PRK Recovery Day 5

The scary sensation of not being able to see, and the feeling of something being in my eye is almost completely gone. I woke up and I’d guess I started the day at 20/50 vision in my right eye and 20/70ish in my left eye. As the day went on my right eye cleared up enormously, well enough to drive comfortably. I’d guess that it wound up at 20/40 or better vision. My left eye by the end of the day was close to where the right eye started.

The feeling of sharpness being hidden by a haze is starting to go down. I don’t know if that means my vision is just getting back to where it should be, or if I’m going to wind up with worse than 20/20 vision. It’s unsettling, but probably nothing. Tomorrow I have my follow-up appointment where they take the contacts out. I’m curious to see if my wildly rough guesses of where my vision is comes close to what it actually is. If my left eye sharpens up as overnight as either eye did last time I’ll be pretty comfortable in driving in the morning. They say that your vision worsens when they take the contacts out. If that is the case, we’ll have to see how much worse. Hopefully that + sleep is a wash.

PRK Recovery day 4

Christmas Day! I survived!

Day 3 of PRK was by far the worst. I had mild sensitivity on day 2 but it wasn’t bad. Day 3 I could barely see. On Christmas Day the light sensitivity was definitely present.

I felt like I had something in both eyes but the left eye was the worst. I could keep my eyes open in a room with lights but I couldn’t look outside and keep my eyes open.

This was the day that I knew that my eyes were healing. I woke up and my sharp vision was gone. Replacing it was a warm fuzzy haze. This wasn’t like being near-sighted. I could tell that there was a sharp line behind the fuzz, but there’s a layer of tissue between diffusing the light. I don’t know how to describe it, but it’s not at all like being near, or farsighted.

Probably the best way to visualize it is as having crystal clear vision, then putting a few layers of Saran Wrap between you and something. It just gets hazy.

On surgery and recovery day 1 I’d say I easily had 20/15 vision. On day 2 in retrospect it probably dropped a little bit. I’d guess 20/20 maybe – not enough to notice, but a drop. In the morning I’d guess I had 20/100 vision, if that in both eyes. Very blurry. Not as blurry as if I’d not had my glasses, but the sharp was gone. It was a little more pronounced in my left eye than my right eye and as the day went on that got progressively more noticeable. By the end of the night my vision in my right eye was much sharper than my left. My right eye had cleared up, I’d guess maybe a 20/60ish vision in my right, 20/80 or 20/90 in my left.

As with the rest of this post, any assumptions I make are purely speculation by an untrained person. I’m comparing my vision pre, post, and in recovery to make a guess.

PRK Recovery Day 3

Day three. AKA life on the surface of the sun.

I finally got the exam scheduled in December to limit my out of pocket. Because of the doctor I picked, I had to have the procedure done in December or lose my HSA money. I had hoped it wouldn’t drastically limit my ability to see on Christmas but it was worse than I had feared. Day 3 of recovery was Christmas Eve.

The light sensitivity was a special kind of hell. I couldn’t keep my eyes open at all with any kind of light so we bit the bullet and my wife drove us to my parents (a 6 hour drive.) Even with the shades the vision center gave us I couldn’t keep my eyes open for a second or two and even without that, they wouldn’t focus. Everything was crystal clear at this point, but the pain manifesting as light sensitivity was out of this world. For the drive I had to have my shades on, and a hoodie over my head for most of the drive. This is easily the most frustrating experience in my adult life. Our vision is precious, and this reminder of it was really a kicker.

I’d had a some contacts really bother my eye earlier in the year (the catalyst for saving for Lasik) and my experience there was light sensitivity that gradually went away as my eyes got used to the light. That was NOT the case here. Second one looking out a window, huh, eyes focused and clear but with a weird sensation forming. Seconds two and three, eyes unfocusing, absolutely no way to stop it. Second four, ow, and actual pain. Seconds five+, tears forming, eyelids shutting, no ability to keep them open.

I love the show House, and one of the things they did in an episode was to note that your body only feels pain in a single area. The light sensitivity was a form of pain. If I pinched myself very hard I could keep my eyes open no problem. That was useful to get through skimming a webpage for some information I needed. Other than that, I was essentially blind around anything bright.

I am incredibly grateful to my wife for taking care of me. She literally had to take my hand as I walked with closed eyes. To an outsider, they probably would have assumed I was blind.

If you are undergoing this procedure, make sure to either have a roommate, significant other, or a very good friend that can take care of you. I’d advise lining up food, taking time off of work, and just being prepared to live in darkness for a day or two.

PRK Recovery Day 2

I started the day working easily (on a computer screen.) I had to dim the screen after about an hour and I wasn’t in discomfort, but I couldn’t have the brightness all the way up without taking breaks. I tried taking the pain medication they gave me but it didn’t affect the light sensitivity at all. It actually made it worse – or so I thought at the time – but it was just gradually increasing. I believe this was the beginning of healing. I no longer felt like there was something stuck in my right eye, but that had moved firmly to my left eye.

