Poor Vision After PRK. Will This Improve?

Question

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?

Arthur Benjamin, MD · Answer

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: 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.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.

Andrew Caster, MD · Answer

It typically takes about 3 months to reach your full vision after PRK. After this time, if the vision is not ideal, then further treatment may be needed. I would recommend that you see your doctor to determine what the problem is now, and what should be done to improve it. You should expect excellent quality of vision after your treatment is complete.

Farzad Yaghouti, MD · Answer

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.

Michael K. Tracy, MD · Answer

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.

Ilan Cohen, MD · Answer

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.

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