PRK (photorefractive keratectomy) is a popular laser eye surgery that reshapes the cornea to correct vision problems like nearsightedness, farsightedness, and astigmatism. While effective, PRK comes with a longer recovery period compared to LASIK and several potential side effects. Here’s what you need to know:
- Dry Eyes: A gritty or burning sensation that may last a few months. Artificial tears and other treatments can help.
- Light Sensitivity: Bright lights may feel uncomfortable, especially in the first few weeks. Sunglasses and dim lighting provide relief.
- Blurry Vision: Common during the first few weeks as the cornea heals. Vision typically stabilizes within 3–6 months.
- Halos, Glare, and Starbursts: Common around lights, especially at night, but usually fade within a few months.
- Foreign Body Sensation and Itching: A scratchy feeling is normal in the first week. Avoid rubbing your eyes to prevent complications.
- Corneal Haze: A cloudy layer on the cornea may develop but often resolves on its own. Rarely, it requires treatment.
- Infections and Rare Complications: Serious but uncommon, these require immediate medical attention if symptoms like severe pain or discharge occur.
Quick Tip: Follow your surgeon’s post-op care instructions, use prescribed medications, and attend follow-ups to ensure smooth recovery. While side effects are usually temporary, contact your doctor if symptoms worsen or don’t improve as expected.
PRK Surgery Side Effects & Complications
1. Dry Eyes
Dry eyes are one of the most common side effects following PRK surgery, often experienced during the recovery process. This happens because the laser disrupts the corneal nerves responsible for regulating tear production, leading to inflammation. As a result, the eyes temporarily struggle to maintain a healthy tear film. Many patients describe a gritty or sandy feeling in their eyes, accompanied by burning, stinging, itching, redness, and sometimes blurry vision – especially in dry or windy environments.
For most, these symptoms improve significantly within the first three months after surgery, though mild dryness might linger for up to six months. In rare cases, the condition can become chronic. Research shows that PRK generally causes less severe and shorter-lasting dry eye symptoms compared to LASIK, as it spares more corneal nerves.
Treatment options include frequent use of preservative-free artificial tears, nighttime lubricating ointments, and, if necessary, punctal plugs or prescription anti-inflammatory drops like cyclosporine or lifitegrast. Some patients may also benefit from oral omega-3 supplements. At Denver Eye Surgeons (https://denvereyesurgeons.com), the care team tailors post-operative treatments to address individual dry eye symptoms and support a smooth recovery.
Lifestyle adjustments can also help ease discomfort. Using a humidifier, avoiding dry or windy environments, staying away from smoke, and reducing prolonged screen time are all effective measures. Certain factors, such as pre-existing dry eye disease, older age, being female, certain medications, and autoimmune conditions, can increase the risk of more severe or prolonged symptoms. Surgeons typically screen for these risks before surgery and may suggest preoperative treatments to minimize complications.
If you notice severe pain, vision changes, persistent redness, or discharge, contact your eye doctor immediately, as these could indicate complications like an infection. Being informed about these causes and treatments will help you manage and recognize other potential effects after PRK surgery.
2. Light Sensitivity
Light sensitivity, or photophobia, is a common temporary side effect after PRK surgery. It can cause squinting, tearing, and a burning sensation when exposed to bright lights, particularly outdoors or in brightly lit environments. Many patients also report seeing increased glare or halos around lights at night, which can be especially noticeable during the early stages of recovery[5, 11].
This sensitivity is usually at its worst during the first week after surgery but tends to improve significantly within the first month as the corneal surface heals. While most individuals experience discomfort for only a few days to weeks, a small number of patients may deal with lingering symptoms beyond the initial recovery period.
Certain factors can make light sensitivity more pronounced, including higher prescriptions, extensive laser corrections, individual healing rates, and pre-existing eye conditions.
