LASIK (Laser-Assisted in Situ Keratomileusis) is a widely performed refractive procedure that corrects vision problems such as nearsightedness, farsightedness, and astigmatism. People seeking permanent vision correction often ask if their age affects eligibility. While there is no official upper age limit, the procedure has a minimum age requirement, and physiological changes throughout life influence suitability. Eligibility depends less on chronological age and more on the specific health and stability of the eye itself.
The Minimum Age for LASIK Candidacy
The minimum age requirement for LASIK is set at 18 years old, a guideline established by the U.S. Food and Drug Administration (FDA). This threshold is based on the principle of refractive error stability. The eye must be fully matured, and the prescription must have remained stable for at least 12 months prior to the surgery.
Vision continues changing throughout adolescence and into the early twenties, a process known as ocular maturation. Performing LASIK on an eye where the refractive error is still progressing risks regression, meaning the vision will worsen post-surgery. To be considered stable, the eye’s prescription should not have changed by more than 0.50 diopters in the preceding year.
While 18 is the legal minimum, many surgeons advise waiting until the early to mid-twenties to ensure stability. The laser reshapes the cornea to match the current prescription, but it cannot prevent the natural progression of refractive errors in an immature eye. Prescription stability is a more absolute measure of readiness than the patient’s age alone.
Age-Related Changes Affecting Suitability in Older Adults
There is no maximum age limit for LASIK, but suitability declines after age 40 due to conditions associated with aging. These physiological changes introduce visual challenges that LASIK, which focuses on corneal reshaping, does not fully address. Alternative procedures are often a better choice for older patients.
One common age-related change is presbyopia, the gradual loss of the eye’s ability to focus on close objects, typically beginning around age 40. This occurs because the natural crystalline lens hardens and loses flexibility. Since LASIK only alters the cornea, it does not correct this lens-based focusing problem, meaning patients will still require reading glasses for near tasks.
Ocular surface health is also a concern, as dry eye syndrome often increases with age. Creating the corneal flap can temporarily disrupt corneal nerves, potentially worsening pre-existing dryness and complicating healing. Furthermore, the risk of developing cataracts, the clouding of the internal lens, increases significantly past age 60. If a patient has developing cataracts, LASIK is not recommended because cataract surgery replaces the cloudy lens and corrects the refractive error more comprehensively.
Essential Candidacy Requirements Beyond Age
Eligibility for LASIK is determined by mandatory, non-age-specific criteria assessed for every patient. The structural integrity of the cornea is a foundational requirement. The cornea must possess adequate thickness to ensure stability after tissue removal.
During the procedure, a portion of the corneal tissue is ablated beneath a flap, and a minimum amount of tissue, often referred to as the residual stromal bed, must remain. Most surgeons prefer a starting corneal thickness of at least 500 microns. The residual stromal bed needs to be at least 250 microns to prevent post-LASIK ectasia, a condition where the cornea weakens and bulges. Patients with higher refractive errors require more tissue removal, making corneal thickness a greater limiting factor.
Overall ocular health is also thoroughly evaluated, as the presence of active eye diseases can compromise outcomes. Conditions such as uncontrolled glaucoma, severe dry eye, or active infections are considered contraindications. The stability of the prescription, defined as no significant change for at least a year, remains a constant eligibility check.
Systemic health factors can also exclude a patient due to their potential to impair the healing process. Uncontrolled diabetes, for instance, negatively affects corneal health and wound healing, often requiring management before surgery. Autoimmune disorders, such as severe rheumatoid arthritis, can be contraindications due to concerns about unpredictable healing. Hormonal changes during pregnancy and nursing can cause temporary vision fluctuations, necessitating a delay until stability is restored.