While modern LASIK surgeries deliver great visual outcomes with high success rates, your eye surgeon should ensure ahead of time that you’re a good candidate to have one. Here is a widely used checklist that physicians use to determine eligibility:

  • Your eyes should be healthy. Your overall health determines how your eyes will heal after LASIK surgery. Eye infections, such as dry eye syndrome, abrasions, and inflammations, should be resolved before the surgery.
  • Your prescriptions should be within the range. LASIK procedures treat various eye problems, including myopia, hyperopia, and astigmatism. Treatment range varies from one type of LASIK to another. Your eye surgeon will determine which LASIK will suit your condition.
  • Thick enough cornea. If you have a high prescription, more corneal tissue will be removed to correct your vision. This is because LASIK can cause corneal ectasia, a vision-threatening eye condition due to abnormal thinning of the cornea.
  • You should be within the age range. Ideally, you should be above 18 years old to be cleared for LASIK. However, your eye surgeon may advise you to wait until you are at least 25, the age at which adult vision stabilizes. While there is no upper limit for LASIK, some factors should be considered. For instance, presbyopia sets in after 40 years.
  • Average-sized pupils. Large-sized pupils are associated with post-LASIK symptoms, such as halos, glares, and night starbursts. Your eye surgeon will measure your pupils when evaluating your eligibility criteria.
  • Overall good health. Some contraindications to LASIK include uncontrolled degenerative or autoimmune diseases, such as rheumatoid arthritis, Sjogren’s syndrome, AIDs, and type 1 Diabetes. However, those with HIV with a good number of immune cell counts can be cleared for LASIK.
  • You’re not pregnant or a nursing mother. Pregnant or nursing women may not be cleared for LASIK. This is because hormonal changes alter the shape of the cornea, leading to temporary vision changes.

Eye and Prescription Requirements for LASIK

LASIK surgery can help to correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism (when the cornea is shaped more oval than round). Most often, LASIK is done to correct myopia, per the U.S. National Library of Medicine (NLM).

LASIK surgery works by reshaping the cornea to improve the way light is focused and reflected into your retina to correct blurry vision.

LASIK is typically not recommended for people with presbyopia (aging eyes wherein reading glasses are needed but distance sight is still an issue); however, this condition can be treated using LASIK through a procedure that creates "monovision" where one eye is corrected to see far and the other to see near. LASIK is most commonly performed on people between the ages of 20 and 40, but it can be done later in life too.

To qualify for LASIK, your vision cannot have changed more than half a diopter in the previous year. The Federal Trade Commission (FTC) reports that myopia can continue to progress until your mid 20s. However, vision has stabilized for most people by the age of 18:

  • 75% have stable vision by the age of 15
  • 91% by age 18
  • 95% by age 21
  • 98% by age 25

The American Refractive Surgery Council publishes that even if you have a high prescription, you may still be eligible and a good candidate for LASIK surgery. Your ophthalmologist can help you to determine if your eyes are a good fit for the surgery.

Eye Conditions Impacting LASIK Eligibility

Conditions such as dry eye can be exacerbated by LASIK surgery and should be treated prior to determining if the procedure is optimal. Since LASIK surgery cuts away part of the cornea, it is important that your cornea is thick enough and provides enough material to work with. If the cornea is misshapen or too thin, LASIK may not be ideal.

When older technology is used, the size of your pupils can matter. Large pupils are sometimes not good candidates for LASIK, as this can increase possible side effects after the surgery, such as blurry vision or poor night vision. Your ophthalmologist should measure the size of your pupils first. Large pupils do not always disqualify you from LASIK; in some cases, the surgery could still be a viable option. This is rarely an issue with advanced technology.

You will need to be able to look continually at a fixed spot or object for at least a minute in order for the surgeons to be able to perform LASIK properly. Certain eye conditions like glaucoma and cataracts, as well as eye infections and injuries, can interfere with LASIK surgery and should be carefully considered prior to surgery.

Why Cataracts Disqualify You from LASIK

LASIK eye surgery corrects refractive errors caused by a reshaped cornea. However, LASIK cannot correct blurriness caused by cataracts, a condition that makes the eyes cloudy and obscures vision. However, patients may be cleared for LASIK after they have undergone cataract surgery.

LASIK Health Considerations

You will need to be in good enough health for surgery in order to be eligible for LASIK. Just like any surgery, LASIK can increase a person's risk for infection, so it is not recommended if you suffer from certain risk factors. It is worth noting, however, that daily wear contacts present a significantly greater risk of infection.

If you suffer from any of the following, Mayo Clinic warns that LASIK may not be the right choice:

An opthamologist is listening to the patient in an exam room.

  • Autoimmune diseases such as lupus or HIV/AIDS
  • Diabetes
  • Rheumatoid arthritis
  • Depression
  • Chronic pain conditions, including irritable bowel syndrome, fibromyalgia, or migraines

Certain medications, such as immunosuppressive drugs, can decrease the functions of your immune system and raise the risk factors of surgeries like LASIK.

Further Considerations Prior to Committing to LASIK

When considering a permanent corrective eye solution such as LASIK, it is imperative to consider the risks as well. There is the potential for conditions like dry eyes, temporary visual disturbances, and short-term side effects that may be difficult for some people to handle. The reward is often much greater than the possible risk, however.

Other considerations may include certain hobbies like contact sports or work-related issues. If you regularly participate in activities wherein blows to the face and or eyes are common (like martial arts, football, boxing, hockey, or wrestling) then you may want to consider alternatives to LASIK. It may also just mean that you will need to wait a bit longer to return to these activities after surgery to allow proper healing time. Generally, the eyes heal completely rather quickly, allowing you to get back to your normal life and daily activities. LASIK can actually minimize risks with some of these contact sports, as it often eliminates the need for glasses or contacts that can be broken or come dislodged during sports.

Some employers may not allow corrective eye surgery, as it is deemed elective. Even though the risks are negligible, some professions will not allow these types of procedures. Be sure to check with your employer prior to committing to permanent refractive eye correction to ensure that this is not a condition of employment.

Much of the time, insurance will not cover LASIK, so you will need to decide how to budget for the surgery and determine how to finance the procedure. There are many financing options open to make paying for the cost of LASIK corrective surgery feasible. In the long run, LASIK surgery can actually save you money on eyeglasses and contacts, so that is something to consider.

Requirements for Every Type of LASIK

While there are many types of LASIK surgeries, including photorefractive keratectomy, LASEK, EpiLasik, PRELEX, refractive lens exchange, Intacs, astigmatic keratotomy, and ALK, all these surgeries have the same requirements. Therefore, your eye surgeon will weigh your eligibility criteria generally before admitting you for the surgery. However, there are minor specific type-specific requirements that your eye surgeon will evaluate before clearing you for surgery.

References

When Is LASIK Not for Me? (July 2018). U.S. Food and Drug Administration.

What Is the LASIK Success Rate? (October 2017). American Refractive Surgery Council.

LASIK Eye Surgery. (October 2018). U.S. National Library of Medicine.

The Basics of LASIK Eye Surgery. (August 2012). Federal Trade Commission.

Does My Eyeglass Prescription Qualify for LASIK? (February 2017). American Refractive Surgery Council.

LASIK Surgery: Is It Right for You? (March 2017). Mayo Clinic.

Dry eye syndrome. (September 24, 2020). Mayo Clinic.

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