#prk2016

Today feels about the same. Scratchy, watery, blurry light sensitive like yesterday evening. My appointment is in DC for my post-op exam and my dad’s taking me today. Thank god for family nearby to drive me! It’s also a cloudy rainy day today, so sunlight shouldn’t be an issue... right? right? 

Last time I checked, wunderground had today as 75%+ cloud cover. Well that 25% of minor light shine through felt like light beams into my eye lids. I had a wide brim hat and glasses that only allowed 12% light to pass through in 75% cloud cover and it still felt as if I was walking straight into the high beams of a headlight. I went back inside, grabbed a towel and put it over my head and went into the car. Other drivers may have found it weird to see a passenger with a towel over their heads, but I could care less. It was bright as hell out there.

Side Note: Essential items to have for the first weekend you have PRK:

- A Towel

- The darkest tinted wraparound glasses you can find

- A dark wide-brimmed hat

- Non-scented non-lotioned hand-sanitizer

- Tissues, at least 10 boxes

- Your choice of OTC pain reliever

- 1000mg Vitamin C + Multi-vitamin (both essential)

- Night eye-shields, you know the black ones that cover your eyes. What you want is to wear your eye shields for protection and put these over them so you are completely blacked out. This saves you from the bulkiness of lugging around a blanket or towel everywhere you go

Now back on topic....

Got to the doctors office in DC and my eyes were a mess. Blurry and watery with tears streaming down my face. They checked me in and then I waited to get called in. Thankfully it was fast. Went into the room and they gave me a miracle eye drop... OMG, how one drop can change a life and make everything feel good. She placed an eye drop in both my eyes and it was night an day, the scratchiness, pain and tears went away in 10 seconds.... They then got me to read the lines from the Snellen Eye Chart. 20/30 Day 1. HELL YEAH! Coming from 20/400+ in both eyes, I won’t lie... the artificial tears couldn’t mimic the real thing that was about to come out from actually feeling like I could see and be free from glasses and contacts. After taking measurements and recording where I was, I met up with Dr. Kang who again proceeded to check both my eyes to see if the contacts were firmly in place. He proceeded to tell me that I was healing ahead of schedule. Damn straight. I was adherent to every single recommendation and was dousing my eyes with 2-3x the amount of artificial tears to avoid drying and promote healing so much that I was crying a river every 30 minutes. He said I was well ahead of normal healing and the process was already halfway done in a day. That felt reassuring. After talking to him a little more, he said to continue doing everything I was already doing and that tonight would be another painful night and to get through it. Again he said the magic green bottle was only a last resort.

Well. After that, it was back home for me. Thankfully the numbing drop that I got lasted another 8 hours. I’m not sure it was supposed to last that long, but it did for me and I felt relief for most of the day. No pain, no irritation, just sensitivity to light and some feeling of if my contact was loose. Everything went fine the rest of the day,and I attribute this to that magical eye drop.

Into the night I continued taking my regimen of 3 eye drops and dousing my eyes with artificial tears. Every time I would wake up prematurely I would have artificial tears and tissues nearby to use. I was covered.

Alright this is directly after surgery, going home and handling the first night.

First thing I need to say about this day. It sucked. My post-op appointment was scheduled for tomorrow morning and in order to get to that point, I had to last the entire evening, night and morning with just eye drops and a tablet of oxycodone. They also gave me a green bottle of eye drops for numbing, but told me to use that as a last resort. Needless to say, I was extremely tempted to use it.

*After Surgery - Still July 28th, 2016

Alright got into the car feeling it was a good surgery, everything was aligned, the birds, the bees, the trees. I took my Pred Forte as encouraged and proceeded to head back home with my GF and my dad. Well this was the best part about the after-surgery.

After getting home it was nothing but sensitivity to light, my eyes feeling scratchy, irritated and watery, and feeling some pressure and pain my eyeball itself. In short, my windows were closed, but I still felt as if someone took a bright airport tracking light and shined it into my eyes and into my eye. It felt as if someone cut a bunch of onions and placed it right in front of my eyes. And then stacking those feelings, it felt as if someone took a toothpick and was scratching my eyes lightly for base tormented pleasure. 

