Three Years After Contoura PRK: Ongoing Dry Eye, Light Distortion, and Persistent Discomfort – Seeking Guidance
Hello everyone. It’s been three years since I underwent Contoura PRK (no flap created, just a "peeled" layer because of thin corneas). While my eyesight is technically 20/20 with both eyes, I am facing several ongoing challenges: **Dryness and Light Distortion:** In dim lighting, lights appear to scatter. It’s not quite halos, and this effect fades for a brief period right after I apply artificial tears. **Refractive Variability:** My right eye still seems to possess a minor residual prescription. I occasionally suffer from headaches, but again, using moisture often provides a temporary improvement in vision clarity. **Recurring Discomfort and Infections:** About once a month, I wake up experiencing sharp pain in my eye. My physician believes I might be unintentionally hitting my eye during sleep, yet antibiotic drops typically alleviate the issue. This feels like I’m making progress one moment and then regressing the next. Has anyone else dealt with such long-term issues? Could these symptoms indicate Recurrent Corneal Erosions (RCE) instead of just unintentional eye contact during sleep? I would appreciate any recommendations for specific drops or treatments, such as punctal plugs or Scleral lenses. Profile: 26 years old, male, 5’10".
Answers (1)
3/5/2026, 10:10:57 PM
OpenHealth AI
It sounds like you’re facing several frustrating and persistent issues following your Contoura PRK procedure. Your primary concerns—dryness, light distortion, refractive variability, and recurring discomfort—are significant and understandably concerning. I’ll help you understand these symptoms and outline practical steps to address them.
Explanation:
-
Dryness and Light Distortion: Persistent dry eye after refractive surgery is common, especially when pre-existing conditions like thin corneas are involved. The scattering of light in dim environments might be partly due to dryness affecting how your eyes process light.
-
Refractive Variability: A minor residual prescription can contribute to visual disturbances and headaches. This can be more pronounced if your eyes are dry, as adequate moisture is crucial for optimal vision.
-
Recurring Discomfort: The sharp pain you experience, particularly upon waking, might indeed be linked to unintentional trauma to your eye during sleep, but it can also suggest recurrent corneal erosions (RCE). RCE occurs when the outer layer of the cornea doesn’t adhere properly and may be more common in dry environments or due to healing irregularities.
Next Steps:
-
Increase Artificial Tears Use: Use preservative-free artificial tears liberally throughout the day, especially before sleeping. They can help manage dryness and improve comfort.
-
Consider Punctal Plugs: Punctal plugs can help by blocking the tear drainage system to keep your eyes moist for longer periods, which might alleviate dryness and improve light distortion.
-
Scleral Lenses Discussion: Explore the option of scleral lenses with your eye care specialist. These lenses can provide a moisture reservoir and may ease discomfort while also addressing vision variability.
-
Consult About RCE: Discuss the possibility of recurrent corneal erosions with your eye doctor. Treatments can include ointments for nighttime use or medications to promote healing and prevent recurrence.
-
Monitor Symptoms: Keep a symptom diary to track your visual clarity, discomfort levels, and any patterns with lighting and activities. Share this with your doctor to aid in diagnosis and treatment planning.
It's essential to address these issues with your eye care professional to tailor a management plan suited to your needs. I hope you find this guidance helpful, and I encourage you to advocate for the options that will provide you the most relief!
Related Questions
Bat Encounter in the Basement – Conflicting Medical Advice on Rabies Shots
Greetings everyone, I am 37 years old, standing at 5’10” and weighing 190 pounds. Yesterday afternoon, I found myself in quite a predicament when a bat appeared to be fluttering around in my basement. I’m uncertain about how it gained entry, but I was fully conscious throughout the experience. The bat seemed to be attempting to find a way out. To manage the situation, I utilized a blanket and a jacket to bring the bat down and subsequently covered it with a storage box. I carefully maneuvered the box towards the door and used a shovel to gently scoop it up and release it outside. Before doing so, I placed a plastic container over the bat to ensure that it remained contained during the transfer. After lying on the ground for approximately 5 to 10 minutes, the bat eventually flew away. Here are some crucial points to note: * The bat **never came into contact with my skin**. * I **did not handle the bat directly** with my bare hands. * There was always **a layer of protection (jacket, box, container, shovel)** between myself and the bat. * I was **completely alert and mindful throughout** the entire incident. After this event, I visited the emergency room for further evaluation. The attending physician stated that rabies vaccinations were **unnecessary**, even after consulting an **epidemiologist** who concurred that there had been **no exposure**. In addition, I reached out to a Teledoc service, and their opinion aligned with that of the ER doctor. However, my primary care physician is advising me to undergo the rabies vaccination for precautionary reasons. This conflicting advice has left me feeling perplexed. I have a couple of questions for the community: 1. Given that the bat **did not have any direct contact with my skin**, is it customary to recommend post-exposure rabies prophylaxis? 2. Should I adhere to the guidance provided by the ER and the epidemiologist, or opt for vaccination to alleviate my concerns? Thank you for your assistance. This situation has been rather stressful, and I’m eager to make the best decision possible. Additionally, it has been nearly 30 hours since the incident. Would the vaccine still be effective if I receive it now or within the next 72 hours?
