LASIK

Your eye works like a camera. Light passes through the clear front of the eye (cornea), through the lens, and lands on the retina at the back. If the cornea is too curved, too flat, or shaped unevenly, light does not focus sharply and your vision is blurry. Glasses and contacts bend the light to make up for the difference. LASIK reshapes the cornea itself so that the eye focuses on its own ².

The procedure has three main steps:

• 1. Numbing. Eye drops numb the eye. Some surgeons offer a mild oral sedative.
• 2. Flap creation. A femtosecond laser (or, less often, a small blade called a microkeratome) makes a thin, hinged flap in the cornea. The flap is gently lifted to one side.
• 3. Reshaping. An excimer laser removes a tiny amount of tissue from the cornea under the flap. The laser is guided by your prescription and corneal map. This step takes 20-60 seconds per eye.

Then the flap is laid back down. It seals in place on its own — no stitches. The whole surgery takes about 10-15 minutes for both eyes.

Good signs you may be a candidate ⁴:

• You are 18 or older (most surgeons prefer 21+).
• Your glasses prescription has not changed much in 12 months.
• Your prescription is within what your surgeon's laser is built to correct (often roughly -12 to +6 with up to 6 diopters of astigmatism, though the exact range varies by device and surgeon).
• Your corneas are thick enough and shaped normally.
• Your eyes are healthy — no significant dry eye, keratoconus, advanced glaucoma, or cataracts.
• You are in good general health.

Signs LASIK may not be right for you:

• You are under 18, or your prescription is still changing.
• You are pregnant or breastfeeding (hormone changes can shift the prescription).
• You have severe dry eye, keratoconus, or thin corneas.
• You have uncontrolled diabetes or an autoimmune disease that affects healing.
• You take steroids or immunosuppressants long-term.
• You have a job (military, contact sports) where a flap injury would be a big problem — PRK may be safer.

LASIK is one of the most studied elective surgeries. Most people are happy with the results, but no surgery is risk-free ³:

• Dry eye. Common in the first weeks or months. Most people get back to baseline by 6-12 months. A small number have lasting dry eye.
• Halos, glare, or starbursts at night. Common at first, usually fade over weeks to months. Worse with larger pupils.
• Under- or over-correction. Some people still need glasses for some tasks, or need a touch-up procedure.
• Flap problems. The flap can wrinkle, slip, or grow cells underneath. These are usually fixable in the office.
• Infection. Very rare with eye drops, but possible.
• Ectasia. A rare condition where the cornea bulges over time. The risk is higher with thin corneas or undiagnosed keratoconus. Modern screening greatly lowers this risk.
• Loss of best-corrected vision. Very rare — about 1 in 1,000 — but losing the ability to see 20/20 even with glasses after surgery.

What it costs in the U.S.:

• Standard LASIK: $2,000-$3,000 per eye.
• "All-laser" or wavefront-guided LASIK: $2,500-$3,500 per eye.
• SMILE: $2,500-$3,500 per eye.
• PRK: $1,800-$2,800 per eye.

The price usually includes the pre-op exam, the surgery, follow-up visits for the first year, and any touch-up needed in that window. Confirm exactly what is included before you sign.

What insurance usually covers:

• LASIK is almost always considered elective. Most U.S. health insurance and Medicare do not cover it.
• Some employer vision plans offer a discount (often 10-20%) at certain LASIK centers.
• Most LASIK centers offer financing — interest-free 12-24 month plans are common.
• You can pay with HSA or FSA pre-tax dollars.