LASIK, or Laser-Assisted In Situ Keratomileusis, is a surgical procedure that reshapes the cornea to improve how light focuses on the retina, reducing reliance on glasses or contact lenses. While many consider this vision correction, not everyone is suitable. This article outlines the key factors determining eligibility for LASIK.
Fundamental Requirements
A fundamental requirement for LASIK candidacy is reaching at least 18 years old. This age threshold is important because the eyes, and specifically their refractive error, continue to develop and stabilize throughout adolescence. Performing LASIK on eyes still undergoing significant changes could lead to suboptimal long-term results.
Another important factor is a stable eye prescription, generally meaning no significant change for one to two years. An unstable prescription indicates ongoing changes in the eye’s shape, which would compromise the long-term accuracy of the LASIK correction.
LASIK is designed to correct specific types and ranges of refractive errors, including nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. While technology has advanced, there are still limits to the degree of correction possible. Typically, LASIK can treat nearsightedness up to -12.00 diopters, farsightedness up to +6.00 diopters, and astigmatism up to 6.00 diopters.
Medical and Ocular Considerations
The health and structural integrity of the cornea are central to LASIK suitability, as the procedure involves reshaping this tissue. Adequate corneal thickness is necessary to allow for tissue removal without compromising the eye’s structural stability. Conditions like keratoconus, where the cornea progressively thins and bulges, typically disqualify individuals as LASIK could worsen the condition.
Certain existing eye diseases can also prevent LASIK. Severe dry eye syndrome, if untreated or chronic, can be a contraindication because LASIK can temporarily decrease tear production. Other conditions such as glaucoma, cataracts, or retinal diseases generally disqualify candidates. Active eye infections or inflammation must also be resolved before surgery.
Systemic health conditions can influence healing and overall risk. Autoimmune diseases like lupus or rheumatoid arthritis, and uncontrolled diabetes, may interfere with the healing process or increase the likelihood of complications. While some individuals with well-controlled autoimmune conditions might be considered, this requires careful evaluation. Similarly, certain medications, such as some steroids or isotretinoin, can affect healing or increase dry eye, potentially impacting candidacy.
Pregnancy and nursing temporarily disqualify candidates due to hormonal fluctuations that can affect vision stability and corneal shape. These changes can lead to unpredictable outcomes, and medications used during or after the procedure may pose risks to a developing fetus or nursing infant. It is recommended to wait several months after nursing has ceased and vision has stabilized before re-evaluating for LASIK.
Lifestyle and Outcome Expectations
Having realistic expectations is important for individuals considering LASIK. While the procedure aims for significant vision improvement and often reduces or eliminates the need for glasses or contacts, 20/20 vision is not guaranteed for everyone. Some individuals may still require corrective eyewear for specific tasks, such as reading glasses later in life due to presbyopia, which LASIK does not correct.
Common temporary side effects include dry eyes, glare, and halos around lights, especially at night. These symptoms typically diminish as the eyes heal, usually within a few weeks to months.
An individual’s lifestyle, including participation in contact sports or professions with a high risk of eye injury, might influence LASIK suitability. However, for many active individuals, LASIK offers freedom from the hassles of glasses or contacts during physical activities.
The Candidacy Assessment Process
Determining LASIK candidacy begins with a comprehensive eye examination. This initial consultation allows the ophthalmologist to assess overall eye health and collect detailed medical history. This evaluation helps identify any underlying conditions that could affect the safety or outcome of the procedure.
A series of diagnostic tests are performed to gather precise measurements of the eye’s structure. These include corneal topography, which maps the curvature and shape of the cornea, and pachymetry, which measures corneal thickness. Pupil dilation is often performed to assess the retina, and dry eye assessments evaluate tear production and quality.
Following diagnostic tests, a detailed discussion with the ophthalmologist is essential. The surgeon reviews all test results, explains whether the individual is a suitable candidate, and addresses any questions or concerns. This conversation covers the potential benefits, risks, and expected outcomes based on the patient’s specific eye characteristics.
If an individual is not deemed a suitable candidate for LASIK, other vision correction options may be discussed. These alternatives could include procedures like photorefractive keratectomy (PRK) or implantable lenses, which might be more appropriate depending on the specific reasons for LASIK disqualification.