My Eye Surgery Experience (PRK with Collagen Crosslinking)

My Eye

So I’m heading out to Beverly Hills today, where I will be getting PRK and collagen crosslinking. This is the culmination of a year’s worth of research and waiting.

Last year, on October 6, I was scheduled for Lasik. A last minute test revealed a small irregularity in the back of my cornea, which is something that people with keratoconus develop. This ended my hopes for Lasik, the appointment was cancelled, and I was terrified that I had a horrible progressive eye disorder.

I have seen multiple doctors and specialists, finally ending up in Beverly Hills, where there is a cornea specialist who sees keratoconus patients on a daily basis. The end result is that while I do not have keratoconus, I am probably at a higher risk for developing it.

I saw Dr. R in Beverly Hills for the first time in December of 2011. I went again in May 2012, and again in September 2012, each time to find out if he thought PRK would be a safe surgery for me. I got the go ahead in mid-September, and scheduled my appointment for October 4, at 2:30.

During this surgery, I will have PRK performed, and then because I am an at risk patient, my eyes will be crosslinked, which involves putting in riboflavin drops and exposing them to light in order to strengthen the tissue of my cornea. This will mean that my vision will improve (I have a pretty high prescription) and I will no longer be at risk of developing eye problems later.

Because it’s a surgery that is not often done in the United States, there is no real way to predict the outcome. I am hoping for 20/20 vision, but there is a good possibility that I will need a touch up procedure after several months to bring my vision to the level that I want. There is very little data on how collagen crosslinking affects the outcome of PRK.

I plan to update this each day with my progress, so that I will have a record of my healing. Hopefully I’ll be able to see the computer screen again after a few days – I did lug my Retina MacBook Pro with me for more screen real estate and bigger fonts.

Day 0: Today I am traveling, and I will visit the doctor for measurements and some tests when I land today around 2:30. From there, we will check in to the hotel and get settled in. I forgot to mention that my awesome mother-in-law is meeting me in Beverly Hills and will be staying with me for the duration. I have quite a few medications with me, and I brought my vitamins, plus other necessities. I hope that I’m prepared for everything.

Day 0 part 2: After arriving at LAX, we immediately drove to my doctor’s office, where I had my pre-surgery examination and testing done. I was having trouble with dry eyes after flying, so the optometrist checked my vision multiple times over to get exact numbers for the surgery. I felt confident with the results, and ended up testing at –7.75/–1.50 in my right eye and –6.75/–2.25 in my left eye. This is about on par with what my eye examination is on a typical day, but there’s always a small amount of fluctuation.

Day 1: My appointment was scheduled for 3:00, so I showed up at 2:00 to get the process started. They gave me valium to calm me down before the procedure, but I was still extremely nervous. After the valium kicked in, I had numbing drops put in place, and the rest of the PRK was a whirlwind. My eyes were held open with those metal eye things, which was easily the most uncomfortable part of the procedure. They used alcohol in my eyes to remove the epithelium and then scraped it away, and this was also a very weird sensation.

After that, I looked at the red light, and it took less than a minute for each eye. This part was entirely painless and not bad at all. If that had been the entirety of my surgery, it would have been over miraculously fast.

When the PRK was done, it was time for the cross linking. Normal cross linking is done with 30 minutes of riboflavin drops and light in each eye, but because I do not have keratoconus, I did 15 minutes in each eye.

I had to have the metal eye openers in my eyes again, which was really unpleasant, especially for a 15 minute stint. Every minute yellow riboflavin drops were put into my eyes (each eye was done individually) and I had to continually stare up at the UV light. The cross linking part sucked, honestly. Afterwards, mitomycin was used to prevent haze.

When I was done, I was pretty out of it, so it was time to return to the hotel to sleep. My eyes were dilated to prevent pain and to reduce swelling, and since I still had anesthetic drops, I wasn’t feeling anything. Peggy, my mother-in-law, filled my pain medication prescriptions, and I went to bed.

Day 2: I was next to blind when I woke up, and extremely light sensitive. This was a Friday, so I returned to my doctor’s office for my follow up appointment in the morning. Everything looked fine, but I was in some pain and uncomfortable, so I spent the day sleeping. Day 3 and Day 4, during the weekend, were very similar.

Day 3: I woke up with extremely red, sore eyes, which prompted me to email my doctor. I had turned on accessibility options on my phone so I could read messages and emails (with the text at the max size). My eyes were undilating, he said, which was causing the pain and redness. I was instructed to increase my antibiotic drops and return on Monday morning. Sunday, Day 4, was also spent with more pain, though the redness cleared up.

Day 5: Monday morning first thing I returned to the doctor because I was uncomfortable and the bandage contacts were moving around in my eyes a lot. I had them removed from my eyes and my epithelium was healed, though there was a rough spot on my right eye. I went out for awhile after this, but it was hard to keep my eyes open because of the light sensitivity.

Day 6: The vision in my left eye seemed to be clearing up, but my right eye was still doing very poorly. I returned to the doctor again, where he said that my eyes, especially my right eye, were extremely swollen and very dry. My right eye was measuring at 567 microns and my left was measuring at 480 microns, when both should have been at about 420 microns. I rested all day.

Day 7: On Wednesday, I went back to the doctor again, the final time before I would leave Beverly Hills. I wasn’t seeing better in my right eye, but my left eye was doing better so I was able to go out and see the LA Farmer’s Market and do some looking around today. I actually spent most of the day out and about without too much difficulty. My eyes were still swollen, and my right eye was very dry. I couldn’t read much on the eye chart, and while my left eye was at about 20/30, my right eye was 20/80. My doctor said that this could take a long time to resolve, and he expected my left eye to be at 20/25 and my right eye to be at 20/50 in a month. Bummer.

Day 8: I was glad to be going home, where I could get more rest in my own bed. I flew home at 1:45, and went straight to sleep. My right eye cleared up a little at this point, but I still couldn’t see much out of it.

