Things We Consider When Assessing Your Suitability for Laser Eye Surgery
If you are considering laser eye surgery, one of your first questions is likely to be whether your eyes are suitable for treatment. Although laser vision correction is not appropriate for everyone, advances in diagnostic technology, surgical planning and treatment techniques mean that many more people can now be treated safely than was previously possible.
Your suitability cannot be determined from your glasses prescription alone. At London Vision Clinic, we consider the stability of your vision, the shape and thickness of your corneas, your eye health, your general health and what you want to achieve from treatment.
We also determine which procedure is most appropriate for your individual eyes. This may be LASIK laser eye surgery, SMILE Pro, PRK/LASEK or PRESBYOND® Laser Blended Vision. The safest recommendation can only be made following a comprehensive clinical assessment.
Laser Eye Surgery Suitability at a Glance
Your suitability is based on the complete health and structure of your eyes, not simply the strength of your glasses prescription.
| Suitability Factor | What We Assess | Why It Matters |
|---|---|---|
| Age and Stability | You must be at least 18 and your prescription will normally need to have remained stable for at least one year. | Stable vision supports accurate treatment planning and more predictable results. |
| Prescription | We consider the type and strength of your myopia, hyperopia or astigmatism. | Your prescription influences whether LASIK, SMILE Pro or PRK/LASEK may be appropriate. |
| Corneal Anatomy | Advanced scans examine the thickness, curvature, symmetry and individual layers of your corneas. | The cornea must be structurally suitable for safe and stable reshaping. |
| Eye Health | We assess your tear film, ocular surface, natural lenses, retina and overall eye health. | Conditions such as significant dry eye, keratoconus or cataracts may affect the recommendation. |
| General Health | Medical conditions, medication, pregnancy and breastfeeding are considered carefully. | Some health factors can temporarily affect vision, healing or treatment predictability. |
| Lifestyle and Goals | Your occupation, sport, night driving, screen use and visual expectations all form part of the assessment. | The recommended treatment should suit both your eyes and the way you live. |
Previously told you are unsuitable? Different clinics have different technology, expertise and treatment options. A comprehensive
suitability assessment
can establish whether another approach may be appropriate.
How is laser eye surgery suitability assessed?
Laser eye surgery suitability can vary between clinics because different providers have access to different technology, treatment options and levels of surgical experience. Being declined by one clinic does not necessarily mean you are unsuitable for every form of vision correction.
London Vision Clinic can treat up to 98% of the patients who attend for assessment. This does not mean that every patient will be suitable for LASIK or that surgery will always be recommended. It means our surgeons can consider a broad range of personalised laser and lens-based treatments rather than relying on one standard procedure.
You can learn more about the assessment process on our dedicated laser eye surgery suitability page.
What factors affect your suitability for laser eye surgery?
Your age and prescription stability
Patients must be at least 18 years old before they can undergo laser eye surgery. However, age alone does not determine suitability. Your prescription must also have remained sufficiently stable, normally for at least one year, so that treatment can be planned around a reliable correction.
A prescription may continue to change during the teenage years and early adulthood. Vision can also fluctuate because of pregnancy, breastfeeding, certain medications or changes in health, including poorly controlled diabetes. If your prescription is temporarily unstable, treatment may need to be postponed until your vision has settled.
The type and strength of your prescription
Laser vision correction can treat several forms of refractive error, including myopia, hyperopia and astigmatism. However, the type and strength of your prescription will influence which procedure is most appropriate.
A higher prescription requires a greater degree of corneal reshaping. This means your surgeon must consider how much corneal tissue would need to be treated and how much should remain afterwards to maintain the strength and stability of the eye.
London Vision Clinic regularly assesses patients with complex or unusually high prescriptions, including people who have previously been declined elsewhere. Depending on the findings of your consultation, you may be suitable for personalised LASIK treatment or another form of refractive surgery.
The shape and thickness of your corneas
Laser eye surgery works by carefully reshaping the cornea, the transparent surface at the front of the eye. The thickness, curvature, symmetry and structural stability of each cornea must therefore be examined in detail.
At London Vision Clinic, advanced corneal mapping helps our surgeons identify subtle variations that may not be detected during a routine eye examination. This includes the use of the Artemis Insight 100™ ultrasound scanner, technology developed through pioneering research led by clinic founder Professor Dan Reinstein and his colleagues.
The Artemis can map the individual layers of the cornea with micron-level precision. This detailed information helps the surgeon calculate how much tissue can be safely treated and identify abnormalities that may affect the long-term stability of the cornea.
