wks out and I am now panicking….although the reason for my PRK is different…(i had cataract surgery and it went bad) and original doofus that did cataract surgery would not help me, I had the PRK after consulting with leading eye surgeon in area.
      But I am panicking all over again like after the cataract surgery…like will I ever be able to see again reasonably out of my right eye…

    • Emily Young

      Hi Lana,

      I remember crying at an intersection around the month mark because I still couldn’t read familiar street signs. A big part of my panic was that I CHOSE surgery– entirely elective.

      I’d say take heart that that leading eye surgeon endorsed this correction. At a month out my right eye was definitely hazier than my left, and by even five months out I wondered if I’d ever stop comparing one eye to the the other eye and thinking one was weaker than the other, but I could functionally see without legitimate concern by the 3 month mark. Somewhere around the 10 month mark I stopped noticing a difference between my two eyes. At a year and a half out I rarely think about it, and only notice a difference in vision when I’m looking at block white text on a solid black background on lit signs.

      So in short, at a month you’re still healing and while I understand the feeling of panic I bet at some point down the road you’ll wish you could experience it again with the confidence you’d come out clear on the other side.

      Hang in there!

      Emily

  • Pingback: My PRK Story: An Introduction – prkrecoveryblog

  • Imran

    Hey! First off, thanks for writing this. Very useful information.

    I was wondering, how long were you on eye drops for (other than fake tears) after the surgery?

    Thanks!

    • Anson Kao

      Hey Imran, I believe it was 4 weeks for medicinal drops. Cheers!

  • Eye Blogger

    Hey Anson, I really enjoyed reading your PRK blog. I had PRK surgery in my right eye about six weeks ago, and will have Visian ICL in my left eye in another six weeks or so (my left eye prescription is almost twice as bad as my right eye). I’ve started my own blog here to document my experience: prk-icl-experience.blogspot.com

    Thanks so much for sharing your experience. Like you, I was also very bored during the first week, just lying around in the dark and listening to some podcasts and music. I’m curious how you’re doing now and if your right eye ever caught up?

    • Anson Kao

      Thanks! Unfortunately, my right eye worsened a bit over the past year, so that I see 20/20 in my left eye and probably 20/40 or 20/50 in my right eye. I may take my surgeon up on a touchup in the next year or so once I’m sure it’s stabilized.

      But aside from that, I’m still very pleased with the results. It’s amazing how much better life is without ever having to think about the logistics of being able to see or dreading dry contact lenses. Hope your experience goes well too!

      Cheers

    • Eye Blogger

      Sorry to hear about your regressed vision, but maybe that will save you from needed reading glasses later! Or if you do need a revision, at least you know what the process is like. I wish you the best and thanks again for sharing your story!

  • Mike Pell

    Wow, now I’m feeling pretty special. Had the PRK on both eyes 12 days ago (on a Friday). I only missed 1 day of work (Monday), and I’m a programmer also. It has been tough, but workable through the first week. I had to get pretty close to the monitor, and every day now gets a little better. I still have the halo effect pretty bad at night though (no driving at night yet). Left eye is around 20/30, right eye around 20/50 now. And still blurry at all distances. The haze effect is going away too. Thanks for this blog. I’m feeling a lot better now about the healing time.

  • http://extremehealthtips.com Laura

    Thank you for shring your experience, it was helpful and detailed.

    Other source: http://eyesadvisor.com/prk-recovery-timeline/

  • Terri Handley Schreder

    Hi. Thank you for the information. What was your prescription before your surgery.

    • Anson Kao

      Approximately -7.5 in my left eye and -8.5 in my right eye, with additional 1.25 astigmatism roughly.

  • Ger Ry

    Thanks for documenting your experience. I’m a SysAdmin and I have been panicking because I’m 3 weeks out and getting headaches everyday while writing bash scripts. I can get around, drive, read street signs, but books and computer screen text are difficult to focus on because of ghosting.

    But this seems normal according to blogs like yours. Looking forward to more clarity soon.

  • Theodoros Papatheodorou

    fun fact. after a year of PRK my right eye is slightly worse than the left. It’s maybe more dry than the left and can’t focus properly.

  • Sergio

    First of all, thank you for sharing your experience with us. There are some YouTube videos with people describing their own experiences but I find blog texts more accurate and understandable.

    I will first describe my surgery.

    I had PRK about 20 days ago (-3.50 myopia and -1 astigmatism). This was the only method I could have, cause my cornea was too thin to have LASIK. Plus, Lasik is kinda risky cause that flap never gets back together with the rest part of the eye and fully healed. The flap remains there even 10 years after. So even if I were appropriate for Lasik I would still have had PRK (despite the longer healing process). Except for the casual Laser surgery I had, due to my thin cornea, I had to have another surgery that would strengthen my cornea. It’s not really a surgery, it’s just a vitamin that your doctor puts in your eyes and then you have to look at a very strong light for a couple of seconds. Everything went well.

    The first days I would notice the drastic change in my vision. I could see a lot clearer but not crystal clear. During the day my vision would be kinda blurry, especially if I used my phone or my laptop. It’s normal that my eyes were getting tired. If I rested them a little bit I could see better, close to crystal clear with the left eye.

    After nearly 20 days, I still have the same vision and my left eye still sees better. Actually I have the same problem with Anson on my right eye. I see kinda blurry and reading on my computer is very annoying cause I rely mostly on my left eye. When I put my lubricating drops they both get a little better for a couple of minutes, only the right eye still a little bit blurry.

    Therefore, at the moment I am happy with my surgery cause finally, I don’t have to worry about my contact lenses all the time. I am just being patient and waiting for the final results. And I do know that with PRK you get the final and hopefully the 100% vision after 3 to 6 months.