Photorefractive Keratectomy (PRK) is a laser eye procedure that corrects refractive errors such as nearsightedness, farsightedness, and astigmatism. Unlike LASIK, PRK involves gently removing the outer layer of the cornea (the epithelium) before the laser reshapes the underlying tissue. Because the eye must regrow the epithelial layer, PRK recovery is a noticeably gradual process. Visual correction is achieved in phases, beginning with immediate healing and culminating in the final, stable result months later.
The First Week: Immediate Healing and Discomfort
The first week is the most physically demanding period, dedicated to the body’s natural process of re-epithelialization. A protective, soft bandage contact lens is placed on the eye immediately after surgery to manage discomfort and remains until the corneal surface has fully healed, typically five to seven days later.
The peak period of discomfort, characterized by burning, grittiness, and foreign body sensations, usually occurs between days one and three. This pain occurs because the corneal nerves are exposed until the epithelial cells cover the treated area. Patients also experience significant light sensitivity and excessive tearing, requiring rest in a dimly lit environment.
Vision is highly fluctuating and blurry during this time, often comparable to looking through a hazy contact lens. Once the surgeon removes the bandage lens, the patient typically experiences an immediate, moderate improvement in clarity, signaling the end of the most intense healing phase.
Weeks Two Through Four: Functional Vision Return
Once the epithelial layer is intact, recovery shifts toward the gradual return of functional vision. By the end of the second week, many individuals can safely resume non-strenuous work and driving, provided their vision meets local legal standards. Vision may still fluctuate noticeably throughout the day, often feeling clearer in the morning and hazier by evening.
This stage requires the necessary use of prescription steroid eye drops to manage the cornea’s internal healing response. These drops suppress inflammation and mitigate the risk of developing corneal haze, which can temporarily cloud vision. Visual acuity continues to improve, allowing patients to read progressively smaller lines on an eye chart.
Visual side effects common in the first month, such as glare, halos, and starbursts, also begin to diminish. Continued use of lubricating drops is important to address persistent dryness, which contributes to temporary visual fluctuations.
The Long-Term Process: Final Visual Acuity
Achieving the final, stable outcome extends beyond the first month, requiring patience as the cornea subtly fine-tunes its shape. While functional vision returns within weeks, ultimate visual acuity continues to sharpen over several months. Most patients achieve their final, optimal result, often 20/20 vision or better, between three and six months post-surgery.
The healing process continues up to the twelve-month mark, when the corneal tissue fully remodels and stabilizes. During this long-term phase, the concentration of the prescription eye drops is gradually tapered down and eventually stopped entirely by the surgeon.
Regular follow-up appointments, particularly at the six and twelve-month milestones, are necessary to confirm stability. Any residual effects, such as mild ghosting or night vision disturbances, typically resolve completely during this final phase.
Variables Influencing Recovery Time
Several biological and surgical factors modify the typical PRK recovery schedule. The patient’s initial prescription strength is one of the most significant variables. Individuals with higher degrees of nearsightedness or astigmatism require a longer period for the cornea to fully remodel and vision to stabilize, due to the greater amount of tissue reshaped by the laser.
A patient’s age also plays a role, as older individuals may experience a slightly slower rate of epithelial regrowth and overall healing compared to younger patients. Underlying health conditions, such as diabetes or certain autoimmune disorders, can also slow the body’s healing response.
Finally, strict adherence to the post-operative schedule, particularly the consistent use of prescribed steroid and antibiotic drops, is directly correlated with a smoother and faster recovery. Non-compliance increases the risk of corneal haze and delays the final result.