Is it possible to be too young for laser vision correction?

While there are general guidelines for the minimum age a patient must be to have laser vision correction performed safely and effectively, the decision is made on a case-by-case basis.

Why do doctors take special care in diagnosing teenage patients before deciding to perform laser vision correction?

FDA (American Food and Drug Administration) guidelines say the minimum age is 18, but the surgery in some young people may not be safe until 21. year of age.

First, it involves an unstable visual defect. When the eyeball remains in the growth phase, each 1-millimeter elongation of the eyeball induces a visual defect of -3.00 diopters. If the doctor operated on an eye with an unstabilized defect, already after the operation, the defect may need to be corrected after some time, i.e. the need for another surgery. Thus, observing the patient, the doctor waits for the moment when he is already sure that the defect has stabilized.

Second, there are eye diseases that only become apparent with age, and diagnosing them can make a patient ineligible for laser vision correction.

Such a disease, which develops for years (e.g., for a period of about 10 – 20 years) and then stops is, for example, corneal cone, which is a progressive eye disease leading to thinning and deformation of the cornea, and further deterioration of vision – myopia and astigmatism and often hypersensitivity to light. It is a disease that in some cases is genetically determined, but also occurs in people suffering from spontaneous congenital defects of the visual system or defects manifested in the course of diseases such as Down syndrome, Alpost syndrome, Marfan syndrome and Ehlers-Danlos syndrome. Corneal cone can appear as a complication associated with allergies and atopy, as well as in several other cases.

All other corneal diseases – congenital corneal pathologies, dystrophic diseases, corneal scars – also prevent laser correction of vision defects.

Third, hold off on laser vision correction when a young person is diagnosed with an autoimmune disease, such as Hashimoto’s disease, type 1 diabetes, rheumatoid arthritis (RA) or allergy or atopy. Autoimmune diseases like to manifest themselves precisely during adolescence. Precise diagnosis and proper “management” of such diseases by specialists promotes stabilization and remission of symptoms. It is during the remission period that an ophthalmologist MAY decide to perform laser vision correction. However, we have to reckon with the fact that if such a “wicket in time” cannot be created that would give laser surgery a chance, we will have to look for another method of treatment.

Indeed, in the case of autoimmune diseases, over-reactivity of the immune system or significant immune deficiencies, increased intrathecal inflammation, endocrine disruption and, consequently, problems with wound healing are registered.

So if you feel like gifting your child a laser vision correction procedure for, say, his 18th birthday, first take him to a good ophthalmologist – only he will be able to make a decision about the procedure.