I got eye surgery this year. I learned a lot about eye things going through the process and wanted to share. If you've been considering eye surgery or have absolutely not considered getting eye surgery, this article may be for you.
Eyes make me very uncomfortable. I had a panic attack at the eye exam where I was prescribed glasses. So if you also have an aversion to eye things, you're in good company. I will 100% neglect to talk about the anatomy bits, I'll only talk about the procedure and experience as a non-medical expert.
Now I will say, in case you haven't gathered from me making an article about eyes, my eye surgery experience has made me less scared of eye things overall. I am still in the "let's not" camp of eyeball discussion, but the surgery is easier to discuss.
Only some people qualify for corrective eye surgery:
Your eyes need to have fully developed and stopped growing which usually means you are in your twenties at least. Having eye exams over a period of time is a requirement to prove this out. For example, I had my first eye exam where I got glasses. Four years later I got another eye exam and my prescription had not changed. Very fortunately, this was sufficient for me to be eligible for surgery.
Your eyes can't have too strong of a prescription, and astigmatism may also rule you out depending on severity. Also the way the common surgeries work is by lasering away your eye. Nearsightedness can be corrected by rounding down the eye to be more spherical but farsightedness actually needs more eye added, and I don't know much about options there. In any case, don't be discouraged. Get an opinion from your eye examiner about your eligibility. In my case, my prescription had been fairly minor with no astigmatism.
There is some time sensitivity to the eye exam and the surgery as in my case I only had about a month between exam and surgery to commit otherwise the exam needed to be conducted again. Luckily, the eye surgeon I opted for did a consultation / exam the morning of the surgery, but had I chosen another surgeon I would have had to keep that in mind.
I opted for Photorefractive keratectomy, which everyone just calls PRK. The most common procedure is LASIK, and PRK is a sister procedure: same cost, roughly the same outcomes, similar enough procedure, and similar eligibility requirements.
There are also other eye surgeries for later in life like for cataracts. The only other common surgery for the 20-30s age group is MonoVision. No acronym. The MonoVision procedure is for people with severe prescription differences between eyes. For example, one eye is nearsighted and the other farsighted. MonoVision adjusts the eyes to have each play to their strength. You'll be able to see well far out of one eye, and see well at short distances using the other. This one has disadvantages for depth perception and takes getting used to post-surgery.
Anyhoo, I was eligible for either LASIK or PRK. Here are the pros and cons:
LASIK wins hella in the recovery time area. With LASIK, you can be recovered and back to life in 2-3 days. PRK has a mandatory week of recovery time, plus about another 1-2 months until the eye is fully back to normal. Not everyone has the luxury to take a week off work to heal, and trust me you won't be doing anything but recovering that week after PRK.
PRK wins in simplicity of procedure. If you are concerned about the safety of eye surgery, you will be happy to know PRK only involves a single laser. Whereas LASIK involves two. I'll discuss the PRK surgery experience below.
PRK, unlike LASIK, does not create an incision/flap in your eye which will never fully heal. LASIK involves creating a flap (laser 1) and then correcting underneath the flap (laser 2). The flap does heal over time, especially on the surface of the eye, but never fully. I didn't want to live knowing I had flaps in both eyes the rest of my life. After a year of healing it makes no practical difference, but to me it was about the principle of it.
LASIK recovery hurts way less than PRK. I only got PRK but just talking with LASIK patients, the pain and duration of pain is easily 5x. With PRK, the laser does way more work of your eye and thus the eye is much more irritated.
I paid $5.1k for surgery on both eyes. This included some lifetime guarantee of touch-ups if I needed them and the post-surgery examinations. Without those things, I was quoted $4.4k by another surgeon. I opted for the more expensive package deal so I didn't have to sort any more logistics out.
I think either surgery will be fine for most people. I have a friend who had done a now defunct procedure other than LASIK, so I happened to be aware of the existence of other options for many years leading up to the surgery. Otherwise, like most people I wouldn't have known to consider anything but LASIK. If the flap doesn't bother you, LASIK is probably the better choice.
I opted to have my consultation and surgery on the same day, but you can separate them. I thought it was better to pack them back to back as opposed to having to make two trips.
Before surgery, I 100% recommend meal prepping. Have meals ready to go for the next few days (LASIK) or week (PRK). You'll also need a surgery buddy to get you to and from the surgery. You might not be able to even look at your phone to call in a ride-share service after the surgery.
The consultation is similar to an eye exam, just without much talking and with more types of tests/scans. Notable to me was the air pressure test and the retinal scans. I got unlucky and needed retinal scanned about fives–this blinded me more than anything going on in the actual surgery.
I was prescribed Gabapentin and took a dose after the consultation. Gabapentin chills you out a bit as an anti-anxiety drug. (Vets also prescribe it for dogs who are anxious to fly in planes I would later find out.) Before the surgery I was also given Valium. I was chilling with the Gabapentin but the Valium took it up a few notches. You can decline the Valium if you want, but I think it helped me a lot to sit through the surgery.
Your eyes are also numbed for the surgery itself. This was chill as the assistant administers the drops for you. The numbing is pretty darn effective. After the surgery, my friend and I got lunch. It was only when I got back to my place an hour after surgery that the effects of the drugs and numbing wore off.