Managing light sensitivity during recovery involves a few simple yet effective strategies. Sunglasses with UV protection are a must when outdoors. Indoors, staying away from direct bright lights and resting in a dimly lit environment can provide relief. Regularly using prescribed lubricating eye drops can also help ease discomfort[5, 11]. These adjustments are part of the personalized care plan provided after surgery.
"Light sensitivity is a normal part of the healing process after PRK surgery, and while it can be uncomfortable, it usually resolves as the cornea heals." – Dr. Brent Deibert, Fellowship-Trained Surgical Retina Specialist, Denver Eye Surgeons.
If light sensitivity becomes severe or persists longer than expected, your ophthalmologist may suggest additional treatments. These could include prescription eye drops to reduce inflammation or temporary bandage contact lenses to protect the cornea during the healing process. At Denver Eye Surgeons (https://denvereyesurgeons.com), the team offers personalized care and closely monitors your recovery to ensure everything progresses as it should.
If you notice worsening light sensitivity accompanied by pain, redness, discharge, or changes in vision, it’s crucial to contact your eye surgeon immediately. These symptoms could signal complications that require prompt medical attention.
3. Blurry Vision
Blurry vision is one of the more common side effects after PRK surgery. Many patients describe it as hazy – similar to looking through frosted glass. This blurred vision can come and go throughout the day, with the first few days to weeks after surgery being the most noticeable period for this effect.
PRK surgery involves removing the corneal epithelium entirely, which then needs time to regenerate. This healing process is the main reason for blurry vision, as the cornea must smooth out and stabilize before achieving clear vision.
Duration and Recovery Timeline
The healing process for blurry vision typically follows a predictable pattern. Vision tends to be at its worst during the first week after surgery. By days 5–7, patients usually start noticing gradual improvements as the cornea begins to heal. Functional vision often improves within two to three weeks, though fine details may still appear a bit blurry. Full stabilization of vision can take anywhere from three to six months. Around 20% of patients may experience longer periods of blurry vision, lasting several weeks.
Factors That Influence Severity
The severity and duration of blurry vision can vary depending on several factors. Individual healing rates differ, and patients requiring higher levels of refractive correction may experience more prolonged blurriness. Complications such as corneal haze or infection can also worsen or extend the blurriness.
However, as the healing process progresses, blurry vision typically lessens over time.
Managing Blurry Vision During Recovery
There are steps you can take to manage blurry vision during recovery:
- Use the prescribed anti-inflammatory and lubricating eye drops to reduce dryness and aid healing.
- Protect your eyes from bright light and UV exposure by wearing UV-blocking sunglasses when outdoors.
- Avoid activities that demand sharp vision, like driving at night, during the early recovery phase.
Monitoring your progress is essential. If your symptoms worsen, contact your eye surgeon promptly.
When to Be Concerned
While blurry vision is a normal part of PRK recovery, certain symptoms should raise concern. If your vision worsens instead of improving, or if you experience severe pain, redness, discharge, or sudden vision changes, reach out to your surgeon immediately. These could be signs of complications like infection or significant corneal haze, which require immediate attention.
At Denver Eye Surgeons (https://denvereyesurgeons.com), we prioritize your recovery by scheduling regular follow-up appointments. This personalized care ensures that any concerns about prolonged or worsening blurry vision are addressed quickly and effectively.
Most patients find that, with patience, the healing process leads to excellent visual outcomes once the cornea has fully stabilized.
4. Halos, Glare, and Starbursts
After PRK surgery, some patients notice visual disturbances like halos, glare, and starbursts. Halos appear as glowing circles or rings around light sources, glare involves excessive brightness or difficulty seeing in bright conditions, and starbursts resemble radiating lines or spikes coming from lights. These effects tend to be most noticeable in low-light settings, such as at night.
The reason behind these disturbances lies in the healing process. As the corneal surface recovers, slight irregularities can scatter incoming light, leading to these visual effects.
How Common Are These Symptoms?
