The health of your eyes plays just as important a role as your prescription. Several conditions can make LASIK unsafe or increase your risk of complications, and we screen for all of them before making any recommendation.
LASIK temporarily reduces tear production by affecting corneal nerves that signal the glands responsible for tear film. If you already have dry eye syndrome, the procedure can worsen your symptoms and slow healing.
We evaluate both the quality and quantity of your tears before surgery. Mild dry eye can often be managed with lubricating drops or punctal plugs before and after LASIK. Moderate to severe dry eye may need to be treated first, and in some cases may lead us to recommend a different procedure altogether.
We carefully examine your corneal shape using advanced tomography, which maps both the front and back surfaces of your cornea. This is important because early corneal disease can be hidden on the front surface alone. Keratoconus is a condition where the cornea progressively thins and bulges forward into a cone shape, and performing LASIK on a keratoconic cornea can accelerate that dangerous weakening.
Cataracts cloud the natural lens inside your eye, and cataract surgery is generally the better vision solution in that situation. Glaucoma requires careful consideration because steroid eye drops used after LASIK can raise eye pressure in susceptible patients. Mild, well-controlled glaucoma is not always a disqualifying factor, but it requires close monitoring.
Retinal conditions such as macular degeneration, diabetic retinopathy, or retinal tears should be stable and well managed before any elective vision correction is considered. Patients with high nearsightedness may benefit from a retinal evaluation before surgery.
A history of eye surgery or injury does not automatically disqualify you, but it does require careful evaluation. Previous surgeries can change corneal structure and make results less predictable. Significant corneal scarring or irregular healing from trauma may prevent safe laser treatment.
A history of herpetic eye disease, including herpes simplex or herpes zoster affecting the cornea, is generally a contraindication unless the condition has been quiescent for a long period and a careful perioperative plan is in place. We review your complete ocular history and examine your corneas thoroughly before making any determination.
We measure your pupil size in dim lighting because larger pupils can increase the risk of halos, glare, and starbursts around lights at night. When your pupils dilate beyond the laser treatment zone, these visual disturbances become more likely.
Your general health affects how your eyes heal after surgery. Certain systemic conditions, medications, and life stages require careful evaluation before LASIK can be considered safely.
Conditions such as rheumatoid arthritis, lupus, and Sjogren syndrome can interfere with normal healing and may worsen dry eye after surgery. Your immune system plays a critical role in corneal recovery, and when it is not functioning normally, healing can be unpredictable.
We evaluate the type and severity of your autoimmune condition, how well it is currently controlled, and whether it already affects your eyes. Patients with mild, stable disease may still qualify, while those with active disease are generally advised to avoid elective eye surgery. Sjogren syndrome in particular often significantly worsens dry eye and may steer the discussion toward non-corneal options.
Diabetes affects wound healing and can cause vision fluctuations that complicate accurate measurements and stable results. Poorly controlled blood sugar carries higher risks of infection, delayed healing, and regression after LASIK.
Hormonal changes during pregnancy and breastfeeding can temporarily alter your corneal shape and shift your prescription. These fluctuations make it difficult to achieve accurate, lasting results from LASIK.
We recommend waiting until at least three months after nursing has ended and your cycles have returned to normal. This ensures your prescription and tear film have fully stabilized before we take precise measurements or perform surgery.
Certain medications can impair wound healing, affect vision stability, or increase surgical risk. Isotretinoin for acne causes severe dry eye and impairs healing, and we typically require patients to be off this medication for at least six months before surgery. Oral corticosteroids can suppress healing, and some medications affect pupil size or tear production.
Bring a complete list of all current medications and supplements to your consultation. We will review each one and identify any concerns before moving forward with planning.
Your candidacy evaluation is a comprehensive visit that allows us to examine your eyes from every angle. We use advanced diagnostic technology and take time to understand your personal vision goals so we can offer guidance that is honest and specific to you.
Contact lenses rest directly on your cornea and can temporarily change its shape, which affects the accuracy of our measurements. We ask patients to stop wearing soft lenses for at least one to two weeks before their evaluation. Toric, extended-wear, or rigid gas permeable lenses may require three to four weeks or longer.