The green bottle never looked so good in my life. They told me though that it could slow the healing. I equated slowed healing to delayed pain. If I took it, it would feel better temporarily but then I’d go back straight into the pain without going further in the healing process. I took some tylenol, proceeded to douse my eyes in eye drops of every type until my eyes streamed the tears I truly felt inside. 

Alright today is the surgery day!

First off, probably the most nervous you will ever be: 1. Because it’s one of the most important organs in your body, 2. Because after it’s done, there’s no going back, so really there’s no need to be worried afterwards.

Alright went in to my eye doctors office for surgery day. The staff was amazing and accommodating! They psyched me up, told some jokes and really got me eased into the entire process, which I appreciated tremendously. Next Kim took me back to her office to go over last minute procedures, reaffirmed that I read up on the expectations for PRK, the healing process, the importance of taking my eye drops. She then gave me some valium and again went over eye drop regimen. It was pretty much drilled in:

1. Zymaxid Eye Drops (Antiobiotic drops) - Started a day before the surgery (checked off) and continuing 4x/day until I run out

2. Pred Forte Eye Drops (Antiinflammatory drops) - Starting 4x spaced out after surgery and continuing 4x/day until told to discontinue

3. Artificial tears - Taken every 30mins after surgery for 2 weeks and as comfortable afterwards

Next after going over my eye care after surgery, she dosed up both my eyes with eye drops for numbing. She then gave me the goodie bag that I would have for the next few weeks including night eye protectors, sunglasses, a zippered bag for my eye drops and a large Hershey’s chocolate bar (because who doesn’t need a chocolate bar after a surgery like this?).

After getting my goodie bag, it was off to surgery feeling numbed up and loose. Dr. Kang was good about it all. They gave me an option of stuffed animals to hold to ease the tension. Of course I doubled up on that offer. Next they had me lay on a surgical bed and put me under a laser scope. Dr. Kang walked me through the entire procedure and it was reassuring knowing exactly what was happening and what to expect. I don’t know exactly what happened only that my vision was blurry and then got clear. All I really wanted to do was to focus and not move so that I did my part in making everything go great. If you’re going through this procedure, chances are you’ve already watched the video of what will happen. Having personally gone through this experience, it’s not as bad as seeing it. The speculum that holds your eyelids open isn’t uncomfortable, you just feel it go in, but afterwards you don’t feel it. Your eye then is so numbed up you can’t feel anything else that is going on. Your main goal is to watch the dot and not move. You do smell burning, which is always an uncomfortable feeling when you realize it’s coming from your eyes. The laser is only actively molding your eye for less than 30seconds. It’s probably less than that, but it really does go by fast. Afterwards, they douse your eye in a cold water bath and place a bandage contact on it, and then it’s off to the next eye. The entire process takes less than 10 minutes.

Today is my comprehensive exam to do last measurements for consistency and for fine tuning the laser to give me the best vision possible. I was also set up for a retinal exam because I mentioned to Dr. Kang that a few years ago a doctor told me I had retinoschesis and last year another doctor told me I didn’t. He told me that I should get it checked out because of the chance that the procedure could cause a retinal detachment. I like how upfront he was with me and gave me the recommendation, so I followed it. I was referred to the Retinal Group of Washington, some of the premier retinal doctors in the Northern Virginia area. My exam went perfect and I was consistent with both eyes, which is great for the laser to give me optimal vision.