The sensation was not distracting, but definitely present.

I made the mistake at the end of the night of trying to see Star Wars. Mistake. I was able to see part of the previews and that was it. Eyes closed for the rest of the movie. Even a thin slit was too painful. My eyes wouldn’t keep open.

PRK – Recovery Day 1

They had me do a follow-up appointment the next day. There wasn’t much to this other than a brief vision exam (I could easily read the 20/15 lines). I’m not sure what to make about that. Some research indicate that people have blurry vision at this point. Others indicate that your vision is better than it will be in the end at this point. For me, I had no discomfort, or blurring at all. I drove back to home and napped/worked (laptop screen.) As prompted, I was using drops at least every 15 minutes. That part is a little frustrating, but… worth it in the end I suppose! Other than my eyes feeling a little weird and my vision being sharper than before even with contacts/glasses, I had absolutely no indication that anything was different until late afternoon.

Towards the end of the afternoon I noticed a little light sensitivity when using a computer screen but thought nothing of it. Only Futurama could nail the doom that would follow so well:

Late afternoon/evening I switched to playing video games. I noticed that my eyes were feeling tired as the evening wore on. I also noticed that I was increasingly sensitive to light. This is one of the symptoms as the epithelial layer grows back so I thought nothing of it. By the end of the day, I struggled to look at a computer screen for longer than 15 minutes. I felt no discomfort other than that – no pain, no ‘something is in my eye’ sensation, no dry eye sensation or anything. The drops kept me pretty lubed up at that point but other than the light sensitivity I still had no indication that I had surgery – other than again not having glasses on and being able to see crystal clear.

PRK – Surgery

I had a week to stew on the procedure after my exam. I knew that I would be terrified during the procedure, but so thankful after. Holding onto that thought helped. I arrived a little early only to be sent to the wrong location (an empty room where I waited for 15 minutes.) The only negative thing I have to say about any of the process at KU vision center is that not everyone is on the same page, and that in a big organization there’s room for disconnects. Eventually I flagged a nurse and proceeded through the paperwork portion. I was a little rushed for time at this point but the administrator that I was working with explained what the implications of what I was working on was. TL; DR, it is a risky process, and things go wrong. The typical outcome of a problem is having ot have a second surgery, but… do your research and read the horror stories first. They are out there and you should definitely understand the worst case scenarios. Keep in mind that there have been giant strides in technology over the last 10 years and the majority of comments are from people that had a problem – not everything will apply anymore, and that for every negative comment, there are probably 9-99 really happy people.

Finally get done with paperwork and get taken up to my room. There they give you a valium (this was the first time I have ever taken medication like that and it really does help.) They did waves of numbing drops. The oddest part of the pre-op process was when they took a (medical) form of a sharpie and drew some dots on my eyes. Weird! Nothing too exciting happened here, it was a total hurry up and wait.

All medication kicks and and I’m led to the actual surgery room. The entire second floor was a huge change from the previous experience where things were a little run down. Everything looked new, clean, and shiny. That helped remove some nervousness. There was a small team standing by. Everyone was very nice and professional – I would assume the majority of their patients are very nervous.

By far the hardest part of the procedure turned out to be next. They put a little device in to hold your eyelids open so they can work on them without your blinking. It’s not super comfortable as it goes in but the discomfort quickly fades as your eye muscles relax. They then put some kind of a ‘well’ into place with a liquid in it that numbs your eye completely. You feel the most pressure during this phase and it’s an odd sensation. Not painful, but very odd. Once that was done Dr. Bishara began scraping off my eye. That was unsettling as well – you can see the brush, feel pressure, and your vision is distorted where the brush is. Miranda explained that she was removing dead skin cells from that part of my eye so the laser would get a perfect run. This part took by far the longest.  Being on valium I was loopy at this point so I’m only guessing, but I’d say this took 5, 10 minutes an eye.

Once she was done here she rotated the chair into place and it was time for laser eyes! To say I was terrified here was an understatement. I had on purpose not read anything on this portion of the experience. Turns out, it was a letdown. The laser charges and discharges multiple times over about 10-20 seconds. With each pulse I think I felt a little wave of heat, and the little LED they have you stare at got a little sharper. When they got done I could see the LED clearly. It was surreal. The process repeated for the second eye. Well of chemicals, scrape scrape scrape, pew pew, all done. With the second eye I saw a white mist between my eye and the LED. It took a second to figure out that that was smoke. They have a vacuum hooked up to quickly suck up any smell of burnt flesh but if you’ve ever smelled this before, or branded a cow… it’s pretty unmistakable. The smell only lingers for a second or two but that was the worst part, just knowing what was happening. There was no pain or discomfort of any kind.