Day 9: My first full day back at home. I spent it resting and catching up on some TV shows. I also mostly rested on Day 10 and Day 11, which was the weekend. I had a particularly bad day on Saturday, and woke up hardly able to see anything at all.

Day 12: I was able to start doing some work again today, but it is hard for me to read. I can see the TV okay, but my distance vision is blurry.

Day 13: My vision is fluctuating a lot. I had a very hard time reading the computer today, even with text enlarged. I had a very bad headache today, exacerbated by a lack of sleep.

Day 14: More trouble with reading, though overall my vision was better today. My eyes are very dry, especially my right eye, and I’m unable to keep them wet enough to be comfortable.

Day 15: It’s Thursday, October 18. My left eye is fairly clear, though I have some ghosting. My right eye is much blurrier, also with a lot of ghosting (meaning I see double images). My right eye is often clearer just after I use drops, and my eyes are extremely dry today, so drops don’t work for long. I emailed my doctor today and he said that I could resume Restasis. I’m currently done with antibiotic drops, but I am using Pred Forte 4x a day, Thera Tears approximately every 15 minutes, antibiotic gel at night, and eye ointment when I sleep. I have also added in GenTears Severe eye gel for when my eyes are unbearably dry. My eyes get very uncomfortable, but I’m not exactly in pain. If my eyes were not so dry, I think my vision in both would be a lot better. Dr. says I may need plugs. At this point, I can see to get through the day and I can see the computer well enough, but my distance vision is still blurry, and reading can be a chore. I’m hopeful that this will all clear up with more healing, though.

Day 16: I’m not having a great day today. My eyes are sore and everything is blurry. It doesn’t matter how many drops I use, my eyes remain dry. This is the first time that my eyes have actually hurt since I healed up. Hopefully the pain is due to dry eye and not a sign of something else, but nothing looks red or irritated. I’ll probably lay down with some ointment in my eyes later for a rest to see if that helps.

Week three: I have decided that updating this every day would be pointless, because there are so few improvements to my eyes now. I haven’t been back to the eye doctor, but tests at home indicate that I am seeing approximately 20/20 with my left eye. My right eye is not quite there yet, and both eyes can vary quite a bit with dryness and random fluctuations. Though I seem to be seeing okay, nothing is quite as crisp as it was when I was in glasses, and the ghosting has not cleared up at all yet. It’s definitely nice not wearing glasses though! When I first had the surgery, I wasn’t sure the pain would be worth it if I needed a touch up, but I know now that I don’t want to go back to wearing glasses, even with a small prescription. I still have very dry eyes, and I am still using steroid drops 4x a day. I expect my drops will be cut down when I go see my doctor next week, and I’ll update again after that. I am curious if I still have remaining refractive error, because it seems like I may still have some astigmatism.

Week Four: I went up to Beverly Hills yesterday for my one month check up. My vision in my left eye is 20/20 with no correction, but my right eye is 20/25 with -.50/-.75. That bit of astigmatism is what is preventing me from seeing clearly out of the right eye. I asked about it, and the doctor told me that it would clear up, so I guess all I can do is wait and see. It’s nice to hear that my left eye is 20/20 – hope it stays that way, and I hope that my right eye’s astigmatism goes away as it heals, because it is enough to affect my vision significantly, especially when I read. After a bunch of tests, I did not have any other problems at all, and I also do not have any haze. I was not given plugs, and he says that my dry eye will heal up. Because I don’t have haze, I think, my steroids were changed. Instead of Pred Forte 4x a day, I will now be using Lotemax, a weaker steroid, twice a day for the foreseeable future. As always, my eyes are dry and a bit sore today, and I’m seeing better out of the left side. I haven’t noticed improvement out of the right eye for a good two weeks now, but I’m hoping that the new steroids will allow it to heal up some. I don’t have another eye appointment until January, but I’ll update this after using the drops for a week.

Week 6 (November 20): I basically have nothing new to report. I’m still not seeing clearly out of my right eye, and I still have ghosting/halos in both eyes when reading light text on a dark background or looking at lights. My vision continues to fluctuate on a daily basis. For example, today my left eye is doing much worse than normal. It’s sore, so I assume this is due to dryness. Both of my eyes are very dry, and I use preservative free eye drops multiple times a day. I’ve switched to Systane Ultra instead of Theratears, which seems to help. I’m also currently using Lotemax twice a day (when I wake up and before bed), antibiotic ointment, and night time gel.

Week 8 (December 4): It’s now been exactly two months since I had my eye surgery. My vision is about the same as the last time I updated (approximately 20/20). My eyes are still dry, but it isn’t quite as bad, and I think the ghosting is improving bit by bit too. I’m still on Lotemax two times a day, I’m still using preservative free tears, and I’m still using GenTeal severe nighttime gel. I’ll go back to the doctor in January, but at this point, I’m not having too many problems aside from the dryness. I do think there’s some lingering astigmatism.

Week 14 (January 17): I had my three month follow up appointment yesterday. My vision in my left eye is better than 20/20, while my vision in my right eye is 20/25. Since my left eye is dominant, my overall vision is 20/20, though I do notice the discrepancy between my eyes simply because my left eye has such sharp, crisp vision. The vision in my right eye has shifted, and I am now a bit farsighted in that eye, which means it is slightly overcorrected. It is currently reading at +0.50, when it was -.50/-.75.

There is still astigmatism in that eye and I neglected to get an exact reading – when I asked about it, he said there was “barely any.” I think it is the lingering astigmatism that makes the vision in my right eye slightly worse, but it’s hard to tell what’s going on with that eye (my vision in that eye will change between blinks). I will definitely ask about it at my 6 month appointment and get some concrete numbers. My vision in both eyes, especially my right eye, still fluctuates a bit on a daily basis, especially when my eyes are dry, I do not get enough sleep, or my eyes get tired. I never had any haze or problems with my healing, so I was taken off of steroid drops as of today. My eyes get dry, but it is not as bad as before. I continue to use Restasis, Systane Ultra Preservative Free Drops as needed, and GenTeal severe nighttime gel when I go to sleep. My right eye will likely continue to shift and the doctor says that the overcorrection may fix itself. Let’s hope. Also, as far as night vision – I have not experienced any decline in my night vision. I don’t really see huge starbursts, just minor ones, and I do see halos around lights. It isn’t bad though. I also sometimes see some glare, especially in my left eye, but those are all things that I expect will get better as I continue to heal. I’ll report back in a few weeks after the steroids have had time to sufficiently wear off.

