PRK Eye Surgery and Night Vision: What Improves and What Doesn’t

If you’re thinking about PRK eye surgery, one of the biggest questions you might have is how it affects your night vision. Many people notice halos around lights, glare while driving or reduced contrast when their pupils enlarge at night and it’s completely normal to wonder whether PRK will improve things or make them worse. Night vision is important for daily life, especially if you drive, work shifts or spend time outdoors after dark.

The truth is that PRK can affect your night vision in several ways, both during healing and long-term. Some changes improve naturally, while others take time to settle, and a few depend on your prescription, corneal shape and pupil size. In this guide, I want to help you understand exactly what happens to night vision after PRK, what improves, what may not, what’s temporary and what you can expect once your eyes have fully healed.

Why Night Vision Matters So Much

Night vision relies on:

  • Wide pupils
  • Strong contrast sensitivity
  • Clear optical surfaces
  • Minimal light scatter

Any disturbance to the corneal surface or tear film can affect how light enters your eye.

This means that PRK which temporarily alters the surface of the cornea naturally causes some night vision changes in the early recovery period.

How PRK Works (And Why It Affects Night Vision)

PRK reshapes the cornea by removing the outer layer (epithelium) and using a laser to reshape the surface underneath.

This process impacts night vision because:

  1. The epithelium needs time to regrow
  2. The surface of the cornea is temporarily uneven
  3. Nerves controlling the tear film are healing
  4. Light scatter increases during recovery
  5. Contrast sensitivity temporarily decreases

These effects are normal, predictable and improve as the eye heals.

Night Vision Changes During the PRK Healing Process

Let’s break down what typically happens week by week.

Night Vision in the First Week:

The first week after PRK is when night vision is most affected.

You may notice:

  • Bright halos around lights
  • Increased glare
  • Hazy or cloudy vision
  • Light sensitivity
  • Reduced contrast
  • Difficulty driving at night

This happens because the surface hasn’t fully healed and light scatters more than usual.

Dryness also plays a big role during this stage.

Night Vision in Weeks 2–4:

As the epithelial layer regenerates, your night vision slowly improves.

You might still experience:

  • Mild halos
  • Some glare
  • Slight fluctuations in clarity
  • Occasional ghosting

Your pupils may reveal healing irregularities when they enlarge at night, but these usually settle with time.

Night Vision at 1–3 Months:

By this point, most people see a noticeable improvement.

You may observe:

  • Clearer night driving
  • Fewer halos
  • Reduced glare
  • Better contrast
  • More stable clarity

Some people still have mild symptoms, especially those with higher prescriptions.

Night Vision at 3–6 Months:

For many patients, this is when night vision feels “normal” again.

You may have:

  • Smooth night clarity
  • Sharper contrast
  • Minimal glare
  • Occasional mild halos in certain lighting

This is the typical timeframe for full PRK recovery.

Night Vision at 6–12 Months:

For some people especially those with high prescriptions night vision continues to improve up to a year after surgery.

By this time:

  • Halos usually reduce significantly
  • Glare stabilises
  • Contrast sensitivity improves
  • Night driving becomes comfortable

Your final night vision depends on your individual eye characteristics, not just the surgery itself.

What Improves After PRK?

Let’s look at the night vision improvements PRK often brings.

Reduced Halos Compared With Contact Lenses

Many people with contact lenses notice halos because:

  • The lens moves slightly
  • Tear film dries out
  • Debris gets under the lens

PRK removes all of these issues long-term.

Better Contrast Sensitivity Once Fully Healed

After your corneal nerves regenerate and the surface smooths out, contrast sensitivity often improves.

This means:

  • Dark objects appear more defined
  • Night scenes look clearer
  • Driving feels more comfortable

Contrast tends to be strongest 6–12 months after surgery.

No Lens-Related Distortion

After PRK, there is:

  • No contact lens displacement
  • No smudging or fogging
  • No protein build-up
  • No dryness from lenses

Your night vision becomes more consistent.

More Stable Optics After Healing

Once healing is complete, PRK provides:

  • A stable curvature
  • Sharp optical surfaces
  • Minimal light scatter

This often leads to clearer long-term night vision than you had with glasses or contacts.

What Doesn’t Improve After PRK?

Some night vision issues have nothing to do with the cornea so PRK won’t fix them.

Large Pupil Size

If you naturally have large pupils, you may always notice:

  • Bigger halos
  • More light scatter
  • Increased glare

PRK can reduce these over time, but pupil size remains a factor.

Retinal or Macular Conditions

If you have:

  • Macular degeneration
  • Retinal scarring
  • Diabetic eye changes

these can affect night vision permanently.

PRK won’t correct photoreceptor limitations.

Natural Ageing Changes

After age 40, you may notice:

  • Reduced contrast
  • Slower dark adaptation
  • Difficulty seeing in dim light

These come from the lens and retina, not the cornea.

Early Cataract Changes

Early lens clouding causes:

  • Glare
  • Halos
  • Faded colours

PRK won’t fix lens clouding only lens surgery does.

