I was referred to Dr. Callahan by my primary doctor, Dr Callahan and staff are extremely nice, professional, and knowledgeable. I’ll return for eye care and have already recommended her to my family.
Chang Liu
What to Expect at a LASIK Consultation and Evaluation
Tests and Measurements During Your Evaluation
Your LASIK evaluation includes several specialized tests that go well beyond a routine eye exam. Each measurement gives us a different piece of information about your eyes, and together they tell us whether LASIK is safe and which treatment approach is best for you.
We begin by examining the overall health of your eyes using specialized instruments to check for signs of disease or damage that could affect your surgery outcome.
We may use dilating drops to widen your pupils so we can see the back of your eye more clearly. The drops take about 20 to 30 minutes to fully work, and their effects can last several hours. This is why we always suggest arranging a ride home.
This is one of the most critical parts of your evaluation. Because LASIK works by gently reshaping your cornea, we need to confirm that your corneas are thick enough and have a healthy, regular shape before any tissue is removed.
- Pachymetry measures corneal thickness in microns using a painless, non-contact device
- Corneal topography and tomography, including Scheimpflug imaging, create detailed 3-D maps of your cornea and help detect early signs of keratoconus, a condition where the cornea gradually thins and bulges
- Epithelial thickness mapping and corneal biomechanics testing may also be used to further assess ectasia risk, meaning the risk of the cornea weakening after surgery
These tests are quick and completely painless, and they provide some of the most important safety information we gather during your visit.
We need your exact prescription to plan a precise LASIK treatment. During refraction testing, you will look through a series of lenses and tell us which ones give you the clearest view.
We also use automated instruments to measure how light enters and travels through your eye. A cycloplegic refraction, where drops are used to temporarily relax the focusing muscles, may be performed to get the most accurate reading. Wavefront aberrometry adds another layer of detail by measuring higher-order aberrations, which are subtle optical imperfections that go beyond basic nearsightedness, farsightedness, and astigmatism.
Healthy tears are essential for comfortable healing after LASIK. We assess the quality and quantity of your tear film to identify any dry eye issues that should be addressed before surgery.
- Tests may include tear breakup time, Schirmer testing, osmolarity, MMP-9 testing, and meibography, which evaluates the oil-producing glands in your eyelids
- If dry eye is found, treatment may include lubricating drops, lid hygiene routines, warm compresses, anti-inflammatory eye drops, punctal plugs, or meibomian gland therapies
Treating dry eye before surgery leads to more accurate measurements and a more comfortable recovery. In some cases, we will recommend waiting until your tear film is stable before scheduling LASIK.
We complete the evaluation by checking your intraocular pressure, which is the fluid pressure inside your eye, to screen for glaucoma risk. We also use imaging technology to assess the health of your retina and optic nerve when clinically indicated.
- Tonometry measures eye pressure using a gentle, non-contact method
- Optical coherence tomography provides detailed cross-sectional images of the retina
- Digital retinal photography creates a baseline record of your internal eye health
These checks help ensure there are no underlying conditions that could affect your surgery results or long-term eye health.
Determining If You Are a LASIK Candidate
Not everyone who wears glasses or contacts is a good candidate for LASIK, and that is completely okay. Our evaluation is designed to find the safest and most effective path to clearer vision for your individual eyes. Here is what we look at when assessing your candidacy.
LASIK can treat a wide range of prescriptions, but there are safe limits to how much tissue can be removed. Your prescription must fall within certain ranges for LASIK to be appropriate for you.
We can typically treat nearsightedness up to about negative 12.00 diopters, farsightedness up to about positive 6.00 diopters, and astigmatism up to about 6.00 diopters. Diopters are the units used to measure refractive error, or how much your vision is off from normal. Farsighted prescriptions above about positive 4.00 diopters tend to have lower predictability and a higher chance of regression over time. Your corneal measurements may also narrow what is safely treatable even within these general ranges.
Your corneas must be thick enough to safely undergo the reshaping process without compromising the structural integrity of your eye. We use a conservative approach to these calculations.
- We target a residual stromal bed thickness, meaning the tissue remaining after flap creation and laser treatment, of at least 250 to 300 microns
- We also monitor the percent of total corneal tissue altered by treatment and aim to keep it below approximately 40 to 45 percent
- Corneal shape must be regular with no signs of keratoconus or ectasia risk on tomography
- Any scarring, irregularities, or thinning may make PRK or another procedure a safer choice
We generally recommend that LASIK candidates be at least 18 years old, though waiting until age 21 or older is often preferable since eyes continue to change through the early twenties. Your prescription also needs to have been stable for at least one to two years before surgery, so that the correction we make reflects where your vision is likely to stay.
