Updated on  February 20, 2024
8 min read

LASIK Candidacy Requirements

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Who Is a LASIK Eye Surgery Canidate?

A large part of LASIK’s success is determined by whether you’re a suitable candidate. Modern LASIK eye surgery delivers excellent visual outcomes, but it’s not right for everyone.

“The latest research reports 99 percent of patients achieve better than 20/40 vision and more than 90 percent achieve 20/20 or better. In addition, LASIK has an unprecedented 96 percent patient satisfaction rate – the highest of any elective procedure”

American Refractive Surgical Council

Here’s a checklist of criteria to help you determine if you’re a good LASIK candidate. The only way to be sure that LASIK is right for you is to schedule a consultation with an eye surgeon.

7 Requirements for a Good LASIK Candidate

1. Your eyes are healthy

Your overall eye health determines how well your eyes heal after surgery. Any active eye infections, inflammation, or abrasions must be resolved before you get LASIK. 

Tell your doctor if you have a history of any of the following eye conditions:

  • Severe dry eye
  • Conjunctivitis (pink eye)
  • Eye injury
  • Keratoconus
  • Corneal dystrophy
  • Herpes-related eye infections
  • Glaucoma or risk factors for glaucoma (high eye pressure)
  • Cataracts
  • Previous eye surgery
  • Eye diseases such as uveitis or iritis

Your eye doctor will review your medical history and examine your eyes to determine if LASIK surgery is safe for you.

2. Your prescription is within range

LASIK procedures can treat a wide range of prescriptions, including:

Vision Defects Myopia Hyperopia And Astigmatism Illustrations

The treatment range varies between different types of LASIK procedures. Your eye surgeon can help you determine which type of LASIK is right for you. 

FDA-approved excimer lasers for LASIK in the United States can correct approximately:

  • -11.00 diopters of nearsightedness
  • +5.00 D of farsightedness
  • 5.00 D of astigmatism

However, LASIK surgeons will have their own limits on how poor your vision can be. Most surgeons offer a free LASIK consultation to determine if you’re a good candidate.

If your prescription is too high, the surgeon may recommend an alternative vision correction surgery. A refractive lens exchange and phakic intraocular lens implant are two procedures that can correct higher prescriptions.

3. Your corneas are thick enough

The higher your prescription, the more corneal tissue the laser must remove to correct your vision. When undergoing LASIK, the surgeon cuts a flap on your cornea, then uses a laser to remove tissue underneath the flap. 

If your corneas are thin, LASIK can increase your chances of corneal ectasia. This vision-threatening condition causes abnormal corneal thinning. 

Modern LASIK techniques, such as bladeless LASIK, may require less corneal tissue. Other potential options for people with insufficient corneal thickness include:

4. You are within the proper age range

Typically, you must be at least 18 years old to have LASIK. However, it is best to wait until your mid-20s when your vision stabilizes. 

There is no upper age limit for receiving LASIK. However, presbyopia begins after age 40. This process affects your ability to focus up close and continues until about age 60.

LASIK doesn’t correct your near vision unless you opt for monovision LASIK. Otherwise, most patients who receive LASIK need reading glasses once they are over 40.

Older age also increases your risk for dry eyes and other eye conditions that may affect your eligibility for LASIK. 

5. Your vision is stable

You should have had no change to your contact lens or glasses prescription in the past 12 months. Changes in your eye prescription are known as refractive instability.

Refractive instability increases your risk of needing a second corrective eye surgery. 

In most cases, a change of 0.25 or 0.5 Diopters is acceptable. Diopters are the units used to measure your prescription.

Factors that can cause your vision to fluctuate include:

  • Being younger than 25
  • Fluctuating hormones from diabetes or another disease 
  • Certain medications
  • Pregnancy or breastfeeding

If you are thinking about LASIK, getting a yearly comprehensive eye exam is ideal. This way, your eye doctor can track vision changes from year to year. 

6. Your pupils are not too large

Your doctor will measure your pupils when they evaluate your candidacy for LASIK. People with larger pupils may be at greater risk for side effects after surgery, including:

  • Double vision
  • Starbursts
  • Halos
  • Glare

These symptoms prevent some people from driving at night or in certain conditions, such as fog.

7. You have realistic expectations

Before having LASIK, you should consider the potential risks for side effects and complications. If your job requires precise vision, you may want to reconsider laser eye surgery in the event you experience any side effects.

Although LASIK success rates are very high, expecting perfect vision may not be realistic. Even the refractive surgeon cannot completely predict how your eyes will heal after surgery. Also, you may need to wear glasses after surgery, such as for reading or night driving. 

6 Reasons People Can’t Get LASIK

These are some health conditions that may prevent you from getting LASIK:

1. Pregnancy or nursing

Many women experience fluctuations in their vision during pregnancy related to hormonal changes. Also, the medications you may take for the LASIK procedure aren’t safe for the baby. It’s best to wait until you have your baby and finish nursing.

