What Are the Requirements for LASIK Eye Surgery?

October 11, 2022


Contributing Author: Dr. Sana Qureshi, MD

Refractive errors are a common eye condition that occurs when the shape of the eye prevents light from focusing directly on the retina (the light-sensitive layer of tissue in the back of the eye). In the United States, refractive errors are one of the most common—and easily correctable—causes of vision impairment. According to the National Eye Institute (NEI), it’s estimated that over 150 million adults in the US struggle with refractive errors. 

LASIK is the most common vision correction procedure to address refractive errors such as nearsightedness, farsightedness, and astigmatism. This surgery involves using a special laser to precisely alter the shape of the cornea in order to improve vision and reduce or eliminate the need for corrective lenses. Many people choose LASIK because of its reputation as a safe elective procedure with an extremely high satisfaction rate. An estimated 700,000 LASIK procedures are performed in the United States each year. 

LASIK Eye Surgery Qualifications

The best way to determine whether or not LASIK is right for you is to have a detailed in-person consultation and evaluation. In general, the basic requirements for LASIK eye surgery include:

  • Age – Although the FDA only authorizes LASIK for those aged 18 and over, most ophthalmologists prefer patients to be at least 21 years old; when most people’s vision stabilizes.
  • Eye health – Candidates must be free of eye diseases, such as glaucoma, dry eye, corneal disease, cataracts, keratoconus, and more.
  • Overall health – LASIK surgery can increase the risk of infection and hinder the healing process, so candidates with certain health conditions may not be eligible for this procedure. 
  • Stable prescription – Candidates must have stable prescriptions for at least 12 months before undergoing LASIK.
  • Cornea thickness – Laser eye surgery on a cornea that is too thin or has an extremely irregular and misshapen surface may result in complications.
  • Pupil size – If the pupils are naturally large, it could increase the possibility of side effects such as halos, glare, and starbursts in dim light.
  • The severity of the refractive error – LASIK may not be suitable for patients with high refractive error, however other options exist including PRK and ICL.
  • Pregnant or nursing – Candidates should postpone surgery if they are pregnant or nursing. 

What Are Refractive Vision Errors?

Refractive errors occur when the shape of the eye prevents light from focusing properly. The cause could be the length of the eye, changes in the shape of the cornea, or a thicker or thinner lens. Blurred vision, double vision, squinting, headaches, or eye strain are some of the symptoms of refractive errors. There are four common types of refractive errors:

  • Nearsightedness (myopia): This condition makes distant objects look blurry. Myopia progresses throughout the adolescent stage when the body is growing rapidly.
  • Farsightedness (hyperopia): This condition makes nearby objects look blurry. Hyperopia is common in children, but it may fade as they grow older. Distance vision is clear with mild hyperopia, while near vision is fuzzy. Vision is obscured at all distances in advanced hyperopia.
  • Astigmatism: Astigmatism occurs when the cornea has an irregular curvature. The cornea is normally smooth and evenly curved in all directions, allowing light entering the cornea to be focused evenly in all planes or directions. In astigmatism the cornea is asymmetrically curved. This condition may cause vision to appear distorted and wavy, similar to looking into a wavy mirror. Astigmatism produces blurry vision at all distances.
  • Presbyopia:  The lens of the eye becomes  rigid and cannot change shape as easily after the age of 40. As a result, the eye loses its ability to accommodate, making reading at close range more challenging. This normal aging process of the lens may be seen alongside myopia, hyperopia, or astigmatism. 

Can LASIK Treat Presbyopia?

LASIK is typically not recommended for presbyopia. However, some patients with presbyopia may choose to undercorrect the non-dominant eye , thus correcting one eye for distance and the other for near vision. 

Preoperative Evaluation Before LASIK

The preoperative LASIK evaluation is an extremely important and structured evaluation used to determine if a patient is a good candidate for LASIK. This evaluation uses several advanced technologies to take precise measurements of the eye. 

The following tests are performed during this evaluation:

  • Dry eye testing – To see if pre-procedure medication is needed to prepare the eyes and lower the risk of complications
  • Manifest and cycloplegic refraction – To determine the correction prescription 
  • Keratometry – To determine the total shape and radius of the cornea
  • Corneal topography – To map the surface curvature of the cornea
  • Contrast sensitivity testing – To determine how well a person can distinguish between light and dark
  • Pachymetry testing – To measure the thickness of the cornea
  • Pupil testing – To evaluate pupil size, especially in dim settings 
  • Wavefront analysis – To detect higher order aberrations that may degrade vision 

The Importance of Medical History 

It’s important to perform a comprehensive medical and ocular history to rule out diseases that could influence LASIK surgery outcomes. Diabetes, autoimmune disorders, and collagen vascular diseases are all examples of systemic diseases that can hinder the healing process.

In addition to your medical history, your doctor may also inquire about the following:

  • Medications – Several medications may influence the outcome of LASIK surgery, so keep a detailed list of your prescriptions, including any over-the-counter medications. 
  • Past surgical history – Any prior eye operations, such as strabismus surgery, should be discussed.
  • Family history – A positive family history for certain diseases, such as keratoconus, may increase a patient’s risk for postoperative complications 

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