Laser-assisted in situ keratomileusis or LASIK surgery (also known as laser vision correction surgery) is the most popular form of refractive eye surgery all over the world. It is particularly because of its safety, efficacy, and cost-effectiveness (Read more in detail at this page).
Whether or not an individual is eligible for the laser vision correction is decided by the treating ophthalmologist through an array of tests including a comprehensive eye evaluation, ensuring that the chosen surgery is best suited for the patient’s eyes and visual needs. The age criteria for LASIK are more relaxed in today’s date than they were earlier. With increasing patient safety data being pooled from across the world, as well as newer emerging variations of LASIK, these are now evolving to incorporate both the extremes of age.
Defined Age Criteria for LASIK Eye Surgery
The US FDA has approved the use of LASIK for those over 18 years. Many doctors may ask you to wait for an additional couple of years, to ensure that your refraction is stable. It is because a person’s prescription does not usually change after eighteen years of age. It is advisable to have a stable prescription for at least one year, before going ahead with LASIK.
The physiology and functioning of the eye undergo a major change around 40 years of age. Most people need glasses for reading, and this condition is known as presbyopia. LASIK does not correct presbyopia, so conventionally; people around forty years of age were not offered LASIK.
However, in current practice, doctors do not hesitate to discuss LASIK with patients of presbyopia as well, offering monovision LASIK. In this case, one eye (usually the dominant eye) is corrected for distance, while the other eye is corrected for near vision. Most patients are happy with this outcome, as they are no longer dependent on either near or distance vision glasses.
Similarly, around sixty years of age, the eyes change again, with most people experiencing the beginning of a cataract. Those who do not have cataracts are still good candidates for LASIK, despite their age. So a comprehensive dilated exam, again, decides eligibility. Also, patients who have not achieved optimal vision after cataract surgery, despite good eye health, are also good candidates for LASIK. It is to highlight the changing and evolving paradigms of the eligibility criteria for laser vision correction.
Age Group Recommendations for Laser Surgery
As far as particular age groups are considered, here are the general recommendations, depending on the patient being otherwise fit, for laser vision correction.
Childhood and the Teens – Below 18 Years
The eyes continue to grow until at least eighteen years of age. Therefore, experts recommend that surgery for vision correction should not be performed until this age, since the benefit will be temporary and the patient will be saddled with glasses as soon as his or her eye prescription changes, due to the natural process of growth.
Also, LASIK is elective surgery, so it is better if the patient has attained the age of consent. That said, LASIK has been used with success to treat severe refractive errors in patients younger than eighteen, especially those suffering from amblyopia or lazy eye, when conventional treatment with glasses or contact lenses has failed to produce optimal results.
Early Adulthood – 18 to 40 Years
It is considered to be the ideal age for laser vision correction, and most doctors prefer to operate as soon as the prescription for glasses has been stable for a year. It is because it provides almost twenty plus years with no dependence on glasses whatsoever. It is also the age group that has been the traditional age group seeking refractive surgery.
Middle Age – 40 to 60 Years
After the age of 40, presbyopia begins to set in, and cannot be handled with conventional laser vision procedures. However, your doctor will discuss with you the possibility of monovision. It provides a practical and simple solution for freedom from both distance and near vision glasses in this age group.
Golden Old Age – 60 Years and Above
There is no fixed upper age limit and is dependent on the individuals’ eye health and visual needs. For patients who do not have any organic reasons for the vision loss including cataract, and have no medical contraindications, they can safely undergo LASIK. The patient also must understand that the development of cataract is inevitable and that laser vision will not prevent it. Also, in the small subset of patients who have not had the desired vision correction after cataract surgery, laser vision correction surgery may be performed to allow better vision without glasses.
Special Considerations in Senior Citizens (People Over 60 Years)
Pre-existing Diseases
Most eye diseases have an age predilection. Cataract, glaucoma, age-related macular degeneration (AMD) and dry eyes are all more prevalent in the aging population, and so the senior citizens seeking LASIK must be evaluated carefully. Basement membrane abnormalities of the cornea are also more common in the elderly as compared to the young and can be the cause of corneal abrasions and poor healing after LASIK. A comprehensive eye evaluation will, therefore, decide the suitability of the person for LASIK.
Some medications taken by elderly patients like Amiodarone are a contraindication for LASIK. Amiodarone is an anti-arrhythmia drug that regulates the beating of the heart. Its use has been linked to light sensitivity, poor corneal healing, hazy vision, glare and colored haloes around lights.
Near Vision Concerns
Almost everyone over the age of forty-five will require reading glasses. It is regardless of whether they have needed glasses for distance vision growing up or not, and this does not change. This age-related decrease in near vision due to loss of elasticity of the natural lens cannot be addressed by LASIK alone.
In fact, to decrease the dependence on near vision glasses, the eye doctors often discuss the option of mono-vision. In this, the dominant eye is corrected completely for distance, offering a clear vision for distance under normal viewing conditions (we rarely close one eye and look in the distance). The other eye is under corrected for distance, such that it has a better vision for near, enough to see the time on a wristwatch, numbers on a mobile phone, and also read not very fine print.
Seniors tend to adapt very well to mono-vision since, under normal, binocular conditions, they do not need glasses for either distance or reading.
Conclusion
There is no general guideline which holds true for the individual patient. In fact, with the changes in laser correction technology and safety, the criteria for eligibility for the surgery are continuously changing. Age as for anything else, that you would want to try and achieve in life, is just a number. The reasons for deciding eligibility and success of the laser vision correction are more dependent on a comprehensive eye evaluation to determine eligibility, and also your visual needs.
In conclusion, do not let your age stop you from seeking a consultation with your eye doctor to discuss laser vision correction.