Thursday, January 31, 2013

My PRK Recovery: Week Four

It's a little frustrating how slow the recovery is at this stage.  I can't tell that there has been any improvement since Week Three.  Sometimes the ghosting actually seems more severe.  At the same time, I was away at a conference for several days and didn't take care of my eyes too well during that time (not putting in drops very often, some alcohol, not getting nearly enough sleep), so I'm not sure how much that factors in.  I tell myself it takes time and at least I can function.  Let's see what the next week brings.

Thursday, January 24, 2013

My PRK Recovery: Week Three

Today marks three weeks since I had PRK surgery and I wish I had more progress to report.  If there were any improvements this last week, they were so incremental that I cannot tell.  Generally speaking, my eyes feel fine but I still have ghosting, which makes everything feel just slightly out of focus and reading on the computer is a little weird.  Not sure if I mentioned this before, but unlike some of the other PRK accounts I read, I've never had any issues with my night vision.  No halos or smudging or anything.  Night looks much as it always looked when I had glasses.  Ghosting seems to be my main issue.  I try to put drops in my eyes when I remember, but I think dryness must not be a problem for me because I frequently forget to.  In the mornings I always have to put some in but once I'm out and about, they don't feel dry for long periods of time.  I've returned to Bar Method and it's great to be able to go through class without my glasses getting in the way all the time.  Right now, I'm just trying to be patient and let my eyes heal on their own schedule.  Overall I'm still very happy I had this surgery, because not having to worry about contacts or glasses is a real pleasure, even with ghosting.

Thursday, January 17, 2013

My PRK Recovery: Week Two

Any change in vision I've experienced this week has been incremental and subtle so I won't bother breaking down the week by day.  The biggest difference I noticed from Week One was a marked improvement in my far vision that seemed to be linked to some deterioration in my near vision.  It's a little hard to explain.  Between days 4 and 7, I felt that I was near-sighted, just with a better prescription.  So objects in the distance were blurry but I could hold up my iPhone and see text fairly well.  Now though, even text up close is blurry.  It's not the same kind of fuzziness I previously associated with near-sightedness, however.  It's more a doubling/shadowing of letters, I guess what some people describe as ghosting. So instead of seeing a V, I see something that looks like a W with half of it fainter.  It's like looking through a microscope in a way, and today I found that if I focus my eyes the way I do when I look through a microscope, I can actually bring the ghosted images together.  However, that seems to be a strain and so I'm trying not to do this.  So the blurriness does have clarity to it and I can read.  I am still enlarging my font though, to reduce the effort involved.

As many people have experienced, my vision is best earlier in the day and tends to blur more toward the end of the day.  I noticed this especially today when I was able to load a gel fairly easily this morning but when I was loading another gel in the evening it was quite difficult and I went mostly by instinct.  I was a bit lax with putting in my drops today though so dryness might have been an issue as well.  In general though, the only time my eyes are noticeably dry are in the mornings.  During the day I have to actively remember to put in drops since I don't experience any discomfort related to that, which surprised me.

I believe each day my eyes are getting better but it's hard to really tell if there's a difference from one day to the next.  Improvement with PRK really has to be measured in terms of weeks I think.  I had my two week checkup today and the doctor claims I'm seeing 20/20, which is exciting.  I don't quite believe I'm seeing that well though and hope I continue to improve my distance vision.  Right now I am mostly awaiting a return of clarity in my vision and eventually I hope to see even better than 20/20.  The person who was with me for most of my checkup kept on trying to get me to read 20/15, but honestly all those letters just looked like tiny circles to me.  My next (and ideally last) appointment is the 3 month mark, so sometime in April.  

Despite the mostly cloudy Portland days, I've been religious about wearing my sunglasses whenever I'm outside to prevent scarring and to prevent errant debris from flying into my eyes.  This is no hardship because I love my sunglasses and one of the worst things about being in glasses is not being able to wear sunglasses ever.  Overall I'm extremely happy with my surgery even though the recovery is gradual.  I'm functioning well at home and at work and the pleasure of not needing corrective assistance is always with me.  One interesting thing is how my eyes no longer feel tired at the end of the day.  With glasses or especially contacts, my eyes would often just feel heavy by the end of the day but even mid-recovery, I don't get that feeling post-surgery (aside from those first few days of course).  It makes such a difference in my quality of life.  Looking forward to the next few weeks!