Not everyone has this luck but I probably could have driven at this point, my vision was as crisp as it ever has been but they valium you up pretty well and not everyone walks out with perfect vision. I had a ride lined up.

The instruction sheet wasn’t super clear here so I was confused and missed my first drop period (also, napped) but you’ll be putting in drops quite often for the next few days/weeks. Nothing eventful happened this evening. My vision didn’t change between this evening and the next day and  then I could easily read 20/15 and I think between 20/15 and 20/10, though that was not tested at the vision center.

PRK process – before

I started wearing glasses since I can remember and throughout the years my vision had steadily grown worse. I had toyed with surgery but given the cost and risks it was not something that I had seriously considered. I’m near-sighted and I have astigmatism. That lead to ever increasingly expensive contacts and increasingly poor vision – even with contacts and glasses. I had a couple of close calls where I was away and had to get contacts in an emergency and had to wait or pay for very expensive same-day glasses/contacts. I hate touching my eyes to the point where putting drops in or having the annual air test was almost impossible. I was terrified at the thought of my eyes being worked on (touched, or the laser) but the thought of being able to read clearly again at a distance made getting more information worth it.

I started doing inquiries and discovered that a good friend had undergone PRK a few years back and a scuba buddy had undergone the procedure a decade ago. They couldn’t rave enough about their vision after and that was enough to make me make the call. In my area there’s a very well known center ( http://www.durrievision.com/ ) that most people go to and then rave about. I did some digging and discovered another location in my area does the same procedure for less. Durrie vision quoted roughly $5,500 for the process and KU Vision Center quoted $4,400. Both places had good reviews and asking around it sounded like they both did a good job. During the process I asked about the machines. Maybe someone can correct me but it appears that for the procedure I’m doing that there was no difference in equipment that either place used.

One of the things that you should know going into this process – you will need a pair of glasses. You cannot wear contacts before the eye exam, or the laser correction. It can distort your eye and you will wind up with an improper correction – read needing contacts/glasses even after finishing the process. Other information that is useful is that Lasik/PRK is not covered by insurance. It’s an out of pocket procedure. I recommend using an HSA to pool money. That was a nice way to save up, but there is a $2,500 annual cap and most won’t roll over much of that, if any.

The exam!

The exam was pretty simple. I got there at 3pm and was done a little before 5pm. I was very worried going in as I typically have my wife put eyedrops in my eye – I couldn’t keep them open. There wasn’t a ton of info on what I would find during the process so it was unsettling.

The three parts of the exam were checking my vision, making sure that my prescription was correct, then mapping out the actual surface of my eye, then testing cornea depth to ensure they were deep enough. The second part of the prescription portion was no different than any glass or eye exam, with maybe a little more time put into it to ensure they nail it.The first part is odd. They had me stare into a machine with some LED’s while it tested/mapped out my vision. The nurse wanted me to not focus directly on the LED but to kind of pick a point past it. That’s probably the hardest part of the entire exam to do. This took several minutes. The nurse didn’t note when I could blink which led to dry eyes and making it harder not to blink during the testing part. I’d recommend making sure to ask to let you know when they’re ready – just to speed things up.

The mapping process was weird. They have you stare into a machine which takes photos of your eyes. There’s lines and waves of patterns and it looks a little like you are staring into an fractal rotating pattern. This part was really easy, you knew exactly when you were being tested. No dry eyes here.

The most uncomfortable part of this was the testing of the cornea, and the dilation. Even this was pretty easy. A nurse literally touches your eye with a machine. You can’t really see anything other than a distortion in your vision where the pressure point is. They have your eyes well numbed by this point so there’s no sensation other than pressure. There’s no pain. They dilated my eyes to validate that the previous checks was correct (apparently most people cheat in vision exams to try to bring things into focus. If you can’t see it without squinting a little, don’t and let them know.)

All of the nurses through this point were very kind and professional. My wife (a dental hygienist) likes to remind me that young men are the worst patients. We are squeamish, and the most high-touch. I was no exception here and I am grateful to the nurses.

Finally I got to see my doctor Miranda Bishara. She talked me through the process and answered all of my questions. I had qualified for either Lasik or PRK, though my corneas were a little on the thin side – if I have more procedures they would all be PRK. Since our eyes are constantly changing in 20 years I might need a touch-up. In addition, there’s a safety factor.

Lasik involves creating a flap of tissue and correcting the cornea under it. PRK involves removing the epithelial layer and then correcting the cornea. There are risks either way but with the flap there’s scar tissue. If there’s trauma, it can cause the flap to rupture. In addition, since the cornea is under pressure and I really like scuba diving (you can have multiple times the pressure of the atmosphere with even basic diving) it seemed that PRK might be a safer option for me. There seems to be no indication that scuba diving is a risk with either option but given my thin corneas, the fact that future operations would be PRK for sure, and the fact that in my doctors experience PRK typically is slightly more stable in terms of vision that is what I opted for.