Is vision worse than before surgery in week 1 normal after PRK?

What's normal

Feeling like you can see worse than you could with glasses before surgery is one of the most common week 1 experiences with PRK, and it does not mean the surgery failed. The American Academy of Ophthalmology says vision is blurry after PRK and gradually improves over about 3 to 5 days, with best vision taking a month or longer.

During the first days the front surface of the eye is literally missing its outer layer, then covered by brand new cells that have not smoothed out. StatPearls describes blurred vision, photophobia, and transient ghosting or glare as common through days 1 to 3. EyeWiki says vision at bandage lens removal is commonly around 20/30 to 20/50, which is often worse than corrected vision was before surgery.

The comparison people make is unfair to themselves in one specific way. Before surgery you were seeing through a clean, smooth lens or glasses. Now you are seeing through a healing cornea with no correction on top. The American Academy of Ophthalmology reports that about 9 out of 10 people who have PRK end up with 20/40 vision or better without glasses or contacts, but that is the destination and not the first week.

Typically worst days 1 to 3, functional but underwhelming at bandage lens removal around days 4 to 7, clearly better by weeks 4 to 6.

When it stops being normal

The pattern matters more than the number. Vision that is poor but slowly improving is the expected PRK path. Vision that improves and then clearly gets worse is the one to act on.

Call your surgeon if vision drops after a period of improvement, if pain increases after day 3 or 4, if there is thick discharge, or if the eye becomes very red. StatPearls notes that delayed epithelial healing shows up as persistent blurred vision with a defect still present around day 4, and that infection typically becomes apparent on postoperative days 2 to 4. Both are treatable and both are better caught early.