Am I too old for LASIK surgery?

DEAR DOCTOR K:

I would like to have LASIK surgery to treat my nearsightedness. I’m 54 — is that too old to have this surgery?

DEAR READER:

LASIK (laser-assisted in-situ keratomileusis) can correct common eye problems: nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. It can eliminate your need for glasses or contact lenses.

LASIK corrects vision by reshaping the cornea, the clear dome at the front of the eye. The procedure is painless, and complications are few when the doctor is experienced.

Your age is not a problem for LASIK. Even in your 50s or beyond, if your eyes are otherwise healthy, LASIK surgery can produce excellent results. Surgical outcomes are similar regardless of age.

The main thing to consider is not your age but whether you have any other eye conditions that could make LASIK less successful. These eye conditions become more common with aging, so the eye doctor should carefully evaluate whether you have them:

  • CATARACTS. With age, the lens of the eye can become clouded. If this happens, the clouded lens can be removed and an artificial one implanted. If you’ve already had LASIK surgery, it’s trickier to choose the correct lenses for cataract surgery. If there’s any sign of clouding, your ophthalmologist may recommend cataract surgery first, and to reconsider LASIK surgery only after the cataract surgery has healed.
  • GLAUCOMA is caused by increased fluid pressure within the eye. The pressure affects the optic nerve, which starts in the back of your eye, leads to the brain and allows you to see. If glaucoma is untreated, it can lead to blindness. Ophthalmologists screen for glaucoma by checking intraocular pressure (fluid pressure inside the eye) and by looking for optic nerve damage.┬áLASIK surgery leads to lower intraocular pressure readings. This may interfere with early diagnosis. So be sure to tell your ophthalmologist if you’ve had LASIK when you are being screened for glaucoma. If your glaucoma is mild and easily managed, you may be a candidate for LASIK. But you should not have LASIK if you have moderate or severe glaucoma.
  • DRY EYE SYNDROME. With age, your eyes produce fewer tears. LASIK often worsens dry eye. Any ophthalmologist you see about LASIK should ask you if your eyes have a tendency to be dry, but just in case he or she doesn’t ask, be sure to mention it.
  • PRESBYOPIA. In our 40s and 50s, we become less able to focus clearly on near objects. That’s because the lenses inside our eyes get stiff, and a stiff lens can’t bend light in the way that’s necessary to see near objects. The usual remedy is to wear reading glasses. LASIK doesn’t prevent presbyopia, or eliminate the need for reading glasses.

The price for LASIK varies by doctor and by community. The average price may be around $2,000 to $2,500. Health insurance generally does not cover the cost.

LASIK isn’t for everyone. But it could be a great choice for you, regardless of your age, depending on any other eye conditions you might have.

(This column is an update of one that ran originally in July 2013.)