My PRK Experience

I had PRK yesterday and I've relied so much on everyone else documenting their experiences that I thought I would share mine.

Age: 36 (Stable prescription for 15 years)

Pre-op prescription: - OD (Right Eye): -4.25, -1.25 Astigmatism - OS (Left Eye): -4.75, -0.25 Astigmatism

Procedure: - Advanced Surface Ablation (ASA/PRK) - My epithelium was removed with a scraping tool (not alcohol or a laser) - Procedure was a Customized Wavefront PRK - I fully intended on asking about the laser but I forgot to ask on account of being nervous AF

Operation: (5/12/17) I'm not going to go into too much detail about the actual procedure. There are plenty of other accounts on here. I'm sure that you are here, like I was, to weigh the pros and cons of the recovery process. Suffice it to say, it's not pleasant from a mental perspective but it is painless. I had a lattice tear in my retina fixed in anticipation of this surgery a year ago and in retrospect that procedure was far more traumatizing. It all happens so fast that it doesn't really matter. Take the Valium, lay back, and just let it happen. Oh and don't move your eyes...

Day 0 (Immediately following the surgery): - My father drove me to the surgery. When I sat up from the table after the surgery I looked over at him in the pre-op room and saw him wave to me. I know I wasn't the blindest (most blind?) person in the world prior to the surgery but I have never seen anything clearly unassisted past about 3 feet in my life. That was an awesome feeling. No eye tests for me immediately following the surgery, so no numbers to report. Just checked to make sure that the bandage contacts were in properly and gave me my eye drop instructions and narco prescription. Walked out of the office and dad drove me home.

I'd like to take a minute to describe what this experience was like. For all the research I did before this surgery, I felt everything was a little ambiguous for my liking. I always read/heard things like "Things are still blurry." or "I can't really see clearly yet." For those of you like me who were hoping to understand what that means, let me try to clarify. I could see 1000% better than without my glasses. I guess I can't speak for everyone, but I psyched my self out so much that I was worried I would be walking around like a blind person. My vision on the way out was improved to the point that if nothing ever got better, I would be able to function for the rest of my life happily. This is probably me setting my expectations low but I went into this expecting the worst and hoping for the best. Yes, things are not crystal clear, yet. But when I go from not being able to see 3 feet in front of my face to, 'things are a little blurry 50 feet away but I can still see them', I take that as a blessing.

Interesting point: My dad went to fill my narcotic for me when I got home, and I have them. I have not felt the need to use them to this point. My eyes leaked like a sieve for about 6 hours, but no real pain. At least as of about 24 hours post surgery. (I now realize that I am going to regret typing that.)

Day 0 (Evening of the day of surgery): - Didn't really sleep. Drops every 2 hours. You would think that 2 Valium would have made me tired but I couldn't sleep. Just took the surgeon's advice and kept my eyes closed as much as possible. Laid in bed and listened to the Celtics/Wizards playoff game. Sounded like a great game. Actually, I was grinning to myself because I would periodically open my eyes to check the score and it finally set in that I could actually read the score... unassisted... no contacts, no glasses. Just my own eyes. Slept great.

Day 1 (Around 18 hours after surgery): (5/13/17) - Woke up around 7:00 AM. Look at alarm clock. Smile in realizing that I can read the alarm clock. No real changes otherwise. Still seeing 1000% better than with no glasses, but still things are a little out of focus at afar. Reading is actually not an issue for me although I'm sure that will change at some point soon from reading others' accounts.

Day 1 (9:30 AM): - Day 1 follow up appointment with my ophthalmologist. He was running late so I spent about 10 minutes reveling in the fact that I could sit in the car and read the hours of operation on his door. Again, not crisply but I could read it. Beats not being able to tell if there was a door there at all. Notice some light sensitivity at this point but nothing unbearable. Initial test less than 24 hours after the surgery reveals:

OD (Right Eye): 20/40
OS (Left Eye): 20/30
OU (Both Eyes): 20/25

Surprising to me actually since I would have said that my right eye was clearer. What is important to understand though is that my vision is fluctuating almost by the minute. There are times where I can see what seems better than what I saw when wearing contacts after a long day of work. There are others when I literally can't see anything in focus. Doctor says that I am healing very well and says to keep up with my drops and keep my eyes closed as much as possible and to not do anything active today. Just relax and keep up with the drops.

