LASIK Candidacy: The Complete Screening Guide

This is a comprehensive look at the candidacy process for LASIK eye surgery:

• The importance of the screening and consultation process
• Information you should prepare for the appointment
• What the evaluation and screening process involves
• What the consultation conversation should cover
• Recommendations beyond LASIK that may be offered
• Potential concerns to look out for in the candidacy process

Considering a vision correction procedure? It is the first step toward choosing what is best for you and your vision. However, it is also important to undergo a comprehensive candidacy screening. This isn’t just a routine eye exam—it’s a detailed evaluation that will determine whether LASIK or any vision correction procedure is right for you and, if so, how to customize the procedure for optimal results.

Understanding what should happen during this screening empowers you to make informed decisions and ensures you receive the thorough evaluation you deserve. Here’s everything you need to know about demanding excellence from your LASIK consultation.

Attention to Detail Takes Time

Your LASIK candidacy screening should last approximately 1 to 2 hours. This extended timeframe isn’t arbitrary—it reflects the comprehensive nature of the evaluation required to safely and effectively plan your procedure.

During these two hours, you’ll undergo a complete assessment of your vision, eye health, and overall medical condition. The goal is to create a detailed map of your eyes and determine four critical factors:

• The overall health of your eyes
• Your overall health
• Whether LASIK is recommended for your specific vision and lifestyle needs
• If you proceed with surgery, the precise treatment parameters for each of your eyes

There are also a few basic criteria that will be assessed:

• Does your prescription fall within the FDA-approved treatment parameters?
• Have your eyes reached ocular maturity? Vision correction procedures are only approved for adults.
• Is your prescription stable? Has it significantly changed in the past couple of years?
• Are there any other problems with your eyes that need to be evaluated?

What Your LASIK Candidacy Screening Should Include

A proper LASIK candidacy screening involves sophisticated diagnostic tools and tests that evaluate every aspect of your eye. The tests are non-invasive and pain-free, using high-powered imaging devices to capture detailed pictures of your eye from different angles.

1. Comprehensive Vision Analysis

Your eyes’ ability to focus will be measured in multiple ways. This goes beyond the basic “which is better, one or two” test you’ve experienced before. Digital analyzers should be used alongside manual refraction to:

• Confirm your exact prescription
• Assess the quality of your vision
• Analyze how light focuses as it enters your eye
• Determine the best approach for correcting your specific vision issues

2. Dilated Eye Examination

Expect to receive eye drops that enlarge your pupils. It is necessary to thoroughly examine internal eye structures, such as the lens behind your pupil and your retina. During dilation, additional vision measurements will be taken to confirm and refine the pre-dilation measurements.

3. Advanced Corneal Analysis

Your cornea—the front surface of your eye, where laser vision correction occurs —requires detailed analysis. High-resolution scans will assess your cornea at the micron level, providing data about:

• Corneal curvature and shape
• Corneal thickness measurements
• Surface irregularities
• Overall corneal health

These measurements are fundamental to determining your candidacy for any vision correction procedure and to customizing your treatment.

4. Retinal Health Assessment

Imaging your retina evaluates the health and function of this critical structure at the back of your eye. The retina processes light and sends visual information to your brain, so its health is essential for successful vision correction outcomes.

5. Tear Film Evaluation

A healthy tear film is part of overall eye and corneal health.  It is also essential to proper healing after vision correction surgery. Modern technology evaluates both the composition and volume of your tears. Understanding your tear film quality helps treat any dry eye symptoms to support better vision and better healing outcomes from surgery.

6. Comprehensive Eye Structure Examination

Using high-powered microscopy, your surgeon should examine all eye structures in detail. This screening should check for conditions that might affect your candidacy, including:

• Allergies that could impact healing
• The presence of a cataract
• Signs of diabetes or other systemic conditions
• Glaucoma or elevated eye pressure
• Macular degeneration
• Any inflammatory conditions

Additional measurements should include eyeball dimensions and pupil size under various lighting conditions.

