LASIK Candidacy Checklist: How Surgeons Decide

Not medical advice. This checklist helps you prepare for a candidacy discussion with your surgeon.

Quick checklist

• Age 18+ with a stable prescription for ~12 months
• Healthy corneas with sufficient thickness and regular shape
• No active eye disease (infection, uncontrolled dryness, significant cataract)
• General health allows normal wound healing
• Realistic expectations about night vision and enhancement policies

What surgeons evaluate

1) Your prescription and stability

• Nearsightedness (myopia), farsightedness (hyperopia), and astigmatism are all treatable within set ranges.
• Surgeons look for little to no change in your glasses/contacts over the last year. Significant recent changes may delay surgery.

2) Corneal shape and thickness

• Corneal topography/tomography maps the surface and deeper layers, screening for irregularities.
• Pachymetry measures thickness. Enough tissue must remain after reshaping to keep the cornea stable.
• If findings suggest keratoconus or borderline corneal integrity, LASIK may be unsafe. Alternatives like PRK or ICL may be discussed.

3) Tear film and dry eye status

• Dry eye is common and manageable. Surgeons prefer to control dryness before surgery to optimize comfort and visual quality.
• Expect a temporary increase in dryness after LASIK; be ready to use artificial tears and follow care steps.

4) Ocular health

• A full exam checks for cataracts, glaucoma risk, retinal concerns, and lid/ocular surface health.
• Treat any active issues before considering elective surgery.

5) Medical history and medications

• Conditions affecting healing (certain autoimmune diseases) or medications like isotretinoin may influence timing and candidacy.
• Pregnancy/nursing can cause temporary vision changes; many surgeons wait until vision stabilizes.

6) Lifestyle and goals

• Night driving, shift work, and high‑contrast tasks are discussed because mild halos/glare can appear early on.
• Sports and occupation inform recommendations (eye protection, downtime requirements).

What to bring to your consultation

• Your glasses/contacts prescription history (if available)
• A list of medications and any eye drops used
• Prior eye surgery reports or specialist notes
• Your goals: distance‑only, monovision, or blended vision options

Red flags that may pause LASIK

• Rapid prescription changes
• Corneal irregularities or insufficient thickness
• Uncontrolled ocular surface disease (e.g., severe dry eye, blepharitis)
• Active infection or inflammation

Alternatives if you are not a candidate

• PRK (surface ablation) for certain corneal shapes/thicknesses
• SMILE in select myopic/astigmatic cases
• ICL for very high prescriptions or thin corneas
• Refractive lens exchange (RLE) where appropriate

Bottom line

Use this checklist to ask focused questions and bring relevant history. The candidacy exam is designed to keep you safe and maximize your outcome.