Disha, a 17 year old entered my room at Centre for Lasik Surgery within Advanced Eye Hospital and Institute Navi Mumbai and started complaining how she hates her glasses. Her friends tease her and she is not able to get the attention of the guy she likes because of her glasses. She came all alone for a consultation as she wanted me to convince her dad that she can undergo LASIK surgery and get rid of her glasses. Today’s youngsters demand and know more than we knew when we were their age.
On the other hand are the baby boomers who continue to redefine aging. As soon as Mr Sharma, a 60 year old gentleman, entered my room I was thinking he must have come for cataract opinion. But to my surprise he had come for a LASIK procedure opinion! He had craved for a glasses free life for years.
I thought to myself how even being an eye doctor I am getting into stereotypes!
So of course the broader question is what is the right age for LASIK surgery?
It is a question that needs an answer, and here we go!
Not before 18- Too young for LASIK!
Most Lasik surgeons tend to avoid LASIK surgery in children less than 18 years as eyes keep changing shape and size into early adulthood. A stable glass power for 1-2 years is also mandatory prior to LASIK laser surgery. We do make exceptions to this rule sometimes. Younger people who are resistant to traditional treatment may benefit from LASIK. For example LASIK can be a viable alternative in children with a condition called anisometropic Amblyopia (where one eye has a very high power and poor vision compared to the other) who are intolerant to spectacle and contact lenses.
What about after 40 -Reading glasses?
The second fluctuation in a person’s eye happens around the age of 40. Soon thereafter, many people start to need reading glasses due to a condition known as presbyopia. LASIK surgery cannot correct two different numbers in the same eye (one for distance and one for reading) but can help with monovision. Monovision is a laser eye surgery that leaves one eye corrected for near vision and the other eye corrected for distance vision. Additionally one needs to remember that reading numbers continue to increase with age. Hence what has been corrected today will stand corrected but future gain in numbers will reflect.
50’s – Too Old for LASIK?
Its never too late for a lasik surgery but we must remember a few things about aging and the eye. At older age, the lens inside the eye may undergo changes and a cataract formation can start. However I have seen some adults who did not have cataract even at the age of 70 or 80 years. It’s possible that a 70-year-old without cataracts or other eye illnesses is actually a better candidate for a lasik surgery than a 30-year-old. The lens has to be clear and the patient must understand that LASIK procedure will not prevent a cataract from developing in the future
Special Considerations before Lasik surgery in older age groups
As with any other patient population, some issues need to be considered:
Pre-existing eye disease: Prior to moving forward with any LASIK surgery, it is imperative to rule out any pre-existing retina and corneal conditions which can interfere with the outcomes. We also need to rule out a check out family for history of corneal disorders, diabetes and glaucoma.
Drug side effects: Some medications taken by older patients could pose a problem, for example Amiodarone is a drug taken for a heart condition. It can have some ocular side effects like photosensitivity, corneal microdeposits, hazy vision, and colored haloes around lights. Rare side effects include corneal ulceration, subcapsular lens opacities and nonarteritic ischemic optic neuropathy.
Person’s medical history and any prescription drugs need to be properly documented before even considering LASIK.
Cataract surgery: Those patients who have already started developing cataracts are better served with a cataract extraction followed by implantation of an IOL. These patients can always be evaluated for multifocal lens suitability. We all need to understand the real possibility of cataract formation months or years following the procedure. Previous LASIK surgery may make calculating a subsequent IOL power difficult. To address this problem, we often record a preoperative topography measurement prior to the LASIK procedure, and then keep this information on file. This baseline measurement taken before the surgery can be extremely helpful for the IOL calculation down the road when cataract surgery may be needed.
Finally a previous cataract surgery does not represent a contraindication for LASIK,
Age certainly influences one’s LASIK candidacy, but it by no means draws an absolute boundary. Don’t let your age hold you back! If you are interested in freedom from glasses – do start investigating, it is never too late to improve the quality of your life. Only thing needed is a detailed medical and ocular evaluation to ensure you qualify for Lasik.