Saturday, January 12, 2013

My PRK Recovery: Week One

Day 0-1: After my nap on Day 0, my right eye started stinging and both eyes started to water considerably.   I napped intermittently through the rest of the day and listened to the TV and radio and my boyfriend kindly read articles to me.  I went to sleep with my dark goggles taped to my face using a little roll they had given me so that I wouldn't accidentally knock the goggles off while I slept.  This was the only night I used that tape because it was awful to take off and made my face really sticky.  But I think for that first night it was a good idea.  Throughout the night and upon waking, my eyes watered pretty much continuously and sometimes I would lift the goggles a little to let the tears out.  When I got up on Day 1, my eyes were quite swollen.  There was some stinging in both eyes so I took a Vicodin to be on the safe side.  I'm a complete wimp when it comes to pain so I was ready to take Vicodin any chance I got.  I want to stress how grateful I was not to be alone during these first few days.  Having someone hand me the correct drops and fetch me pills/water/food and keep me company was so important to my sense of well-being.  I felt very lucky.

Day 1 Checkup: I had my one day followup at 10:45am so my boyfriend drove me to Casey.  My eye exam went really well even though my eyes were swollen and still sensitive so it was difficult to keep them open for long.  They put some drops in my eyes (not sure what it was, they said they don't give it to patients because repeated use delayed healing) and asked me to read the vision chart and I tested at around 20/30 for each eye.  You can imagine my delight!  Doctor said everything looked good and that I could wear regular sunglasses instead of the goggles.  I was also allowed to shower and wash my face, I just had to be careful not to get water in my eyes.  I was giving some preservative-free eye drops and instructed to use them every hour.  After the assistant placed those special drops in my eyes, the watering pretty much went away for the rest of the day.  For the rest of the day, there was no stinging, but my eyes got tired easily.  I really enjoyed looking around and marveling at my sharp eyes.  They were good enough that I could even send a few emails from my iPhone.  

Day 2: When I woke up, my eyelashes were stuck together a little bit so I gently washed the lids with some water so I could open them.  Vision was noticeably worse this day, but still a million times better than what it was before surgery.  I could get around my apartment and easily identify objects.  My eyes were again watery during the night and morning but felt dry by noon.  I delayed taking any Vicodin until I felt a hint of stinging and after that, I had no discomfort whatsoever.  I wore my sunglasses all day and kept my apartment on the dark side since I felt a little bit more light sensitive than I had the day before.  This was probably the only time I've ever been grateful that Portland is such a cloudy city.

Day 3: By this time I was excited that I seemed to have gotten through the first 72 hours without experiencing anything I could really describe as pain.  Aside from some stinging and lots of watering, I had no discomfort with my eyes and spent my time napping and listening to things.  I could look at the TV, but the images were fairly blurry - it was very clear to me that my vision was nowhere near as sharp as they had been on Day 1.  However, I wasn't too discouraged since this seemed in line with everything I had been told to expect.  I had been taking 2 Vicodin a day on Days 0-2, but on this day I didn't feel like I needed any and didn't take the rest of my pills.  I started off the day feeling very light sensitive, despite the sunglasses and spent quite some time simply resting with eyes closed.  But as the day progressed, the sensitivity began to alleviate and I was able to take the sunglasses off.  My near vision was actually pretty decent since I could read things on my iPhone, although my eyes tired easily.  That evening I took a little walk out with my boyfriend, and didn't notice any change in my night vision (aside from the obvious blurriness/ghosting). 

Day 4 Checkup: I couldn't wait to get my contact bandages out, because even though I never felt them, I really didn't like the thought of these things being in my eyes for so long.  The doctor peeled them off using little tweezers and the feeling was a little unpleasant, but not awful.  Ironically, after I had the contacts out I started feeling like I had something in my eyes from time to time.  My vision test was dreadful this day.  I could not read any of the lines at all on the chart.  While I knew my vision wasn't as good as on Day 1, I admit to being a bit taken aback by this.  The doctor said I was healing just fine and there was still some corneal haze, but he was very noncommittal about my vision and simply said we would know more at the two week checkup.  This vagueness sort of worried me more than anything.  But at the same time, I kept in mind all the accounts I had read before and kept my hopes up.  After all, it's only been 4 days.  After the checkup, we went to walk around and grab lunch.  While I wore my sunglasses outside, my eyes were perfectly comfortable without them indoors.  It felt really good to be out and about again.  I couldn't read the street name signs well, but I could navigate my usual routes easily and identify my bus.  I can't stress how impossible even this blurry vision would have been before the surgery.

Day 5: This was my last day using the medicated drops.  My initial instructions had been to take them for six days, but my doctor was quite explicit during the Day 4 checkup to discontinue after Day 5.  I was looking forward to this also because 1) it's a pain to remember to take drops four times a day and 2) I'd read in a number of places that healing occurs more rapidly once you stop using the steroid drops.  Of course, I'd also read that you don't want the cornea to heal too much/too fast because that could lead to regression, so it was with somewhat mixed feelings that I stopped using the drops.  Vision was much the same as previous day.  My boyfriend had flown back home this day so I spent my time watching blurry TV (got addicted to the show Damages).