March 19, 2014 (Day 1): After several appointments over the course of 2013, I was finally ready for a touch up in my right eye. I arrived in Beverly Hills on Tuesday and had my appointment at 2pm on Wednesday, with pre-op stuff happening at 1pm. I was given a valium shortly after I arrived and had my vision checked one last time. My right eye measured in at +1.00/-1.25, so I was a bit farsighted with some astigmatism (the machine actually measured me at +1.50/-1.25, but I guess the extra +.50 didn’t give me any noticeable improvement). I did have a hard time with the measurements, trying to decide what was best, so I’m crossing my fingers that the surgery turns out all right in the end. Surgery itself was fairly unpleasant, especially the part where the epithelium was scraped off of my eye — that’s never a fun experience. As it was last time, the metal thing that held my eye open was one of the worst parts, but since there wasn’t too much correction involved, it was over quickly. I slept most of the rest of the day but wasn’t in too much pain because of the numbing drops.

March 20, 2014 (Day 2): Because I needed to have one eye done at a time, I had to work on the day after I had my surgery. In hindsight, this was a mistake. I was in a lot of pain on the day after and my job involves staring at the computer. I rested the eye as much as possible and took percocet every four hours. I needed to use my numbing drops once, and it felt like my eye was a lot more uncomfortable this time around than during the last surgery — probably because I was putting too much strain on it. After work I stayed in the dark and listened to audiobooks. I wasn’t seeing well at all at this point and my eye was VERY red and swollen.

March 21, 2014 (Day 3): I was still in pain today and needing the percocet, but it wasn’t as bad as it was on Thursday, so working was a bit easier. I kept the eye as closed as much as possible since it was still red, swollen, and light sensitive, but I got through the day. Audiobooks were my entertainment again, in an effort to rest my eye as much as possible.

March 22, 2014 (Day 4): This was a Saturday, so I spent most of my time in the dark with my audiobooks. My eye was still uncomfortable, but I didn’t need percocet anymore and it was less red and swollen. I went out to the Farmer’s Market in the early evening for dinner and spent a couple hours walking around. Eye was not healed enough to be able to see well, lots of halos around things.

March 23, 2014 (Day 5): There wasn’t really much pain after day 4 and my eye was more uncomfortable than anything else. Very dry and blurry, with lots of haloing. Epithelium was not healed. Because there wasn’t too much pain I actually spent almost the entire day out from noon on. We went to brunch and then to Hollywood to visit the Wax Museum and some shops. I was even okay to go see a movie because I still had one working eye, but my right eye still wasn’t seeing much.

March 24, 2014 (Day 6): This was the day of my follow up appointment and also the day I was flying home. After getting checked in the morning, my epithelium was not healed and the bandage contact was not able to be removed. I went home with instructions to remove it myself. Started steroid drops 4x a day today.

March 25, 2014 (Day 7): Took out my bandage contact in the morning, which was a huge mistake. My epithelium was not healed and I was extremely uncomfortable — felt like something was in my eye. Made it very hard to work, and I kept ointment in my eye as much as possible. Still couldn’t see.

March 26, 2014 (Day 8): Eye was still quite sore, but my epithelium seemed to be healing. Had to spend all day at a convention, which was not great in terms of resting my eye. Lots of dryness, still can’t see.

March 27, 2014 (Day 9): Had to spend another day at the convention and I didn’t stop to put drops in very often, which was probably a mistake. Could see a little better out of the right eye, but street signs and distance vision are still very blurry.

March 28, 2014 (Day 10): Got to stay home today, which felt a lot better for my eye. Put in drops often and vision seemed to be clearing up just a tiny bit. Still doing steroid drops 4x a day.

March 29, 2014 (Day 11): If my vision was clearing up yesterday, I’ve taken several steps backwards today. My eye is very, very blurry with lots of halos. Can’t see the computer screen because of the blurriness and distance vision is equally bad. My eyes both feel very dry today because I got an insufficient amount of sleep, so I’m trying to use drops often. As I did last time, I have a lot of anxiety over my right eye — the blurriness I have now makes it seem so much worse than it was before the surgery. Still spending lots of time on the computer, which may be causing some eye strain, so I may try to spend some time sleeping for the rest of the day.

April 18, 2014 (Day 31): My vision in my right eye has cleared up quite a bit and a lot of the time it’s much better than before my enhancement. I do still have quite a bit of fluctuation though, so some days it really isn’t very clear at all. It’s still dry and there’s some haloing/starbursting around lights. I’m still using Lotemax 4x per day, though I’ve just emailed to see when I should cut down. Last time I dropped down to twice a day at about a month. I also assume I’ll be able to resume restasis soon, which should help with the dryness. As I learned with my last surgery, I really won’t know the final results of this surgery for several more months, but the vision in my right eye is clearing up enough that I should be able to schedule my left eye surgery in a few more weeks.

May 21, 2014 (Day 1): Eye surgery for my left eye today. Things did not go well. In February I had measured in at -.25/-.75 @160 astigmatism. On surgery day during vision tests my doctor said there was no astigmatism (after I was already sedated). Eye tests put me at 20/20 with -.50 (possibly due to dryness?) and I ended up getting no astigmatism correction. I am very worried that this is going to result in an eye that is a little bit overcorrected and that still has astigmatism. This was also a particularly painful surgery — the night I had it done I had to take pain pills and I could barely sleep.

