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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7744
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I originally had PRK in March 2012. After the 6 month healing

Customer Question

I originally had PRK in March 2012. After the 6 month healing process both eyes settled in at about 20/40. Towards the 4-5 month mark one eye watered a lot (no infection, just watered all the time). Had revision performed October 2013. Left eye hit 20/30 and hasn't changed. Right eye hit 20/25 but at 5 months it was 20/30. Now almost a 6 months it is watering a lot. Everything is a little blurry, computer, faces, car dashboard. They put me on restasis and now it waters more. Is watering a sign of regression? Is something wrong? Would a 3rd procedure produce any different results. First time I was left with a little bit of astigmatism. Second time, no astigmatism. Thank you.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Why did you have PRK instead of LASIK?

Dr. Rick :

are you available to chat?

Dr. Rick :

What you are experiencing in not a sign or regression, nor will the excessive tearing cause any damage to your eyes or regression in your PRK treatment.

Dr. Rick :

What you are experiencing in the most common side effect/complication of PRK and LASIK........dry eyes. This is caused because of the loss of the normal nerves in your cornea that are needed to maintain the constant, background, lubricating tear production that is normally present to soothe and protect your eyes...

Dr. Rick :

But, you say: "How can my eyes be dry, when all they do is water"? That is a very good question. Let me explain:

Dr. Rick :

When your eyes are "dry" and irritated they make more tears....this is the "something is in my eye" mode of tear production, not the "my eye feels fine and I'm making tears to keep things moist" mode. The use of natural tears will help your eye turn off the flood of "something in my eye" tears that comes from your eyes being dry. Does this make sense?

Dr. Rick :

So. What should you do? Continue using the restasis and artificial tears. Also, do this simple treatment for any blepharitis you might have...

Dr. Rick :

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Dr. Rick :

Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Dr. Rick :

So. As you can see, there are more things that can be done to help.

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?


 


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I’ve earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

 


We have been experiencing problems with the chat system for the last few days. Our engineers are working on it. However, I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.
We have been experiencing technical difficulties with the chat system. Please allow me to retype my chat here for your review:


Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : Why did you have PRK instead of LASIK?
Dr. Rick : are you available to chat?
Dr. Rick : What you are experiencing in not a sign or regression, nor will the excessive tearing cause any damage to your eyes or regression in your PRK treatment.
Dr. Rick : What you are experiencing in the most common side effect/complication of PRK and LASIK........dry eyes. This is caused because of the loss of the normal nerves in your cornea that are needed to maintain the constant, background, lubricating tear production that is normally present to soothe and protect your eyes...
Dr. Rick : But, you say: "How can my eyes be dry, when all they do is water"? That is a very good question. Let me explain:
Dr. Rick : When your eyes are "dry" and irritated they make more tears....this is the "something is in my eye" mode of tear production, not the "my eye feels fine and I'm making tears to keep things moist" mode. The use of natural tears will help your eye turn off the flood of "something in my eye" tears that comes from your eyes being dry. Does this make sense?
Dr. Rick : So. What should you do? Continue using the restasis and artificial tears. Also, do this simple treatment for any blepharitis you might have...
Dr. Rick : The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.
Dr. Rick : Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.
Dr. Rick : So. As you can see, there are more things that can be done to help.
Dr. Rick : Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I’ve earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7744
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 1 year ago.

I had PRK because my corneas were too thin for LASIK. I will keep using restasis and lubricating drops, and try to treat for blepharitis. That could be an issue. But why is my vision in one eye at a point that all distances are blurry. How many times can an eye be treated with PRK? Or are more revisions not safe or productive?


THank you for your previous answers. I will rate you after this.

Expert:  Dr. Rick replied 1 year ago.
That is what I thought.

When I first started doing refractive surgery RK was the state of the art..then came PRK; still painful, but better results.

I'm glad your vision is better.

Your are limited to the amount of treatment by the thickness of your cornea, just like in LASIK, so you can have more PRK until you get close to that limitation...but I wouldn't recommend pushing things too far.

Sometimes in trying to get things "perfect" you end up with a complication and loosing the "pretty good" that you have.....

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