2 Month Follow-Up

I had my 2 month follow up appointment today and the results were great... 20/20 vision in my right eye and I could read part of the 20/15 line in my left eye. My best corrected vision is about the same as it was before surgery. I could read slightly more with my left eye after about .25 diopters of correction and I had approx .25 diopers of astigmatism in my right. Both of these numbers are small enough to be neglected according to the folks at Insight. I'm glad I'm not going to be one of the 3-5% that needs another surgery after a -8 diopters correction!

I'm going to remain on Vexol (steroid) drops for the next couple of weeks - 2x per day this week and then down to 1x per day next week. After that I'm done with steroid drops and just need to take rewetting drops as needed.

My vision has been great overall for the past month. I stopped having problems with night vision probably about a week after my last June post. I have started to notice a bit more "ghosting" or "haloing" around bright objects in low light. It's nothing that makes driving or doing anything difficult at night - just more of an annoyance than anything. I'm not sure whether I'm just noticing this now that the rest of my vision is as good as it is and it has been there the entire time or if it's been getting worse. Dr Johnson said to monitor it for the next month. He said to pay attention to whether my eyes are dry when I notice it - It may be due to lack of tear film. He did mention that the tear film was slightly less than normal in my visit today - and I have noticed that my eyes have been more dry than usual for the past two days.

Thursday, Day 14

The past few days have all been very similar with respect to my vision. I feel like I start out the day with the kind of vision that makes me forget I ever had surgery. This lasts until about 5-6 PM when my eyes start to dry out a bit and I notice my vision getting a bit blurry. Rewetting drops help but slight blurry vision persists for the rest of the night.

I was able to drive Tuesday night after the Rockies game with no problem. I did have a bit of trouble making out street signs but it didn't really matter much since I knew where I was going :)

Today I had my follow up appointment. I was able to see 20/20 in both eyes and could read some of the letters in the 20/15 line. I did need to strain to read them and they seemed to be going in and out of focus. The doctor said that is normal and it will take a month or two for that to all settle out. He says everything looks very well on the surface of the eye, there's just a lot of healing that still needs to take place. I'm safe to do anything I want at this point other than rub my eyes. I went wakeboarding tonight with no issues (and really enjoyed not dealing with contacts!)

I was instructed to stay on the steroid drops (Vexol) for the next month and keep using rewetting drops when my eyes are dry.

Monday, Day 11

I would call today the most "normal" day of vision I've had since surgery. My left eye lagged a bit and there were moments where I would notice some difficulty reading the screen, but overall I noticed vision problems less today than any other in the past week and a half.

My next follow-up appointment is tomorrow morning so I will have some new vision measurements to share.

Sunday, Day 10

Last night I went to a party with friends. I noticed blurry vision most of the night and my eyes were very dry between rewetting drop applications. I felt like I was straining a bit to make out faces/expressions. It's the first time I've been out at night since the surgery. My night vision wasn't great but by that time my vision in the light had deteriorated to the point where I'm not sure whether the poor vision I had at night had anything to do with the fact that it was dark outside. I had a friend drive me home. I could have driven if I absolutely needed to but I definitely noticed some difficulty making out signs and pedestrians. I did not have any problems with oncoming car headlights when sitting in the passenger seat and I noticed no halo or other effects you hear about with LASIK.

Today my left eye seems like it's worse than it has been all week. Everything seems blurry with the left eye regardless of distance. I don't think I'd be able to read anything with my left eye only.

My right eye seems pretty similar to yesterday (maybe slightly better) and great compared to my left eye.

Saturday, Day 8 And Morning of Day 9

I didn't post yesterday because I really had nothing new to say. My vision had remained about the same since my post on Wednesday. I was able to spend a full day Friday (about 11 hours) looking at a computer screen, although I was ready to be done by the end of the day. I can't say for sure whether it was actually getting easier or whether I was just getting more used to the slight level of blurriness that remains.

It's now Saturday AM, just under 24 hours + 1 week since I went into surgery. I have an exciting development this morning... overnight my left eye has caught up with my right! This morning I can see as well (or possibly better) with my left eye. I'm guessing if I took an eye test this morning I would be 20/20 in both eyes. This is reassuring because my left eye heeded extra correction (from -8 dioptres) and had the highest chance of needing an additional surgery (3-5% according to the statistics I'd read.)

As of this morning very little evidence of surgery remains. I think I might be slightly more light sensitive (squinting a bit as I type with morning light streaming in) and I have not yet attempted night driving. I did wake up with very dry eyes this morning, however within a few minutes of blinking my eyes feel back to normal (even without rewetting drops.)

I will continue with updates as I see any changes.

Thursday. Day 7

My vision today seems very similar to yesterday, possibly slightly worse. I had no issues whatsoever driving to work today (first time driving since surgery) and driving home after working a full day.

