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Am I suitable for LASIK?

LASIK suits some eyes well and other eyes not at all. Being told you are not suitable is not bad news: it means a careful check found a reason why the risk would be higher for you. This guide explains what eye doctors and laser centres look at, so that you know what to expect. At ReNew Vision, the LASIK suitability check-up and counselling are done here, and the laser treatment is done at a laser centre we refer you to; see LASIK in Goa: check-up and referral.

What decides whether I am suitable for LASIK?

There is no single test. Suitability comes from your age, your spectacle power and how stable it is, the shape and thickness of your corneas, the health of the rest of your eyes, your general health and what you expect from the treatment.

Your age

LASIK is for adults. In teenagers and many people in their early 20s the eyes are still changing, and short sight in particular often keeps increasing. Most laser centres treat people from 18, and many prefer the early 20s or later. There is no fixed upper age, but from the mid-40s near vision changes with age, and from the 50s and 60s an early cataract may be starting. If a cataract is developing, cataract surgery with a suitable lens may make more sense than LASIK; see choosing a lens for cataract surgery.

How stable your power is

Your spectacle power should have changed very little, usually by no more than half a unit (0.5 dioptre), for at least a year. LASIK corrects the power your eye has today. If the eye keeps changing afterwards, the power comes back. Bring your old prescriptions to the check-up: they are the simplest proof of stability.

How much power you have

LASIK is used across a wide range of short sight, long sight and astigmatism. Very high powers need more tissue to be removed from the cornea, and there is a safe limit to how much can be removed. Above that limit, the laser centre may suggest a different method, such as a lens placed inside the eye, or advise you to stay with spectacles or contact lenses.

The shape and thickness of your cornea

This is often the deciding factor. The laser centre measures the thickness of the cornea and maps its shape before it agrees to treat you. A cornea that is too thin, or that shows signs of keratoconus (a condition in which the cornea thins and bulges into a cone), is usually not treated with LASIK, because the treatment can weaken it further. Keratoconus can run in families and is more common in people who rub their eyes a lot, for example because of eye allergy. Tell the eye doctor if anyone in your family has it.

Dry eye

LASIK can make dry eye worse for some months, and sometimes for longer. If your eyes already feel gritty or burning, especially after long hours on a screen or in an air-conditioned office, the dry eye is treated first and checked again before any decision. Read more about dry eye and screen strain.

The rest of your eye

The eye doctor checks for conditions that would make LASIK unwise or less useful: glaucoma or raised eye pressure, cataract, retina problems, past eye infections (especially herpes infection of the cornea), inflammation inside the eye, and a lazy eye. LASIK can reduce the need for spectacles in a lazy eye, but it cannot make that eye see more clearly than it already does with the right spectacles.

Your general health

• Pregnancy and breastfeeding can change the spectacle power for a while. Laser centres usually ask you to wait until some months after breastfeeding has ended.
• Diabetes needs to be well controlled, with a healthy retina.
• Autoimmune conditions, such as rheumatoid arthritis or lupus, can affect healing and often rule LASIK out.
• Some medicines, including some tablets for acne and medicines that affect healing or immunity, matter. Bring a full list.

Your work, sport and expectations

Some careers, including the armed forces and aviation, have their own rules about eye surgery; check the current rules before you decide. People who play contact sports should say so, because the type of treatment may matter. Most important of all, LASIK suits people who understand that it aims to reduce dependence on spectacles, not to make the eye perfect, and that reading glasses are still likely from the 40s.

Who is usually not suitable for LASIK?

• people under 18, or whose power is still changing
• people with thin or irregular corneas, including keratoconus
• people with severe dry eye that has not settled with treatment
• people who are pregnant or breastfeeding
• people with poorly controlled diabetes or some autoimmune conditions
• people with active eye infection or inflammation, uncontrolled glaucoma or significant cataract

Some of these are permanent reasons and some are temporary. Dry eye can be treated, a pregnancy ends and a changing power can settle, so a "not now" is not always a "never".

Which tests are done, and where?

At ReNew Vision: your history, vision and spectacle power (sometimes after drops that relax focusing), eye pressure, an examination of the lids, tear film and cornea under magnification, and a retina examination after dilating drops. The eye doctor then explains the findings and the options.

At the laser centre: a map of the cornea's shape, a measurement of its thickness, and any other tests the centre needs for its method. These tests are not done at ReNew Vision. If you wear contact lenses, you will be asked to leave them out for a time before these tests, because lenses change the shape of the cornea.

What if I am not suitable?

You can still see well. Spectacles remain the simplest and safest way to correct power, and modern lenses are thin and light; see our Vision Correction Centre. Contact lenses suit many people for sport and work. A laser centre may also discuss other procedures for eyes that do not suit LASIK. Later in life, if you need cataract surgery, the choice of lens can also correct much of your power. Compare the options in LASIK, glasses or contact lenses.

How do I find out if I am suitable?

Book a LASIK check-up at ReNew Vision Eye Hospital, Vaddem, Vasco da Gama. Eye OPD Monday to Saturday, 4 pm to 7 pm. Call or WhatsApp 072489 88039. Bring your spectacles, old prescriptions, contact lens details and a list of your medicines, and someone to take you home, because dilating drops blur vision for a few hours. The fee is explained when you book; the cost of the laser itself is the laser centre's, as explained in what decides the cost of LASIK.

Questions patients ask

What is the age limit for LASIK?

Most laser centres treat adults from 18, and many prefer the early 20s or later, once the power has been stable for a year. There is no fixed upper age, but after the mid-40s near vision changes, and later an early cataract may make cataract surgery the better route.

Can I have LASIK with high spectacle power?

Sometimes. High power needs more tissue removed from the cornea, and there is a safe limit. The laser centre's corneal thickness and shape tests decide. Above the limit, other procedures or staying with spectacles or contact lenses may be advised.

Can I have LASIK if I have dry eyes?

LASIK can make dry eye worse, so the dry eye is treated first. If it settles well, LASIK may still be possible. If it stays severe, the eye doctor will usually advise against laser treatment.

Can I have LASIK during pregnancy?

No. Pregnancy and breastfeeding can change the spectacle power, and healing can be different. Laser centres usually ask you to wait until some months after breastfeeding has ended and your power is stable again.

What tests are done before LASIK?

At ReNew Vision: vision and spectacle power, eye pressure, an examination of the cornea and tear film, and a retina check after dilating drops. At the laser centre: a map of the cornea's shape, its thickness and any other tests its method needs.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.