My PRK Adventure: Clear Vision With Much Less Pain Than Expected
What's the Difference Between Lasik and PRK?
I thought I'd give a little bit of background information on PRK here for those who don't know much about it, but if you really just want to know the details of my experience, feel free to skip this part of the article.
Now that you've got those two links, I'll explain the difference between Lasik and PRK in laymen's terms.
Lasik surgery involves using a laser to cut a thin flap in the eye. Once this flap in the eye is opened up, the necessary corrections to the eye can be made by reshaping the cornea using lasers. Then the flap is laid back down. Essentially, your eye is its own band aid when that flap is replaced.
Recovery for Lasik surgery is usually relatively quick and while not exactly painless, not especially painful either. Some people do experience pain, but many just experience the discomfort of dry eyes. Usually after a good night's rest, the patient feels pretty good and is excited that their vision has been miraculously restored.
In PRK surgery, rather than cutting a flap in the eye, the top layer of the eye (the epithelium) is completely removed and then the necessary adjustments to the cornea are made the same way that they are during Lasik.
The main difference here being that since there was no flap made in the eye, protective clear contact lenses (called bandages) are put in the eyes after the procedure to protect them while the cells of the epithelium have time to regenerate and give your eyes a fresh new protective layer.
The recovery after PRK is known to be much more slow and uncomfortable than Lasik with it being quite normal for patients to experience extreme discomfort for at least 48 hours. Many people will tell you that they felt like they had sand/pepper/onion juice/glass in their eyes for about a week after the surgery. Yikes!
The other difference in recovery is that while Lasik patients seem to have crystal clear vision quite quickly with it generally stabilizing within a week's time, PRK patients take quite a bit longer to have their vision stabilize, with it often taking months to be truly consistent.
Now you're probably wondering why anyone would choose to do PRK. Everyone's eyes are different, and depending on variables such as the the thickness of the cornea, some people can't do Lasik surgery.
Along with that, many people argue that there is more potential for complications after Lasik. This is one reason that historically the military has opted for PRK over Lasik surgery.
A Little Background On Me and My Eyes
As I was researching PRK (photorefractive keratectomy), I was specifically seeking out stories of people who were similar to me, both in vision prescription and temperament, to see how the surgery went for them. That being said, I thought I'd give you a little bit of background about to me, so that you can see how well your own story might relate to mine.
I had great vision all the way into my mid 20s. My first pair of glasses at age 24, were optional, at least that's what the doctor said. He said I was totally fine to drive and do anything else, but if I wanted glasses to sharpen up my distance vision a bit, I could get them.
After getting that explanation from the doctor, I thought I'd skip the glasses, but made the mistake of trying some on for fun, and ended up thinking they were pretty cute on me. So, I basically got my first pair of glasses as a fashion statement.
I wore those glasses for five years, and then eventually decided that I wanted contact lenses instead. I wore contacts for about five years, and the strongest prescription I ever had was -2.00 in my right eye and -1.75 in my left eye, so nothing super crazy, but enough to be an annoyance.
I never thought I'd consider eye surgery, because just the thought of it freaked me out, but after hearing so many testimonials of people who got Lasik done and loved it, I decided to give myself the gift of vision for my birthday this year, and that's how I got where I am now.
The other aspect of who I am that plays into this story quite a bit is that I have a history of anxiety, so it's easy for me to work myself up into a state of panic over things that many people would think aren't a very big deal. As you may have guessed, the idea of vaporizing the top layer of my eyeballs off was a bit anxiety inducing, but I'll get more into that later.
My Free Lasik Consultation
As I mentioned earlier, I somehow managed to get a big boost of courage earlier this year, and decided that I was going to have Lasik surgery. I scheduled my free consultation, and walked into the appointment feeling perfectly confident that Lasik was the right thing for me. My biggest fear was that I'd be told I didn't qualify for corrective surgery.
Well, at least that's what I thought my biggest fear was going into the appointment.
The doctor put numbing drops and dialating drops into my eyes, and then did several tests on my eyes themselves and the normal vision testing that you do when you see an eye doctor. I was left with a tablet to watch an informational video on Lasik (which I've included in this article), and then another doctor came back and said I was a perfect candidate for PRK.
That's when I started freaking out and decided there could be worse things than finding out I didn't qualify for surgery. You see, my husband had PRK done, and while he'll tell you that it's one of the best decisions he's ever made, I was there for his recovery, and it was horrible.
I instantly had flashbacks of him lying in bed for days in our dark room with blackout curtains and complaining that it was too bright and the light was hurting his eyes. I remembered me encouraging him to come outside several days post-op and him only being able to handle the outdoors for about 20 minutes, even with sunglasses on. I remembered the horrible day that his protective contact lens fell out, and he was in so much pain that he was going back and forth between nausea and being on the verge of passing out.