Taking a nap now and going to listen to some baseball and pop the windows open. Will update tomorrow with more results.

EDIT: When I say no real pain, I mean to say no real PAIN. There is discomfort. I wore contacts for 20 years so maybe I'm just used to it. Day of surgery, feels like you have a contact that is put in backwards. <-- perfect description, at least for me. Day 1 (after surgery): As long as I'm not in the sun, just feels like I have had my contacts in for 36 hours. Fighting the urge to adjust your contact is literally the worst part about this so far.

Day 1 (30 hours post-op): I've been taking it easy and listening to the Indians/Twins game. I have popped my eyes open to look at the score or the game on occasion and I can tell my vision is getting worse. Assuming that this is the beginning of my epithelium growing back. Still, not awful, just less crisp. Part of the healing process which I'm glad I prepared myself for. Time, water, drops... we'll get there... Still no PAIN, less discomfort than before, no narcos taken at this point.

Day 2: (5/14/17) Vision is definitely worse today, as to be expected. Very difficult to read the clocks or any text at a distance, if at all. Can still get by reading a bit on the computer or phone, although I'm trying not to look at either as much as possible. Slept great last night. Virtually no discomfort today. Just feels like I've had contacts in my eyes for 48 hours, which I have. Took a walk outside this morning. Light sensitivity was not that bad with sunglasses on and it's very bright here today. I go to the ophthalmologist tomorrow afternoon. Unless something improves overnight, I fully expect that I will score much worse on the visual acuity test. Even with my vision as it is right now, I would still say that I am seeing great. It's as if I'm wearing my glasses and they are just very dirty. Can't see fine details but I can see at a distance pretty good considering.

Day 2 UPDATE: I got antsy and decided to go walk up to where my friends play volleyball today. A little ticked that I couldn't play, but I was sitting out in the sun with two pairs of sunglasses on. Blue blockers they gave me after the surgery and an old pair I had that fits over glasses. Maybe overkill but light sensitivity is definitely an issue at this point. All of a sudden for about 30 minutes, the vision in my right eye became crystal clear as if I had my contacts in. Left eye, not so much. But it was amazing to see what I will hopefully eventually have.

Day 3: (5/15/17) Bit of a roller coaster today. Woke up this morning, my right eye was markedly clearer, left eye was still blurry much like yesterday. On my way to my appointment, my left eye snaps into focus and was the clearest that it has been yet. Get to the ophthalmologist, vision acuity tests:

OD (Right Eye): 20/40
OS (Left Eye): 20/40
OU (Both Eyes): 20/30

Doctor looks at my eyes and decides everything is healing perfectly and takes out the bandage contacts one at a time. Right contact comes out, no discomfort but vision definitely gets quite a bit worse. To be expected I remember. Left contact comes out, searing pain. Worse than anything post surgery. Doctor looks at my eye and notes that the epithelium in my left eye was disturbed when he removed the contact. To be on the safe side, bandage contacts put back in both eyes. Bit of a disappointment but I knew this would be a process and things could come up. Doctor says that my epithelium will have to grow back and smooth over before he will take them back out again. Follow up appointment a week from today. He says that this does happen unfortunately but will not effect long term results, will just delay the healing process a few days. (Doctor's equivalent of: 'my bad') I'm bummed but I don't really have a choice in the matter, so positive thoughts and continue to heal. Good news is that he measured my vision after putting the contacts back in and I am still 20/30 even with my irritated left eye. Que sera, sera.

Day 5: (5/17/17) I feel like I turned a corner in my right eye today. I can see amazing. Honestly, in that eye I am seeing almost as good as I did with contacts in. Haven't had another appointment yet so I don't have numbers, but if I had to guess today I am seeing 20/20 out of my right eye. Left eye is back to Day 2 on account of the bandage contact incident. Which is frustrating as hell since I know what my vision would be like if my epithelium wasn't disrupted on Monday. A few more days and hopefully my left eye will catch up. Right now it's like I have one prescription contact in, and it is awful. Good news is that after talking with my surgeon and reading a little online, I learned that the epithelium regrows in a normal healthy adult in 7-10 days. When there is trauma (like taking a spatula and scraping the front of your eyeball off then shooting lasers into your eyes) it heals even faster. So I am keeping up with my drops and trying to take it easy. Back to work today for the first day. Could have actually gone yesterday, but the light sensitivity was pretty bad and I was worried I wouldn't be able to keep my eyes open. By the end of the day the last few days, my eyes are done. I wish I knew how to better describe this but they are just done. It's as if all the focusing and light sensitivity is just overwhelming and they just stop working properly. Nothing is in focus and the smallest amount of light is almost unbearable. In all I am very happy and hopeful for my end result. Trying to be patient and positive. My least favorite part of this whole process so far is the damn clam shell eye covers you have to wear at night. They don't have a comfortable orientation on my face and that stupid medical tape sticks to everything. I've been peeling the tape glue off my face all day despite taking a shower and washing my face separately. First world problems I guess.