My next visit this morning was with the Retinal Group of Washington for my retina exam. I was dilated before getting here from the comprehensive exam, and then they dilated me again. They then took me in the back room where Dr. Sonya Bryant began to look at my retinas in both eyes. She started with the Right, found white with pressure and told me exactly what that meant. She was upfront with everything and told me exactly what she found, which I appreciated. Next she checked my left eye and after one look, she found a retinal hole. She began to prod around my eye to see the movement of the retina and then she told me that she wouldn’t recommend me for LASIK or PRK until I corrected this. I told her that I was scheduled for Thursday and she said she would send the results to Dr. Kang and he would hold off of surgery until I corrected the hole. She told me that the hole could potentially get bigger and cause weakening of the underlying structures causing fluid to leak through and cause pressure in my eye and blindness. She told me that I should get this repaired as soon as possible. She said she could do a procedure today to laser seal the hole. I told her I would  go through with it and she did it. She then proceeded to laser the hole to scar it up and adhere it so fluid wouldn’t leak through it. 

In the end, I chose the Eye Doctors of Washington and Dr. Kang in Northern Virginia.

When I went in for the consultation, I felt everyone was streamlined everyone was attentive to my needs and were looking out for my best interest. They took my eye measurements, looked at my vision and then I talked to Kim who described the process of LASIK and PRK. I told her I was interested in PRK and she described the process in detail, how it would be painful at the beginning and how the healing went. I like how no one gave me the good aspects of both procedures, they told me up front what I could potentially expect. Kim told me some people doing PRK would have minimal pain through the weekend, while some others would have extreme pain for the first few days. She told me that I could be in either category, just that I could expect some pain early on. After talking to her, I talked to Dr. Kang.

Dr. Kang is awesome in that he came in during the consultation to talk to me. Some other places don’t have their Doctor’s or surgeons talk to you until you commit to a procedure with them. Dr. Kang talked to me on my first visit before I even committed and I appreciated that. I asked him about LASIK and about PRK. He told me I was a candidate for both and that I could choose either, but he recommended me for LASIK. I told him I was interested in PRK because my activity level and he said up front it would be painful and the recovery was longer, but that it was my choice on which one to choose since I qualified for both. On a side note here, I researched more on PRK and LASIK based on activities, and unless you are getting hit in the head or in activities that can lead to head and face trauma, such as boxers, grapplers, pilots and race drivers, LASIK may be for you. I told him about my research and he said the chance of LASIK flap dislocation is rare and many athletes have LASIK done on them. 

With all that said, I still decided to go the route of PRK. Even if the chance was smaller, I didn’t want to have my flap dislocated down the road, so I chose the option where there is no flap and my eye surface integrity remains structurally sound even years after the procedure.

A little about me. Like everyone who is at this stage of deciding whether or not they should go for LASIK, I have bad vision. I’ve had over 20/400 vision in both eyes since 4th grade. I’ve been active in sports and outdoor activities since then which encouraged me to go for LASIK when I saved up enough money so I didn’t have to worry about what every active person with glasses fears... breaking those new glasses you just bought, fearing the old glasses you’ve held up with tape will soon break apart for the last time, or you’ll lose your contacts and again have to put them back in after they’ve been on the ground... We’ve all gone through that.

In reviewing LASIK, I found out that there are other alternatives to LASIK. SHOCKER!? I looked up LASIK and found that LASIK is the newer technology built up from the older procedure of PRK. PRK was the earlier procedure where they would shave off the superficial layer of the eye and then laser correct the cornea afterwards. The healing process was longer and it was more painful early on, which created the need for a procedure that had a quicker healing time and was less painful, ie. LASIK. Like PRK, LASIK corrects the cornea via laser, but to get to the corrected layer, instead of shaving the top layer of tissue, they cut the top layer into a flap of which they can pull back to access the underlying layer that they laser. They then pull the flap back over which allows for increased healing speed and less pain. It is less pain because instead of having the top layer of cells regenerate, you just put the flap back over and the top layer of cells is still intact. 

So, if LASIK is better in terms of healing and pain, why do you people choose PRK? One reason people choose PRK, is because they don’t have to worry about he flap. A lot of research studies have shown that the flap can be dislocated several years after the original procedure from light contact. The chance is low, most studies put this at a percentage of less than 7% occurrence in 1000 people, but it still has a chance of occurring. Which is why, I considered PRK, because of this chance and being active, I didn’t want to risk a dislocated flap.

Below is a video of how LASIK and PRK are performed.