Surviving PRK/LASIK: Pre-Surgery

Booking a laser vision correction can be a really stressful experience… There’s a lot of information out there on the pros and cons of each procedure, the clinics are all trying to sell you on something, and you may second- or triple-guess yourself at multiple points during the process. I know I did.

There are a lot of great online resources that provide helpful, rational advice on LASIK and PRK, and they can be invaluable during the process. The clinic that does your procedure, once you’ve selected one, will also be an amazing help–they’ve seen it all before, done it all before, and are always happy to answer your questions or assauge your fears. You can read hundreds upon thousands of distinct “this is how the procedure went for me” stories, both good and bad–and you can get a pretty solid idea of what to expect from your procedure and the healing process in most circumstances.

That said, having gone through a vision correction procedure recently myself, I wanted to put together some advice that I wish I’d known before surgery myself. Hopefully it will help someone else as they go through this path.

NOTE: I am not a medical professional. Even if I was, I am not YOUR medical professional. This is not officially sanctioned medical advice in any way. Always consult a trained optometrist or opthalmologist in matters of the eyes and eye health. Your eyes are important, take care of them!

Try to book the cycloplegic refraction in the late afternoon (after work)

…Or, at least, for a time when you won’t have to do much close up reading afterwards. Many LASIK clinics will ask if you want to do the dilated eye exam during the original booked consultation, or if you want to reschedule that part (or do it through your own optometrist). If possible, either book the consultation for an afternoon where all you’ll need to do is go home, or reschedule the refraction for end of day.

Why? When they use the dilating eye drops, your distance vision will be mostly unaffected, but your ability to see things within arms length may be severely affected. It can make reading paperwork or using the computer a huge struggle. It’s certainly possible to do, but it is not a pleasant experience, and your work productivity will likely tank for the afternoon.

If you have to do the cycloplegic refraction during the day and you need to go back to reading things afterwards, try taking your glasses off. If you’re like me and couldn’t see beyond your elbow it may mean you’ll be bumping up the font on your computer to 300%, using the accessibility options liberally, and squinting super closely at the monitor… but it does work!

Additionally, you may not want to plan on much night driving after the test if you can help it… But if you do, be prepared for serious starbursting on lights. On the plus side, starbursts are a potential (although often only temporary) side effect of laser vision correction, so you’ll be able to see in advance if this is a deal breaker for you.

Ask about your pupils

It has been suggested that you are more likely to experience visual aberrations (starbursts, haloing) if the area that the laser corrects on your eye (the “optical zone”) is smaller than your fully dilated pupil size. For many people this won’t be a problem–the lasers available can treat their fully dilated pupil, no problem. They’re less likely to run into permanent starbursts/haloing after surgery.

For some people (especially white males with blue eyes), their pupils may be bigger than the optical zone that the laser can treat. This means that at night, when the pupil is fully dilated, there’s light entering uncorrected sections of the cornea, leading to the visual problems.

To try to avoid this, ask the clinic what your dilated pupil size is, and ask what laser they’re running and the optical zone it can treat. (They may try to include a “blend are” into that calculation–you will want to know the size of the actual optical zone, without the additional blend area.) If your pupil size exceeds the laser’s optical zone, you may be at risk for permanent starbursting/haloes. If this isn’t a problem for you, that’s okay! But if it is, and if they dismiss your concern without explaining things to your satisfaction, consider a different clinic for your procedure.

Supplement Omega-3 Fish Oil

Omega-3 fish oil is supposed to be helpful for eyes–in particular, for building and maintaining a tear film and preventing dry eyes. Is it true? Not sure, to be honest. But some LASIK/PRK patients recommended 2000mg a day was helpful in aiding recovery. You may want to start this a few months in advance.

Also: “No fishy burps” is a dubious claim. You may still get fish burps. Some brands will taste like you just had sushi. It’s possible there are some brands that really do not cause fishy burps but don’t be too surprised if it still happens.

Prepare the paperwork

Review the paperwork. Make sure it’s all signed where it needs to be signed, that the financing (if applicable) is all sorted out, and that you have carefully reviewed the take-home instructions part of the paperwork (if any). Any questions? Contact the clinic in advance, get it all cleared up so you don’t have anything to worry about the day of the procedure.

Set the paperwork with any other items you’ll be bringing with you on surgery day, so you don’t forget it.

Prepare your eyedrops

Make sure you’ve picked them up from the pharmacy, opened the boxes, peeled off the little plastic seals, and put them some place you know you can find them. (How about in the refrigerator? Or next to your bed?) Your clinic may have had you start antibiotic eyedrops up to a week in advance, so be sure to follow all instructions.