Managing Post-Acute Withdrawal Symptoms (PAWS): Exploring Phenobarbital and Alternative Treatments
Male, 36 years old, height 5'9", non-smoker, no caffeine intake. I initially shared my experience on benzorecovery but didn't receive much engagement. I thought it would be beneficial to consult with medical professionals regarding my treatment approach to ensure I’m not overlooking anything crucial. Currently, I am 52 days free from benzodiazepines. My history includes a daily regimen of 8mg clonazepam, 6mg Xanax, and 0.5mg Halcion for the past 18 years, under the care of an ill-suited physician. Upon my decision to seek help, I checked into the Caron Treatment Center, which provided a pleasant environment, but their tapering schedule was far too aggressive for my needs. I was prescribed 75mg of Librium for just two weeks before they discontinued it. Subsequently, I consulted a new psychiatrist who has now placed me on phenobarbital. Despite the option to revert to benzodiazepines, we agreed that since I had been benzodiazepine-free for six weeks and they were entirely out of my system, it would be imprudent to reintroduce them. Interestingly, I found that my previous use of benzodiazepines often triggered anxiety. At present, my treatment consists of phenobarbital at a dose of 130mg twice daily to manage PAWS. I would appreciate insights from others who have experience with phenobarbital, particularly regarding its impact on GABA and glutamate levels. This connection is essential for me, as I often feel hyper-alert, experiencing a rapid heartbeat, excessive sweating, muscle twitching, and significant nerve and muscle discomfort. In addition to phenobarbital, I am taking: - 450mg of Lyrica daily (previously tried gabapentin at maximum dosage with no improvement, but Lyrica has been beneficial for some reason) - 50mg of promethazine as needed - 320mg of extended-release propranolol daily Are there any other medications or therapies I could propose to my psychiatrist to enhance my PAWS management? At one point, I was on four different benzodiazepines concurrently (Xanax, clonazepam, Ativan, Halcion) and managed to taper off Ativan independently, which led to my decision to seek treatment at Caron, costing $65,000 for a month. My new psychiatrist is open to exploring various options. I have tried nearly all classes of psychiatric medications aside from MAOIs, including antidepressants, antipsychotics, and anticonvulsants. I'm keen to hear from anyone about their phenobarbital experiences and what additional medications could bolster my approach to alleviating PAWS symptoms. Thank you for your assistance!
New Rash Appears After Fever in Toddler
My two-year-old daughter has developed a new rash underneath her mouth following a recent recovery from a significant fever that her pediatrician suspected was caused by the seasonal flu B virus. **Timeline of Events:** - On Friday evening, her temperature first spiked to 102.3°F. - Throughout the weekend, her fever remained elevated: without medication, it ranged from 103°F to 104.5°F, while taking acetaminophen or ibuprofen, it was between 100.5°F and 102°F. - By Monday, I reached out to her physician, who advised monitoring her condition for an additional day before coming in. - On Tuesday, we visited the doctor as her fever began to decline, though it hit 103.5°F around 2:30 PM after 12 hours without any fever-reducing medication. - The doctor conducted tests for COVID-19 and the flu, both returning negative results. However, the doctor mentioned it had been a while since her last check-up and suggested a possible virus clearance. - A urine test was ordered to rule out a urinary tract infection (UTI). We also proceeded with a home kit test for the same. - All tests came back negative. - By Wednesday, she no longer had a fever and her mood was notably cheerful. As of today, Thursday, a rash has appeared on her chin. Should I be worried about this rash? What could potentially be causing it? At what point should we distinguish between simple irritation of the skin and something more concerning?
Concerns About Isotretinoin and Intracranial Hypertension
Hello, I'm currently taking Trazodone (150mg) and Doxazosin (2mg), and I have recently begun a course of Accutane (20mg). A known complication associated with Accutane is an increase in intracranial pressure, which can escalate to a serious and potentially life-threatening condition. I participate in a sport known as Rhönrad, which involves significant upside-down movements for extended periods—think of it as flipping and rolling continuously for one to two hours each week. I'm concerned about the potential risks. Does this activity put me at a higher risk of developing intracranial hypertension? Are there any measures I can take to mitigate this risk? Thank you for your advice!
Seeking Insights on Ongoing IBS Symptoms
Hello everyone, I'm a 25-year-old male reaching out for some guidance. I've been living with irritable bowel syndrome (IBS) for roughly a year, likely stemming from food poisoning that I experienced. I've managed to alleviate most of the typical symptoms by adhering to a gluten-free, lactose-free, and low FODMAP regimen. However, there's one persistent issue that's lingered, and I believe I've given it ample time to resolve, though it may have been too long based on what my healthcare professionals have indicated about it not being a permanent condition. The specific problem I face is related to my bowel movements, particularly in the mornings. After each average bowel movement, I find myself needing about three to three and a half hours before feeling fully clean. This is often coupled with mucus, a common annoyance for many people dealing with IBS. Is this experience common among others? Will I have to endure this indefinitely? What might this symptom indicate—is it possibly more serious than just IBS?