Day 6: I have some markers around my apartment that I use to determine my level of visual acuity for that day and every day had been checking my progress with these markers.  There is the little clock on my kitchen stove and my Kitchenaid mixer.  On this day, I felt like I could distinguish the mixer just a little bit better than on previous days.  Hopeful!  At this point, I ran out of the preservative-free drops I had been given so I bought some more at Rite Aid.  Again, noticed that I couldn't see the street name signs unless I was fairly close to them, nor could I see faces clearly until they got closer.

Day 7: Eyes were quite dry upon waking and I felt like there was some debris in them.  But after putting in drops and blinking a bit, the sensation went away.  On this day, my eyes felt like there were some clouds in front of them.  When I put in eyedrops, the clouds would part briefly and I could see more clearly, without ghosting.  But after a few blinks the clouds return and things are blurry again.  However, I could tell that the blurry state of vision on this day was better than it had been two days ago.  And the clarity underneath the clouds put me in a quite cheerful frame of mind.

Friday, January 11, 2013

My PRK Recovery: Introduction and Day 0

I had PRK surgery on both eyes last week and thought I would record my own recovery process because it was so incredibly helpful to read about other people's experiences when I was considering the surgery myself.  Reading these accounts also helped to set my expectations for the surgery and maintain optimism during the days when it seemed like my vision might be devastated forever.  The one thing that really stood out from reading all those accounts is how variable the recovery process is for each person, so this is my account.

Stats: I'm 32 years old and my prescription going in was -8.0 diopters for both eyes with a slight astigmatism in one eye.  The thought of eye surgery always freaked me out even though I knew several people who had had Lasik and loved it.  I would have happily continued on in contacts but in the last year or two, I seemed to have developed a sensitivity to contacts and could no longer wear them comfortably.  Even the daily disposables were difficult to wear.  With such a high prescription, my glasses were kind of intolerable so I started looking into eye surgery.

Consultation: I'm an OHSU employee so the Casey Eye Institute was the obvious place for me to look at.  Since I was so nervous about eye surgery I definitely wanted a reputable institution with very experienced doctors.  If anything happened to my eyes my career would literally be over so I was not going to cheap out on this.  I first went to a free information session, which demystified the whole process for me, and I scheduled my consultation soon after.  The consultation was $100, but this amount was deducted from the total surgery amount when I chose to undergo the surgery.  During the consultation I learned that my corneas were of average thickness, but since my prescription was so high, I was a borderline candidate for Lasik, which was what I wanted.  I could do Lasik, but would not be able to do a followup procedure if it was necessary because there would not be enough cornea left.  The doctor explained everything and left the decision up to me.  Given that my prescription was so high, I wasn't super confident that I could fix my eyesight in a single procedure and thought I should play it safe.  So I chose PRK and scheduled my appointment.  

Cost: The cost was $2000 for each eye, but I got a 25% discount as an OHSU employee and planned to pay for the procedure with money set aside in a Flexible Spending Account.  I calculate my actual cost (after tax savings) as closer to $1100 per eye, which was more than reasonable for such a respected institution.  

Pre-Surgery Preparation:  I made my appointment in October for the earliest date in 2013 (so I could sign up for a flexible spending account).  At that point I had already been free of contacts for a few weeks (important for an accurate consultation).  Since my contacts were irritating my eyes and I wanted my eyes to be in their natural shape as long as possible pre-surgery, I only wore glasses for the next three months.  Four days before surgery, I discontinued wearing makeup and starting wiping my eyelids with some sterile washing pads they provided for me in the morning and evenings.  I forgot to do it twice but I guess it was fine!

Surgery (Day 0): After checking in, the receptionist told me I could take my Valium pill so I did.  I really have no idea if it was effective, but I was definitely quite nervous during the procedure and it's possible that it would have been worse without it.  I recommend you take the pill if given the chance.  As others have described, numbing drops are placed in both eyes, eyelashes are taped back, some cold sinister contraption is placed in to hold lids open (I absolutely HATED this part the most), and a solution is dropped on the eye to dissolved the epithelium.  The doctor handled everything and a technician operated the laser I think while another technician assisted the doctor.  Everything I would experience was explained beforehand, which was really reassuring when I was actually experiencing it.  Anyway, after the technician counted out the time, the chemical solution was washed away and the doctor scraped on my eye to get rid of the cells I guess.  This felt weird but did not hurt.  Really the most uncomfortable thing for me was inserting that lid contraption.  Then I was told to focus on a green light (which was super fuzzy to me) and not move.  The lasering smelled like a blowdryer was running and was very quick and the most delightful part so far.  As my eye was lasered, I could see the fuzzy green light come into focus.  My eye was then flushed with cold solution I think and that was that.  When I got up from the padded table, I was able to already see very well.  It was incredible.

I was told to take one of my Vicodin pills right away and to use my medicated drops four times a day (antibiotic one first, then steroid).  I put on my dark goggles and my boyfriend drove me home and I slept for a couple of hours.  My eyes felt sensitive but I was amazed by how well I could see.