Halos and glare are fairly common during the early recovery period after PRK. Research shows that around 20–30% of patients experience these visual effects in the first few months following surgery. These symptoms are usually more intense at the beginning of recovery and gradually improve as the cornea heals and smooths out. Interestingly, these disturbances are less frequent after PRK compared to LASIK, especially in patients with smaller pupils. However, individuals with larger pupils may find these symptoms more noticeable in dim lighting.
Duration and Recovery Timeline
The good news? These issues are temporary for most people. Symptoms like halos and glare often peak within the first few weeks after surgery and start to fade over the next several months. By three to six months, many patients see a significant reduction in these disturbances as their corneas stabilize. That said, recovery timelines can vary. A small percentage of patients – about 20% – may still experience mild symptoms even a year after surgery. This gradual improvement aligns with the overall healing process following PRK.
Risk Factors and Severity
Certain factors can make these visual disturbances worse or extend their duration. For example, having larger pupils or undergoing a decentered laser treatment can increase the likelihood of persistent symptoms. Decentered treatments – where the laser is slightly misaligned by as little as 0.5 mm – are rare, occurring in only 1–3% of patients, but they can lead to ongoing problems like glare and halos. Additionally, higher levels of refractive correction and pre-existing irregularities in the cornea can make these effects more pronounced.
Managing Visual Disturbances
Most of these symptoms resolve naturally as the healing process continues, but there are ways to manage discomfort in the meantime:
- Use preservative-free lubricating eye drops to combat dryness and improve clarity.
- Avoid night driving during the early recovery stages, as low-light conditions can make symptoms more noticeable and impact safety.
When to Seek Medical Attention
While temporary visual disturbances are expected, certain warning signs shouldn’t be ignored. If symptoms become severe, worsen over time, or are paired with pain, redness, discharge, or significant vision loss, you should contact your eye surgeon immediately. These could signal complications like infection or corneal haze that need prompt treatment.
Understanding these visual effects can help you navigate the recovery process and prepare for other potential side effects, such as foreign body sensation and itching.
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5. Foreign Body Sensation and Itching
After undergoing PRK surgery, many patients report feeling as though there’s sand, grit, or even an eyelash stuck in their eye. This sensation, often referred to as foreign body sensation, is one of the most common side effects during the recovery process. Alongside this scratchy feeling, you might also deal with itching, burning, or general irritation.
These symptoms occur because PRK surgery removes the corneal epithelium, leaving nerve endings exposed, which naturally leads to irritation as the eye begins to heal.
How Common and Severe Are These Symptoms?
Foreign body sensation and itching are almost universal in the first few days after PRK. They’re a normal part of the healing process. Most patients describe the discomfort as mild to moderate – enough to be distracting or make you hesitant to engage in activities that require focused vision, but not debilitating to the point of disrupting daily life.
The sensation tends to worsen with activities like blinking, reading, or using digital screens. Itching can be particularly annoying, as the natural urge to rub your eyes must be resisted during recovery.
Duration and Recovery Timeline
These symptoms follow a fairly predictable timeline. The most intense discomfort typically occurs within the first four to seven days after surgery, gradually easing as the corneal surface heals. For most people, the foreign body sensation subsides within three months, though the worst of it is behind them by the end of the first month.
As the epithelium regenerates and nerve endings recover, the scratchiness and burning steadily diminish. By the end of the first month, most patients notice a significant reduction in discomfort, though occasional mild sensitivity may persist.
Effective Relief Methods
While these sensations improve on their own, there are practical ways to ease the discomfort:
- Preservative-free artificial tears: These can keep your eyes hydrated and help alleviate the gritty sensation. Your surgeon will recommend suitable options and how often to use them.
- Cold compresses: Applying a cold compress to closed eyelids can soothe itching and burning. Just be sure not to put any pressure on your healing cornea.
- Over-the-counter pain relievers: Medications like ibuprofen or acetaminophen can help take the edge off the irritation and make the recovery process more comfortable.
