When Is LASIK Not an Option?
LASIK is a surgical procedure which uses a laser to subtly re-shape the cornea, the clear front part of the eye. Its purpose is to free you from contact lenses or glasses, if possible, or to at least reduce your dependence on them.


/Vision-Eye Care News Articles/ - SACRAMENTO, CA, February 11, 2007 - Brief description of LASIK
Your eye surgeon will discuss the options with you, together you'll decide on the best approach. He or she will explain how it will be done and how you can optimize your recovery.
There are several variations of the LASIK procedure, but basically they all follow this sequence:
· A small thin flap is created on the surface of the cornea
· It's folded back so as to expose the underlying tissue, the stroma
· The laser is precisely directed at the areas on the stroma that need re-shaping and in a few seconds, has done the work
· The little flap is replaced and heals up by itself, with no stitches
· Your vision is instantly improved, although there's some recovery for a few days and further improvement may become evident after a few months
Factors which may rule out LASIK
Health conditions
When you first contact your eye surgeon to see if LASIK can be done for you, you'll be asked to answer a lot of questions about your health. There are some conditions which would prevent good healing after LASIK and which will therefore rule you out, if you have them:
· Diabetes
· Some auto-immune diseases (e.g. rheumatoid arthritis, multiple sclerosis, myasthenia gravis, AIDS or lupus)
· HIV
Medications
Some medications would interfere with healing, such as retinoic acid (used to treat acne) and steroids.
Eye conditions
If you have what's called refractive instability, you may not be a good candidate for LASIK. Refractive instability refers to relatively frequent changes in your visual acuity, such that you need new prescriptions for contact lenses or glasses.
This can be caused by a variety of factors, such as:
· Pregnancy and breastfeeding
· An age of early 20's or younger
· Fluctuating hormones because of a disease, e.g. diabetes
· Certain medications you may be taking
So if you've had a change in glasses or contacts during the past year, you may not be a good candidate for LASIK.
Presbyopia - If your vision has been fine until recently and you're over 40, the problem is likely to be presbyopia. LASIK can't treat presbyopia, which gradually comes on us as we age, and causes us to need reading glasses.
Glaucoma - Most eye surgeons are reluctant to perform LASIK on someone with glaucoma, unless it was detected at an early stage and has been well-controlled. Glaucoma is a condition where the pressure inside the eyeball is too high because fluids are blocked from draining out properly.
Thin corneas - The cornea can be thinner in some people, and since LASIK is a procedure to re-shape it, a too-thin cornea can be a counter-indication for LASIK.
Dry eyes - LASIK tends to worsen this condition, so if it's already in place, your eye surgeon may not want to risk exacerbating it.
Other miscellaneous factors
· If you're a participant in contact sports, e.g. boxing, wrestling, martial arts, or any activity in which your face is likely to be hit
· If you're averse to risk-taking, you may be a poor candidate for LASIK. All surgery brings some risk, however tiny, and sometimes results are not exactly what was hoped for.
· Legally, you must be over 18
· If you've had any previous refractive surgery, such as PRK or RK, further refractive surgery like LASIK may not be recommended.

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