Poor Vision After PRK. Will This Improve?

Hello Doctor,I had PRK June 1st though I am able to drive without corrective lenses,I am unhappy with my quality of vision.Previously,I had myopia -5.50 and astigmatsim -3.50 in both eyes.Since PRK,I have blurry vision throughout the day and worst of all, colours appear much duller and things seem bleached and my computer screen is very dull and i dont see the high definition quality on my tv and lap top anymore.I also have ghosting at day and night , halos and star bursts.Will this improve?

Doctor Answers 5

Vision After PRK

While it is impossible to accurately diagnose and give treatment advice without seeing a patient, a few things do come to mind. From the description of your preoperative refraction it sounds like you were very nearsighted with a high degree of astigmatism. We can also postulate the reason PRK was chosen over LASIK was the corneal thickness on the lower side. Here are some of the reasons that could explain your symptoms:

  1. Dry Eyes. A common finding after LASIK or PRK causing irregularity in the corneal surface. This should be treated with Artificial Tears, Restasis drops and most likely punctal occlusion.
  2. Post PRK haze. This occurs in patients who have high degrees of correction. To minimize the risk of postoperative haze formation doctors use mitomycin C during the procedure. Postoperatively patients should be encouraged to avoid UV exposure by wearing sunglasses. Haze usually responds well to topical corticosteroids and resolves over weeks to months of treatment. Haze may also be associaged with significant regression of treatment (return of nearsightedness). 
If significant regression occurs an enhancement procedure maybe contemplated. The most dreaded complication would be corneal ectasia or irregular thinning of the cornea. This condition should be diagnosed as early as possible by corneal imaging and may be treated with corneal collagen crosslinking. It is bet to return to your surgeon ASAP and have a thorough evaluation.

West Hollywood Ophthalmologist
5.0 out of 5 stars 1 review

PRK recovery

unfortunately, the recovery after PRK is very slow, and can take weeks to months

that's why I stopped doing PRK in 1999--in my opinion, that's an archaic procedure

in LASEK or epiLASEK, which are the Advanced Surface Ablations (ASAs) which have replaced PRK, the recovery is much quicker than in PRK

you should have had your Bandage Contact Lens in place for nearly a WEEK, not just a few days. when we started leaving the BCL in longer, our recovery time decreased a lot

here's a list of things that your surgeon should tell you to do to speed up your recovery:

  1. don't do any optional recreational activities (eg TV) until you see clearly
  2. use a high-quality, preservative-free artificial tear every hour while awake
  3. use an ointment at night
  4. drink enough water so when you pee it's clear (best evaluation of hydration)
  5. 500mg Vit C 2x/day
  6. sunglasses when outdoors always
  7. punctal plugs
  8. branded PredForte 4x/day for this entire month (dec to 3x/day in July)
  9. need to check IOP to make sure #8 isn't raising your eye pressure

Anyway, if you do ALL of the above you will see well by July 4th, and then you can tell your friends that they should get LASEK so their recovery is much quicker than PRK!:)

Emil William Chynn, MD, FACS, MBA
New York Ophthalmologist
4.6 out of 5 stars 20 reviews

Poor Vision After PRK.

Hi Jandj
Typically PRK results stabilizes by the third month following PRK. If it has been more than three months since your PRK procedure and you continue to have issues with quality of your vision, you should see your refractive surgeon to see if an an enhancement is advised for any residual refractive errors. 

Farzad Yaghouti, MD
San Diego Ophthalmologist
4.8 out of 5 stars 4 reviews

Poor Vision After PRK

You had a large treatment with significant astigmatism in both eyes so your vision should continue to improve for several more months. Having said that, after three months your vision would generally be moving in the right direction. If you have seen no improvement at all, it is possible you will need an enhancement at some point. It would be best to have your surgeon take a look to make sure that you do not have any problems unrelated to your surgery that might be affecting your vision.

Michael K. Tracy, MD
San Diego Ophthalmologist
5.0 out of 5 stars 2 reviews

PRK recovery

It is not unusual to have blurred vision, glare and halos immediately after PRK. There is a normal amount of inflammation in the cornea after PRK which can cause this. This inflammation will likely reduce in time with the proper use of medications. Make sure you follow up as directed by your surgeon and take the medications as prescribed. It can take several weeks for the corneas to fully heal and vision to sharpen.

Ilan Cohen, MD
New York Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.