LASIK Candidacy: The Consultation Discussion

Beyond the technical measurements, your consultation should include thorough discussions about several key areas:

Your Complete Medical History: Be prepared to discuss your full health history in detail. Certain medical conditions, such as diabetes, autoimmune disorders, or pregnancy, can impact eligibility for LASIK or other vision correction procedures. Additionally, medications like corticosteroids can affect the healing process and may influence timing or candidacy. It is important to be as open and thorough as possible to ensure your health and safety moving forward.

Realistic Outcome Expectations: You and your surgeon should have a direct conversation about specific, realistic expectations based on your personal vision and eye characteristics. This isn’t the time for generalities. Expect a personalized discussion about:

• The level of vision correction you can expect
• Potential risks specific to your history and examination
• The likelihood of achieving your vision goals
• Any limitations based on your eye measurements
• What you should experience during recovery from surgery
• When you should expect to achieve your outcome

Comprehensive Risk Discussion: Every surgical procedure and contact lenses carry risks, and LASIK is no exception. Your surgeon should thoroughly explain potential complications, their likelihood in your specific case, and how they would be managed if they occur. This conversation should be balanced, honest, and tailored to your individual risk profile.

Future Enhancement Possibilities: Discuss the potential need for future enhancements or retreatments. Understanding the factors that might necessitate additional procedures and the practice’s policy on enhancements helps you make informed decisions about your long-term vision care.

What if you aren’t a Candidate for LASIK? What Are Your Options?

Today, refractive surgeons – ophthalmologists who specialize in surgeries to correct vision problems – have a variety of procedures to recommend, helping people reduce or eliminate their need to rely on glasses or contacts to see clearly. If your candidacy screening reveals issues that make LASIK a less-than-optimal choice for you and your vision, another vision correction procedure will likely be recommended. There are other laser-based procedures, including SMILE and PRK, as well as options that use refractive lens technologies like Implantable Collamer Lenses (ICL) and intraocular lens implantation similar to cataract surgery, known as a refractive lens exchange. All are designed to provide excellent vision to good candidates.

Red Flags to Watch For

Your LASIK candidacy screening should feel like a medical consultation, not a sales pitch. Be wary of:

High-Pressure Sales Tactics: If you feel rushed to make a decision or pressured by special offers and coupons, consider seeking a second opinion. Quality surgical care doesn’t rely on aggressive marketing.

Confusing Conversation about Cost: A written estimate that clearly outlines what’s included and what additional costs might arise is standard. An unusually low advertised price may not reflect your total expenses or cover the latest advanced technologies that have improved safety and outcomes.

Rushed Evaluations: If your screening feels hurried or superficial, that’s concerning. As discussed above, proper evaluation requires time and attention to detail.

Lack of Personalized Discussion: Generic information and one-size-fits-all recommendations suggest insufficient attention to you and your circumstances.

Informed consent is a process that begins with your candidacy screening and ends with your signature on the informed consent form before surgery. You should not feel rushed or pressured to sign the informed consent until you feel you have a thorough understanding of what the procedure entails, what to expect from the recovery and healing process, and the potential for risks and complications.

Consider consulting with multiple surgeons to find one who meets your standards for thoroughness, transparency, and expertise. You should feel comfortable with your surgeon and confident in their approach to your care.

Remember, getting a “great deal” should never be the primary factor in choosing a surgical provider. Your vision is irreplaceable, and cutting corners can have lasting consequences. Invested in the highest quality care available.

Taking Control of Your Vision Correction Journey

A comprehensive LASIK candidacy screening is an essential part of the process. By understanding what should happen during this evaluation, you can ensure you receive the thorough assessment necessary for safe, effective treatment.

Your vision deserves the most careful consideration, and you deserve to make decisions based on complete, accurate information about your eyes and your options. Don’t settle for anything less.

The prospect of life without glasses or contacts is exciting. It begins with a thorough, professional candidacy screening, which can and should include a conversation that covers all of your questions and supports your curiosity. Demand excellence from the start, and you’ll be setting yourself up for the best possible experience and outcomes.