Prepare your dark room

The clinic will probably tell you that the recovery won’t be that bad. And for LASIK, they’re right! You’ll probably be able to skip this step entirely and just plan on a really long afternoon nap.

For PRK, do it anyway. If you don’t have black out curtains (and even if you do!), consider blocking out the window(s) to your bedroom the night before the surgery with cardboard or a garbage bag, etc. There’s a chance you might not be super light-sensitive. There’s a good chance that you will be. Having a nice, dark place to recover is great in either case.

Another thing you may want to consider: night lights. Especially in bathrooms, hallways, or the kitchen, so that you can stumble around in the mostly-dark if you’re unable to tolerate turning the lights on.

If you have a red-light flashlight, or another light source that has red bulbs/LEDs, you may find it helpful to have nearby during your recovery. I couldn’t tolerate regular light at all, but a hunting flashlight that used red LEDs was something I could stand and gave me enough light in the blacked-out bedroom to be able to see enough to put in eyedrops. (Or to help someone else see–there was a day or so that I needed someone to do the drops for me as I pried my eyes open, and if they’d have turned on the regular lights it would have made the whole process much more unpleasant!)

Enjoy a small breakfast or snack

Your clinic may offer you a sedative (often Ativan or Xanax). This may cause nausea for some people if you take it on an empty stomach, so they’ll usually recommend that you have a quick breakfast before the procedure. (Your clinic may have snacks or food available the morning of surgery–mine had muffins for the clients–but this is not a guarantee.)

Arrange for a ride

It will be in the instructions, but you will need a ride home. Even if you walk out of the surgery with ²⁰⁄₂₀ vision or otherwise sufficient sight to drive, there is a very good chance that you will be dizzy, light-sensitive, or otherwise have very irritated eyes. Have a friend or family member drive you, call a taxi/Uber/Lyft, etc.

You may not want to rely on public transit unless absolutely necessary–if you’re light-sensitive or dizzy, having to cope with a bus or train may be unpleasant. (I know I’d considered taking the bus home from my surgery–but was so incredibly glad I was able to arrange a ride instead, because I was pretty miserable and wanted to hide in bed ASAP within ten minutes of leaving the surgery room.)

Don’t expect to use your phone much

When you get escorted out of surgery, you will be told to sit with your eyes closed for a few minutes. Then you will be given even more eyedrops and possibly poked at by an optometrist to verify that things are looking good and there’s nothing urgent that needs tending to.

The clinic staff will likely let you get away with a quick text (to contact your ride, for example), but they will probably tell you to stop if you immediately try to start browsing intently. Your eyes have just gone through a very traumatic procedure, they want you to rest them. Plan to keep texts short and sweet if you need to send any immediately after surgery.

If you’re getting PRK, they advise against using your phone or screens much until the bandage contact lenses are removed. (Not that you’d really want to, depending on how your recovery goes!) This can be anywhere from four days to a week.

Bring gum (or hard candies)

The absolute worst part of the PRK experience, in my opinion, was the taste of the eyedrops. The staff will dump what feels like three or four bottles worth of eyedrops in your eyes during the course of the procedure (numbing, antibiotics, steroids, more numbing, a bit more numbing, more antibiotics, let’s make extra sure everything is numb, etc.) and they all taste horrible.

Tasting eyedrops? “Clearly you’re doing it wrong,” you might say. (I’ve been told so.) But unless you take special care–and sometimes even then–the drops will drip down your tear ducts and you will get a taste. In the pre-surgery build up, they will not have the time to try to block your tear ducts to minimize this. You often will not have the ability to either.

Bring gum. Chew it as soon as you’re allowed to after the surgery. It will make the taste go away.

Bring a hat and sunglasses

You may be light-sensitive leaving the clinic. (I know I was!) Having a hat to help shade your eyes from the sun can be incredibly helpful.

The clinic will generally provide a pair of sunglasses, but a “just-in-case” pair never hurt. (And honestly, I’ve heard some people double up on the sunglasses, wear a hat, and cover their faces with a hood to get out of the sun during the ride home after their surgeries. My experience wasn’t quite that bad, but my ride home was very, very short.)

Attend the surgery

Don’t worry! The surgeon and his staff will walk you through every step, and it will be over before you know it. The sedative they offer will help if you need it.

Head onward to Part II, which will cover the recovery period: coping with pain and light sensitivity, the bandage contact lens, driving, etc.