Critical Do’s and Don’ts
The most crucial rule during recovery is to avoid rubbing your eyes at all costs. Rubbing can interfere with the healing epithelium and may lead to complications or slow down your recovery. If the urge to rub becomes overwhelming, turn to a cold compress or extra lubricating drops for relief.
When to Seek Medical Attention
While foreign body sensation and itching are normal after PRK, certain symptoms should prompt immediate action. Contact your eye surgeon if you notice worsening pain, redness, discharge, decreased vision, or swelling, as these could indicate an infection or other complications. Additionally, unusual symptoms like pus, significant swelling, or fever should not be ignored – seek medical care promptly.
If you’re in the Denver area and struggling with prolonged or severe symptoms, clinics such as Denver Eye Surgeons provide thorough post-operative care. They can help determine whether your recovery is on track or if further treatment is needed.
Next, let’s dive into corneal haze, another common side effect of PRK surgery.
6. Corneal Haze
Corneal haze, though less common than dry eyes or light sensitivity, is an important post-PRK concern due to its potential to blur vision. This condition is marked by a cloudy or opaque layer forming on the cornea, which can interfere with visual clarity.
Unlike temporary issues like dryness, corneal haze arises when keratocytes – specialized cells in the cornea – deposit extracellular material. This buildup creates a foggy effect that can obstruct clear vision.
Understanding the Two Types of Corneal Haze
Corneal haze is generally divided into two categories:
- Type 1 Haze: This type typically shows up within one to three months after surgery and often clears up within a year.
- Type 2 Haze: A rarer form, Type 2 haze develops after three months and can persist for over three years.
How Common Is Corneal Haze?
Thanks to advancements in laser technology, the occurrence of corneal haze has significantly decreased. For patients with low myopia, rates are now under 2%, while those with high myopia may experience rates as high as 8.6%. Certain factors, such as severe prescriptions, larger treatment zones, or excessive UV exposure during recovery, increase the risk. This is why wearing sunglasses during the healing process is strongly recommended.
Recognizing the Symptoms
Common symptoms of corneal haze include:
- Cloudy or blurry vision
- Increased glare or halos around lights
- Reduced contrast sensitivity
Patients sometimes describe their vision as resembling a view through a foggy window. In some instances, haze may lead to refractive regression, partially reversing the vision correction achieved through surgery.
Treatment and Management Options
Mild cases of corneal haze often resolve on their own. If treatment is needed, options include:
- Topical corticosteroid drops: These help reduce inflammation.
- Mitomycin C: Applied during surgery for patients at higher risk.
In rare cases, additional anti-scarring medication or surgical intervention may be required. Early detection and prompt management are crucial to avoid long-term issues with vision.
When to Contact Your Surgeon
If you notice cloudiness, worsening vision, or signs of infection – such as pain, redness, or discharge – reach out to your surgeon immediately.
For those in the Denver area, Denver Eye Surgeons offers expert care for post-surgical complications, including corneal haze.
Next, we’ll explore infections and other rare but serious complications that can arise after PRK surgery.
7. Infection and Other Rare Complications
While most PRK patients only deal with minor, short-term side effects, it’s crucial to be aware of rare complications that demand immediate medical attention. Among these, infection is the most serious and can lead to permanent vision damage if not treated promptly.
Understanding Post-PRK Infections
Although infections after PRK surgery are rare, they can have serious consequences. The risk is slightly higher compared to LASIK because the cornea remains exposed during the healing process, making it more vulnerable. These infections typically occur within the first few days to weeks following surgery, while the corneal epithelium is still in the process of regenerating.
Recognizing Infection Symptoms
Spotting an infection early can make all the difference between a smooth recovery and long-term complications. Symptoms to watch for include:
- Intense redness that worsens over time
- Pain that goes beyond the usual post-surgical discomfort
- Unusual discharge or pus from the eye
- Swelling around the eye or eyelids
- Fever accompanying eye-related symptoms
- Rapid and noticeable vision decline
Unlike normal healing, these symptoms tend to escalate, signaling the need for immediate attention. Beyond infections, there are other rare but serious complications to consider.
