PRK recovery log: 2 months
Background: 28M active trail runner, mountain biking, scrambling / climbing, backcountry skiing. Small prescription, astigmatism was the main thing being corrected. Chose PRK over LASIK specifically because of the outdoor lifestyle and no flap even though I qualified for LASIK. Prior to the surgery I loaded up on vitamin C and started taking an Omega 3 supplement which I’m still on.
Day of Surgery (Day 0)
Surgery was faster than I expected. The actual laser was maybe 10 seconds per eye. All the prep takes way longer than the laser itself. I don’t remember the ride home from the Valium but immediately took a two hour nap. Eyes felt gritty and dry but nothing I'd describe as real pain. Stayed in a dark room but I have blackout shades which helped a lot.
Day 1
Burning started coming in waves later in the day, which caught me off guard. Felt like when you cut a really strong onion and it stings your eyes. Light sensitivity was significant and I ended up just keeping my eyes closed all day. Managed pain with ibuprofen and acetaminophen alternating but did have hydrocodone on standby. Kept up with steroid drops and lubricant drops on schedule. Dark room, lots of sleep.
Day 2
Worst day for me pain wise. The burning was more intense and more sustained than day 1. Light sensitivity peaked to the point where I had two pairs of sunglasses on in my room with blackout shades and my eyes closed. I'd tell anyone doing this to just mentally prepare for whatever your rough day is and you’ll know when it starts. Seems like a lot of people have day 2 or 3 the worst day. I ended up taking the hydrocodone which helped significantly. Lubricating drops every 20-30 minutes helped as well
Day 3
Noticeably better than day 2. Felt like I'd turned a corner. Pain was largely gone, just some residual grittiness. Dropped back to regular acetaminophen. Still blurry and very light sensitive but the burning sensation was mostly gone. Lubricating drops every 20-30 minutes.
Days 4–6
Still basically pain free, but my right eye had a lingering foreign body sensation that the left didn't. Vision was overall still blurry and light sensitive, this is where the frustration started setting in for me because I felt fine but couldn’t see super well. Went for short walks, and was able to finally watch tv / look at my phone for more than a few seconds. Lubricating drops every 20-30 minutes.
Day 7–8
I went back to work day 7 and had to adjust my screen brightness, contrast and text sizing. Looking at a computer screen also increased my dryness and use of lubricating eye drops significantly. At my 1 week follow up which was on day 8, the bandage lenses came out after they confirmed the epithelium was closed. Activity restrictions were mostly lifted and my vision was around 20/35 at this point. Right eye was slightly blurrier than the left, Surgeon said everything looked on track and I could begin moderate outdoor activity with sunglasses as my eyes allowed. Lubricating drops every hour ish, or as needed. Legally cleared to drive on day 8 as well.
Week 2
Got back out trail running. Lots of vision fluctuating day to day / hour to our, often worse by end of day as eyes got dry and tired. Right eye persistently behind the left which was annoying. Around day 12–15 the frustration with slow progress peaked. Seems like this is pretty universal with PRK the plateau phase after the main recovery is the mentally harder part.
Week 3
Right eye still lagged but slowly improved. Good days and bad days. One thing I noticed that surprised me was even with the slightly blurry vision my eyes felt less fatigued than before surgery. At this point I was still using lubricating drops every hour and it seemed like most of the blurriness was related to my eyes being dry. Steroids were tapering, still using lubricant drops every hour.
Month 1
Finished steroid taper and eyes felt dry and tired immediately after stopping which took a few days to adjust. At my 1 month post op I discussed some lingering dryness issues and the surgeon let me know that my tear film wasn’t healing as fast so I would have some issues with that going forward, they scheduled a 2 month follow up and mentioned we could look at additional measures for the dry eyes at the next appointment if things didn’t improve. They gave me some very thick gel type drops to put in at night, and suggested I use a thicker drop during the day. So, I switched to the Systane Pro PF drops during the day. They are much thicker than the Refresh PF drops I had been using and seem to help my eyes stay moist longer. They claimed my left eye was 20/20 and my right was 20/25 but seemed like they were both closer to 20/30 in terms of which line I could actually read clearly in full on the chart.
Month 2
I saw significant improvement in vision clarity around week 6, I think the night drops really helped keep my eyes moist at night and the Systane Pro PF drops helped during the day. I was able to cancel the 2 month follow up given the improvement. I feel like my eyes are a clear 20/20 or better at this point and am very happy I went through the procedure. I still use drops 2-3x per day but everything is back to normal or better. I expect the dryness will continue to improve slowly over time.