About once a week I will see a patient who was told that they are a good candidate for LASIK, but actually should probably avoid getting it. Several times a week, however, I'll see a patient that was told that they wouldn't be a good LASIK candidate, but is actually a great candidate. Most commonly, the person told they shouldn't have LASIK was given "astigmatism" as the reason.In 1998, it was excellent advice to avoid LASIK if you've got astigmatism. In 2014, though, even high amounts of astigmatism can be cured with LASIK better than with contacts or glasses. The improvement in technology in 16 years has been enormous.
A simple example of the fact that we can do things now that we couldn't back then would be the concerned looks you'd get telling the 1998 LASIK researcher they could find the answer by "using their phone to google it." But many doctors—including eye doctors—stick with guidelines created when LASIK was in its infancy.
So what makes someone a non-candidate for LASIK? There are a lot of special cases that require a consult to address, but the vast majority of non-candidates are advised against LASIK for one or more of three reasons:
- The cornea, clear dome on the front of the eye, that is treated by laser is too thin to safely treat with laser.
- The cornea has a shape to it that is too steep, too flat, or too lumpy of a dome to have predictable good results.
- The lens inside the eye, not the cornea, is too cloudy to justify doing LASIK to fix the prescription.
There are other reasons someone might not be a good LASIK candidate, but all of those reasons combined end up being only a fraction of one of these three. We have a lower candidacy rate at Hunter Vision than other LASIK centers because I'm pretty neurotic about every factor being perfectly aligned for someone to love their vision after LASIK. It means that I probably tell a few people they shouldn't have LASIK that would have done well with it, but believe me, that is a way, way better situation than being told you were a good candidate when you weren't.