Day 7: (5/19/17) Noticing improvement in both eyes today. My left eye is getting back to the point that my right eye was on Wednesday. Still a little blurry but nowhere near as bad as it was a couple days ago. I am still frustrated that my left eye is behind the other but just staying in good spirits. I had a moment yesterday when both eyes were in perfect focus and I could see so much better than when I had my contacts in. I am hoping for that to be the end result and trying to be patient. I am actually pretty worried about getting the bandage contacts taken out on Monday. I don't want another set back, but I also remember my vision in my right eye getting quite a bit worse when they were taken out. Hopefully that won't last too long. I loathe going to sleep to put those eye guards on every night. Can't wait for that to be over.

Day 10: (5/22/17) Got my bandage contacts out today. No searing pain this time. I will say that while there were no significant improvements I can tell that things are still changing. Many times I feel like my reading vision in my right eye has gotten worse over the last few days and my left eye was getting much better close up but worse farther away. I have to keep reminding myself that my eyes are on different healing schedules. Before getting my contacts out:

OD (Right Eye): 20/40
OS (Left Eye): 20/50
OU (Both Eyes): 20/40 (I guessed a couple of the 20/30 but they weren't really legible)

I held my breath while the contacts come out hoping everything sticks together this time. Vision gets noticeably worse in my right eye but nowhere near as bad as when they took it out a week ago. Left eye vision goes completely to crap, much like I noticed in my right eye last week. Doctor checks and everything is fully regrown. She says that my left eye is noticeably more irregular on the surface (likely from my incident last week) but says that everything will even out in time. After contacts out:

OD (Right Eye): 20/40 (Minus one letter)
OS (Left Eye): 20/60
OU (Both Eyes): 20/40 (I could read the 20/40 line but with really no help from my left eye)

Honestly if it were not for my right eye being relatively better, I wouldn't have been able to drive after this appointment. Step down my drops starting on Thursday. Down to one single medicated drop after today. Doctor says that I can stop sleeping in the clam shells starting tomorrow if I feel comfortable.

Day 11: (5/23/17) I wasn't going to update today but thought I would report that my left eye has made major gains in the last 24 hours. Around 24 hours after I had my bandage contacts taken out I had what I would describe as almost clear in my left eye. Things were so much less blurry and hazy but I couldn't read text. I worked out over lunch and ran a few miles (amazing after 10 days off) and there is a TV in our workout room. I couldn't read anything but I felt as if it was so close to coming into focus. Hard to describe. By the time I was home, almost no haze and text is starting to come into focus closer to my right eye. It is a huge relief for me personally but the difference in clarity between eyes was giving me a major headache. Anyone that has had one contact in for an extended period can empathize with that.

Day 14: (5/26/17) Had a follow up appointment this morning. I actually am starting to hate these appointments because I think I am seeing so much better than the visual acuity tests indicate. I really think that my vision is fluctuating so much that I just have bad timing. I downloaded an app that allows you to test your vision to a degree. (Eye Chart HD for those interested) It's not exact for many reasons but it's a starting point. My main complaint is that it obviously has no idea how big your screen is, so how can it know how far it should be away from your eyes. It says 4 feet and I thought I was reading 20/20 in my right and 20/40 in my left. Anyway, my left eye has almost caught up to my right eye at this point, very happy about that. Things are still not clear but I know that is coming. As many others have noted, when I put in the preservative free drops, my vision is crisp and clear for like 2 minutes. I asked the doctor about this today and he confirmed that this should be an approximation of what my final vision should look like. The explanation that I got was, because my epithelium had to completely regrow, the surface is still like the surface of a golf ball. The eye drops fill in the divots and make it a complete surface. Apparently as my eye heals, it will eventually get to that point by itself. Not saying that is the truth, just reporting what my doctor told me. He likened it to when people have cataract surgery and can't see that well at first, but if you have them look through a pin hole, they can see great. I have no idea what that means, just thought I would pass it along. I asked him to explain it, but to be honest he didn't give me any more information that would be useful to this discussion. So I guess doctors think we are all stupid. I would have pushed it further but I had to be somewhere so, whatever. Visual acuity was:

