Candidacy & the eye exam

What “being a candidate” really means

Being a candidate does not mean a procedure is right for you just because you want less dependence on glasses or contacts. It means a licensed ophthalmologist has examined your eyes and thinks the likely benefits may outweigh the risks for you.

This matters because the same prescription can lead to different answers in different people. One person may be a reasonable LASIK candidate. Another may be safer with PRK, SMILE, an implantable lens, cataract or lens surgery, or no surgery at all.

A careful surgeon is not trying to talk everyone into surgery. In fact, many people are not good candidates. An honest exam may end with:

• yes, one procedure may fit your eyes better than others
• maybe, but more testing or time is needed
• not now, because your prescription or eyes are still changing
• no, because the risks are too high

That is normal. Saying no can be the safest answer.

If you are still learning the basics, our service overview can help you compare common options. If you want to speak with surgeons near you, you can get matched at no cost. Sightlume is only a free matching service. We do not do exams, diagnose eye conditions, or tell you which surgery to choose.

What the eye exam usually checks

A candidacy exam is more than reading letters on a wall. The surgeon and staff usually measure several things to see whether surgery may be safe and whether one procedure makes more sense than another.

Common parts of the exam include:

1. Your prescription and whether it is stable
They look at nearsightedness, farsightedness, and astigmatism, and whether your prescription has been changing. If it is still moving, surgery may be delayed.

2. Corneal thickness and shape
For procedures like LASIK, PRK, and SMILE, the cornea must have enough healthy tissue and a normal shape. Thin corneas or suspicious maps can make laser surgery a poor choice.

3. Pupil size and night-vision concerns
Large pupils do not automatically rule out surgery, but they can matter when discussing glare, halos, and night driving symptoms.

4. Tear film and dry-eye signs
Dry eye before surgery matters. Surgery can sometimes make dryness worse, at least for a period of time, and in some people symptoms can last longer.

5. Overall eye health
The exam may look for cataracts, retinal problems, corneal disease, glaucoma concerns, inflammation, or other issues that can affect safety and results.

6. Your age and focusing needs
If you are around the age when reading vision starts changing, the conversation may include presbyopia and the fact that surgery may not remove the future need for reading glasses.

7. Your goals and daily life
A good surgeon asks what you actually want. Better sports vision? Less dependence on contacts? Better distance vision? The right answer depends on your job, hobbies, and tolerance for tradeoffs.

The exam is also the time to talk honestly about risks. These can include dry eye, glare, halos, starbursts, under-correction, over-correction, regression, infection, inflammation, flap complications with LASIK, slow healing with PRK, and rare loss of vision. Results vary from person to person. For a fuller risk overview, read LASIK risks and side effects.

Who is often not a good candidate

There is no single rule, but some situations make surgery less likely or mean more caution is needed.

You may be told not now or no if you have:

• a prescription that is still changing
• corneas that are too thin, irregular, or suspicious for weakening disorders
• significant dry eye symptoms or poor tear quality
• active eye disease or infection
• uncontrolled health conditions that may affect healing
• cataracts or age-related lens changes that make corneal laser surgery a poor fit
• expectations that surgery cannot realistically meet

You may also hear that a different procedure is worth discussing. For example:

• Someone who is not a good LASIK candidate might still be considered for PRK.
• Someone with a high prescription or thin corneas may ask about implantable lens options such as ICL.
• Someone with early cataract changes may need a lens-based discussion instead of corneal laser surgery.

None of that means surgery is safe or recommended for you. It only means the conversation can be more complex than a simple yes or no.

Be careful with marketing that makes everyone sound like an easy candidate. Real candidacy is individual. Many people do best by waiting, keeping glasses or contacts, or deciding the tradeoffs are not worth it. That is a valid choice.

Questions worth asking at the consultation

Bring questions. You are not being difficult. You are making an important decision.

Useful questions include:

• Which procedures do you think fit my eyes, and why?
• Why are you not recommending the other options?
• What specific risks matter most in my case?
• Do you see signs of dry eye, thin corneas, irregular corneal shape, or anything else that raises concern?
• What kind of vision changes might still leave me needing glasses, contacts, or reading glasses?
• If my result is under-corrected or over-corrected, what happens next?
• What is the recovery usually like for this procedure, and how long before work, driving, exercise, or screen time feel normal?
• What does the total price usually include, and what might cost extra?

Also ask yourself a few questions:

• Do I feel rushed?
• Were the risks explained clearly, not minimized?
• Did they answer in plain language?
• Did they seem willing to say no if I am not a good candidate?

You have every right to compare consultations before deciding. Our guide on how to choose an eye surgeon can help you evaluate the conversation, not just the sales pitch.

What to do next

If you are thinking about vision-correction surgery, a practical next step looks like this:

1. Learn the main options
Understand the difference between LASIK, PRK, SMILE, ICL, and lens surgery. They are not interchangeable.

2. Expect a real exam, not a promise
No website, quiz, ad, or phone call can tell you for sure that you are a candidate.

3. Compare more than one consultation if you can
Especially if one office feels rushed or makes the decision sound too easy.

4. Review price as a range, not a guarantee
Typical US costs are often around $2,000-$3,000 per eye for LASIK, $1,800-$2,800 per eye for PRK, $2,200-$3,200 per eye for SMILE, and $3,000-$5,000 per eye for ICL. Both eyes are usually about double. These are estimates, not quotes. The real price depends on the procedure, your eyes, the technology used, and your area. Surgery is rarely covered by insurance. You can read more on costs.

5. Take your time
It is OK to wait. It is OK to keep glasses or contacts. No surgery should happen until you understand the tradeoffs.

If you want help finding licensed eye surgeons for consultations near you, Sightlume can get you matched for free. We only collect contact details like your name, phone, email, ZIP code, preferred language, and which procedure you are curious about. We do not collect medical history or health records.

This page is general educational information, not medical advice. Only a licensed eye surgeon, after an in-person exam, can tell you whether you are a candidate and what may be appropriate for your eyes.