Why Some People Get More Halos Than Others

Halos are common after PRK, but some people notice them more due to:

  • High pre-surgery prescription
  • Large pupils
  • Dry eyes
  • Irregular corneas
  • Healing patterns

The good news is that halos typically fade with time.

How to Reduce Halos After PRK

If halos bother you, several strategies can help.

Treat Dry Eye Consistently

Dryness causes:

  • Light scatter
  • Fluctuating clarity
  • Increased halos

Using lubricating drops can help dramatically.

Use Night Drops or Gel: Some gels reduce scatter and improve clarity temporarily.

Follow Your Drop Schedule: Steroid and lubricating drops help smooth the healing surface.

Avoid Bright Headlights: High-beam headlights exaggerate halo perception.

Consider Anti-Reflective Glasses: Even after PRK, you can wear glasses for night driving if needed.

Does PRK Cause More Halos Than LASIK?

In the early recovery phase, PRK and LASIK cause similar halo patterns.

Differences:

  • PRK takes longer to heal
  • LASIK stabilises faster
  • PRK produces a smoother long-term surface for some patients

Many people with PRK experience fewer long-term halos because there’s no flap edge to scatter light.

Night Vision Risks After PRK

While PRK is generally safe, here are the most common night vision issues.

Halos: Most common immediately after surgery; usually fade.

Starbursts: Occasional for high prescription patients.

Glare: More common early on; improves with healing and dryness treatment.

Reduced Contrast: Temporary and related to nerve healing.

Ghosting: Often resolves as the cornea smooths out.

When to Seek Help

Although uncommon, contact your surgeon if:

  • Halos worsen month by month
  • Vision suddenly decreases
  • Light sensitivity becomes severe
  • Shadowing appears in both eyes
  • You feel your night vision isn’t improving at all

Most problems have simple solutions, such as dryness management or enhancements.

PRK Enhancements for Night Vision

In rare cases, an enhancement may help if healing or light scatter continues for longer than expected.

Enhancements can:

  • Improve clarity
  • Reduce halos
  • Correct residual prescription
  • Smooth irregularities

Your surgeon will decide whether this is appropriate after your cornea stabilises.

PRK vs Contact Lenses: Night Vision Comparison

PRK long-term:

  • Stable night clarity
  • Good contrast sensitivity
  • Fewer distortions
  • No lens scatter

Contact lenses long-term:

  • More dryness
  • Increased halos with lens movement
  • Smudges, protein build-up
  • Variable clarity

PRK usually provides more consistent night vision once healed.

PRK vs LASIK: Night Vision Comparison

LASIK pros:

  • Faster recovery
  • Earlier night clarity

LASIK cons:

  • Flap edge may scatter light
  • Higher dry eye risk
  • Night glare may persist longer

PRK pros:

  • No flap edge
  • Stable long-term night clarity
  • Lower long-term dryness risk

PRK cons:

  • Slower recovery
  • Longer period of halos early on

Choosing between the two often depends on your corneal thickness and lifestyle.

Night Vision Tips After PRK

To optimise your night vision as you heal:

  • Use lubricating drops regularly
  • Wear sunglasses outdoors to minimise light sensitivity
  • Avoid driving at night in the first weeks
  • Reduce screen brightness
  • Follow your drop schedule carefully
  • Use a humidifier indoors

Small habits can make a big difference.

Frequently Asked Questions:

