LASIK Candidacy Requirements: What to Know
Understanding LASIK Candidacy Requirements
We typically recommend LASIK for patients who are at least 18 years old, though many eye doctors prefer candidates to be 21 or older. Your eyes continue to change during your late teens, so waiting until your vision stabilizes helps support lasting results.
There is generally no upper age limit for LASIK as long as your eyes are healthy. However, age-related conditions like cataracts may develop later in life and could affect whether LASIK is the best choice for you.
Your eyeglass or contact lens prescription must remain stable for at least one to two years before LASIK surgery. When your prescription keeps changing, it means your eyes are still shifting, and correcting them now might not give you permanent results.
- We review your prescription history from previous eye exams
- Stable vision means your prescription has changed by less than 0.5 diopters
- Hormonal changes, medications, or health conditions can affect stability
- Young adults may need to wait longer if their vision is still changing
LASIK can correct a wide range of prescriptions, but there are limits. We can typically treat nearsightedness up to about -12.00 diopters, farsightedness up to about +6.00 diopters, and astigmatism up to about 6.00 diopters.
If your prescription falls outside these ranges or your measurements suggest a different approach, we may recommend alternatives like PRK, SMILE, or implantable collamer lenses. Our eye doctor will measure your exact prescription during your evaluation and discuss which options work best for your specific needs.
LASIK reshapes your cornea to correct how light enters your eye, which improves nearsightedness, farsightedness, and astigmatism. However, it does not prevent age-related vision changes like presbyopia, which affects your ability to see up close after age 40.
- LASIK corrects refractive errors by reshaping the corneal surface
- It does not treat eye diseases like glaucoma or macular degeneration
- You may still need reading glasses as you age
- Some people choose monovision LASIK to reduce reading glass dependence
- If considering monovision, a contact lens trial is recommended to help you assess whether you can tolerate reduced depth perception
Eye Health Requirements for LASIK Candidacy
Your cornea must be thick enough to allow safe reshaping during LASIK. Candidacy depends on leaving a safe residual stromal bed after surgery and keeping the percent tissue altered within accepted limits. The exact amount of corneal thickness needed depends on how much tissue we need to remove to correct your prescription.
During LASIK, we create a thin flap and then reshape the underlying corneal tissue with a laser. If your cornea is too thin, removing tissue could weaken it and lead to serious complications. We measure your corneal thickness precisely during your evaluation. Your surgeon will calculate safe treatment parameters based on corneal thickness, flap thickness, and ablation depth to lower the risk of ectasia.
A healthy, regularly shaped cornea is essential for LASIK success. We carefully screen for conditions like keratoconus, which causes the cornea to thin and bulge into a cone shape, or corneal scars from previous injuries or infections.
- Irregular corneal shape can distort vision after LASIK
- Keratoconus typically disqualifies you from LASIK
- Corneal dystrophies may affect healing and outcomes
- We use advanced mapping technology to detect subtle irregularities
Active eye infections or certain eye diseases can prevent you from having LASIK. We require that any infections be fully treated and resolved before considering surgery. Chronic conditions like cataracts or severe retinal disease may also disqualify you or require treatment first. Well-controlled glaucoma is not an absolute contraindication but requires careful evaluation of optic nerve health and pressure.
If you have a history of herpes simplex or herpes zoster eye infections, we evaluate your case carefully. These infections can reactivate after surgery and cause serious complications, though some patients may still be candidates with proper precautions.
- Active blepharitis or meibomian gland dysfunction should be treated before surgery
- Prior herpes simplex or zoster keratitis may warrant antiviral prophylaxis around surgery
LASIK can temporarily worsen dry eye symptoms, so we evaluate your tear production before surgery. Patients with severe dry eye syndrome may experience significant discomfort after LASIK and may not be good candidates.
