PRK Recovery Timeline: My Day-By-Day Experience

By Melissa Evans Persensky

It’s a big and exciting moment when you find out you qualify for PRK (photorefractive keratectomy) surgery. Your days of glasses and contacts may be a thing of the past!

But then the questions start:

• What exactly should I expect after PRK?
• The surgeon told me that the results won’t be immediate. But what do those early days actually look like?
• Why can’t I just get LASIK like everyone else seems to?

I know. That was me.

After 23 years of sticking contact lenses in my eyes and searching for my glasses (yet again), I was over it. And even though the thought of vision correction surgery was intimidating, the hope of clearer vision won out.

I made the appointment. I lined up a ride home from surgery (thanks, Mom!). And looking back, I’m so very glad I did it.

But in between surgery and my contacts-free life now? Even for all of my research (I am a healthcare writer, after all), it seemed a mystery at the time.

So, allow me to share my day-by-day recovery from PRK.

But of course, experiences vary. That’s true of any surgery, medication or diagnosis. So, I asked Jason Marcellus, OD, my optometrist throughout my journey, to weigh in, too. We hope this will help give you a clearer picture of what to expect for your day-by-day PRK recovery.

Pre-surgery

Last year, my optometrist shared that my prescription had stabilized and suggested that I could be a candidate for refractive surgery. In my mind, that meant LASIK. That’s the one you always hear about. The Kleenex® of the laser vision correction world.

I met Dr. Marcellus at Cleveland Clinic’s Cole Eye Institute during my pre-surgical appointment. That was after I watched a video about the types of refractive surgeries: LASIK, SMILE and PRK. LASIK, with its short recovery time (You can be back to work the next day!), was the one I hoped for.

After watching the video, members of the refractive surgery team performed a slew of tests.

• A glaucoma test, where they puffed air into my eyes
• An eye exam, to confirm my current prescription
• Corneal topography, a test to essentially “map” your cornea (all I had to do was look at a light)

After that, Dr. Marcellus shared that I was a good candidate for PRK.

The first words out of my mouth? Can’t I just get LASIK? PRK sounds like it kind of ... sucks?

He explained that all refractive surgeries have similar outcomes (that is, they’re my ticket out of contacts). But that LASIK was out of the question for me.

“Your cornea is the outside layer of your eye. When we look at it up close, it’s like looking at a topographical map of peaks and valleys. Your valleys are too deep for LASIK,” Dr. Marcellus explained.

As for the suck-factor?

“Yes, the first few days after PRK can be uncomfortable,” he acknowledged. “But it doesn’t last long. And after that, you’ll be on your way to getting out of those glasses.”

What’s more, he said that after the early discomfort, you’re less likely to deal too much with dry eye, which can take months to go away after LASIK.

“With PRK, you get all that healing out of the way in a shorter window up front,” he advocated.

The more I thought about it, the more I realized I was willing to deal with some up-front obstacles in hopes of having better vision. No pain, no gain, right?

So, I took a deep breath, scheduled the surgery and spent the next few weeks wondering what exactly my recovery would feel like.

Day 1: PRK surgery

My surgery took place on a Thursday. That’s the most common surgery day for PRK, at least at Cleveland Clinic, Dr. Marcellus shared. “That way, you have the weekend to take it easy and recover. A lot of times, having PRK on Thursday means you can be at work by Monday.”

I had been given a prescription for a Valium® (diazepam) to take before the procedure, if I so chose. I chose not to.

They called me into a surgical room and I lay on the table. My surgeon, James Randleman, MD, squirted a few numbing drops in my eyes and used an appliance to hold them open.

They got to work squirting more things into my wide-open eyes and swabbing them off. It wasn’t painful or even uncomfortable. (Though, it is admittedly unsettling to see things coming at your eyes.)

I was then told to look into the green light. There was no way not to really.

A few minutes and a few more swabs later, Dr. Randleman placed the bandage contacts. Think: contacts, but without a prescription — just a shield to protect your eyes in those first few days.

The eye-opener device was removed and I sat up. Procedure complete.

I blinked a few times and looked around. The room was a little fuzzy — similar to how things looked without my glasses on.

Then, I had a chat with Dr. Marcellus for my discharge instructions.

He gave me some sunglasses and three different kinds of eye drops: an antibiotic, an anti-inflammatory and several tiny tubes of preservative-free artificial tears (and specific instructions to avoid any artificial tears not labeled “preservative-free”).

I also had a prescription for a few opioid pain killers, which I chose not to fill, and instructions to alternate between acetaminophen (Tylenol®) and ibuprofen (Advil®) every four hours for the next several days.

Among the things I was told not to do that week:

• Vigorous exercise (you don’t want sweat in your eyes)
• Swimming
• Wearing makeup
• Playing contact sports

I would also need to try to keep water away from my eyes, including when I shower or wash my face.

With that, Mom drove me home.

As we were in the car, the numbing drops wore off. My eyes felt heavy. Like I was staring into the sun, and every reflex in my body was telling me to close my eyelids. So, I did.

When I got home, I took acetaminophen, used my eye drops and took a nap. I stayed in bed most of the day. My recovery was officially underway.

