PRK Journal, Day 28

It's now been nearly a month since the surgery.  The last week has been pretty steady, with actually a small decline, especially in the left (reading) eye.  It's nothing that has kept me from from doing any normal activities, just a little loss in sharpness.  There's still supposed to be some fluctuations in the course toward the final corrected vision, so I'm not too concerned.  Hope it improves though.

Reading and computer work is all fine and normal now.

PRK Journal, Day 21

The past week has been one of continued gradual progress, and maybe a plateau for now.  The target test numbers have leveled off right around the 20/20 level for each eye, with the right eye always a little better as planned.  It is the distance eye and got the full Custom Vue treatment.  The left eye did not as there's no point in the ultra fine tuning since it was to be left short of full distance correction anyway, as the reading eye.

I'm hoping that this isn't the final level though.  Things are still not as sharp as they were with glasses, plus they take just a little longer to come into focus.  It feels like I have to be closer than before to street signs and license plates, for example, to be able to read them.

I am now working with my computer at the high resolution setting I used pre-surgery.  Need for the artificial tears has fallen off drastically.  I now use them only a couple of times a day, and it's not a strong need.  The eyes do continue to dry out somewhat at night.  I usually wake up one or two times and decide to reach for the drops.  This also continues to get better.

One sort of gross note:  I'm still taking the steroid drops, now three times a day, and I find I can taste them in the back of the throat right afterward.  Makes you think there's a system leak back there somewhere, like radiator coolant finding its way into the fuel lines.  But we are not cars, and tasting eye drops is apparently common and harmless.

PRK Journal, Day 14

Tomorrow it will be two weeks since I had PRK surgery to correct my vision.  There has been great improvement in the past week.  Distance vision has improved almost every day and is now near (but not quite at) 20/20 in my distance eye.  There's still a hard to describe lack of sharpness that's not the same thing as acuity.  I don't know if this is a monovision effect or what, but it also gets better every day and isn't really that noticeable now unless I'm looking for it.  On about day eight the road signs finally started becoming legible.  Close up vision isn't quite as good, though also improving.  It tends to start out reasonably good in the morning and degrade somewhat over a day of computer use.  I've been able to bump up the screen resolution and bump down the font size, though it's not yet comfortable at the full resolution I had before.  But I can work without any major issues now.  I have much less need for the artificial tears--maybe 4 or 5 times a day I feel the need compared to 30 or more times a day last week.  Also I'm definitely reading with my left eye, as planned.

Overall I'm feeling much more encouraged than I was a week ago.  Other reports I've read have people still not experiencing good vision even after three or four weeks.  I think doing a quantitative test every day has been helpful.  It's really hard to decide how well you're seeing just using words.  And when your vision changes every day it's hard to remember exactly how it was a day, two days, three days ago.  The target test has forced me to see that there's been consistent improvement, even if slight. Seeing a target from five inches farther away than yesterday isn't a big difference, but cumulative improvements do add up.

The acuity graph shown is an estimate, based on an assumption that my daughter's contact-corrected vision is 20/20.  She can see the target at 12.5 feet.  I'm now at about 11 feet.  The graphs should be taken as having error bars on the order of a foot or so, since it's hard to exactly pinpoint where the target comes in to clear view.  Also I've been taking the measurement first thing in the morning, when things seem to be at their clearest.  I've been losing 6-12 inches by the end of the day, only to regain that loss and more after a night of sleep.  Hopefully that daily regression will stop as things settle in.

The graphs show what I reported earlier: with surgery on Wednesday, vision on Friday and especially Saturday went south very quickly, rebounding after that.  Days 6 to 9 showed a lull, with steady improvement thereafter.

I've had no issues with night driving, in contrast to some.  No halos.  Bright sunshine is still a little too intense without sunglasses, which I'm supposed to wear for a summer anyway for healing purposes.

PRK Journal, Day 7

A bit of a frustrating day working on the computer.  It was hard to read, though I managed.  I've read others reports from the 1-3 week range saying that the artificial tears gave a brief improvement in vision, and I've found the same.  I get one or two noticeably clearer minutes.  As a result I'm plowing through the tears at quite a rate, probably every twenty minutes while I'm at the computer.  Which the doc told me is just fine, in fact it helps the healing.  I'm using the rest of my preservative-free drops first.  They're fairly expensive but I'm happy to pay a few dollars for any acceleration of the timeline.  I've also got a bunch of cheaper drops with preservatives which I haven't tried yet.

I was out last night.  I could have driven.  I'll still try to avoid it for a bit if I can.  Sign reading is still a bit dicey.

I'll switch to weekly updates from here.  Apologies to any readers on the dullness of these reports.  Basically I'm forcing myself to keep a record so I can see what the progress has actually been.  Also I found that these types of running journals on other blogs to be very helpful, so maybe mine will be of similar use to others considering or recovering from PRK.

Comfort: Hitting the artificial tears as hard as ever.  Otherwise fine.
Photosensitivity: Only bright sun and direct glare (as off wet streets)
Target: Both eyes: 72 inches.  Right eye: 72 inches.  Left eye: 57 inches.
Closeup vision: not so great today.
Driving: OK, not night driving yet.
Working: Did it, but it was tough.