I told the doctor about my husband's experience, and I was told that I'd witnessed the worst case scenario, and it's usually not that bad, but I was freaked out!
I scheduled my surgery before I left, knowing that if I didn't schedule it then, there's no way I'd have the courage to schedule it later, and I headed home to experience one of the most severe panic attacks I've ever had in my life.
The Days Leading Up to PRK
The physical preparation for PRK was relatively easy. I was told that my eyes were pretty dry, so I should start using right away to prepare my eyes for the surgery. I'm not an advertiser, but I'm mentioning the brand since the doctor specifically recommended those eye drops. I was told that if I used these I could do eye drops twice a day instead of four times a day, and that sounded like a win to me. Systane lubricating eye drops
Other than the eye drops, I was told to quit wearing contact lenses a week before the surgery. I had a vacation scheduled and was planning on being at Disneyland seven days before the surgery, so I asked if six days would be long enough without contacts, and was told that would be fine.
As I mentioned before, I had a pretty bad panic attack the night of my free consultation, but fortunately I had a vacation planned between then and my surgery, so I had plenty of time to relax and get myself feeling better.
It wasn't until two days before my surgery that I started to freak out again and started googling anything I could possibly find about people's experiences with PRK.
I read a lot of articles much like this one. Some of them were positive; a lot were scary.
I literally almost cancelled my surgery the day before, because I was so freaked out. I tried to rationalize that my prescription wasn't that strong. I second guessed why I ever thought I wanted surgery in the first place.,
Being a religious person, I made my decision a matter of prayer and felt very strongly that things were going to go fine, so I decided to go through with it, but I was very close to cancelling the surgery all together.
Obviously, I can't tell you one way or the other how your surgery is going to go.
There are a lot of horror stories out there, but (warning: spoiler alert!) so far the worst part of my surgery was all the stress and worry leading up to it.
This isn't my surgery, but a picture of someone else's so you can see what it's like. If you're lucky, they give you a teddy bear to hug!
Morning of Day One (Surgery Day!)
When I arrived at the office, they had me sign all these papers saying I understood everything that could possibly go wrong with the surgery. I had already read the exact same papers at home, and opted to sign them without rereading them in order to keep anxiety to a minimum.
I was taken back into a room where my vision was checked one more time, and the doctor once again told me I was a great candidate for PRK, and even mentioned that based on what they were seeing during my eye exam it's possible that I could end up with better than 20/20 vision. I was very excited about that, although still nervous about the procedure in general.
The doctor gave me detailed instructions about my post-surgery prescription drop schedule, because it's very important to use the steroid drops, antibiotic drops, and lubricating drops on a regular basis. To save time later on, I'll tell you now that I've followed those directions very precisely post-op. That may be part of what's helped me to recover so well.
I was given a low dose of Valium to calm me down, and by the time the surgery started I felt like I was ready to fall asleep, which was kind of nice. The medicine obviously worked.
Everyone told me the surgery would be quick and easy, but I was really surprised by how quick and easy it actually was. It seemed like it was finished before they had time to get started. Really, it was that fast, and absolutely painless! I was in the operating room for less than 10 minutes.
I thought that my eyes were going to be super sensitive to light and start hurting immediately, but I managed to walk out to the car without sunglasses. That being said, it was a very overcast Seattle winter day. I probably wouldn't have said the same thing on a bright sunny day.
I was given numbing eye drops that I was told I could use as needed throughout the day. I was specifically told not to worry about rationing them, because I'd get a new bottle of drops the next day if i needed them.
Those eye drops were a life saver! The nurse had joked that I should keep them on my nightstand at all times so that they were close by. I literally didn't let them out of my hand at all that first day.
I used the drops for the first time probably 20 minutes after the surgery and then was very faithful about using them every 10-15 minutes until I was able to get my pain killer prescription filled around noon.
Yes, I did experience some discomfort, but the good thing is, those drops really work! The pain would subside within a minute or so of putting those drops in my eyes.
Afternoon and Evening of Day One
My mom was able to pick up my pain killer prescription in the early afternoon, and I was grateful that she did, because the pain was definitely getting stronger. Thank goodness for those numbing drops!
Initially, I hadn't planned on taking any pain killers unless I really needed them. I'm more into natural cures, and don't usually take medicines unless it's an absolute emergency. They had to really talk me into the Valium before the surgery, which I think was worth it by the way.
By the time my mom came with my pain pills, it was apparent I wouldn't be getting any sleep or rest unless I did something about the pain. I took half of one of the pain pills in the early afternoon, and from then on out, I only needed the numbing eye drops every hour or so.
I spent most of the afternoon and evening sleeping and listening to an audio book, but mostly sleeping. Even when I was awake, I spent my time with the lights off, wearing a sleeping mask, and keeping my eyes closed. I figured the more rest for my eyes the better, and I didn't want to experience the pain I'd seen my husband experience.