Days 2-3: Initial PRK recovery

The next two days, I mostly stayed in the dark. I listened to podcasts and eBooks. I had Siri read and send my text messages. I took two naps. My husband took over the household duties and cared for our kids and dog.

I’d say my eyes were closed 90% of the day for Friday and Saturday.

It’s not that my eyes hurt necessarily. It was more that keeping them open felt like entirely too much work. Over-the-counter pain relievers took the edge off, but it just felt so much better to opt out of opening my eyes at all. If I kept them open for more than a few minutes, they begged to be closed again. So, I obliged.

My eyes watered. My eyelashes felt crusty. And I hadn’t mastered the art of putting in eye drops, which dripped down my face.

It’s OK, I reminded myself. They said these days would be uncomfortable. This is normal. This is healing.

In sharing my first few days with Dr. Marcellus later, he explained what was happening at the cellular level.

“When you have PRK, we’re removing the outer part of the cornea, which is like the top of your skin. It’s a part of your body that grows and regrows constantly,” he pointed out. “That takes two or three days to heal, which is why you have those initial days of irritation. You essentially have an open wound on your eye that your body is working to heal.”

Days 4-7: Things are looking (blurrily) up

On Sunday, day four after PRK, I opened my eyes. And kept them open all day.

It was a turning point. The watering had stopped. I wasn’t reaching for artificial tears every 30 minutes.

I was up and about. I played games with my kids. I folded laundry.

I could look at my phone for a few minutes, but even with the screen brightness turned down, it felt too bright to look at for long.

The trouble? The world was looking blurry — enough that I couldn’t read the clock on my dresser. And yes, I tried putting my glasses on to see if it would help. It didn’t. The surgery changed my prescription so that my glasses were now too strong. Yet my eyes weren’t yet strong enough to actually see.

Baby steps, I reminded myself. The fact that my eyes were open and I was participating in my home life was huge. I went back to work on day five, with my computer screen zoomed in to 120%.

But I wondered when I’d have my “Aha! I can see!” moment.

Days 8-10: Slow and steady progress

I went to my follow-up appointment with Dr. Marcellus one week after my surgery date.

A vision screening confirmed that my eyesight was 20/50 in one eye and 20/60 in the other. Not exactly optimal, but a big improvement from the 20/400 vision I had before surgery.

For context, that means that before surgery, if I wasn’t wearing glasses or contacts, I could make out the big “E” on the eye chart ... and nothing else. After surgery, I could see about five rows above the 20/20 vision line on the chart.

“You’re technically legal to drive during the day,” Dr. Marcellus shared. “But I definitely don’t recommend driving at night yet.”

Still, he said that I was progressing on track. But my slow-and-steady progress wasn’t standard for everyone.

“Plenty of people come in for that one-week appointment after PRK and they have 20/20 vision,” he said. “Others, like you, take longer to get there. There’s a range of what’s normal.”

For some people, the bandage contacts fall out on their own. Mine didn’t. And Dr. Marcellus confirmed I was ready to be rid of them. He swiped them out. It felt very odd. (Think about it ... has anyone ever taken out your contacts for you!?) But there’s good reason not to DIY that.

“There’s a method to it,” Dr. Marcellus cautioned. “You have to be careful taking the bandage lenses out because you don’t want to disturb all those new cells underneath. You can risk undoing all that work your eyes have been doing to heal.”

Over the coming weeks, he assured me that my sight would improve.

“When you’re healing, the cells come in sort of like an avalanche. They pile up. And they need to smooth out for you to see well,” Dr. Marcellus put it. “When you blink, it’s like spreading icing on a cake. The more you swipe at it, the smoother it gets.”

At that appointment, all restrictions were lifted. I was free to sweat, swim and do all the contact sports I wanted. I didn’t need the antibiotic drops anymore and would slowly cut back on the steroid drops over the next few weeks.

Now, all that was left was to sit back and wait for the icing to smooth out.

Weeks 2-6: Are we there yet?

Removing the bandage lenses started to make a difference.

Each morning, muscle memory had me reaching for my contact case after I brushed my teeth. It was a routine that I’d followed day in and day out for more than 20 years.

But around week two, that changed. Rather than feeling compelled to put my contacts in, I reached as if I needed to first take my glasses off first. Progress!

I started looking at screens without any discomfort. I started driving (starting only with places I was familiar with). I turned the text size on my phone back down to the default settings. And I didn’t keep tiny tubes of preservative-free artificial tears in every room of my house.

As the weeks went on, I stopped thinking about whether it was too dark for me to drive to my daughter’s dance class. Or if it was safe for me to drive my son and his friend to a hockey game. I just ... did it.

I did it with confidence that my vision was A-OK. Without glasses. Without contacts. Just my eyeballs. Clearly seeing the world.

Those of us who get PRK might not get a share-worthy Aha! moment. We may not wake up one morning and go from a world of haze to one that’s crystal clear. It may be more of a slow burn. A steady buildup that takes time. And it can take some patience.

But good things come to those who wait. And I’m happy to report that at my three-month follow-up, I have 20/16 vision (yep, a titch better than 20/20). And it was well worth it.