If measurements appear inconsistent at your appointment, we may ask you to extend this contact lens holiday and return for repeat testing. Staying in glasses during this period allows your corneas to return to their natural shape.
Corneal tomography maps both the front and back surfaces of your cornea, giving us a detailed picture of its shape, curvature, and thickness at every point. This data is essential for detecting even subtle signs of irregularity or early ectatic disease that could make LASIK unsafe.
At The Eye Center, our iLASIK platform uses the iDesign 2.0 wavefront system, which captures thousands of data points about how light travels through your eye. This level of detail goes far beyond a standard eye exam and allows our LASIK Surgeon to plan a highly customized correction with the Advanced CustomVue platform, which is approved by both the US Navy and NASA.
We also perform a thorough manual refraction using trial lenses to confirm your precise prescription. Together, wavefront data and refraction measurements allow us to program the VISX STAR S4 IR excimer laser with 3-D ActiveTrak for your specific eyes.
Because LASIK temporarily reduces tear production, we assess your tear film quality and quantity before determining your candidacy. We use tear breakup time testing, Schirmer testing, and sometimes specialized dyes to evaluate how well your tear film spreads and holds across your eye surface.
A dilated eye exam allows us to thoroughly examine your retina, optic nerve, and internal structures. We check for any signs of disease or abnormalities that could affect your candidacy or require treatment before LASIK is considered.
We document a baseline intraocular pressure reading and may use tonometry methods that are less affected by corneal thickness. This baseline is important for accurate pressure monitoring in the years following surgery.
Understanding what you hope to achieve helps us determine whether LASIK can realistically meet your expectations. We ask about your occupation, hobbies, driving habits, and any sports or activities that might affect your recovery or long-term results.
Setting honest expectations is a key part of every evaluation. We explain what outcomes your specific measurements suggest are likely, review potential side effects, and address your questions. If you are considering monovision correction for presbyopia, we typically recommend a contact lens trial to confirm you tolerate it before choosing the surgical version.
Like any surgical procedure, LASIK carries risks you should understand before making your decision. Most side effects are temporary and improve during healing, but some may take longer to resolve or require additional treatment. We review your individual risk factors in detail during your consultation.
Most patients experience some degree of dryness, glare, halos, or fluctuating vision during the healing period. These effects are a normal part of recovery and typically improve over days to weeks as your cornea heals.
While uncommon, more serious complications can occur and are important to understand before consenting to surgery. Our LASIK Surgeon reviews these possibilities with every patient so you can make a fully informed decision.
Not qualifying for LASIK does not mean living with glasses or contacts forever. Several excellent alternatives can deliver outstanding vision correction depending on your individual anatomy, prescription, and health profile.
Photorefractive keratectomy, or PRK, uses the same laser technology as LASIK but works directly on the corneal surface without creating a flap. This preserves more structural tissue and makes PRK a strong option for patients with thinner corneas or those in contact sports and high-risk occupations where a flap could be a concern.
Recovery from PRK takes longer than LASIK, with several days of discomfort and gradually improving vision, but the final results are comparable in most cases.
The EVO Visian ICL, or Implantable Collamer Lens, is a small prescription lens placed surgically inside your eye in front of your natural lens. This approach corrects very high nearsightedness and myopic astigmatism without removing any corneal tissue, making it an excellent option for patients whose prescriptions exceed the safe range for laser correction.
Small incision lenticule extraction, known as SMILE, is a laser procedure that corrects nearsightedness and astigmatism through a tiny incision without creating a flap. The absence of a flap may reduce dry eye symptoms and preserve a greater degree of corneal strength.
SMILE currently treats a somewhat narrower prescription range than LASIK and does not treat farsightedness. If you have borderline corneal thickness or significant concerns about dry eye, we may discuss whether SMILE is appropriate for your situation.
In some cases, continuing with glasses or contact lenses is the safest and most appropriate decision. If your eyes or health conditions present risks that outweigh the benefits of surgery, or if your expectations cannot realistically be met, we will have an honest conversation about non-surgical options.
Modern lens technology provides comfortable, high-performance vision for virtually any prescription. Choosing to wait or opt out of surgery entirely is always a valid and respected decision.