Other Rare but Serious Complications
Though uncommon, the following complications can also arise after PRK:
- Corneal Ectasia: This condition involves the progressive thinning and bulging of the cornea. It occurs in just 0.04% to 0.6% of PRK cases, with most cases (96%) linked to LASIK rather than PRK.
- Central Corneal Scarring: Scarring in the central visual area can significantly impair vision and may require further treatment.
- Severe Permanent Dry Eye: While temporary dryness is normal, some patients may develop chronic dry eye that persists long after surgery.
- Irregular Astigmatism: Uneven healing across the corneal surface can lead to distorted vision that’s challenging to correct with glasses.
Immediate Action Steps
If you notice signs of infection or other severe complications, contact your eye surgeon right away. Early treatment is critical and may include:
- Antibiotic eye drops for infections
- Anti-inflammatory medications to reduce swelling
- Oral medications for more severe cases
- Emergency surgical intervention, though rarely needed
Delaying treatment can lead to permanent damage, so act quickly if symptoms arise.
Prevention and Risk Factors
Certain behaviors and conditions can increase the likelihood of complications:
- Poor hygiene during recovery
- Pre-existing eye conditions or immune system disorders
- Ignoring post-operative care instructions
- Using contact lenses before full healing
- Exposure to contaminated water while recovering
Following your surgeon’s post-operative care guidelines is your best defense against complications.
When to Seek Specialized Care
If you experience persistent or severe symptoms after PRK, it’s essential to seek specialized care. Clinics like Denver Eye Surgeons offer expert management of post-surgical complications and can provide same-day appointments for urgent cases. While these complications sound intimidating, they remain rare when PRK is performed by skilled surgeons and patients stick closely to their recovery protocols.
Side Effects Comparison Table
Here’s a quick-reference guide to PRK side effects, summarizing their symptoms, duration, frequency, severity, management tips, and when you should reach out to your surgeon. This table complements the detailed information provided earlier by offering a side-by-side comparison.
| Side Effect | Symptom Description | Duration | Frequency | Severity | Management Strategies | When to Contact Surgeon |
|---|---|---|---|---|---|---|
| Dry Eyes | Grittiness, burning, or a sandy sensation in the eyes | Weeks to several months | Very Common (most frequent issue) | Mild to Moderate | Use artificial tears or lubricating drops, avoid dry environments | If symptoms worsen or persist longer than expected |
| Light Sensitivity | Discomfort or pain in bright light, need to squint or close eyes | 3 days to 2 weeks | Very Common | Mild | Wear sunglasses, avoid bright settings, dim indoor lighting | If sensitivity increases or doesn’t improve after one week |
| Blurry Vision | Hazy or fluctuating vision that varies throughout the day | 3 days to 4 weeks | Very Common | Mild to Moderate | Allow time for healing, attend follow-ups, avoid eye strain | If vision worsens or doesn’t improve after one week |
| Halos, Glare, Starbursts | Rings, excessive glare, or star-like patterns around lights, especially noticeable at night | 2 weeks to 6 months | Common | Mild to Moderate | Avoid night driving initially, use protective eyewear; symptoms often resolve on their own | If symptoms persist beyond 6 months or worsen |
| Foreign Body Sensation & Itching | Feeling like something is in the eye, itching, tearing, or irritation | 3 days to 2 weeks | Very Common | Mild | Use artificial tears, avoid rubbing eyes, wear protective lenses if prescribed | If pain becomes severe or symptoms don’t improve within a week |
| Corneal Haze | Cloudy or foggy vision, reduced clarity | Type 1: 1-12 months Type 2: 3+ months to years |
Uncommon | Moderate | Anti-inflammatory eye drops, regular monitoring; often resolves naturally | If haze appears suddenly or vision decreases significantly |
| Infection & Rare Complications | Severe redness, intense pain, discharge, swelling, fever, or rapid vision decline | Variable (requires immediate attention) | Very Rare (0.04%-0.6% for ectasia) | Severe | Seek immediate medical care, use prescribed antibiotics, or oral medications if needed | Immediately for any signs of infection or serious complications |
It’s normal to experience temporary discomfort after PRK, and most side effects are mild and short-lived. The first week is typically the toughest, but significant improvements usually follow in the weeks ahead.