I read several accounts of people's PRK surgery where they said they opted not to wear sleep masks, because they thought it could introduce bacteria to their eyes. When I asked my doctor about it, he said it should be fine, and that the antibiotic drops would take care of any bit of bacteria that might be introduced, so I decided to go for it. Personally, I recommend it!
I took a full pain pill before I went to bed and slept quite well with no pain at all.
That was surprising to me, because I had heard so many accounts of people experiencing excruciating pain, but I definitely wasn't complaining about my unique situation.
I woke up really confused. I had expected to be in a lot of pain, but I didn't have any pain at all.— Me the morning after the surgery
Morning of Day Two
I woke up really confused. I had expected to be in a lot of pain, but I didn't have any pain at all. My eyes were definitely a bit more sensitive to the light than they'd been the day before, but other than that, I was feeling great! To make things even better, I could see quite clearly!
I had a 24 hour follow up appointment that my mom drove me to, but I remember commenting to her that I could have driven myself. My vision was great!
When I got to the appointment, the doctor was very pleasantly surprised with my progress. I was told that most people at that point would have been wearing sunglasses even in a room with all the lights turned off, so it was really impressive, and even a bit odd that I didn't feel like I needed sunglasses at all, even if it was a rainy Seattle day.
I asked it if it would be healthier for my eyes if I was wearing sunglasses, and I was told that really it was just a matter of comfort, so I should just do what I feel comfortable with.
A quick vision test showed that my vision was 20/20, although admittedly, I could tell that it was fluctuating off and on throughout the morning, and while I felt like I'd be fine to drive to that appointment, sitting there in the appointment, the doctor's face was a bit blurry to me.
The doctor warned me that it's normal for your vision to get really good, get a lot worse, and then slowly progress back to the good point. In other words, I shouldn't expect my vision to stay as good as it was at that appointment.
I was also told that I could keep using the numbing drops for the rest of the day as needed, but should try to use them as little as possible since they do slow down the healing process. Then I was told to throw them away before going to bed that night. The idea of throwing away my numbing drops made me a little nervous, but since I was feeling so great that morning, I wasn't overly concerned. The doctor mentioned that although I'd been instructed to use my lubricating eye drops at least four times a day, more is better, so I decided to try to use them as a replacement for the numbing drops unless the pain was unbearable.
I left the appointment feeling very encouraged, and although I'd been told to go home and rest, my mom and I went out to lunch to celebrate before I retired back to my world of darkness.
Holy Hannah! I never knew my eyes could hurt so bad!— Me the evening of day two
Afternoon and evening of day two
Holy Hannah! I never knew my eyes could hurt so bad!
Maybe I overdid it in the morning by going without sunglasses and going out to lunch and all. Maybe it was because I was trying to wean myself off of the numbing drops. I don't know the exact cause of my discomfort, but I literally felt like I had an onion juice IV pumping a constant flow of burning liquids into my eyes for hours on end.
I sat on my couch in the dark with my sleeping mask on all afternoon and evening.
I still used my numbing drops from time to time, and by the evening those increments were becoming more and more frequent. I was still trying to avoid the pain pills, so I didn't take one until right before I went to bed.
I definitely experienced several hours of pain before I took that pill, but it was bearable. I mean if it wasn't, I would have taken a pain pill sooner.
On top of the discomfort, my vision was really quite blurry. Whenever I got a text message, I had to have my mom read it for me. The combination of the brightness of the phone (that had the brightness setting turned all the way down) and the fact that my eyes were blurry in general made it impossible to read anything on my phone.
I literally didn't experience any discomfort on day three! None at all!— Me on day three
I woke up really groggy from my pain pill the night before and ended up sleeping most of the morning. When I woke up, I opted to listen to my audio book with my eyes closed, because I didn't want to risk triggering a painful event like the one I had experienced the day before.
That being said, I literally didn't experience any discomfort on day three! None at all!
Rather than using my lubricating eye drops four times a day, I tried to use them at least once an hour which I think helped a lot with comfort control.
My eyes were still quite blurry, but I'd been warned that my vision would fluctuate a lot throughout the healing process, so I wasn't all that worried about it.
By afternoon I was quite stir crazy, so I decided to take my dogs for a walk. My vision was blurry, but I felt fairly confident I could see well enough that I wouldn't walk into any trees or cars or anything, so I headed out on my first walk post surgery.
I kept going back and forth between having my sunglasses on and off. Again, I didn't want to risk anything that could trigger the onion juice feeling in my eyes again, but I ended up totally fine.
I had a rehearsal for a Christmas choir performance that night, that I had planned on not going to. I'd heard so many horror stories that I assumed I'd be curled up in a ball in a dark room somewhere writhing in pain, but since that wasn't the case, I decided to go.
My music was definitely blurry, but I was able to read it, so I consider that another success.
