Lasik Candidates

The Ideal LASIK Candidate

The ideal candidate includes those who:

• Are over 18 years of age and have had a stable glasses or contact lens prescription for at least two years.

• Have sufficient corneal thickness (the cornea is the transparent front part of the eye). A LASIK patient should have a cornea that is thick enough to allow the surgeon to safely create a clean corneal flap of appropriate depth.

• Are affected by one of the common types of vision problems or refractive error – myopia (nearsightedness), astigmatism (blurred vision caused by an irregular shaped cornea), hyperopia (farsightedness), or a combination thereof (e.g., myopia with astigmatism). Several lasers are now approved by the U.S. Food and Drug Administration (FDA) as safe and effective for use in LASIK, but the scope of each laser’s approved indication and treatment range is limited to specified degrees of refractive error.

• Do not suffer from any disease, vision-related or otherwise, that may reduce the effectiveness of the surgery or the patient’s ability to heal properly and quickly.

• Are adequately informed about the benefits and risks of the procedure. Candidates should thoroughly discuss the procedure with their physicians and understand that for most people, the goal of refractive surgery should be the reduction of dependency on glasses and contact lenses, not their complete elimination.

The ‘Less Than Ideal’ Candidate

 Sometimes, factors exist that preclude a candidate from being ideal for LASIK surgery. In many cases, a surgeon may still be able to perform the procedure safely, given that the candidate and physician have adequately discussed the benefits and risks, and set realistic expectations for the results. Candidates in this category include those who:

• Have a history of dry eyes, as they may find that the condition worsens following surgery.

• Are being treated with medications such as steroids or immunosuppressants, which can prevent healing, or are suffering from diseases that slow healing, such as autoimmune disorders.

• Have scarring of the cornea.


More often, factors exist that may keep an individual from being a candidate immediately, but do not preclude the individual from being a candidate entirely. Candidates in this category include those who:

• Are under age 18.

• Have unstable vision, which usually occurs in young people. Doctors recommend that, prior to undergoing LASIK, candidates’ vision has stabilized with a consistent glasses or contact lens prescription for at least two years.

• Are pregnant or nursing.

• Have a history of ocular herpes within one year prior to having the surgery. Once a year has passed from initial diagnosis of the disease, surgery can be considered.

• Have refractive errors too severe for treatment with current technology. Although FDA-approved lasers are available to treat each of the three major types of refractive error – myopia, hyperopia and astigmatism – current FDA-approved indications define appropriate candidates as those with myopia up to -12 D, astigmatism up to 6 D and hyperopia up to +6 D. However, laser eye surgery technology is evolving rapidly, and doctors may be able to treat more severe errors in the future.

The Non-LASIK Candidate

Certain conditions and circumstances completely preclude individuals from being candidates for LASIK surgery. Non-candidates include individuals who:

• Have diseases such as cataracts, advanced glaucoma, corneal diseases, corneal thinning disorders (keratoconus or pellucid marginal degeneration), or certain other preexisting eye diseases that affect or threaten vision.

• Do not give informed consent. It is absolutely necessary that candidates adequately discuss the procedure and its benefits and risks with their surgeon, and provide the appropriate consent prior to undergoing the surgery.

• Have unrealistic expectations. It is critical for candidates to understand that laser eye surgery, as all surgical procedures, involves some risk. In addition, both the final outcome of surgery and the rate of healing vary from person to person and even from eye to eye in each individual.

In Summary...

Nearly everyone considering LASIK or laser eye surgery has dreamed about being free of lenses to drive, work, play sports, swim, or just see the alarm clock in the morning. The best candidates are between 21 and 60 years old with healthy eyes. Athletes, police officers, and firefighters have occupations that benefit greatly by being free of lenses. For most of the rest of us, LASIK is mainly a matter of convenience and lifestyle. Recent advances in technology, technique and nearly 15 years of experience here in the United States makes it a better time than ever to have laser vision correction.

But laser eye surgery, LASIK & PRK, is not for everyone. The most common reasons for not being a candidate include severe dry eyes, cataracts, very large pupils, thin corneas, and irregular corneas. There may be other refractive surgery options other than laser eye surgery for some of these conditions. The best way to determine if you are a candidate is to see a reputable laser eye surgeon for a complete eye exam. Using this information your doctor can tell you more about your eyes and any potential reasons you should not have surgery. A more complete list of the contraindications, warnings, and precautions to laser eye surgery is given below.

CONTRAINDICATIONS: Laser eye surgery is contraindicated in patients who: are pregnant or nursing; show signs of keratoconus; are taking the medications isotretinoin (Accutane®) or amiodarone hydrochloride (Cordarone®); or have an autoimmune disease, collagen vascular disease (Rheumatoid arthritis, lupus, Wegener’s, others), or an immunodeficiency disease.

WARNINGS: Laser eye surgery is not recommended in patients who have: insulin-dependent diabetes; severe allergies; a history of herpes simplex or herpes zoster keratitis; a history of infectious diseases (HIV, hepatitis, TB, others); severe dry eyes; cataracts or other significant eye disease; or who have a prescription that is continuing to change.

PRECAUTIONS: The safety and effectiveness of Laser eye surgery have not been established: in patients with progressive myopia; ocular disease; corneal abnormality; previous corneal or intraocular surgery; trauma in the ablation zone; history of glaucoma; or history of keloid formation (excessive scarring); in patients who are taking the medication Sumatripin (Imitrex®); in patients under 21 years of age; in non-Caucasian patients for farsightedness w/wo astigmatism; in patients with implant lenses after cataract surgery; individuals suffering from significant depression or anxiety disorders; or in patients with exceptionally high prescriptions or low prescriptions.

Most Common Reasons for NOT Being a Candidate for Laser Eye Surgery

Very dry eyes
Early or pre-cataracts
Thin or irregular cornea
Diabetes, autoimmune problems, or other diseases
Large pupils