- We test your tear production and quality during evaluation
- Mild dry eye can often be managed with treatment before surgery
- Treatable eyelid conditions like blepharitis and meibomian gland dysfunction should be managed before surgery
- Severe or chronic dry eye may require alternative procedures like PRK
- For patients prone to dryness, options like SMILE or PRK may be considered after individualized counseling
- Post-operative dry eye typically improves within three to six months
- We may recommend tear supplements before and after surgery
Overall Health Requirements and Restrictions
We do not perform LASIK on patients who are pregnant or nursing. Hormonal changes during pregnancy and breastfeeding can temporarily alter your vision and corneal shape, which means your prescription may not be stable.
We recommend waiting until after pregnancy and at least several months after lactation has ended. This waiting period allows your hormones to stabilize, and a stable prescription should be confirmed before proceeding.
Certain autoimmune conditions can affect healing after LASIK. Disorders like rheumatoid arthritis, lupus, and Sjogren's syndrome may interfere with how your cornea heals or increase your risk of complications.
- Autoimmune conditions can impair wound healing
- Some disorders increase dry eye risk significantly
- We evaluate each case individually based on disease severity and control
- Well-controlled conditions may still allow LASIK in select cases
If you have diabetes, your blood sugar control affects your LASIK candidacy. Uncontrolled diabetes can lead to diabetic retinopathy, delayed healing, and increased infection risk. We typically require that your diabetes be well-managed with stable blood sugar levels. Good candidates typically have stable glucose control and no active diabetic eye disease on exam.
Our eye doctor will review your recent hemoglobin A1C levels and examine your retina for any diabetic changes. Patients with excellent glucose control and no diabetic eye disease may still be good candidates for LASIK.
Some medications can affect healing or increase complications after LASIK. Drugs like isotretinoin for acne, oral corticosteroids, and certain immunosuppressants may interfere with proper corneal healing.
- Do not stop or change any prescription medication without first consulting the prescribing clinician
- Isotretinoin can cause severe dry eye and must be stopped months before surgery
- Corticosteroids may slow healing and increase infection risk
- Amiodarone for heart rhythm can cause corneal deposits
- Topiramate can cause eye-related side effects
- Oral antihistamines may worsen dry eye symptoms
- Always disclose all medications and supplements during your consultation
- We may ask you to stop or adjust certain medications before surgery
Preparing for Your LASIK Evaluation
Your LASIK evaluation is a comprehensive eye exam that takes about one to two hours. We perform multiple tests to measure your eyes precisely and determine if you are a safe candidate. This visit also gives you time to ask questions and discuss your goals. Pupil size is measured in low light to help assess night vision risks and guide treatment planning.
Bring your current glasses and a list of all medications you take. We will dilate your pupils to examine the inside of your eyes thoroughly, so your vision will be blurry for several hours afterward. Plan accordingly and consider bringing someone to drive you home.
Corneal topography creates a detailed map of your cornea's surface, showing its shape, curvature, and any irregularities. This painless test uses special imaging technology and takes only a few minutes. It helps us detect conditions like keratoconus that would make LASIK unsafe.
- The topographer projects light rings onto your cornea
- You simply look at a target while the machine captures images
- Pachymetry measures your corneal thickness using ultrasound or light
- Corneal tomography maps the posterior corneal surface and, if available, epithelial thickness mapping can improve detection of early keratoconus
- These measurements guide our surgical planning and laser settings
Refraction testing determines your exact eyeglass prescription. Our eye doctor will have you look through different lenses and tell us which ones make your vision clearest. We also perform automated refraction using computerized instruments for additional precision.
Wavefront technology measures how light travels through your entire eye, detecting even tiny imperfections. This advanced analysis allows us to create a customized treatment plan that addresses your unique vision needs. Many surgeons also use topography-guided or wavefront-optimized treatments depending on your corneal measurements.
Complete and honest disclosure of your medical history is critical for your safety. We need to know about all health conditions, previous eye surgeries or injuries, medications, allergies, and lifestyle factors that could affect your candidacy or recovery.