May 22, 2014 (Day 2): Had my follow up appointment. Eyes, including right eye, are extremely dry. Right eye has patches of dryness and a little bit of haze. I am prescribed minocycline to combat the dryness, which I am to take once per day alongside restasis. Lotemax four times a day to start on day 5 and right eye goes back to Lotemax once per day. Right eye vision is fairly clear… but seems to suffer in low light. Doctor says all of my eye problems are likely due to the severe dry eye. I traveled home on this day and spent the day resting. After working Friday, I also spent the weekend resting and letting my eye heal up. Vision remained poor but has been improving as epithelium healed.

May 26, 2014 (Day 5): Bandage contact came out today (via me). Eye was very sore so I got lots of rest and used a lot of eye drops.

May 27, 2014 (Day 6): I had another follow up, this time with Dr. M in Palo Alto. He looked at my left eye and said the epithelium was healed and that the irritation/pain should be clearing up in a few days. Vision at this point was not good at all. He also looked at my right eye and said that it had some pretty severe patches of dryness — he said my low light vision (and crazy fluctuations) were likely due to the dryness. He’s suggested plugs, which Dr. R has also mentioned, so that may be my next step.

May 29, 2014 (Day 8): My vision has improved a little bit in the left eye, but I am beginning to be a bit worried about how blurry it remains. Looking at my right eye history, it wasn’t really clearing up until about day 10 or 11, so hopefully the next few days will bring some progress. Have been working very long days with a lot of time on the computer, which is probably not helping things along. I can read text on the computer, but distance vision is still blurry. 20/40-50, maybe. Right eye two months out is still fluctuating, assuming that’s the dryness though. My eyes have felt extra dry lately and I’ve been going through drops like a starving plant in the desert. Really hoping this left eye doesn’t end up needing another surgery — it definitely seemed like I had some astigmatism (I had glasses for it that cleared it up).

May 30, 2014 (Day 9): I definitely still have astigmatism. My vision clears up after I put on my glasses, which is disappointing. My vision in my left eye is very blurry lately — not sure if this is the dry eye or a healing issue.

May 31, 2014 (Day 10): I’ve been going through Systane eye drops like crazy because of the dryness. For some reason, my left eye has had a major downshift in vision lately, which is concerning. Going to give it a couple more days and then go back to the doctor I see in Palo Alto. Still using steroid drops four times a day, plus lots of rewetting drops and gel/ointment at night.

June 1, 2014 (Day 11): My distance vision is still quite bad and seems much worse than it was in my right eye on this day. I went out for a hike and realized that I’m seeing everything in double. I’ve had haloing and star bursting, but this is much, much worse than anything I’ve experienced before. If it isn’t better in the morning, I may go ahead and see if I can get back in at the doctor. It gets a bit clearer right after an eye drop, and then goes back to being blurry — might be the dryness causing this. Not sure what else I can do to improve it. Super concerned about the left eye right now.

June 3, 2014 (Day 13): It seemed like my vision improved a little bit today. I wasn’t outside, but it looked like things were a bit clearer for one day at least. Not much else to report today.

June 4, 2014 (Day 14): Well, that one day of somewhat better vision sure didn’t last. I’m back to not being able to read the titles on the bookshelf on the opposite wall and my double vision is just as bad as it was a few days back. I am not sure if things would be clear or not without that crazy double vision, but as it stands, I honestly can’t see at all. Probably somewhere around 20/60, if not 20/100 right now. There are moments where it’s clearer, sometimes after I’ve used eye drops, but at other times, eye drops do nothing for me at all. No idea what’s causing the blurriness and double vision, but I sure hope it’s dryness and not something worse. Still on steroids 4x a day, minocycline, and systane often. Two more days of work, then I’ll try to rest my eyes on the weekend. Terribly anxious over the vision in my left eye.

June 6, 2014 (Day 16): No improvement over the last two days. My eye is still blurry with severe double vision.

June 8, 2014 (Day 18): So if I keep my eye closed and use tons of drops, when I open it briefly, it’s quite a bit clearer. The blurriness is likely a result of dryness, but that doesn’t account for the crazy ghosting. Went out shopping today, vision sucked for most of the day.

June 10, 2014 (Day 20): I think the blurriness has improved a little, which might mean the dry eye is abating a bit. I did go through a ton of eye drop vials, though. I emailed my doctor today and was told I could cut down to Lotemax twice a day. I also restarted Restasis today, so I am hoping that will help. Now both eyes are on Restasis, with the left eye getting two drops a day and the right eye getting one drop a day. Plus systane, plus minocycline and ointment at night.

June 11, 2014 (Day 21): Didn’t use as many systane drops today so the awful blurriness was back today. Can’t read the bookshelf, but vision still seems a bit clearer. I don’t have ghosting with my near vision, only my far vision, and I have no idea what that means. Distance vision ghosting is still very severe and hasn’t really let up. Definitely not like anything I’ve had before.

June 13, 2014 (Day 23): I wish I could say my eye had improved over the last couple of days, but I think it’s actually gotten a bit worse. Very dry, very sore. Can’t see. Still clears up a bit with drops, but the ghosting is ever present. Forgot to make an appointment for a follow up with Dr. M, will have to call next week. Not being able to see at this point is frustrating and pretty scary, with the other surgeries my eyes were much better by now.

June 18, 2014 (Day 28): As I creep closer to the 30 day mark, I am regretting this “enhancement” surgery more and more. Today is a very bad eye day; my eyes are both sore (especially left) and my vision is as blurry as ever. Can’t read the bookshelf and all distance vision is blurred. I’ve been on restasis for several days and taking minocycline, but there’s been no improvement to the dryness (if that’s what’s causing the problems). At times, when I put on my glasses, my vision is much improved… so there is, of course, lingering astigmatism that was not fixed at all. I guess I just live with that (and wear glasses) or have another surgery at some point down the road after all of this heals up. I am pretty upset that the astigmatism that had shown up for a YEAR prior was not treated, but what can I do but wait to heal? Still having some pretty awful ghosting and plenty of anxiety. Have an appointment on June 27 with Dr M., will see what he says and then possibly make a Beverly Hills appointment. Am not sure that will do me any good at this point though since all I can do is wait to heal up (at least, I *HOPE* I heal).