For most side effects, simple self-care – like artificial tears, sunglasses, and avoiding eye strain – is enough to manage symptoms. However, the "when to contact surgeon" column highlights situations that need urgent attention, such as unmanageable pain, signs of infection, or worsening vision.
The severity ratings also help you prioritize your concerns. While mild symptoms like light sensitivity are manageable with basic care, severe issues require immediate action. Fortunately, most patients experience only mild to moderate effects, making PRK a predictable procedure with manageable recovery.
Conclusion
PRK is a highly effective option for vision correction, but being aware of its side effects can help you navigate the recovery process more smoothly. Most of these side effects, like mild discomfort or dry eyes, tend to resolve within a few weeks or months, making it easier to focus on achieving the best possible results. This is why professional guidance is so important throughout your recovery.
The first three days after surgery are often the most uncomfortable for patients, but things usually improve steadily after that. While it may take longer for vision to fully stabilize compared to LASIK, addressing side effects like dryness or light sensitivity with proper care ensures better outcomes. For example, using lubricating eye drops or temporary anti-inflammatory medications can make a big difference for those experiencing prolonged symptoms.
Having experienced ophthalmologists by your side is invaluable. They not only provide personalized care but also adjust treatments when needed and offer reassurance during any uncertain moments. If you face challenges like lingering dry eyes or sensitivity to light, close monitoring and tailored care can help you recover more comfortably.
Serious complications are rare, especially when you follow your post-operative instructions closely. Protecting your eyes from bright light, avoiding rubbing them, using prescribed eye drops, and attending follow-up appointments all play a key role in minimizing risks and promoting faster healing. Staying informed and sticking to these guidelines can make your recovery smoother and help you achieve the best results.
FAQs
What are the differences between PRK and LASIK when it comes to recovery time and side effects?
PRK and LASIK are both popular options for vision correction, but they differ in terms of recovery time and possible side effects. With PRK, the outer layer of the cornea is removed, which means it takes time to heal. This can lead to temporary discomfort, blurry vision, and sensitivity to light that may last from a few days to several weeks.
On the other hand, LASIK typically offers a faster recovery. Many patients notice improved vision within just 24 to 48 hours. That said, both procedures can cause side effects like dry eyes or halos around lights, though these issues are usually short-lived.
If you’re weighing your options between PRK and LASIK, the skilled team at Denver Eye Surgeons can help you decide which procedure aligns with your needs. They’ll also provide personalized care to support you through the recovery journey.
How can I reduce the chances of developing corneal haze after PRK surgery?
To reduce the chances of developing corneal haze after PRK surgery, it’s crucial to stick to your doctor’s post-surgery care plan. This often involves using prescribed eye drops to control inflammation and ward off infection. Additionally, protect your eyes from UV rays by wearing sunglasses when outdoors. Refrain from rubbing your eyes and follow any activity restrictions your surgeon recommends to support proper healing.
If you’re worried about corneal haze or other side effects, reach out to your eye care professional. Clinics like Denver Eye Surgeons provide expert advice and tailored care to help you achieve the best results from your PRK procedure.
What long-term side effects should I consider before getting PRK surgery?
While PRK is a proven method for correcting vision, it’s worth noting that some people might encounter a few long-term side effects. These can include chronic dry eyes, sensitivity to light, or variations in vision clarity. The good news? These issues are typically mild and tend to improve as your eyes continue to heal.
Having open conversations with a qualified eye care professional is essential. At Denver Eye Surgeons, our skilled team is committed to offering personalized care and supporting you throughout your PRK experience to help achieve the best results possible.