2. General health problems

Certain autoimmune disorders or immunodeficiency diseases increase the risk of complications during the healing process. These include:

  • Sjörgen’s syndrome
  • Rheumatoid arthritis
  • Type 1 diabetes
  • Lupus
  • AIDS

People with these conditions tend to have severe dry eye problems and are at risk for a complication called corneal melting.

Diabetic patients may experience delayed wound healing after LASIK. They may also experience visual fluctuations related to blood sugar changes. However, it’s possible to have LASIK if your diabetes is well-controlled and you don’t have any eye problems. 

3. Cataracts

Age-related cataracts usually develop around age 60 and cause the lens inside your eye to become cloudy. Generally, LASIK is not recommended if you already have cataracts. LASIK cannot correct your vision entirely, and your vision will continue to change as the cataracts progress.

cataracts scaled e1598035826129

Most eye surgeons recommend waiting until you need cataract surgery. This procedure not only gets rid of your cataract but also corrects your vision. The surgeon places an artificial implant in your eye that restores your eyesight.

4. High-impact activities

Consider your options carefully if you engage in high-impact sports such as basketball or martial arts. Although this complication is rare, eye trauma can potentially dislodge the corneal flap long after your surgery. 

When you consult an eye surgeon, discuss any activities that may put your eyes at risk. Your eye surgeon may recommend PRK instead of LASIK since the surgery does not involve creating a corneal flap.

5. Medications 

Certain drugs are not safe to use if you are having a LASIK procedure. Medications that should not be taken before LASIK include:

  • Steroids
  • Isotretinoin (Accutane)
  • Amiodarone

Your eye surgeon can advise you how long you need to discontinue the medications before surgery. 

6. Previous eye injury or surgery

If you had an eye injury that left a significant corneal scar, you might not qualify for LASIK.

Previous eye injury or eye surgery may increase your risk for LASIK complications. Give the eye surgeon your complete health history. If you already had laser eye surgery in the past, it might be possible to have a second enhancement procedure.

Alternatives to LASIK

PRK

Photorefractive keratectomy (PRK) is an excellent option for people with thin corneas. This procedure doesn’t involve cutting a corneal flap. 

Instead, the surgeon removes the outer surface of your cornea (epithelium). Then, they reshape the cornea with an excimer laser. 

LASEK

Laser epithelial keratomileusis (LASEK) is similar to PRK. It uses a special microkeratome device that exposes the cornea to an alcohol solution.

The LASEK procedure removes less corneal tissue than LASIK. This makes LASEK another great option for people with thin corneas.

SMILE

Small incision lenticule extraction (SMILE) is a newer approach to laser vision correction. The SMILE surgical procedure involves removing a disc-shaped piece of corneal tissue (lenticule). This reshapes your cornea.

IOLs

An intraocular lens (IOL) is an artificial lens that replaces your eye’s natural lens. IOLs are common in cataract surgery.

Other surgical procedures that use IOLs include:

  • Phakic intraocular lenses. These IOLs sit either behind your iris, in front of your lens, or between the iris and cornea.
  • Refractive lens exchange. This vision correction procedure is like cataract surgery but for people who don’t have cataracts.

Glasses and Contacts

If you have a refractive error and find that laser vision correction isn’t right, eyeglasses or contact lenses are your best bet.

Summary

  • LASIK is a highly successful procedure, but not everyone is a good candidate.
  • A strong candidate for LASIK should have healthy eyes and good overall health.
  • Having stable vision, thick enough corneas, and average-sized pupils are other important considerations for LASIK.
  • If LASIK isn’t right for you, talk to your doctor about alternatives, such as PRK, LASEK, or SMILE surgery.
Updated on  February 20, 2024
6 sources cited
Updated on  February 20, 2024
  1. Arevalo, J. Fernando, et al. “Rhegmatogenous Retinal Detachment after LASIK for Myopia of up to –10 Diopters: 10 Years of Follow-Up.” Graefes Archive for Clinical and Experimental Ophthalmology, 2012.
  2. Daoud, Yassinej, et al. “Refractive Surgery in Systemic and Autoimmune Disease.” Middle East African Journal of Ophthalmology, 2014.
  3. Myung, David, et al. “Pupil Size and LASIK: A Review.” Journal of Refractive Surgery, 2013.
  4. Sandoval, Helga P., et al. “Modern Laser in Situ Keratomileusis Outcomes.” Journal of Cataract & Refractive Surgery, 2016.
  5. When is LASIK not for me?” U.S. Food and Drug Administration, 2018.
  6. What Is the LASIK Success Rate?” Refractive Surgery Council, 2017.
The information provided on VisionCenter.org should not be used in place of actual information provided by a doctor or a specialist.