June 21, 2014 (Day 31): Well, I just passed a month. No improvement. Blah. Still have blurred vision most of the time (except after I keep my eye closed for a period of time, use an eye drop, or take a shower) that appears to be caused by continual dryness. When I take a shower my vision is quite crisp, so I am hoping that means this is a dry eye situation that will clear up in more time and not something more serious. I use a lot of eye drops and as of this week, I am experimenting with different brands — I bought Refresh Optive Advanced, Refresh Celluvisc, and Bausch & Lomb Soothe. That’s in addition to both the Restasis and the Lotemax (and minocycline taken orally). I’ve also ordered a hygrometer so I can check the humidity — I’m thinking I might get a humidifier to help. There’s a chance I might be using too many eye drops, but I don’t want to cause damage by having a poorly lubricated eye. Seems my tears are of poor quality and possibly evaporating too quickly? Eager to go to my dr. appt next Friday to get some info on what’s going on. This week I’ll try more warm compresses and upping my flaxseed dose.

June 24, 2014 (Day 34): No change.

June 27, 2014 (Day 37): I had a follow up appointment today. Dr. M says there is a fusion line in the epithelium of my left eye that is causing my problems. When the epithelium heals, the layers coming back together can form a ridge, which is what has happened. This ridge is causing me to have blurry vision and ghosting, and all I can do is wait for it to go away (literally — I asked if there was anything else I could do and he said sleep for 2 months). On the topography scan, this looked like a section of raised yellowness while the rest was green (right eye, which healed properly, is all green). Emailed Dr. R with the results and he says to cut down to Lotemax once per day and to use tons and tons of eyedrops in the eye (I looked this problem up, using a lot of eyedrops helps to smooth things out. I’m picturing it like a stone in a river). I’m also supposed to use eye ointment at night, but I was already doing that. So I guess I’ll be using eyedrops like crazy to see if it helps at all. Also continuing flaxseed, minocycline, and restasis, but I got no mention that my eyes looked dry.

July 30, 2014: I haven’t updated in over a month because there’s been little change. The blurriness has cleared up somewhat, but the ghosting has not gotten better at all. I’m basically starting to worry that the ghosting isn’t ever going to clear up — nothing is really clear at a distance because I’m seeing double. I have an appointment with Dr. M towards the end of August, and I’m also planning to go see Dr. R in Beverly Hills at some point in the near future to figure out what the problem is and how it can be fixed. I am still using eyedrops constantly (mostly Celluvisc) in an effort to clear up the ridge in my epithelium and I’m still using all the aforementioned treatments and remedies for dry eye. My eyes don’t feel dry anymore. Am also still on one drop of Lotemax a day.

August 24, 2015: Well, over the past year my left eye has cleared up a lot, but as I expected, I have lingering astigmatism and the last surgery actually seems to have made it worse. Left eye measures in at -1.50 to -1.75 astigmatism, plus some minor farsightedness (varying from +0.25 to +1.00 in various eye tests — none of this is an exact science!). I’m having the astigmatism corrected in another PRK surgery that will take place on August 27, 2015 with Dr. R. I saw Dr. R in September of 2014 and again in August 2015, and at the latter appointment, he said I could do another surgery to fix the astigmatism and bring the left eye (my dominant eye) to 20/20. Not looking forward to another long healing time, but I’m hoping fixing the astigmatism will go a long way towards improving my vision and giving me a better final result.

As for my right eye, it has some lingering astigmatism too, somewhere around -0.50 and a bit of farsightedness, but the vision in that eye is currently much better than my left eye (it’s nearly 20/20), so I am not planning to mess with that eye again. Since my left eye is my dominant eye, it bothers me a lot more than my right eye. What I’ve learned from this process is that it’s very hard to control healing and final result — getting an exact perfect measurement is impossible. I am pretty close to 20/20 vision with both eyes now, so correcting the astigmatism in the left eye should give me a solid 20/20 provided healing goes well. I also hope that some of the farsightedness might clear up in the future. Given the healing time and pain, I want this to be my last PRK procedure.

After surgery on Thursday, I’ll be heading home on Friday, and on Monday, I’ll see Dr. M to get my bandage contact out before going back to work. Dr M. will also be handling most of my post-op care (expensive! I have to pay for each these visits) so I won’t see Dr. R again until late 2015 or early 2016.

August 27, 2015 (surgery day): Had my eye checked at 11:30 a.m., prescription was the same as the last checkup and the same as an independent eye test I had over the weekend, so I was confident I had the right measurements this time around. +0.75 hyperopia with -1.75 @ 005 astigmatism. Walked to surgery center down the street and got my 5mg Xanax, which did not feel like enough. After doing this four times, I think I was more anxious than I would be if it was my first time.

At around 12:15 I was called in and had my eye cleaned and we went over all my aftercare instructions. From there we went into the surgery room and I laid down on the table with a heavy blanket and a big teddy bear to squeeze. Eye surgery is traumatic, so having the teddy bear and the blanket is soothing — I’m glad they provide those. Metal thing that holds my eye open was stuck in, anesthetic drops were put in, and the scraping of my epithelium began. I was definitely still feeling some pain right off the bat, so I had a lot of anesthetic drops. Once the epithelium was off, I had to look at the laser for a few seconds (small corrections don’t take long). So I stared at the red light and smelled the burning eye and then it was all over. Lots more drops went in followed by the bandage contact.

Got all my drops, my big black sunglasses, and then we were done. Got an Uber back to the hotel and I went right to sleep. Didn’t do much besides sleep for the rest of the day, just woke up to eat something from Veggie Grill and went back to sleep.

August 28, 2015 (day 1): Woke up at around 10 to get ready for my follow up appointment. Took a shower wearing goggles so water didn’t get into my eye. My eye was still dilated from the drops the day before so I was feeling no pain. Dr. R said everything looked good, so after that we headed to the airport. Got something to eat, sat around for awhile, and got home around 4 p.m. Went straight to bed afterwards and slept for the rest of the day.