OD (Right Eye): 20/30
OS (Left Eye): 20/40
OU (Both Eyes): 20/20 (minus one letter)

I'm down to one steroid drop, 3 times a day. Sleeping comfortably without the clam shells for 2 nights. So far, very happy. Now the long road to amazing clear, crisp vision.

Day 23: (6/4/17) Meant to update on Friday when I had my appointment but had a busy weekend. Some time on Thursday, my left eye caught up and actually surpassed my right eye. It was such an amazing relief to not have one eye so much better than the other. The depth perception issues were becoming unbearable. On my appointment on Friday (3 week follow up) my left eye was so good that I actually thought my right eye had regressed. A bit of advice I read somewhere before the surgery, I can't stress enough. People generally don't take the time pre-surgery to pay attention to the differences in their vision from eye to eye. Everyone seems to scrutinize the differences between their vision in each eye after surgery and they get worried about something being wrong in one eye or the other. I took a good week before surgery to really notice the subtle differences in my vision, and this has helped me put my mind at ease throughout this recovery process. Pre-surgery, my left eye was considerably more blurry than my right, even with contacts. This is probably because I had a contact that corrected my astigmatism in my right eye but apparently the astigmatism in my left eye was so slight that they didn't have a contact for it, or so I was told. So just know that both of your eyes are not going to be exactly the same. After the recovery is over and I stop doing the whole 'camera 1, camera 2' routine, I fully expect that I will just keep both of my eyes open like a normal (read not compulsive) person and everything will be fine. Anyway, I did great on the visual acuity test, I think:

OD (Right Eye): 20/25 (Plus one letter on 20/20)
OS (Left Eye): 20/25 (Plus two letters on 20/20)
OU (Both Eyes): 20/20 (minus one letter)

Went on my first long drive over the weekend and I can still tell that my eyes get tired after being active for too long. Drove up about 2 hours away and the drive there was nice, I could read all the street signs, similar to contacts in after a long day. On the drive back after standing around in the sun for 4 hours, my eyes were very tired. I put in drops like every hour but it didn't seem to help. I could function and I felt comfortable driving on the highway, but things were not coming into focus until they were about 50 feet away. Things seem to get almost imperceptibly better everyday. It's not until a few days pass that you notice you are seeing better. Down to steroid drop 2 times a day. Next appointment set for 6/16.

Side note: I woke up one day last week in the middle of the night and my right eye was redder than hell and felt irritated. I got really nervous that I somehow got an infection. Put a bunch of eye drops in an paced out of being nervous for 15 minutes or so. Went to bed and everything was better in the morning. Guess I must have accidentally rubbed it or gotten something in my eye, pet dander or something.

Day 30: (6/11/17)

Obligatory 30-day update: My vision has gotten better over the last week. Nothing day-by-day to note but looking at my last post and remembering what my vision was like, things are much more stable today. I can see pretty darn good and I am very happy with my recovery so far. I would estimate that I am at about 90% of my best vision with contacts. For instance I still can't pick out the individual leaves on the trees about 50 feet away and I could with contacts in. But it's so close! Still, when I put eye drops in things become near perfect for about 2 or 3 minutes. I have noticed that my vision is directly linked to hydration. Water is your friend during this recovery for sure. Went fishing over the weekend and was out in the sun for 5 or 6 hours, had a couple of 'pops'. The next morning I could tell that my eyes were dry. Point of interest for me was that I finally understand now what people mean by dry eyes. When reading others' posts I always heard people describe dry eye problems. I always took this as your eyes were itchy or just felt dry. I now understand that dry eye after PRK actually means that your visual acuity is severely affected (effected? I always get that one wrong) by dehydration. I don't think I ever had this issue pre-surgery, but to be honest I never paid any attention to it. Maybe something else to check out before you have the surgery. Anyway, simple fix. Stay hydrated and use your eye drops! Very excited for my next appointment on Friday.