They put you in a fully reclined chair for the surgery. The chair is pretty much like a dentist chair. They hold your eyelids open so you don't need to worry about closing your eyes: you couldn't if you tried. They also give you a light source to stare at while the surgery is happening. The light (1) gave me something to do, and (2) helped keep me focused straight ahead.
Both LASIK and PRK are quick. PRK was about two minutes per eye, but with the Valium hitting it felt even shorter. The laser doesn't hurt at all, but you can hear it activate and whizz while it's doing its thing. I was warned about the smell of the laser burning your eyeball. I can confirm I did catch a whiff! It wasn't anything special if you've ever burnt hair in a hair dryer.
In those minutes of surgery, the experience felt like a car wash more than anything. The assistants are putting so much solution in your eyes to clean away whatever.
Once each eye is finished, they place a contact bandage atop the eye to make sure nothing gets in there while it is healing. I never did regular contacts so I don't have a point of reference, but these contacts felt secure, and thick: I could feel them ever so slightly with each blink.
Once the PRK surgery was complete, the surgeon shook my hand and was basically like, "Alright get out of here before it starts hurting." They gave me a to-go bag of various drops and written instructions for the next few weeks.
As I said, I arrived home and the drugs and numbing trailed off. The battle began.
I'd mentioned the meal prep tip already and here's another tip: memorize the post surgery instructions before the surgery. I say this because written instructions are useless to someone who cannot see. (I gave this feedback to the surgeon.)
While it doesn't happen to everybody, the pain caused my eyes to be welded shut for a time. I could sneak very quick glances like a photo-only camera, otherwise I was walking around blind. I was super light sensitive so I lived mostly in the dark. It was good I had read the instructions many times over waiting for the surgery to begin, otherwise that would have been hectic.
Another pro-tip: you'll be given three bottles of eye drops. Make sure to open them before the surgery, or get someone else to open these bottles for you for the first time. I'd not been so angry in so long as I was trying to open a little tiny bottle completely blind and under a great deal of pain.
The three bottles of eye drops:
In the first few days, I was spamming the numbing and inflammation drops to abide the pain. The numbing drops only are meant to last three days so you have to be a bit conservative. Let the pain guide you to a proper dosage I say.
Our good friend Gabapentin will also be taken in the first few days in the mornings. I recommend Daft Punk's Random Access Memories album while under the influence and laying in bed.
The first and second days are just pure, constant pain. I had been warned the feeling is like scraping your eye on the sidewalk and it's not as bad as that, but not by much. Notably, the pain is so constant I did not sleep more than 15 minutes consecutively the first night. You're also uncontrollably crying. It's the natural thing eyes do when they believe they've just been scrapped on the pavement.
The second and third days, the pain begins to taper off. A new challenger approaches: you've run out of tears. I didn't know if I could run out of tears. My whole life they seemed readily available, but turns out after two nonstop days of crying my tank was empty. This became the game the next few days: add moisture to your eyes before dry eye gets you.
I ran a humidifier in my bedroom and kept it sealed best I could. The artificial tears become important in this phase and I also spammed them for a bit, every hour or so.
By day four, the pain was controlled well enough I could start to alleviate the third and final boss: boredom. There's literally nothing to do except try to sleep through the pain or listen to music the first few days. With the pain decreasing, I took some time to make phone calls to people I'd not spoken to in a while. I was also able to keep my eyes open for longer, but preferred not to dry them out that way.
Day six, the pain is mostly gone. I was settled into my eye drop schedule and no longer riffing it with additional drops. More importantly, this was the day I went back to the surgeon to get the contact bandages removed. That was a relief. The small snagging it had been doing on my eyelid made me uncomfortable. Without the contacts, my eyelid movements were buttery smooth; more than I ever felt they were prior.
The outer part of the eye, its protective coating, heals more quickly than the parts that were corrected with the laser. So while I no longer had safety contacts, I still had much healing to do. I continued the eye drops until they ran out, which was about a full week and a half after the surgery in my case.
As the healing process continued, the pain was gone but I was still quite sensitive to lights and computer screens for a good two weeks. In this time my eyes would also have good days and bad days in terms of how much strain they could bear.
Everyday felt as if my eyes had batteries which indicated just how much eye strain they could handle before shutting down. I found taking naps gave me a few extra hours in normal light. Week over week, the eye strain limit increased until by about five weeks in I stopped noticing anything abnormal.
About a month after the surgery is the final post-operation exam. This is just a regular eye test to confirm your vision is improved, which mine definitely was. Compared to the other two visits, this one is anti-climatic. You're just done. There's still more healing that happens over the next few months, but I didn't notice any more changes after two months out.
The PRK recovery time is quite an experience. You can see why LASIK being only 2-3 days of healing definitely gives it a competitive edge. However, after two months, I was really quite happy with PRK. My heart sings, "no flap, no flap" and the pain will become a distant memory over time.
I'm happy with my corrective eye surgery experience. It wasn't without a whole bunch of pain certainly. However, having my eyes back in action has been great in a lot of ways.
I hope writing about my experience has given you some insight into the whole process, gave you some actionable advice, or at least entertained you with my suffering.
BUT, if it didn't. Don't worry, the best part of eye surgery will now be revealed: I got it on camera. Yes boys and girls, strap in as we watch my eye surgery: (watch with sound on for the full experience)
I hope that was as good for you as it was for me.
Thanks for reading and see you later!