Is pain in the first few days normal after PRK?

What's normal

The American Academy of Ophthalmology says that for 2 to 3 days after PRK you may have some eye pain, and that over the counter medicine usually controls it. Many surgeons also prescribe stronger medicine for the first nights.

The pain has a physical cause. Removing the epithelium exposes corneal nerve endings, and the discomfort typically peaks while the surface is still open. EyeWiki describes peak discomfort at days 2 to 3 with significant improvement by days 4 to 5, matching the roughly 3 to 5 day re-epithelialization window StatPearls describes. Most people describe it as burning, watering, and a foreign body sensation rather than a deep ache.

A 2023 systematic review published in Ophthalmology by the American Academy of Ophthalmology found that bandage soft contact lenses, topical and systemic NSAIDs, postoperative cold patches, and systemic pain medicine all improved pain control after PRK. If your plan is not working, there are options to discuss with your surgeon.

Typically starts hours after surgery, peaks around days 2 to 3, and drops off sharply once the epithelium closes around days 3 to 5.

When it stops being normal

Pain that clearly worsens after day 3 or 4, instead of easing, is the signal to call. By then the surface should be closing and pain should be receding. StatPearls notes that infection after PRK, while very rare at roughly 0.0013 percent, typically becomes apparent on postoperative days 2 to 4, and that delayed epithelial healing shows up as a persistent epithelial defect around day 4.

The American Academy of Ophthalmology says to call your ophthalmologist if your pain is not helped by over the counter medicines. New discharge, a white spot on the cornea, or vision that drops after it had been improving all mean call now rather than wait for your next appointment. Never use numbing drops on your own.