- Tell us about any vision changes or eye symptoms you experience
- Disclose family history of eye diseases like glaucoma or keratoconus
- Mention hobbies or occupations that involve eye injury risk
- Report any previous difficulty healing from surgeries or injuries
- Withholding information can lead to poor outcomes or complications
Pre-Operative Preparation Steps
You must stop wearing contact lenses before your LASIK evaluation and surgery. Contact lenses temporarily reshape your cornea, and we need to measure your eyes in their natural state for accurate results.
Soft contact lenses typically require one week before the evaluation. Toric or extended-wear soft lenses generally require two weeks. Rigid gas permeable lenses typically require three to four weeks plus an additional week per decade of wear if needed. Scleral lenses often require a longer break guided by serial measurements.
We may prescribe antibiotic eye drops to start one or two days before your surgery to reduce infection risk. Follow the dosing schedule exactly as directed. Some patients also begin using artificial tears several times daily to optimize eye surface health.
- Do not skip doses of prescribed pre-operative medications
- Avoid over-the-counter eye drops unless approved by our eye doctor
- Continue your regular medications unless we tell you otherwise
- Ask about any medications you are unsure about
On surgery day, shower and wash your face thoroughly but do not apply makeup, lotions, perfumes, or cologne. These products can increase infection risk and interfere with the laser or medications. Wear comfortable, loose-fitting clothing and avoid anything that goes over your head.
Do not eat a heavy meal right before your procedure, though a light snack is usually fine. Arrange to arrive at least 15 to 30 minutes early to complete paperwork and prepare. The actual laser treatment takes only about 10 to 15 minutes for both eyes, though you will be at the surgical center for about two hours total.
- Avoid alcohol for 24 hours before surgery
- Avoid caffeinated beverages the morning of surgery if you are prone to anxiety or dry eye
- Do not use hair products or scented lotions on surgery day
You cannot drive yourself home after LASIK because your vision will be blurry immediately following surgery. Arrange for a responsible adult to drive you to and from your procedure and stay with you for at least the first few hours.
- Your driver should plan to stay throughout your appointment
- You will receive protective eyewear to wear immediately after surgery
- Have someone available to help with eye drops if needed
- Plan to rest at home for the remainder of surgery day
- Do not drive until your doctor confirms it is safe, typically after the first post-op visit
- Most people return to work within one to three days
Potential Risks, Side Effects, and Limitations
Most LASIK patients experience temporary side effects during the first few days or weeks after surgery. These effects are usually mild and improve as your eyes heal.
- Dryness, scratchiness, or a feeling of something in your eye
- Fluctuating or hazy vision as your eyes heal and adjust
- Glare, halos, or starbursts around lights, especially at night
- Increased light sensitivity for several days or weeks
- Temporary changes in contrast sensitivity
While uncommon, serious complications can occur after LASIK. Understanding these risks helps you make an informed decision about surgery.
- Infection, which requires prompt antibiotic treatment
- Diffuse lamellar keratitis, an inflammatory response under the flap
- Epithelial ingrowth, where surface cells grow under the flap
- Corneal ectasia, a progressive weakening and bulging of the cornea
- Flap-related complications including displacement with significant trauma
LASIK provides excellent vision correction for most patients, but outcomes vary and some limitations exist.
- Under-correction or over-correction may occur and affect your final vision
- Enhancement procedures may be needed to fine-tune your results
- Regression is possible, particularly with higher hyperopic treatments
- You may still need glasses for certain tasks like night driving or reading fine print
- LASIK does not prevent age-related vision changes like presbyopia
Post-Operative Care and Recovery Requirements
Your eyes may feel scratchy, burn, or water for the first few hours after LASIK. This is normal. Keep your eyes closed as much as possible for the first four to six hours and rest in a dark room. Sleep helps your eyes heal and makes you more comfortable. Avoid getting water directly in your eyes while showering for at least one week.
Wear the protective eye shields we provide, especially while sleeping, for at least the first week. These shields prevent you from accidentally rubbing or bumping your eyes during healing. Avoid touching or rubbing your eyes even if they feel irritated, as this could dislodge the corneal flap.