If you are pregnant or nursing, we recommend waiting until at least three months after delivery and until nursing has ended, and until your prescription has restabilized, before proceeding with LASIK.
Certain health conditions and eye conditions can interfere with healing, increase risk, or make LASIK less effective. We review your full medical and ocular history carefully to identify any factors that could affect your outcome.
- Autoimmune diseases such as lupus or rheumatoid arthritis may slow healing or increase inflammation
- Uncontrolled diabetes can impair wound healing and raise infection risk
- Immune-suppressing medications may need to be discussed with your prescribing physician
- Keratoconus, severe dry eye, glaucoma, active cataracts, epithelial basement membrane dystrophy, recurrent corneal erosions, or prior herpetic keratitis may rule out LASIK
- History of keloid scarring or poorly controlled allergies that lead to eye rubbing may also be a concern
If we determine that LASIK is not the right fit, it does not mean you are out of options. We will discuss alternative procedures such as PRK, implantable collamer lenses, or refractive lens exchange depending on what suits your eyes best.
Understanding Your LASIK Options and Recommendations
If you are a candidate, your LASIK Surgeon will walk you through the technology and treatment approach that best fits your eyes. There are several variations of laser vision correction, and the right choice depends on your prescription, corneal measurements, and lifestyle.
Modern LASIK uses a femtosecond laser, an extremely precise laser, to create the corneal flap instead of a surgical blade. This bladeless approach offers greater control, a more uniform flap, and a lower risk of flap-related complications compared to older blade-based methods.
Custom wavefront-guided LASIK takes personalization a step further by mapping the unique optical imperfections in your eye and tailoring the treatment specifically to them. This approach can address higher-order aberrations beyond standard prescription errors and may improve the quality of your night vision and reduce glare or halos around lights. Topography-guided and wavefront-optimized treatments are also available to minimize the introduction of new aberrations and manage irregular corneal optics. We will recommend the approach that is most appropriate for your eye profile.
If your corneas are too thin for LASIK, or if your lifestyle puts you at risk for flap-related issues, we may recommend photorefractive keratectomy, or PRK. PRK reshapes the cornea using the same laser technology as LASIK but without creating a flap, making it a strong alternative for patients who do not qualify for LASIK.
For very high prescriptions, implantable collamer lenses, which are small lenses placed inside the eye, may offer a better outcome. For patients over 40 who have early cataracts along with a refractive prescription, refractive lens exchange may be the most appropriate path. Your LASIK Surgeon will explain which option gives you the best chance of clear and stable long-term vision.
Before you make any decisions, your LASIK Surgeon will review all potential risks and side effects so you can give truly informed consent. Understanding these possibilities is an important part of the process.
- Dry eye symptoms that are usually temporary but can persist in some patients
- Night glare, halos, and starbursts around lights that typically improve over weeks to months
- Infection or inflammation requiring prompt treatment
- Flap-related issues such as displacement, striae (wrinkles), or epithelial ingrowth beneath the flap
- Corneal ectasia, a weakening of the corneal structure, in patients with predisposing risk factors
- Undercorrection, overcorrection, or regression that may require an enhancement procedure
- Rare but serious vision-threatening complications
Most people who undergo LASIK achieve vision of 20/20 or 20/25, but individual results vary based on your prescription and overall eye health. We believe in honest, straightforward conversations so you know exactly what to expect going in.
A small percentage of patients may need an enhancement procedure after their initial surgery. Patients over 40 may still need reading glasses for close-up tasks, a normal part of aging unrelated to LASIK. We will discuss all of these possibilities with you so that your expectations are well-grounded and you feel confident in your decision.
After Your Consultation: Next Steps
Once all your tests are complete, your LASIK Surgeon will sit down with you to review everything and outline a clear plan. Whether you are moving forward with surgery or exploring alternatives, you will leave the appointment with a thorough understanding of your options.
We will walk through each test result and explain in plain language what the findings mean for your candidacy. If LASIK is right for you, we will describe the procedure in detail and discuss what recovery looks like. We will also review the informed consent process, including risks, benefits, and your personalized treatment plan.
If LASIK is not the safest option for your eyes, we will explain why and present the alternatives that we believe can still help you achieve better vision.
If you are ready to move forward, our team will help you find a surgery date that fits your schedule. We suggest choosing a time when you can take at least a day or two off to rest and recover comfortably.
