Monday, May 16, 2011

PRK and Blurry Variable Vision

Question: I recently got PRK done on my eyes. Lately I have noticed that my eyes get blurry throughout the day. The best example I can come up with is its like I had been swimming all day and opening eyes under the water. What I have also noticed is that they get blurry when I put any kind of drops in my eyes such as the anti-inflammatory drops or my moisturizing drops. I wouldn't worry about it if it wasn't for the fact that my eyes didn't do this after the procedure. I'm just wondering when I can expect this to clear up so I can get to seeing clearly.

Answer: You do not state how long ago you had the PRK procedure and you don't disclose the degree of refractive error-assumed to be nearsightedness-that was corrected. Both of these factors may be relevant. First, PRK is a type of laser eye surgery called surface ablation-that is, the leaser energy is delivered to the surface of the cornea. That is different than LASIK, which is a lamellar procedure whereby the laser energy is delivered in between layers of the cornea. Surface ablation procedures such as PRK typically have a slower visual recovery. Depending on the degree of myopia to be corrected it can take as long as 3 months for high prescriptions to yield totally stable results. Generally, the higher the prescription corrected the longer the visual recovery time. This is because it takes a fair amount of time for the cornea to "remodel' and for the top layer-the corneal epithelium-to return to its preoperative normal structure. it just takes time.

Second, in all types of corneal surgery-PRK or LASIK, but even greater with PRK, we are causing a significant temporary disruption of the tear film. The tear film is an important optical component and can cause variable foggy filmy vision to occur if it is not stable. Keeping the eye lubricated-very lubricated facilitates the healing and visual recovery. It could simply be that you have a temporary tear film deficiency and dry eye causing your symptoms. Last, in some small number of cases it is possible that during the postoperative healing phase a condition called "corneal haze" can develop. Typically corneal haze is asymptomatic unless it is quite severe. So there are several possibilities that may or may not be contributing to your symptoms. It is worthwhile for you to schedule a visit with your eye surgeon in order to determine which if any of these are causing your blur and what can be done about it as well as how long it might last.

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