We will prescribe medicated eye drops including antibiotics to prevent infection and anti-inflammatory drops to reduce swelling and promote healing. Use these drops exactly as directed, following the specific schedule we provide. Proper use of your drops is crucial for good outcomes.
- Wash your hands thoroughly before applying any eye drops
- Wait at least five minutes between different types of drops
- Use preservative-free artificial tears frequently to keep eyes lubricated
- Continue drops for the full prescribed duration even if eyes feel fine
- Store medications properly and check expiration dates
Avoid swimming, hot tubs, and whirlpools for at least two weeks after LASIK to prevent infection. Water from pools, lakes, and oceans contains bacteria that can cause serious problems during healing. You should also avoid contact sports and activities with eye injury risk for at least four weeks.
Do not wear eye makeup for at least one week, and replace all eye makeup products you used before surgery to avoid bacterial contamination. When you resume wearing makeup, be gentle and avoid getting products directly in your eyes. Most normal activities can resume within a few days.
- Avoid dusty, sandy, or smoky environments for at least one week
- Wear protective eyewear for exercise or any activity with impact risk for at least four weeks
- Wear sunglasses outdoors for comfort and to reduce light sensitivity
We will see you for follow-up visits the day after surgery, then typically at one week, one month, three months, and six months. These appointments let us monitor your healing, check your vision progress, and address any concerns. Attend all scheduled visits even if your vision seems perfect.
- Your one-day visit confirms the corneal flap is healing properly
- We measure your vision at each visit to track improvement
- Follow-up exams allow us to detect and treat any complications early
- Most vision stabilization occurs within three to six months
Contact our office immediately if you experience severe pain that does not improve with over-the-counter pain relievers, sudden vision loss, or vision that gets significantly worse instead of better. These symptoms could indicate a serious complication that needs urgent treatment.
Also call right away if you notice increasing redness, discharge, or swelling, as these may signal an infection. Flashes of light or new floaters could indicate retinal problems unrelated to LASIK but requiring prompt care. We provide an emergency contact number for after-hours concerns.
Frequently Asked Questions
If you do not qualify for LASIK, we discuss alternative vision correction options that may work for you. PRK, SMILE (small incision lenticule extraction), implantable collamer lens (ICL), or refractive lens exchange might be suitable depending on why you are not a LASIK candidate. Sometimes treating an underlying condition like dry eye or waiting until your prescription stabilizes makes you eligible later.
Yes, aging affects your eyes and may change your candidacy over time. Presbyopia begins around age 40 and affects near vision, which LASIK does not prevent. Age-related conditions like cataracts might develop later, and if you need cataract surgery, that procedure also corrects your vision. We reassess your candidacy if you were previously not eligible and circumstances have changed.
We need to correct your stable, permanent prescription rather than a temporary one. If your eyes are still changing, LASIK might give you clear vision now but become less effective as your prescription continues shifting. Waiting for stability helps your results last as long as possible and reduces the need for future enhancement procedures.
Several alternatives exist depending on your specific situation. PRK reshapes the cornea without creating a flap and may be better for thin corneas or certain occupations. SMILE is a flapless procedure for eligible myopic prescriptions that removes tissue through a small incision, offering advantages for patients in high-contact-risk occupations or athletes. Implantable collamer lens (ICL), a type of phakic intraocular lens, works for very high prescriptions or thin corneas. Refractive lens exchange replaces your natural lens and may be ideal for patients over 50 or those with early cataracts. We help you choose the best option for your eyes and lifestyle.
We recommend coming to your evaluation without eye makeup, though face makeup is usually acceptable. Eye makeup can interfere with some diagnostic tests and increases the risk of particles getting into your eyes during examination. If you do wear eye makeup, we may ask you to remove it before testing begins, so arriving without it saves time.
Getting Help for LASIK Candidacy
If you are interested in LASIK, schedule a comprehensive evaluation with our eye doctor to determine your candidacy. We will perform thorough testing, review your health history, and discuss whether LASIK or another vision correction option is right for you. Come prepared with questions and realistic expectations, and we will guide you through every step of the process.