Can You Be Too Old for LASIK?

3. Cataracts

This condition causes clouding of the eye. You should wait to have LASIK until after you’ve had cataract surgery.

4. Diabetes

This metabolic disease can also affect your sight. Although some people with well-controlled diabetes may be candidates, they may have a longer healing period.

5. Immunodeficiency conditions like HIV

People with these conditions may not heal properly after surgery due to the conditions themselves or medications like steroids, which can slow healing.

6. Glaucoma

This is a group of diseases that damage the optic nerve. Those with uncontrolled glaucoma are not a good candidates for LASIK.

7. Large pupils

Depending on the size of your pupils, LASIK may not be recommended.

8. Migraines

If you take sumatriptan (Imitrex) for migraines, you might be at risk for drug-induced conjunctivitis (pink eye).

9. Thin corneas

Instead of LASIK, those with thin corneas might do better with photorefractive keratectomy (PRK). In this procedure, the epithelium, the top surface of the eye, is removed rather than forming a flap, as is done with LASIK.

10. Dry eyes

This condition, where your eyes don’t make enough tears, is common in people over 50. LASIK can make it worse.

You would want to check with your doctor to see if you have any of these conditions or others that would make you less eligible, such as problems with your immune system. “They don't necessarily mean that you can't have the surgery, but there are risk factors for healing,” Munir says.

Questions to ask before choosing a surgeon

Ask your eye doctor to help you find a reliable surgeon. You will want to find someone who does the operation frequently, so it’s a good idea to ask how many years the surgeon has been performing the procedure. You can also ask what kind of laser they use to see if it’s the latest FDA-approved technology. The newest technology was released in 2018 and is called iDESIGN Refractive Studio, STAR Excimer Laser System.

What to expect

If you’re feeling nervous, the doctor can prescribe a sedative to take before the procedure, and you should have someone drive you to and from the surgery center. The doctor will seat you in a reclining chair, numb your eye, and use an instrument to hold your eye open during the half-hour surgery. The doctor will create a flap on the cornea using a laser to reshape it, thus correcting your vision. Many people have 20/20 vision or better after surgery.

Once you are ready to go home, your doctor will give you goggles to wear while you sleep to protect your eyes from scratches. After the surgery, keep your hands away from your eyes. You shouldn’t shower until the next day.

The American Academy of Ophthalmology warns that some people might have discomfort following the procedure that diminishes over time. This can include:

• Blurry vision
• Double vision
• Dry eyes
• Eye pain
• Halos
• Light sensitivity
• Scratchiness

Andreoli says typically the halos and dry eye side effects are worse for people over 50.

You'll visit your eye doctor a day or two after the procedure to check your eyesight and assess the healing process.

You may need touch-ups later

People who get LASIK can enjoy better vision for a long time, but not forever, because laser surgery doesn’t prevent the eye from changing or aging, according to the Refractive Surgery Council. Some people need reading glasses several years after LASIK surgery.

“The average LASIK patient in the United States can go about 10 to 15 years before they are slipping and starting to need distance glasses,” Andreoli says. One option is to get a touch-up. She cautions there may be some trade-offs to getting an enhancement. She adds that a touch-up may sharpen your eyesight for distance but may worsen your close-up sight.

Cost considerations

LASIK surgery can cost between $1,000 to $ 4,000, and insurance may not cover much, if any of the cost, because it is considered an elective surgery. If you’re still working and have a Flexible Spending Account or a Health Savings Account, you can use funds from those accounts for the surgery. Medicare considers this surgery elective and does not cover the cost but some Medicare Advantage might. You’d have to check with your provider about your case. Although insurance will not likely cover any of the cost, the surgery center may offer a warranty, which is worth asking about.  

Be wary of low-cost deals that seem too good to be true. In 2024, the Federal Trade Commission (FTC) refunded $1.1 million to consumers tricked by bait-and-switch advertising by LCA-vision. Advertisements for $300 procedures were actually priced between $1,000 and $2,295 per eye for the surgery. Patients were given the true cost estimate following an eye exam during an in-person consultation.

When deciding whether LASIK is right for you, consider your overall health, cost, and long-term expectations.