PRK Journal, Day 6

There were lots of milestones today.  I drove for the first time, I worked for the first time, and I had the bandage lenses removed.  Driving was basically fine, especially since I've driven the routes I drove a thousand times.  I can read most signs, but sometimes it takes a second for them to come into focus.  I reduced the resolution on my work computer monitor and blew up the fonts so I would have to strain as little as possible.  It's workable, but some improvement would definitely be nice.  There's still a blur surrounding all the letters.  I took frequent brief rest breaks as my eyes got tired.

The checkup appointment went well.  First they check the distance vision on each eye with a standard eye chart.  The instruction is to read the smallest line you can, but as I was reading one line, the next line would gradually sharpen enough to be read, so I ended up reading several lines.  They then tested the left eye for reading, and again smaller lines would come into focus as the seconds passed.  I ended up being able to read much smaller than I thought, but until the focus comes more quickly, reading itself will not be fully normal.  An interesting addition is that they also test the reading eye by having you look through a shield with pinholes in it.  The diffraction through a pinhole really, really reduces blur.  It was nice to (briefly) see sharp text again.

The tech then took the bandage contacts out.  They really stick on there, and it takes some manipulation to get them off, which hurts a little.  Overall a relief, though my eyes felt a little dry and scratchy afterwards.  The doctor then came in and examined each epithelium with a scope.  He initially though he saw a small defect in the right eye.  He had the tech put some dye in that eye and looked at again.  He declared it looked not completely healed ("a little ratty" was his exact term), but there were no defects requiring any action.  It ought to catch up in a day or two.  The left eye had healed very well.  With the lenses gone, I don't need the plastic eye shields to sleep any more, which is nice.  No more human fly look.

Unfortunately the removal of the lenses has led to a small drop in vision.  Not enough to restrict driving or working, though noticeable.  Gradual improvements with some fluctuation should be the rule from here on.  He advised holding off on night driving for a couple more days.

I had been on three medicated drops: a non-steroidal anti-inflammatory, an antibiotic, and a steroid (FML).  I'm now done with the first two.  I'll stay on the steroid for four more months, tapering down the dose each month.  I gather that the steroid slows how quickly the eye regrows.  You don't want it to happen too fast or some irregularities can develop.

Artificial tears now go from every thirty minutes to as I wish for comfort.  Right now I still find myself doing it every thirty minutes anyway.

Comfort: Eyes are a little tired from a day on the computer, and the removal of the lenses also led to some dryness.
Photosensitivity: as before, sunglasses outside, fine inside.
Target: Both eyes: 68 inches.  Right eye: 68 inches.  Left eye:56 inches.  This reading was taken at the end of the day, after the lenses came out.  Pretty sure it was a decent bit better this morning.
Closeup vision: Especially immediately after the lens removal, reading is a little strenuous.  Still lots of blur.
Driving: First day.  It's OK and seems safe enough.  Holding off on night driving for now.
Working: First day.  Reasonable success.

PRK Journal, Day 5

After a somewhat dispiriting Saturday, I woke up this morning to noticeably better vision.  There is not nearly as much smudge and blurriness surrounding everything.  While the target test numbers are better, they don't fully convey that difference.  That test is measuring acuity, but one can read a letter with lots of blur around it, or without.  I can read text in a normal book fairly comfortably at the moment.  I was able to reduce the font on the computer as well.  Testing individual eyes, it looks like I'm reading with the left eye, as is the plan.  The right eye has improved greatly over yesterday in its distance role.  On the whole things are still far from my previous glasses-corrected vision.

I'm sure things will continue to fluctuate and this marked improvement over yesterday is probably a local max rather than a permanent gain.  There are still weeks to months more until final stabilization.

I've been on three medicated drops: a non-steroid anti-inflammatory, an antibiotic, and a steroid.  The non-steroid course finished yesterday so I'm down to two, each of which is taken four times a day.  Plus the artificial tears, which I've been fairly disciplined about using every thirty minutes as directed.  I've read other reports where people have awoken in the morning to very dry eyes, some as far as having their lids stuck to the eye and needing to work artificial tears into the corner just to be able to open.  I haven't had anything like that.

Comfort: Pretty good, though I'm writing this in the morning.  I'm looking forward to getting the bandage lenses off tomorrow though.
Photosensitivity: Just fine indoors, still need sunglasses outdoors.
Target: Both eyes: 77 inches.  Right eye: 77 inches.  Left eye: 41 inches.
Driving: I feel like I could at the moment but will again take today off.  The plan is to drive to work tomorrow.
Working: Tomorrow.

PRK Journal, Day 4

This was definitely the worst day of vision so far.  I did the target test in the morning.  It doesn't really reflect how bad I could see today.  I tried it a couple of times after that without measuring and it was more in the 20 inch range.  The right eye was previously saving the left.  Now the left has moderately improved while the right went south.  Reading almost anything was difficult and blurry.  I went to a ballet performance and a play.  I could follow the action but could not really get the faces in focus.  This is sort of discouraging, even though the doctor told me this would probably happen.  Hope this is the bottom.  I couldn't really do much useful work like this.

Comfort: Tired eyes most of the day, especially evening.  No real pain.
Photosensitivity: A little more, not severe.  Sunglasses definitely necessary outside.  Felt more comfortable away from windows inside.
Target: Both eyes: 53 inches.  Right eye: 37 inches.  Left eye: 42 inches.
Closeup vision: Very blurry.  Reading was very hard and strenuous.
Driving; Would have been a bad idea, especially if I needed to read any signs.
Working: Not yet.