Morning of Day Four
I woke up a few times during the night with my eyes feeling extremely dry, so I used my lubricating drops quite liberally. When I finally woke up this morning, my eyes were feeling super dry again and I was still tired, so I filled my eyes with lubricating drops and went back to bed for a couple of hours.
I just want to clarify that I wasn't really experiencing any pain, just dry eyes.
When I woke up two hours later my vision was great! In fact, I was feeling so good that I decided it was time to start documenting my experience.
Up until today, I didn't want to risk looking at a computer screen for too long, and even today I'm not going to overdo it, but I wanted to write my story while it's still fresh in my mind, so that it doesn't become sugar coated or exaggerated over time.
I have to say that after looking at the computer for an extended amount of time, my vision is quite blurry again. I'll definitely have to go back and check this for typos, but still no eye pain.
It's hard to know if the blurriness is from looking at the computer or just being awake with my eyes open for longer than I've had them open in four days.
Again, I'm just happy that I'm not experiencing any pain.
Also, I've still been trying to use my lubricating drops on a very regular basis. I'm hoping that getting my contact "bandages" taken out tomorrow will help with the eye dryness.
Do you ever feel like your life is a blur...literally?
Afternoon and Evening of Day Four
I went for an afternoon walk which did feel like it was putting some strain on my eyes. By the time I got home, I had a bit of a headache from trying to focus when my eyes didn't want to focus.
I still managed to stay up until a normal time, something that I hadn't done since my surgery.
I woke up several times experiencing discomfort and had to put in eye drops. Again, I didn't experience any severe pain, but I think the protective contact lenses in my eyes were getting too dry while I was sleeping.
If only it were that easy...
My appointment started out with a quick vision check where I felt like a bit of a failure. Try as I might, I couldn't read anything they were putting in front of me, and I was told that my eyes weren't quite up to the legal standard for driving. Good thing I brought a friend with me!— Me day five
Morning of Day 5 (My Second Follow-Up Appointment)
I was told that I should be able to drive myself to my five day follow-up appointment, but with the inconsistency of my vision, I opted to have a friend give me a ride. That turned out to be a good idea.
My appointment started out with a quick vision check where I felt like a bit of a failure. Try as I might, I couldn't read anything they were putting in front of me, and I was told that my eyes weren't quite up to the legal standard for driving. Good thing I brought a friend with me!
The doctor said I shouldn't stress it too much, and will probably be fine to drive within a few days.
After my vision test, the doctor removed the clear contact lenses from my eyes. That was quick and painless, and I'm hopeful that now I'll be able to sleep through the night without experiencing the discomfort that's woken me up the past two nights.
Other than that, nothing new to report. As I'm typing this, the monitor is a little bit blurry, but not too bad, and I'm not experiencing any pain.
Nothing like waking up to a glorious new day with crystal clear vision!
I can see! I woke up so happy that I thought I was going to cry!— Me on day six
Morning of Day Six
I woke up once during the night needing to use some lubricating drops and that was it. Then this morning I arose with a great surprise.
I can see! I woke up so happy that I thought I was going to cry! My vision is crystal clear. I've been awake for a few hours and it hasn't regressed at all!
The doctor told me yesterday that with PRK you often have a two steps forward, one step back type experience, so one good day doesn't necessarily guarantee that the next day will be great, but it's certainly encouraging. I'm so excited!
Two and a Half Weeks
Well, I'm on day 18, and my vision has honestly been pretty steady since day six. I've had one or two days when it seemed like my eyes were a little bit more blurry, but nothing substantial.
The biggest thing I've noticed in contrast to my pre-surgery situation is that my eyes still have a tendency to get dry. I don't notice it too much during the day, but I've woken up several mornings feeling like my eyes were dry. Because of this, I've been trying to use eye drops a few times a day whether I feel like I need them or not.
Three and a Half Weeks
My vision is still great! I haven't noticed much fluctuation in the past week.
I have had a few times when my eyes, the right eye in particular, felt really dry. I've had twice now that I've woken up feeling like my right eye was glued to my eyelid or something. I can easily open my eye, but it's not comfortable when I do so (slightly resembles the sensation of pulling off a band aid only not nearly as bad). Fortunately, the discomfort is temporary and easily remedied by eye drops.
I'm definitely hopeful that the consistent need for eye drops will diminish over time though. I'm still using eye drops probably an average of four times a day.
Today I went to my one month post-op appointment, and I was excited to hear that not only do my eyes look great, but I also have 20/15 vision! I am so excited to hear that!
I'm still using lubricating eye drops a few times a day, but other than that my eyes are as good as new, and today the doctor told me that the dryness in my eyes should continue to gradually improve over the next few months.
My vision is fantastic, I don't experience any eye discomfort, and I have absolutely no regrets! PRK was the best birthday present I have ever given to myself!