LASIK, or Laser-Assisted In Situ Keratomileusis, is a procedure that uses a laser to reshape the cornea to correct common vision problems. These refractive errors include nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. While LASIK is an effective method for achieving clear vision without glasses or contact lenses, a person’s age plays a defining role in determining eligibility. Suitability for laser vision correction is tied directly to the stability of the patient’s vision, not just chronological age.
The Necessity of Vision Stability
Eligibility for LASIK rests heavily on the concept of refractive stability, which is more relevant than chronological age alone. Refractive error refers to the eye’s inability to bend light correctly, and stability means this error is no longer changing significantly. Most eye surgeons require a patient’s prescription to have remained largely unchanged for a period of 12 to 24 months before they will consider performing the procedure. A prescription change of less than plus or minus 0.50 diopters over a year is commonly considered stable enough to proceed with the surgery.
In younger individuals, vision often fluctuates because the eye is still undergoing a process of ocular maturity. Growth patterns and hormonal changes can cause the shape of the eye to continue changing into early adulthood. For example, nearsightedness frequently progresses throughout the teenage years. Performing LASIK on an eye that is still changing would only correct the prescription temporarily, leading to vision regression and potentially necessitating a second procedure.
The Standard Minimum Age and Exceptions
The U.S. Food and Drug Administration (FDA) has generally approved LASIK for individuals who are 18 years of age or older. This minimum age is established because most patients begin to achieve the necessary refractive stability around this time. Many surgeons suggest waiting until the mid-twenties, however, as eyes may continue to mature and prescriptions may slightly shift past the age of 18.
The age of 18 is a guideline based on probability, not a strict medical cutoff for every person. In extremely rare instances, exceptions may be considered for patients under 18 who have severe, uncorrectable vision differences between their eyes or other specific medical needs. Furthermore, certain occupational requirements, such as those for military service or law enforcement, may prompt a surgeon to consider a younger candidate if stability can be definitively proven through extensive documentation.
LASIK Considerations for Patients Over 40
For patients reaching middle age and beyond, the primary consideration shifts from prescription stability to the effects of the eye’s natural aging process. Beginning around age 40, most people develop presbyopia, a condition where the eye’s natural lens becomes less flexible, making it difficult to focus on close objects. Standard LASIK corrects distance vision by reshaping the cornea, but it does not prevent or correct this age-related loss of near vision.
Patients over 40 who undergo a standard LASIK procedure to correct their distance vision should anticipate needing reading glasses for close-up tasks post-surgery. To address the effects of presbyopia, surgeons may suggest Monovision LASIK, which corrects the dominant eye for distance and the non-dominant eye for near vision. The brain blends the images from both eyes, reducing the need for reading glasses, although this technique can sometimes compromise depth perception.
As patients move into their late 50s and 60s, an alternative procedure known as Refractive Lens Exchange (RLE) may become a more appropriate option than LASIK. RLE involves replacing the eye’s natural lens with an artificial intraocular lens (IOL), which can correct vision at multiple distances. Since RLE removes the natural lens, it also eliminates the future possibility of developing cataracts. For patients over 45, RLE provides a more permanent solution and addresses future cataract risk.