Who should not have laser eye surgery?

HotbotBy HotBotUpdated: July 3, 2024

Introduction to Laser Eye Surgery

Laser eye surgery, often referred to as LASIK (Laser-Assisted In Situ Keratomileusis), is a popular procedure aimed at correcting vision problems such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. While the surgery has a high success rate and can significantly improve quality of life, it is not suitable for everyone. Identifying who should not have laser eye surgery is crucial for ensuring patient safety and optimal outcomes.

Underlying Health Conditions

Autoimmune Diseases

Individuals with autoimmune diseases such as lupus, rheumatoid arthritis, and multiple sclerosis are generally advised against laser eye surgery. These conditions can impair the body's ability to heal, increasing the risk of complications during and after the procedure.


People with diabetes may face challenges with healing and are at a higher risk of infection. Additionally, fluctuating blood sugar levels can affect the stability of vision, making it difficult to achieve consistent results with laser eye surgery.

Chronic Dry Eye

Patients with chronic dry eye syndrome are often not good candidates for laser eye surgery. The procedure can exacerbate this condition, leading to severe discomfort and prolonged healing times. Pre-existing dry eye issues need to be carefully evaluated and managed before considering surgery.

Ocular Health Concerns

Thin Corneas

The thickness of the cornea is a critical factor in determining suitability for laser eye surgery. Individuals with thin corneas are at a higher risk for complications such as ectasia, a condition where the cornea becomes weakened and begins to bulge. Pre-surgical evaluations include corneal topography to ensure the cornea is thick enough to safely undergo the procedure.


Glaucoma patients are often advised against laser eye surgery due to the potential impact on intraocular pressure. The procedure can temporarily raise eye pressure, worsening the condition and potentially leading to further optic nerve damage.


Individuals with cataracts are typically not good candidates for laser eye surgery. Cataracts cloud the lens of the eye, impairing vision, and usually require a different surgical approach known as cataract surgery to correct the issue.

Age-Related Considerations

Under 18 Years Old

Laser eye surgery is generally not recommended for individuals under 18. The eyes are still developing during these years, and vision can continue to change. Performing the procedure too early can result in the need for additional surgeries later in life.

Older Adults

While age alone is not a contraindication for laser eye surgery, older adults are more likely to suffer from age-related conditions such as presbyopia or cataracts. A thorough evaluation is necessary to determine whether laser eye surgery or an alternative procedure is more appropriate.

Pregnancy and Nursing

Hormonal Changes

Pregnancy and nursing can cause hormonal fluctuations that affect vision. These changes can make it difficult to determine the true refractive error, leading to suboptimal results from laser eye surgery. It is generally advised to wait until after pregnancy and nursing, when vision has stabilized, before considering the procedure.

Psychological Factors

Unrealistic Expectations

Individuals with unrealistic expectations about the outcomes of laser eye surgery may be disappointed with the results. It is crucial for patients to understand the potential risks and benefits and to have realistic goals for the procedure. A thorough consultation with an ophthalmologist can help set appropriate expectations.

Anxiety Disorders

Patients with severe anxiety or those who are unable to remain calm during medical procedures may struggle with the demands of laser eye surgery. The surgery requires the patient to be still and cooperative, and high levels of anxiety can hinder this process.

Occupation and Lifestyle Factors

Contact Sports

Individuals who participate in contact sports such as boxing, wrestling, or martial arts may be advised against laser eye surgery. The procedure can make the eyes more susceptible to trauma, increasing the risk of complications from physical impact.

Frequent Exposure to Dust and Chemicals

Occupations that involve frequent exposure to dust, chemicals, or other irritants can pose a risk for individuals considering laser eye surgery. These environments can hinder the healing process and increase the likelihood of infections or complications.

Navigating the complexities of laser eye surgery candidacy involves a thorough understanding of various health, lifestyle, and psychological factors. It is essential to consult with a qualified ophthalmologist to evaluate individual circumstances and make an informed decision. The path to clear vision is a journey that requires careful consideration and personalized medical advice.

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