Had PRK 1 Week Ago, Right Eye Has Been in Pain and Right Now I'm 20/40, is That Normal?

20/40 is pretty normal a week after surgery depending on your prescription. Having more pain in one eye than in the other is also very common. If your surgeon has examined you and you are doing well, most likely your vision will continue to improve in both eyes.

The vision commonly can fluctuate for up to about a month following PRK and this is very common among patients having had PRK. 

I usually explain to my patients who get PRK that their vision will seem good right after surgery and then get worse before it gets better. This is due to the normal healing sequence. It takes time for inflammation to develop in the eye and cause mild blur after the surgery. Then, when the inflammation subsides and the cornea heals, the vision will improve. It can be scary if it is unexpected but it is the typical course. 

Visual recovery after PRK can take as long as 3 months, although vision usually improves within 2-4 weeks. LASIK patients recover much more quickly, often within days. At the 3 months time point, LASIK and PRK patients generally both obtain excellent vision.

It is completely normal for your vision to be 20/40 one weak after a PRK procedure. It takes longer than for Lasik to get complete recovery and ideal vision. Even minor irregularities in your tear film can lead to a decrease in best corrected vision. It is also possible to experience some minor haze and dryness that will lead to some visual problems. It sounds like your surgery went well and your vision should stabilize within a few weaks. Your doctor may prescribe a longer course of drops, including steroids to help speed up your recovery. Overall, PRK is a safe surgery and if properly performed should lead to a great result.

It takes substantially longer for vision to stabilize after PRK than with LASIK.  I tell all of my PRK patients to have no great visual expectations for at least two weeks after surgery.  20/40 vision after a week is common and normal.

The results of PRK do depend upon one's healing.  Following healing the front surface of the eye, the corneal epithelium, it does take time to settle down for one's vision to be at the optimal level. This may take from one week to six months, depending upon an individual's healing. Your vision is within the normal range at this point.  Please call your eye doctor with any concerns you might have and go in for an extra visit.

this is a normal result after PRK, as recovery is slow and painful after PRK, it can also scar

this is why i switched to LASEK, which is a form of Advanced Surface Ablation (PRK is the not-advanced type of surface ablation--we use the term surface ablation to indicate we are lasering the surface, not inside the cornea as in the cutting LASIK or IntraLase techniques)

LASEK is painless and has fast recovery, unlike PRK. the chance of scarring is also lower

ASA involves removing the epithelium of your eye in one clean sheet, so it's not scraped off in little pieces (as in PRK). this removal is much less traumatic, so doesn't incite what is known as the inflammatory cascade, which is the cause of the delayed healing, pain, and possible scarring after PRK

so if your eye doctor says "you need a PRK" because you have a high Rx or thin cornea and can't get LASIK, what he really means is "you need a Surface Ablation" to save tissue (by not cutting the flap), and then your choices are either getting the older PRK, or the more Advanced Surface Ablation, which is either LASEK or epiLASEK

PRK is a two step procedure. The first step is, after thoroughly numbing the eye, to gently remove the outer layer of the cornea....it is called the epithelium. The excimer laser pattern is then applied to the cornea and the procedure is complete. It takes somewhere between 3-7 days for the corneal epithelium to completely grow back and, typically, the surgeon leaves a bandage contact lens in your eye while this healing is occurring. Some corneal irritation is not uncommon in the first few days, as the surface heals back. While this is a short term nuisance and worry, it should not affect the long term result. In our 15 year review of Lasik and PRK results we have found the visual results to be equal and excellent. It is just the first week after PRK that some extra healing and inconvenience can arise.