Having thin corneas does not automatically rule out treatment. Some patients may be better suited to a surface procedure such as PRK or LASEK, while others may be considered for SMILE Pro. The recommendation depends on the complete anatomy of the eye rather than one measurement alone.
Your eye health
Your consultation will include a detailed examination of your eye health. Conditions affecting the cornea, retina, optic nerve, natural lens or ocular surface may influence whether surgery is appropriate.
Dry eye is particularly important because laser treatment can temporarily affect tear-film stability. Mild or manageable dryness does not necessarily prevent treatment, but it should be identified and treated before surgery where appropriate. The cause and severity of the condition may also influence whether LASIK, SMILE Pro or a surface-based procedure is recommended.
Other findings, including keratoconus, significant cataracts, active eye infections or uncontrolled eye disease, may mean that laser eye surgery should be delayed or that a different treatment would be safer.
Your general health and medication
General health can affect healing and the predictability of refractive surgery. Your clinical team will therefore ask about medical conditions, previous operations and any medication you currently take.
Conditions that affect the immune system, connective tissues, hormone levels or wound healing require careful individual assessment. Having one of these conditions does not always mean treatment is impossible, but your surgeon will need to understand how well it is controlled and whether it introduces additional risk.
Laser eye surgery is not normally performed during pregnancy or breastfeeding because hormonal changes can temporarily affect the prescription, corneal measurements and tear film. Treatment can usually be reconsidered once breastfeeding has finished and the vision has become stable again.
Your lifestyle and occupation
The most suitable procedure must also fit your daily life. Your occupation, hobbies, sporting activities, screen use, night driving and recovery requirements can all influence the recommendation.
For example, patients involved in contact sports may benefit from a flap-free procedure such as SMILE Pro or PRK/LASEK. Other patients may place greater importance on rapid visual recovery, close-up vision or reducing their reliance on reading glasses.
Your surgeon will consider these factors alongside your clinical measurements rather than selecting a treatment based only on your prescription.
Your expectations of treatment
Understanding what you hope to achieve is an essential part of determining suitability. Laser eye surgery is designed to reduce dependence on glasses and contact lenses, but the likely result will depend on your prescription, age, eye health and natural visual potential.
Your consultation should provide a realistic explanation of the expected outcome, possible side effects, recovery and whether glasses might still be helpful for certain activities. Treatment should only proceed when the anticipated benefits justify the risks and align with your expectations.
Can laser eye surgery treat age-related reading vision?
From the early to mid-forties, the natural lens inside the eye gradually becomes less flexible. This makes it increasingly difficult to focus on close objects and is known as presbyopia.
Standard distance correction alone does not restore the natural flexibility of the lens. However, some suitable patients can be treated using PRESBYOND® Laser Blended Vision.
PRESBYOND creates a personalised blend of vision between the two eyes. One eye is predominantly focused for distance and the other supports near vision, while a carefully calculated blend zone helps the brain combine the images across intermediate distances.
Professor Reinstein developed the original Laser Blended Vision treatment approach in 2004, and London Vision Clinic has extensive experience in assessing and treating people with age-related reading vision.
What if another clinic has said you are unsuitable?
If you have been declined elsewhere, it may still be worthwhile seeking a specialist second opinion. Different clinics may have different prescription limits, diagnostic technology and experience in managing complex cases.
However, patient safety must always come first. There will be circumstances in which our surgeons agree that corneal laser treatment is not advisable. If this happens, they will explain why and discuss whether another form of vision correction could be considered.
Possible alternatives may include ICL surgery or, for appropriate patients, lens replacement surgery. In some cases, the safest recommendation may be to continue using glasses or contact lenses.
Which laser eye surgery treatment might be suitable for you?
LASIK, SMILE Pro and PRK/LASEK all correct vision by reshaping the cornea, but they use different surgical techniques. PRESBYOND is designed specifically to address presbyopia and age-related reading vision.
No single procedure is automatically best for everyone. The right treatment depends on the relationship between your prescription, corneal anatomy, tear film, age, lifestyle and long-term visual needs. Our laser eye surgery treatment guide explains the differences in greater detail.
Find out if you are suitable for laser eye surgery
The only reliable way to establish your suitability is through a comprehensive assessment with an experienced refractive surgery team. At London Vision Clinic, your eyes are examined in detail before a personalised recommendation is made.
Whether you are researching LASIK in London, exploring another laser procedure or seeking a second opinion after being declined elsewhere, our team can help you understand the available options.
To learn more, contact one of our clinic coordinators or book your suitability consultation today.