August 29, 2015 (day 2): It was a Saturday, so I could stay in bed all day. I listened to some of my audiobook and watched some YouTube videos with my good eye (lasered eye stayed closed). I was still feeling no pain, just a little irritation from the bandage contact, and surprisingly, there was little light sensitivity. Couldn’t see anything though.

August 30, 2015 (day 3): Sunday. Did the same thing I did Saturday. Lots of rest, lots of eye drops (I use Refresh Advanced Optive). I’d been trying to get a lot of protein, so I’d been eating a lot. Ordered vegan pizza and salad, ate a lot of it. Still no real pain, but I did take some Advil. I never ended up using any vicodin/percocet or numbing drops in my eye. I just didn’t have the same pain level this time around that I had last time.

August 31, 2015 (day 4): Since it was a Monday, I had my follow up appointment in Palo Alto with Dr. M. Relayed message that Dr. R thought my bandage contact should stay in for 7 or 8 days given past healing issue, but Dr M. said my epithelium was fully healed and there was not really any benefit to keeping the contact in. So it came out. Immediately after my eye felt a little raw, but there was no real pain. That didn’t last. The removal of the bandage contact was actually the most painful time during the healing process this time around. I had to work, so my eye was feeling very raw and irritated. Vision was completely blurry, worse than it had been with the contact in.

Towards the end of the day, it also started feeling like there was a tear in the epithelium (feels like a scratch in the eye, like something’s in it) and that’s not a pleasant feeling. Ended work at 5 instead of 6 and proceeded to have a full on panic attack over my eye. Last time I had some issues with the way my epithelium healed that hugely impacted my vision for several months, so I was worried that would happen again this time around. Totally freaked out. Took ativan to calm down, listed to some music and then some of my audiobook until John brought me dinner. After that I fell asleep around 9pm…. got up later for drops and went back to bed.

September 1, 2015 (day 5): Woke up feeling a little better, but my eye definitely still had a raw feeling. Had to work (which means looking at a computer screen all day), so I tried to keep the eye closed as much as possible during the day. Vision was surprisingly not terrible, but I expect it to continue to fluctuate for the next few weeks. I’d say it’s slightly worse than before the surgery, and if I had to guess, I’d guess around 20/30 to 20/40. I use the bookshelf in my room as my personal vision gauge, and I can kind of read the titles. On day 5 last year, I couldn’t. There is little ghosting so things already seem to be going better than they did during my last left eye surgery. Still going to make sure to give my eye a lot of rest so it has the time that it needs to heal. Started Pred Forte drops 4x a day today, continuing ciprofloxacin 4x a day, and still using tons of preservative free drops. Refresh Advance Optive and Refresh Celluvisc (a thicker drop) plus some Soothe ointment at night (I use this because it’s lanolin free and lanolin irritates my eye).

September 2 to 4, 2015: Since I started Pred Forte, I haven’t had any improvement in my vision. For these days, my eye was still sore so I spent a lot of time with it closed while I worked and I rested in a dark room directly after work to give it a bit of a break from the computer screen.

September 5 to 7, 2015: Spent almost all of the three-day weekend in bed in the dark listening to audiobooks to give my eye some time to heal before next week, which is going to be incredibly busy with a lot of time at the computer. My vision fluctuates like crazy because of the steroids, and likely because of the dryness. I went out at night one night and learned that I still have some severe ghosting in my left eye, along with halos and starbursts around light.

September 8, 2015: This is my first day back at work after resting my eye for three days. I’m not feeling as much fatigue from looking at the screen, but I’m still going to try to give my eye as much rest as I can during this very busy week. I am at the point in my healing where I have non-stop anxiety because my vision is fluctuating so often. For the most part, things are blurry. I can’t comfortably read the computer screen because of the blurriness and because I have some ghosting. I wasn’t good about recording my near vision during my previous surgeries, so I can’t remember if this is the same healing process I had before. Sometimes when I blink my vision clears up a bit, but for the most part, things are blurry. The computer screen is hard to read and so are the titles on the bookshelf. An unofficial Snellen chart on my iPad suggests my vision is about 20/30 right now. Lots of ghosting/double vision, which I hope goes away because that’s the major problem I had with this left eye before the surgery. Still on Pred Forte and lots of Refresh Advance Optive, even more than usual because it’s very dry where I live right now — 11% humidity! My next appointment with Dr. M is in September, so I guess I’m going to spend the next few weeks totally freaking out about my vision, per usual.

September 9, 2015: Bought a humidifier so my eye would be more comfortable. Today was a big Apple event so I had to work all day. By the end of the day, my eye was super sore and exhausted, couldn’t spend anymore time looking at the screen. I actually emailed Dr. M in a panic today because my eye hasn’t been improving… I asked if I should come in for another appointment, but I ended up speaking with a nurse from his office who made me feel a little better. She says that I could go in for another appointment, but there’s nothing they can really do or alter until the 1 month appointment because my epithelium is still healing and trying to smooth itself out. She said what I’m experiencing is normal and that it might clear up once I quit steroids, since they slow healing. On the plus side, my glasses no longer improve my vision at all… but John’s glasses that correct for nearsightedness and astigmatism at a different angle do seem to help, which sounds like bad news to me. I really hope that’s just a side effect of healing. ?

September 10, 2015 (Day 14): Two week mark. Still not much improvement. Nothing is clear when I read and neither is my distance vision. For the rest of the week, I need to spend ~12-15 hours a day working, which I’m sure isn’t helping anything.

September 11, 2015: Bought a humidifier so my eye would be more comfortable. Another 15 hour day on the computer trying to get caught up on some work and then I had to stay up late for iPhone pre-orders. Eye is not happy and vision is not good. It gets worse throughout the day — when I wake up, it’s a little clearer than it is at the end of the day when I’m getting ready to go to bed. Towards the end of the day, I can’t see anything at all.

