Can Your Vision Be Too Bad for LASIK?
Last Updated:
You may have heard that LASIK surgery is not an appropriate treatment for everyone. There are narrow qualifying parameters for the kinds of eye conditions for which LASIK surgery is advised. Bear in mind that the first refractive laser eye surgery was performed in 1989; repairing eye tissue with laser beams has only come so far.
There are also alternatives to LASIK surgery, which goes to show that LASIK, while popular, is just one more tool in the eye surgery tool bag. They are photorefractive keratectomy (PRK), and Refractive Lens Exchange (RLE), where we just replace the lens with an artificial one instead of trying to repair it. Here we break down the right conditions for LASIK surgery and its alternatives. There are several factors determining if LASIK eye surgery is right for you, all having to do with your eye and cornea condition and even measurement stats. Even if you’re a candidate for LASIK, you might still want to explore alternatives, depending on your long-term vision plans
Table of Contents
- Who Cannot Get LASIK?
- Diopters And Your Vision Prescription
- What Alternatives To LASIK Exist?
- How to Learn if You Are a Candidate
You deserve clear vision. We can help.
The board-certified surgeons at NVISION have performed over 2.5 million procedures. Your journey to better vision starts here.
Who Cannot Get LASIK?
In a nutshell, your cornea and pupil are subject to all kinds of subtle effects which cause them to fluctuate. When making these microscopically-precise adjustments to living tissue, we’re just as likely to make the eye worse than better without being certain of the correct configuration of the eyeball. Imagine laying a table-cloth over a circular table which keeps changing its size. That’s your lens over a growing and shrinking pupil. (note: we’re generalizing here, of course)
There are also dozens of tiny metrics involving the cornea, pupil, lens, and intraocular muscles. Anything regarding these factors can make you disqualified for LASIK surgery.
The following factors might make LASIK procedures too risky for you, based on the general recommendations for candidacy requirements:
Being younger than 18
You should be at least age 18 (some surgeons even prefer early-20s) to be a LASIK candidate. Our eyes fluctuate as long as we’re still growing, and certain facial features (along with our brains, BTW) don’t set in their adulthood shape until then.
Being Pregnant
Here’s a fun fact: Hormonal fluctuations during pregnancy affects your vision stability. So any time from first trimester all the way out to breast-feeding isn’t a good time for LASIK surgery.
Furthermore, prescription eyedrops are part of the LASIK aftercare process, and chemicals from these eyedrops can affect both a developing fetus and breast milk.
Having a Chronic Health Issue
Conditions like diabetes, or inflammatory / autoimmune disorders, can make LASIK too risky for you. Things may vary on a case-by-case basis, but most of the time there is too much complication for such an elective procedure.
Having a Prior Eye Condition
This can be anything such as tissue scarring from past injury, dry eye conditions, or previous eye surgery. One important factor is your cornea structure. If your cornea is too thin, LASIK won’t do you much good because there isn’t enough corneal tissue to work with. It is important for eyes to be healthy, free of diseases, injuries, and infections.
Having Your Eyeglass Prescription Change Over the Past 2 Years
If you have recently experienced changes in your natural vision requiring a change in prescription glasses, you might not be a candidate for LASIK. For LASIK surgery to be a good idea, the eye lens and cornea need to be stable in shape over time.
Having Too-Large Pupils
Having pupils at the top end of normal diameter can also make LASIK unfit for your case. This is because there would be too much risk of side effects, especially in considering night vision.
Having Issues With Vision Quality
Obviously, LASIK is prescribed to correct myopia, hyperopia, and astigmatism. But, aside from those, if you also experience other, additional conditions, such as light distortion effects or poor night vision, you might be a poor candidate for LASIK surgery. This is what the recommendations mean when they specify “good eye health.”
Diopters And Your Vision Prescription
Whether you have been fitted for glasses or contacts, you might have noticed that the prescription mentions a number. Your prescription, or refractive error (the degree to which your corneas fail to focus), is measured in units called “diopters.”
So, LASIK surgery is only advised for those falling within the parameters of eye measurements. For example, they might say “astigmatism within 6 diopters.” If your cornea fall outside these measurements, LASIK surgery can’t help you.
You will have to attend several tests and exams to determine all these metrics for your eye’s components. These examinations will include measurements of your corneal thickness, pupil circumference, and shape of your cornea, among other things.
What Alternatives To LASIK Exist?
While LASIK surgery is a powerful tool in vision correction, it’s not always right for everybody. If you don’t constitute a good candidate for this operation, there are other options for vision correction.
Refractive Lens Exchange (RLE)
This is where, instead of trying to repair a cornea, we swap it out with an artificial one. This is a great procedure with many patients recommending it, and it’s easier to qualify for RLE than LASIK surgery. Replacement lenses come in all shapes and sizes geared for correcting different refractive errors.
Photorefractive Keratectomy (PRK)
PRK and LASIK are very similar, but in LASIK we try to preserve the eye as much as possible and reseal it to where it heals without a scar. IN PRK, the cover from the front of the cornea is removed completely. While PRK has fewer disqualifying conditions than LASIK, it also has more side effects and risks.
How to Learn if You Are a Candidate for LASIK
The only way to know for certain if you are a candidate for LASIK eye surgery is to consult with an experienced and reputable surgeon. Your surgeon will give you an eye examination, take measurements, and determine your candidacy. This is generally done during a LASIK consultation.
LASIK surgery comes with a high success rate and a high patient satisfaction rate, but success is more likely if you are a good candidate for the surgery. Be honest about your medical history and eye health during your consultation. Transparency will help you to get the best results from any eye procedures.
References
- Comparison Between Surgical Outcomes of LASIK With and Without Laser Asymmetric Keratectomy to Avoid Conventional Laser Refractive Surgery Adverse Effects. (June 2020). Scientific Reports.
- LASIK Surgery. (November 2020). Voices in Bioethics.
- Functional Outcome and Patient Satisfaction After Laser In Situ Keratomileusis for Correction of Myopia and Myopic Astigmatism. (January 2015). Middle East African Journal of Ophthalmology.
- How to Determine an Ideal LASIK Candidate. (April 2019). Optometry Times.
- High Myopia as a Risk Factor for Post-LASIK Ectasia: A Case Report. (February 2019). Digital Journal of Ophthalmology.
- Clinical Outcomes After Small-Incision Lenticule Extraction Versus Femtosecond Laser-Assisted LASIK for High Myopia: A Meta-Analysis. (February 2021). PLOS ONE.
- https://www.urmc.rochester.edu/eye-institute/lasik/about-vision/candidate.aspx. (U Rochester medical center).
- https://www.nature.com/articles/s41598-020-67269-y. (Nature.com).
- https://americanrefractivesurgerycouncil.org/eyeglass-prescription-qualify-lasik/. (Refractive Surgery Council).
- https://www.allaboutvision.com/eyewear/eyeglasses/what-is-a-diopter/. (All About Vision).
This content is for informational purposes only. It may have been reviewed by a licensed physician, but is not intended to serve as a substitute for professional medical advice. Always consult your healthcare provider with any health concerns. For more, read our Privacy Policy and Editorial Policy.