Not everyone is suitable for laser eye surgery. The best way to determine your suitability is to attend a consultation at a clinic of your choice. The Surgeon will undertake a thorough assessment of your eyes and you will be advised of your suitability.
Whilst there is some variation between different clinics, the typical suitability rate is around 85%, meaning 15% of people are likely to be unsuitable for the surgery.
As laser eye surgery has improved over the years the prescription range has widened, meaning fewer people are beyond the treatable range. There are however certain general health conditions and eye conditions that may mean you are not a suitable candidate for surgery.
The following lists the main contraindications to laser eye surgery:
General: Laser Eye Surgery Suitability:
- Diabetics: In order to be considered suitable for laser eye surgery it is important that your diabetes (blood sugar levels) is well controlled. Having well controlled blood sugar levels will ensure that your prescription is stable and also minimise your chances of developing diabetic retinopathy. These issues will be carefully checked by your Surgeon during your initial consultation before they make a decision on your suitability for surgery. You can read more about this at the following link: Laser eye surgery and diabetes.
- Rheumatoid arthritis: People with rheumatoid arthritis do not tend to heal as well following surgery and they also often have dry eyes. Both these factors could make you unsuitable for laser eye surgery as you will be at a higher risk of complications following surgery.
- Lupus syndrome: Some surgeons will be happy to perform laser eye surgery if your lupus is well controlled. This is down to your surgeon so you will need to discuss it with them during a consultation.
- Epilepsy: Most surgeons will be happy to carry out surgery providing you have been seizure free for a certain period of time – discuss this with your surgeon.
- Certain medications: If you are taking medications such as Tamoxifen or Methotrexate you may be unsuitable for laser eye surgery. During your consultation your Surgeon will take a detailed history of your health, including any medications that you are currently taking.
- Graves’s disease: Most Surgeons will deem you unsuitable for laser eye surgery if you have this condition.
- HIV positive or taking immuno suppressive medication: Both these conditions will mean you are unsuitable for surgery. The reason for this is that your immune system will not be functioning properly meaning you are at a higher risk of developing an infection during or after surgery.
- If you are pregnant or breast feeding: Your Surgeon will advise that you wait until at least 3 months after you have stopped breast feeding before you can be considered for laser eye surgery. This is because the hormonal changes that occur in your body during pregnancy and breast feeding can alter your prescription. You can read more about this at the following link: Laser eye surgery and pregnancy.
- Metastatic cancer: You are unsuitable for laser eye surgery if you have this condition.
- Psychological problems: You will be considered unsuitable for laser eye surgery if you are unable to understand the risks of surgery or are unable to comply with the post operational instructions.
Eyes: Laser Eye Surgery Suitability:
- Any active eye infection: This will need to be treated by your Surgeon before surgery.
- High eye pressure: During laser eye surgery the pressure within your eye will temporarily increase which could be an issue if you already have high eye pressure. This will depend on how high your eye pressure is and whether your eyes are otherwise healthy. Your Surgeon will assess this during a laser consultation.
- Dry eyes: Dry eyes are one of the most common complications following laser eye surgery. If your eyes are already dry then you are at a higher risk of having problems post-surgery. Your surgeon will discuss this with you and assess your tear film during a consultation. You can read more about this at the following link Laser eye surgery and dry eyes
- Previous Herpes eye infection: You will not be considered suitable for laser eye surgery if you have had a previous Herpes eye infection as it is an infection that can reoccur.
- Scarring of the cornea: This could be from a previous infection or trauma. Whether you are suitable will depend on the degree and location of the scarring.
- Lazy eye (amblyopia): A lazy eye means that even when wearing contact lenses or glasses you are still unable to see very far down the eye test chart. If your amblyopia is mild, you may be considered suitable for laser eye surgery. You will need to discuss this with your surgeon. Read more about laser eye surgery and lazy eyes in our detailed guide.
- Unstable prescription: Your glasses and contact lens prescription needs to be stable for at least 12 months to ensure your laser surgery will be long lasting. Surgeon’s views on what constitutes stability can vary so it is best discussed with them.
- Very high prescription: If you are beyond the prescription range for laser eye surgery you may have to consider a non-laser alternative such as implantable contact lenses or refractive lens exchange. Over 95% of prescriptions are now suitable for laser eye surgery meaning this is less of a problem than it was previously.
- Prism in your glasses: Prism is often used in people’s glasses when they have problems with the muscles in their eyes. You will need to discuss with your surgeon as to whether or not you are suitable as it will depend on the exact reason that you need the prism.
- Glaucoma: Whether you are suitable will depend on the extent of your glaucoma and also on how well it is controlled. Another critical factor is whether or not you have any optic nerve damage as a result of the disease. This is something that will decided by your surgeon on a case by case basis.
- Cataract or macular degeneration: This is down to the discretion of the Surgeon and relates to the severity of the condition.
- Optic neuritis: Not suitable for laser surgery.
- Corneal endothelial dystrophy: Not suitable for laser eye surgery.
- Keratoconus: People with keratoconus are not suitable for laser eye surgery as it results in a thinning of your cornea.
The final decision will always be down to the surgeon.