September 12/13, 2015: Spent the weekend resting my eye as much as possible, and I’ll do the same next weekend. Next week is another week where I have to spend countless hours on the computer trying to get caught up at work after the Apple event. I found a way to describe what the ghosting is like — it’s like everything has a really bad 90’s drop shadow. On all text. And street signs. Ghosting is actually worse with my distance vision.

September 14, 2015 (Day 18): Another super long day. This is officially day 18. I’m still not really seeing much improvement… things may be a little clearer but it’s changing so gradually and fluctuating so much that it’s hard to tell. Can’t read text on the computer screen clearly from an arm’s distance away, and the text on the bookshelf is maybe a little bit clearer but I wouldn’t call it readable yet. Since John’s glasses make text clearer… I may still have leftover astigmatism. Or nearsightedness. Not sure if that’s part of the healing process, but I sure hope so. Not getting better so far.

September 20, 2015 (Day 24): I’ve been using a ton of drops, and sometimes it seems like there’s a little progress towards improved vision, but then I take several steps back. Yesterday my vision seemed like it was near 20/20 when I went out for awhile (street signs were nearly clear) but today my vision is worse, even though I spent most of the day resting, playing iPad games, and listening to my audiobook. Still using Pred Forte 4x a day and I’ve restarted Restasis. Doctor’s appointment is next week, where I’ll find out what’s going on with the eye. Until then, it’ll just be tons and tons of drops and carrying on like usual. Hopefully the crisper vision will come back — as of today, I can barely read the 20/25 line and the bookshelf is blurry. Yesterday I could kind of make out the 20/20 line, but still with a ton of ghosting. Not sure if that ghosting is lingering astigmatism or caused by dryness and remaining healing left to be done. Middle distance vision is still my worst vision — looking at things a few feet away is where they seem to be blurriest. I really hope this surgery turns out well in the end and that this next week results in a lot of healing — very much hoping my left eye will end up as good or better than my right eye once the steroids are done.

September 29, 2015 (Day 33): Well, I had my one month followup appointment with Dr. M this morning, and it’s bad news. Before surgery, I had -1.75 astigmatism in my left eye. Currently I have -1.75 astigmatism in my left eye, at a different axis. So right now, my vision is no better than it was before I had the surgery. WHAT. THE. FUCK. Seriously, what the hell? How does it get worse at a different axis? Was the surgery done incorrectly? I have no idea at this point, but I am incredibly upset about it right now.

Dr. M says it is early in the healing process and that the astigmatism could clear up. But he also says it might not. He says it could clear up, it could stay the same, or it could get worse. Who knows! Time and luck will determine what’ll happen and he says there’s absolutely nothing else I can do right now. I am not optimistic because I also had astigmatism in my right eye that never ended up clearing up until I had a second surgery. Am I going to need *another* PRK to fix the astigmatism induced by this last touchup? I really hope it clears up somewhat. I can live with a little astigmatism, but -1.75? That makes everything blurry, from text to faces.

Dr. M says that I can stop Pred Forte now, but I have emailed Dr. R for the final word on that because I don’t usually cut steroids out so soon. Spending today doing plenty of crying so my eyes are well lubricated, but on a daily basis, still dry. I’m just so frustrated and upset with the results right now. Still using lots of drops, on Restasis twice a day. I won’t know the final outcome of this surgery for another month or two, but it’s looking grim at 1 month and two days.

Had a call with Dr R. in the afternoon following appointment with Dr M. He says not to worry about it and that it’s the dryness causing the astigmatism, but that’s the same thing that he said last time. Last time it was not dryness and Dr M. did not mention any dryness. My eye still feels a little dry some of the time, but I’m not convinced it is affecting my vision enough to induce all that astigmatism. I won’t be stopping steroids, but cutting down to Pred Forte 1x a day for the next month. I’m supposed to call in a month. Until then, I’ll use the Pred Forte 1x, Restasis 2x, and continue with all my preservative free drops. I’m already taking minocycline, vitamin C, and flaxseed, but just ordered another vegetarian Omega 3 pill to take with those. I’ll also try to cut down on after work computer time. Other than that I can only cross my fingers and hope it gets better because there’s not much else to do.

October 12, 2015 (Day 46): I haven’t updated for the past two weeks because it makes me depressed to write about the condition of my eye. It’s now been six weeks and things are no better. If anything, my vision has gotten a bit worse over the last two weeks. Ghosting is still extreme. I can’t comfortably watch some television shows because of it (mainly cartoons because the high contrast makes me see double). My vision fluctuates a lot during the day. It tends to be a little better in the morning and then it gets worse as the day goes on. I’m also seeing worse in the dark than I do when it’s bright, something I’ve never really experienced before. I have several objects around the house I use to check my vision — bookshelf is blurred, photographs across the room have blurry faces, and the computer screen is still blurry at arms length.

Sometimes it becomes clearer for a few seconds when I focus on something, but I’m not sure if that’s indicative that things are going to get better. I think that’s just me focusing through the astigmatism. I’m using drops all day long (Celluvisc and Refresh Optive Advanced). My eye does seem to get drier and more sore as the day goes on, but the dryness is getting better and the blurriness is still there, so I’m not sure any of this can be attributed to dryness (as with last time). Still using Restasis 2x a day and Pred Forte once a day. I don’t have another appointment with Dr. M for three months, but I’ve been instructed to call Dr. R in another couple of weeks.

16 thoughts on “My Eye Surgery Experience (PRK with Collagen Crosslinking)

  1. Julie ..i just read your journal …i know its been 2year a
    i am going through of what u been ..please send e mail and tell me how doing ..i hope that u great now ..take care

  2. Hey.i’ve had the same procedure done for keratoconus about a month ago.trust me it’s totally worth everything coz living with untreated keratoconus is absolutely terrible.and I feel much better than before. Your blog made me feel I’m not alone.tc n get well soon

  3. I can’t compare anything from the first surgery since I started all over with the most recent one. Right now the ghosting isn’t really improving. Ghosting can be caused from the eye still healing or it can be from astigmatism. I have induced astigmatism, hence the ghosting. I’m not sure at this point if it’s going to get better or if I’ll need another surgery or glasses.