Once again today it seems my vision is best the first few minutes after using rewetting drops.

I noticed a bit more light sensitivity when outside during lunchtime, but no problems when I put sunglasses on.

Wednesday, Day 6

I feel like the vision in my right eye was very near perfect today. Still a bit of blur that seems to disappear for a few moments when I use the rewetting drops. My left eye is lagging a bit but in general I can see well (I'm typing this on my mobile phone.)
Tonight I stood in front of the mirror and started to try to take my contacts out by habit! I guess that means my vision is getting better. After keeping the car in the garage for a week I think I'm ready to drive to work tomorrow.

Tuesday (day... 5?)

Today was pretty similar to yesterday. I didn't wake up with 20/20 vision but I did have pretty consistent vision all day. I did work a full day after catching a ride in with my co-worker Matt. In reality I think I'm fine to drive today but didn't think I needed to take any extra chances. I stared at a computer screen most of the day and by 5:00 I was ready to call it a day and lay down on the couch for a while. It was less about eye strain and dry eyes though and more about just getting annoyed with reading slowly and needing to sit so close to the monitor.

Today the big change has been that I feel like I have 20/20 vision for the first few minutes after I put in rewetting drops.

I went for a jog over lunch hour and that went fine. I really have no symptoms left other than cloudy and hazy vision.

I'm going to plan to ride with Matt to work again tomorrow and wait another day to attempt driving out of an abundance of caution.

Monday - Follow up appointment 2

Monday was the day of my follow up appointment and the day I finally was able to get my bandage lens removed. I felt sure this was causing most of my discomfort and suspected it may have been causing some of my vision problems as well.

I woke up 20/20 on Monday again... however once again my 20/20 state only persisted for about 10 minutes.

My follow-up checkup at 8:45 went fine... the doctor said I had regrown enough epithelium to completely cover both corneas although it appeared it was still very thin in the center on the left eye. I was given some new medicine to use now that the bandage lens was off.

Removing the bandage lens was slightly uncomfortable but not bad - again numbing drops are your friend here. I did feel better once the lens was removed but unfortunately could not see any better. If anything I was seeing slightly worse on Monday than I was on Sunday... however I didn't have the light sensitivity issues.

I was able to work on the computer for approximately 4 hours Monday, I then took a break and went out to Sushi with Tom and Sam. I came back at around 9 and wrote this blog! The biggest difference from Sunday has (thankfully) been the lack of eyestrain... even though I can't see well at least I don't have problems focusing. Other than some occasional dry eyes and bouts of additional blurry vision I'm not having any problem using the computer. I'm planning to go back to work tomorrow although I still don't feel comfortable driving yet. I think I could do it if I absolutely needed to but I plan to get a ride with a co-worker just to be safe.

The Third 24 Hours

The big excitement on Sunday morning was waking up 20/20! Well sort of... I felt like I had 20/20 vision for about the first 10 minutes, then everything went cloudy again. I had read this was normal so I wasn't concerned. It was a relief to be able to see well again even if it was only for a few minutes.

Sunday was pretty similar to Saturday with the exception that I noticed more light sensitivity. I wore my sunglasses inside at all times and shielded my eyes with my hands whenever I looked up. I spent most of the day inside but sat outside for a while after dark.

The Second 24 Hours

I was warned by the doctor (and by several blogs) that the 2nd and 3rd days are typically worse than the first. This was true for my case as well.

My vision was blurry and it was hard to focus on anything. My TV is mounted above my fireplace and looking up at it was very tiring - it felt like I was straining to make anything out. I spent the day listening to an audiobook (George Orwell's 1984.) I highly recommend setting up an audiobook for the recovery period... this was an excellent way to kill time. I spent most of the day with my eyes closed.

Later that evening I was feeling fine and felt anxious to get some fresh air. I went for a walk with Tracy down to the end of the block and back, then spent a few minutes in the backyard watering my trees. I then had dinner while watching/listening to Friday's Tonight Show with Conan O'Brien on my Mythtv.

At about 8:00 or so I started having my first real bout of PRK pain. My eyes started watering and did not stop... I had tears dripping off my chin for the better part of an hour or so. The feeling for me wasn't a "needles in the eyes" pain like other sites described, it was more like (as a contact wearer) the feeling you'd have if you slept in your contacts overnight and didn't have rewetting drops. Eventually the rewetting or pain drops worked but it took a while.

I went to bed at about 11:00 and slept through the night without issues. I woke up again at 5:00 with dry eyes but this time with no pain... after some rewetting drops I slept soundly again until about 8:00.

The first 24 hours

The first 24 hour period after the procedure was in a word "uneventful." I slept off the sedative from about noon-5, then had dinner and "listened" to some TV. i could see well enough to do everything other than read or use the computer but I had been encouraged to keep my eyes closed as much as possible. I went back to bed at about 10 and slept through most of the night with no problem.