- Most patients schedule surgery within a few weeks of their consultation
- You will need a driver to take you home on surgery day
- Plan your first post-operative visit within 24 hours of surgery
- Avoid scheduling surgery right before major events, travel, or demanding work periods
LASIK is generally considered an elective procedure, which means most medical insurance plans do not cover it. However, there are several ways to make surgery more manageable financially.
Health savings accounts and flexible spending accounts allow you to use pre-tax dollars toward your LASIK cost. We also work with financing programs that offer payment plans, including low- or no-interest options. Our team will walk you through all available options and help you find an approach that fits your situation.
Before your surgery date, we will give you detailed written instructions to help you prepare. Following these guidelines carefully helps protect your eyes and supports the best possible outcome.
- Continue to avoid contact lenses for the required period leading up to surgery
- Do not wear eye makeup, lotions, or perfume on surgery day or for one week after surgery
- Arrange transportation to and from your surgical appointment
- Fill all prescribed eye drop prescriptions ahead of time so they are ready when you get home
- Plan to rest at home for the remainder of surgery day
- Wear protective eye shields while sleeping for the first week as instructed
- Avoid getting water directly in your eyes for one week and avoid swimming or hot tubs for two weeks
- Limit heavy physical activity for the first 24 to 48 hours as advised
LASIK is a very safe procedure, but it is important to know which symptoms require prompt attention. Please contact us right away if you experience any of the following after your consultation or surgery.
- Severe or worsening eye pain that does not improve with prescribed drops
- A sudden decrease in vision or increasing redness and discharge
- Significant new light sensitivity, especially combined with discharge
- Any trauma to your eye or concern that your flap may have been displaced
- New or sudden flashes of light, a significant increase in floaters, or a dark curtain appearing across part of your vision
Do not wait to see if these symptoms resolve on their own. Prompt care after LASIK is always the right choice.
Frequently Asked Questions
Below are answers to some of the questions patients ask most often about their LASIK consultation and what comes next.
If your pupils are dilated during the visit, your vision will be temporarily blurry and you will be more sensitive to bright light, which makes driving unsafe for several hours. We always recommend planning for a ride home on the day of your consultation. If dilation turns out not to be necessary, you may be able to drive, but it is best to confirm this when you book your appointment rather than assume.
Not qualifying for LASIK does not close the door on better vision. Depending on the reason, you may be an excellent candidate for PRK, which removes the need for a flap entirely, or for an implantable collamer lens procedure for high prescriptions. If you have early lens changes, refractive lens exchange may also be an option worth discussing. Our goal is always to find the safest path that gives you the most meaningful visual improvement for your specific eyes.
The timing depends on your schedule, our surgical calendar, and whether any preparatory steps are needed, such as treating dry eye first. Many patients schedule surgery within one to two weeks of their consultation, while others prefer to take more time to reflect and prepare. There is no pressure to rush, and we want you to feel completely ready before you commit to a date.
Yes, you should plan on taking at least a half day off, and ideally a full afternoon. If your pupils are dilated, close work such as reading or using a computer can be difficult for several hours. Arriving at your consultation without the pressure of returning to work immediately makes for a more relaxed visit and gives you more time to ask questions and process the information you receive.
Mild to moderate dry eye does not automatically disqualify you from LASIK. In many cases, we can treat your dry eye in the weeks or months before surgery and then reassess your candidacy once the surface of your eye has stabilized. More severe or chronic dry eye may make LASIK a riskier choice, and in those cases we would explore whether PRK or another approach is a better fit. The dry eye tests performed during your evaluation give us the specific information we need to make that determination for you individually.
Most patients achieve very significant reduction in their dependence on glasses or contacts, and many achieve 20/20 or better. However, LASIK does not prevent the natural changes that come with aging. After age 40, most people gradually lose some ability to focus up close, a condition called presbyopia, and may need reading glasses even after successful LASIK. For distance vision, a small number of patients may need an enhancement procedure if some prescription remains after initial healing. We will discuss your specific expectations and likelihood of needing glasses for any tasks based on your individual measurements.
Schedule Your LASIK Consultation at NewView Eye Center
Our team is committed to giving every patient a thorough, honest evaluation and the personalized guidance needed to make a confident decision about their vision. We are proud to bring that level of care to patients across Northern Virginia, and we would love to help you explore whether LASIK is right for you. If you are ready to take the first step, we invite you to schedule your consultation and let our experienced LASIK Surgeons give you a complete picture of your options and what clearer vision could look like for you.
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