  4. I am sorry to say but I really enjoyed reading your journal of your epic trials with prk. I do hope things have turned for the better and that’s why you haven’t updated. I am early on in my prk recovery. I am at day 35 and I am experiencing some astigmatism .75 I would say. It isn’t unbearable but it is enough to notice and drive you mad when you try to read things. I work on the computer all day too and it is really noticeable when one is clear and the other isn’t. I just hope it will resolve itself or may go back to a contact in one eye.

    Thanks again for the detailed account and I sincerely wish that you have made a full recovery and happy. I know how you feel when it’s always on your mind.

    Take care

  5. Yes. So I last had surgery on my left eye in August of 2015. The outcome didn’t look good, but towards the end of the year, the vision in my left eye started getting better and better. Right now, the vision in my left eye is 20/20… there is still a little bit of astigmatism left. The vision in my right eye is about 20/25 because that eye is still a bit farsighted. I might get glasses at some point for the right eye, but my overall vision is 20/20 so I haven’t done that yet.

    My eyes are still very dry. I use Restasis and preservative free eye drops daily, plus I still take flax seed pills and vitamin c. I see glare/halos/some double vision at night and sometimes when watching tv, and it gets worse when my eyes are tired/dry. I suspect this is permanent and I don’t expect it to heal. It’s frustrating, but a side effect I can live with. It’ll be another six months before I go back for another appointment to check progress.

  6. Hi Juli, I read your journey with great interest. Thank you for documenting your experience. Has there been improvements, vision wise and with your dry eyes since your last post? Do you still experience ghosting? I’m 3 months post PRK. I still have pretty significant ghosting in 1 eye that’s causing me some grief. My eyes are also quite dry and I’m just about to start Restasis, 2x a day. How often are you using Restasis and the preservative eye drops? Thank you.

  7. Hi Juli

    I read thru your journal. I must say that I feel really sorry that your PRK experience didn’t end up as you expected. I hope that you are feeling better now.

    My initial evaluation showed that I may develop Keratoconus problem and may need crosslinking treatment after the PRK. I have my surgery appointment booked for the next Thursday (only a cpl of days down the road).

    I started reading about this condition online. Among tons of details available on the internet, I found details on your journal the most helpful. Reading all the trouble that you went thru made me wonder if I really want to do PRK enhancement at all. Especially that I will go on a long flight of 20+ hours less than three weeks after my surgery and I won’t be able to follow up with my surgeon at least for the next 12 months after my surgery. In any case, I’m more certain that ever to cancel my appt now. God knows maybe I’ll do it some other time when I am in a better condition but definitely not now!

    I was asking myself “did she check Dr. R’s reviews prior to the surgery”? Maybe it’s the time for you to check with another eye specialist. Anyways, I really appreciate your effort in writing this journal—very helpful and informative.

    I wish you get well very soon!

    Abdi

  8. Yes, I did a lot of research before my appointment, and I do actually see two specialists, one who handles my follow up care in my home town (Dr. M at Stanford). It’s now been several years since my original surgery, and I don’t regret it. My vision isn’t perfect and I’m still reliant on eye drops, but overall, I’d do it again. In a few years, I may get another touch up — I don’t want to go back to glasses! It was a very long, very painful ordeal, though.

  9. Ghosting, no, but dry eyes, yes. I continue to have dry eye problems even now, more than a year after the last surgery. I use Restasis 2x a day and the other drops whenever I need them. That tends to be when I wake up and a few times throughout the day. My vision never did get perfect, but I have 20/20 vision with both eyes and that’s an improvement from where I was before. The ghosting that I had took many months to heal, but it did get better.

  10. Hi Juli,

    I had my PRK done and having severe haze in my right eye. I was just wondering if it is the same Dr R. who also operated on me. Can you please reply me in mail the name of the doctor?

    I wish you do well with the eyes and your dry eyes problem gets resolved.

  11. I still have dry eyes and I use drops multiple times a day, but it’s so much a part of my life that it’s not really much of a hassle. I’ve got 20/20 vision overall, but there’s some astigmatism in my right eye and it’s only about 20/25 on its own. Left eye is a little better. I may have it re-evaluated at some point when I get a bit older if it shifts at all, but I’m satisfied with my vision for now. It’s certainly much better than what I started with!

  12. Hi Juli,

    I just posted the following message, but then realized that the speech-to-text function left some errors. I have corrected those, so hopefully you can delete the previous comment and post this one instead.

    Thank you for posting your blog. I came across it today while looking up information on risks and side effects of corneal cross-linking surgery. My son had the surgery in both eyes about 3 weeks ago. Before the surgery his left I was pretty good, with blurriness in his right eye. I have been very worried about him, because he experienced extreme pain and extreme light sensitivity for a few days after the surgery. Thank goodness those cleared up and he started feeling much better. However, although his right eye seems to be staying about the same, he has some significant double vision in his left eye at this point. The doctor tells us that it could take another one to two months for that to heal. I am trying to hope and trust that that is accurate and he will get better, but as a mom I am worried, particularly as once he starts work he will be spending a lot of time in front of the computer. Reading through your blog made me realize that the healing process is probably much longer than we initially thought it would be. After reading your blog, I feel a little bit more hopeful that maybe the double vision is temporary and will improve with time. Thank you so much for taking the time to share your journey!

  13. Yes, it did take several months for my eyes to settle and heal completely. One of my eyes in particular had some pretty serious double vision for quite awhile, but it did clear up for the most part. Sometimes the cornea grows back a bit irregular with ridges and uneven tissue, but the eye eventually smoothes it out over time, like a pebble in a stream. It’s possible your son has some lingering astigmatism or some overcorrection, but you won’t know for sure just yet. He should take lots of short breaks when using the computer and make sure to have plenty of drops on hand so his eyes don’t get dry.

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