I woke up at 5 AM with some sharp pain in my left eye - it felt like my bandage contact had become glued to my eye overnight. After some tears and rewetting drops and a few minutes of pain I was back to normal again. I slept soundly until about 7:30 or so.

I went back in for my day-after appointment (my friend Craig drove) at 9:00 Saturday morning and was told by the doctor that approx 30% of my epithelium had regrown and everything was on schedule. I was advised not to try to read or use the computer for the next few days until the bandage lens was removed. I made a follow-up appointment for Monday the 8th at 8:45 AM.

The Surgery

I arrived at Insight for my PRK procedure at 10:15 AM on Friday June 5th 2009. I was given a mild sedative to help me relax and a squeeze ball to help relieve anxiety. I also received several eye drops before going into the procedure. Immediately before entering the room with the laser I had one more visit with the surgeon (actually the first time I had met the surgeon...) he took one last look at my cornea but did no further vision tests.

I would guess I entered the laser room at approximately 11:00 AM or so. Before starting I had the surgeon humor me and tell me which correction would be done in each eye... it made me feel better at least!

The procedure started with some clamps placed on my eyelids to hold them in place. I expected this to be much more uncomfortable than it was. It's probably a combination of the numbing or other drops applied to your eye but it really wasn't that uncomfortable. I could feel my eyelids flinching occasionally as if they were blinking and it actually felt like they were closing and re-opening rapidly.

Next something that looked like a small ring on a stick was lowered onto the surface of the cornea. I could feel some liquid dripping on the surface of my eye and heard the nurse counting down from 45 in the background. This was the application of the chemical to remove the epithelium in preparation for the laser.

After 45 seconds the ring was removed along with the chemical. The surgeon then used something that looked like a miniature broom to remove the remaining epithelium. This sounds painful but was not - again probably due to the numbing drops. It felt a bit like someone was pressing on my eyelid with a pencil eraser.

Finally it was time for the laser. I was expecting something to hold my head or eye in place for this part of the procedure but I was mistaken. I just looked up at a green dot in the laser, located about 6-12 inches from my head. When the laser started it sounded a bit like a arc welder or some type of spark device going off raplidly. After reading other posts I had expected the "burning hear" smell, however it was even stronger than I expected and definitely unmistakeable. The laser took probably 10-15 seconds during which time the green light got wider and blurrier as I watched it.

After the laser, the surgeon doused my eye with cold water. It was minimally uncomfortable... I didn't experience the "ice cream headache" others have, it just felt very cold... especially on the sides of my eye.

Finally, a bandage lens was placed over my eye. This looked thin and clear, approximately twice the size of a normal contact lens.

The entire experience was repeated on the left eye.

When the surgery was complete I sat up on the table and instantly noticed that although my vision was blurry I could see much better than when I entered the room. This was reassuring.

I walked out of the room on my own and sat down in a chair in the waiting area. I was given another series of drops. In another 20 minutes or so I talked to the doctor again. He did a few more checks to make sure the bandage lens was in place and everyhing looked OK. I recieved a kit with eyedrops and instructions for the next 4 days. I left shortly after and was home around noon.

Pre-Op

I didn't decide to blog this experience until after I decided to go ahead with PRK, so some details may be spotty here...

Background: I'm 30 years old and have worn soft contacts for approximately 20 years, approx 16 hours per day. I almost never wear glasses other than to get in and out of bed.

I went to three different places for pre-op LASIK screening. LASIK was definitely my first option. Of the three places I visited, one (Icon) told me I could do LASIK and two told me I should do PRK instead in the left eye based on my prescription and cornea thickness. The two that told me I should use PRK both used the same facility, Insight LASIK in Layfayette CO. I had initially planned to to PRK correction in the left eye and LASIK in the right eye.

I decided to go with insight over icon mostly for convenience reasons since Insight was much closer. I also did get the feeling that Insight was a bit more thorough and potentially a bit less "assembly line" than Icon in the pre-op screening. The cost was slightly higher at Insight - $2100 per eye as opposed to $1500 at Icon.

My cornea thickness measured 3 weeks before surgery (using the pentacam) was 522 uM left eye and 524 uM right eye. My prescription was -8 diopters in the left eye and -6.5 in the right eye.

As recommended by the doctors I visited in the pre-op screening, I went without glasses for two weeks, then went back for another pre-op visit. The pre-op visit consisted of another pentacam test as well as a test with an ultrasonic instrument used to test cornea thickness. After wearing contacts for two weeks I was told my right eye thickness had shrunk to 508 uM, making the right eye thickness borderline for LASIK. The doctors at Insight recommended I do PRK in both eyes. I reluctantly agreed... I wasn't excited about the potential for a longer and more painful recovery but decided it would be a safer option.