PRK Journal, Week 5

It has felt like I've hit a vision plateau over the last two weeks, with little or no improvement.  Just some minor ups and downs.  I am fully functional, but not at my pre-surgery level with glasses.  I have begun to notice some ghosting, a fainter secondary image slightly off of the primary image.  That leads to blurring when reading at distance.  When I stare at a difficult target for a few seconds, I'm able to differentiate the two and finally read it, but it's quite different than normal sharp vision.  As I've said in previous posts, this surgery has emphasized to me that vision is a complicated eye/brain process, the subtleties of which are not nearly encompassed by a single acuity measurement.

Today I had my last followup appointment until six months from now when both eyes should be settled at their final level.  The bottom line is that my right (distance) eye is somewhere between 20/25 and 20/30, and my left (reading) eye is at 20/50.  Something of interest I probably should have put in the first post is that pre-surgery the right eye was at -4.00 diopters and the left eye was at -6.50.  Today the doctor said it generally takes on the order of one month per diopter to fully stabilize, so there are still a couple of months of improvement to come (recall that the left eye is purposely being left about a diopter short for reading purposes).  The scan revealed a small remaining astigmatism on the right eye which should smooth out with time.  He's still confident that that eye is on target for 20/20.  The left eye has a larger remaining astigmatism, and still a prominent epithelial ridge.  This is where the regrowing cells collide and form a sort of temporary epithelial Himalayas over the center of the pupil.  He was surprised that I'm able to read as well as I can with that eye right now.  When the ridge is beaten down by a few more weeks of blinking action, he said the reading should get much sharper.

If anyone is carefully reading these, they'll have noticed that my system of estimating acuity is, charitably, way off.  Neither eye is at 20/20 in reality, and the left eye isn't even close.  Perhaps I've been unconsciously biasing the results by convincing myself I can see the legs of the m in "Brahm's Lullaby" at distances where I can't quite.   And maybe my daughter was being more strict with herself when she claimed she could only make it out at 150 inches when using my standard she'd be more like 180 or something.  At any rate, I've altered the scale of the measurements so that today I'm at 20/27.5 on the right eye.  Unfortunately that adjustment leaves the left eye at 20/29, which again is way off what the pros measured today.  Perhaps another possibility is that the improvement will consist more in the time it takes to resolve the m at distance (currently several seconds) than in changing the distance itself.  Regardless, the exercise has been valuable in determining whether things are getting better, worse, or staying the same.

Other notes: the doctor saw a small amount of corneal haze today, which again is normal and should clear up.  He reiterated the need for sunglasses through the summer, which I've been following.  He also gave me a DVD of my surgery, which I'll watch at some point and maybe post here.

Steroid drops continue for the next three months, tapering off as we go.  Currently I'm to continue it three times a day, losing a drop per day per month.  The drops are $42 a bottle which lasts about two weeks at the current rate.  That's $8/gram, which is only about a sixth the price of gold, so what am I complaining about.