Once our LASIK Surgeon determines you are a good candidate, we provide clear instructions to help you prepare for surgery and recover as smoothly as possible. Knowing what to expect at each step helps reduce anxiety and supports the best outcome.
You will continue avoiding contact lenses from your evaluation through your surgery date. The specific duration depends on the lens type you wear, ranging from one to two weeks for most soft lenses to three to four weeks or longer for rigid gas permeable or hybrid lenses.
LASIK at The Eye Center is performed in our accredited in-office surgery suite, so you never need to travel to a separate hospital or surgery center. The procedure typically takes about 15 to 30 minutes for both eyes, and numbing drops keep you comfortable throughout. You remain awake and resting on a reclining chair while our LASIK Surgeon works.
You will feel light pressure during the treatment but should not experience pain. Immediately afterward, your vision will be blurry and you may notice mild tearing or sensitivity to light as the numbing drops wear off. This is completely normal.
Most patients notice significantly improved vision within 24 hours, though full stabilization may take several weeks. We schedule follow-up visits the day after surgery, then at one week, one month, and three months to monitor your healing closely.
Serious complications after LASIK are rare, but you should contact us immediately if you experience sudden vision loss, severe pain that does not improve, or signs of infection such as increasing redness, discharge, or swelling. Flashes of light, new floaters, or a curtain-like shadow across your vision require urgent evaluation to rule out retinal problems.
Mild dryness, glare, halos, and fluctuating vision are normal in the first days to weeks after surgery. If anything about your recovery concerns you, we encourage you to reach out rather than wait for your next scheduled appointment.
These questions address practical details and decision points that patients commonly raise during or after their LASIK consultation.
Yes, LASIK effectively corrects astigmatism, which is caused by an irregular corneal curvature that prevents light from focusing cleanly. The laser is programmed to address your specific pattern of astigmatism, often treating it alongside nearsightedness or farsightedness in a single session. The key is whether your astigmatism falls within the safe treatment range and your cornea has adequate thickness, both of which we assess during your evaluation.
If you are over 40, LASIK corrects your distance vision but does not stop or reverse presbyopia, the natural aging process that affects close focus. You may find you need reading glasses for small print even with excellent distance vision. Monovision, where one eye is corrected for distance and the other for near, can reduce this dependence, and we typically recommend a contact lens trial to confirm you tolerate it before choosing the surgical version.
Borderline candidacy requires an especially careful conversation about risks, benefits, and alternatives. In some cases, optimizing a factor such as treating dry eye first or waiting for further prescription stabilization can move you into a more favorable range. In other cases, an alternative like PRK or the EVO Visian ICL may offer a better safety profile for your specific anatomy. Our LASIK Surgeon will walk through each option with you so you can make a confident, informed decision.
Treating both eyes during the same session is standard practice and is safe for the vast majority of appropriately selected patients. It minimizes the period of unequal vision between your eyes and reduces the number of visits required. In rare situations involving individual risk factors, our LASIK Surgeon may recommend staging the procedures, and that decision will be discussed with you in advance.
Enhancements are sometimes performed after full healing if a meaningful prescription remains. Candidacy depends on how much corneal tissue remains, whether your refraction has been stable, and how much time has passed since your original surgery. At The Eye Center, our LASIK Surgeon's proprietary nomogram, refined over more than 40,000 procedures, has contributed to an enhancement rate below 1.5 percent, one of the lowest in the field. We discuss enhancement policies and timing during your initial consultation so you know what to expect.
Prior eye surgery does not automatically disqualify you, but it does require thorough evaluation. The type of surgery, how long ago it was performed, and how it affected your corneal structure all factor into the assessment. Some patients with previous refractive procedures may be excellent candidates for an enhancement or an alternative approach, while others may need to explore non-surgical solutions. We review your complete ocular history before drawing any conclusions.
The Eye Center has been helping patients throughout Northern Virginia see more clearly since 1989, and our LASIK Surgeon brings a depth of experience and technology that is difficult to match. We offer free LASIK consultations at four of our five offices, and our team is committed to giving you honest, individualized guidance, whether that means LASIK, an alternative procedure, or continuing with your current correction. Contact us today to schedule your consultation and find out what is possible for your vision.