  1. Does PRK permanently affect night vision?
    PRK does not usually cause permanent night-vision problems. Most patients experience halos, glare and reduced contrast only during the healing phase, which can last several weeks to a few months. As the corneal surface smooths out and the epithelium regenerates, light scatter decreases and night vision becomes clearer. In the long term, many people actually notice better night clarity than they had with glasses or contact lenses because there is no lens movement, smudging or dryness to interfere with vision. Permanent night-vision issues after PRK are rare and usually related to factors such as very large pupils, unusually high prescriptions or age-related retinal changes rather than the surgery itself.
  2. Why do halos and glare appear after PRK?
    Halos and glare occur because the surface of the cornea becomes temporarily irregular while the epithelium heals. This uneven surface bends light in a less organised way, causing rings, scatter or glow around bright lights, especially at night when the pupils enlarge. Another reason is post-surgery dryness, which disrupts the smooth tear film required for sharp night vision. As the cornea regenerates, nerves heal and the tear film stabilises, these symptoms gradually fade. The degree of halos varies between individuals depending on prescription strength, pupil size and how quickly their epithelial layer settles.
  3. How long does it take for night vision to return to normal after PRK?
    For most patients, night vision begins improving noticeably within the first month. However, the timeline varies. Many people feel comfortable driving at night again by 6–8 weeks, while others, especially those with higher prescriptions, may experience mild halos or glare for up to three to six months. In some cases, night-vision clarity continues to refine for up to a year as the cornea undergoes slow, subtle smoothing and nerve regeneration. The overall trend is gradual improvement, not deterioration, and night vision almost always stabilises as healing completes.
  4. Is night vision worse with PRK compared to LASIK?
    In the first few weeks, PRK patients often notice more pronounced night-vision disturbances than LASIK patients because PRK involves surface healing, which takes longer to stabilise. LASIK creates a corneal flap, allowing for quicker initial clarity. However, PRK tends to produce a smoother corneal surface in the long term, and because there is no flap edge to scatter light, many people ultimately report fewer halos months down the line. Long-term night vision after PRK is generally excellent and comparable to, or in some cases better than, LASIK, especially for individuals prone to dryness or with thinner corneas.
  5. Why do some people still have halos months after surgery?
    Halos that persist for several months can be linked to slow epithelial smoothing, slightly larger pupil sizes or residual dryness. People with higher prescriptions often take longer to stabilise because more corneal tissue is reshaped during surgery, resulting in a longer visual adjustment period. Mild imperfections in the healing pattern can also temporarily widen the zone where light scatters. Persistent halos do not necessarily indicate a problem; they usually reflect a gradual healing timeline. However, if halos worsen rather than improve, the surgeon may check for dryness, epithelial irregularities or residual refractive error.
  6. Can PRK improve night vision if I already struggle with glare or halos before surgery?
    Yes, PRK can improve pre-existing night-vision issues, especially if your halos and glare are caused by contact lens dryness, lens movement or smudging. Many people who rely on contact lenses experience inconsistent night clarity because lenses shift when blinking or become dehydrated in low-humidity environments. PRK eliminates these issues completely by reshaping the cornea permanently. However, if your night-vision problems stem from large pupils, early lens changes or retinal conditions, PRK may not resolve them because these factors are unrelated to the cornea.
  7. Does pupil size affect night vision after PRK?
    Pupil size plays a major role in how lights appear after PRK. When your pupils widen in dim lighting, they expose more of the healing corneal surface. If the transition between the treated and untreated areas of the cornea is still settling, this can lead to halos or glare. People with naturally large pupils often notice more pronounced light scatter in the early months. Over time, as the corneal surface smooths and the optical zone blends more seamlessly, these visual effects generally diminish. Surgeons often consider pupil size during pre-operative assessments to set realistic expectations.
  8. Will eye drops help improve night vision after PRK?
    Yes, lubricating eye drops can significantly improve night vision during recovery. Dryness is one of the biggest contributors to glare, halos and fluctuating clarity, and artificial tears help create a smoother optical surface for light to pass through. Steroid drops prescribed during the healing process can also reduce inflammation, which helps the epithelium regenerate more evenly. Some patients benefit from thicker gels at night, which reduce light scatter while sleeping and improve morning clarity. Consistent use of drops, especially in the first few months, makes night-vision recovery quicker and more predictable.
  9. When should I be concerned about my night vision after PRK?
    Mild halos, glare and contrast reduction are normal in the early months, but you should seek professional advice if symptoms become progressively worse instead of improving. Sudden drops in clarity, increasing light sensitivity, shadowing in both eyes or a sharp increase in glare can indicate dryness, epithelial irregularities or inflammation that may require treatment. True complications are rare, but early intervention helps prevent prolonged discomfort. Your surgeon will evaluate your corneal surface, tear film and prescription stability to determine whether additional treatment or adjustment is needed.
  10. Can PRK enhancements help with night-vision problems?
    Enhancements are an option when night-vision issues persist beyond the normal healing period and are caused by residual refractive error or irregular healing. An enhancement involves performing a small additional laser adjustment once the cornea has fully stabilised, usually after six to twelve months. This refinement can reduce halos, improve contrast and sharpen night clarity. Enhancements are not always necessary and are recommended only when tests show clear optical irregularities. In most cases, night-vision symptoms improve naturally without requiring further intervention.

Final Thought: What to Expect from Night Vision After PRK

Night vision changes after PRK are completely normal, and most of them settle gradually as your eyes heal and the corneal surface becomes smoother. Halos, glare and reduced contrast sensitivity can feel unsettling in the beginning, but they almost always improve with time, especially as dryness reduces and the epithelium stabilises. Long-term, many people actually achieve clearer and more consistent night vision than they ever had with contact lenses or glasses.

If you’re exploring whether PRK surgery in London could benefit you, get in touch with us at Eye Clinic London to schedule your consultation.

References:

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  2. Hersh, P.S., Brint, S.F. & Maloney, R.K. (1998) ‘Photorefractive keratectomy versus laser in situ keratomileusis: a comparison of optical side effects’, Ophthalmology, 105(8), pp. 1512–1523. https://pubmed.ncbi.nlm.nih.gov/9709763/
  3. Mannis, M.J. & Holland, E.J. (2002) ‘Night vision disturbances after refractive surgery’, Cornea, 21(6), pp. 560–566. https://pmc.ncbi.nlm.nih.gov/articles/PMC3343536/
  4. Lee, H.K., Lee, K.S. & Kim, J.K. (2006) ‘Changes in higher-order aberrations after PRK and LASIK and their relation to night vision symptoms’, Korean Journal of Ophthalmology, 20(3), pp. 182–187. https://pmc.ncbi.nlm.nih.gov/articles/PMC2854969/
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