LASIK Consultation and Co-Management
LASIK Consultation and Co-Management in Phoenix
We want to be precise about this, because a lot of optometry websites are not. Laser vision correction is surgery, it is performed by ophthalmic surgeons, and an optometrist does not do it.
What an optometrist does is the assessment before and the care afterward, and both matter a great deal. The candidacy evaluation determines whether surgery is a good idea for you at all, and the post-operative care is where complications are caught and healing is monitored.
The useful thing about getting that evaluation here is that we have nothing to sell you. A surgical centre evaluating your candidacy is also the business that benefits if you proceed. We are not, and we will tell you plainly when we think you should not have it.
The procedures, briefly
- LASIK
- A thin flap is created in the cornea, tissue underneath is reshaped with a laser, and the flap is replaced. Fast visual recovery and little discomfort. Requires adequate corneal thickness and a regular corneal shape.
- PRK
- The surface epithelium is removed and the cornea reshaped directly, with no flap. Recovery is slower and more uncomfortable, and the end result is comparable. Often the better choice for thinner corneas and for people in contact sport or occupations with eye injury risk, since there is no flap to displace.
- SMILE
- A small lenticule of tissue is removed through a tiny incision. No flap and less disruption to corneal nerves, which may reduce post-operative dry eye. Suitable for a narrower range of prescriptions.
- Implantable collamer lens
- A lens implanted inside the eye rather than reshaping the cornea. The main option for high prescriptions and thin corneas that rule out laser procedures. Reversible, which laser reshaping is not.
- Refractive lens exchange
- The eye's natural lens is replaced with an implant, essentially cataract surgery before a cataract. Often the right answer for presbyopic patients over about fifty.
What makes a good candidate
- A stable prescription, unchanged for at least a year, ideally two
- Age eighteen or over, and in practice usually mid-twenties or later once the prescription has settled
- Adequate corneal thickness for the amount of correction needed
- A regular corneal shape with no sign of keratoconus or thinning, which is the single most important screen
- Healthy eyes with no significant dry eye, uncontrolled glaucoma or active disease
- Not pregnant or nursing, since hormones shift the prescription temporarily
- Realistic expectations about what the surgery will and will not do
When we advise against it
This is the part of the conversation that is genuinely worth having with someone who is not selling the procedure.
The most important screen is corneal topography looking for early keratoconus or corneal thinning. Laser surgery on a cornea with undetected early ectasia can trigger progressive corneal weakening that is very difficult to manage. This is exactly why topography is not optional, and it is a scan we run as standard.
We also advise caution with significant untreated dry eye, since LASIK temporarily worsens it and a marginal tear film beforehand can become a real problem afterward. Treating the dry eye first often changes the outcome. And we will say when a prescription is still moving, because operating on a moving target produces a result that drifts.
What we actually do
- Independent candidacy evaluation
- Full examination, corneal topography, corneal thickness measurement, tear film assessment and prescription stability review. An honest opinion with no interest in the answer.
- Surgeon referral
- We refer to surgeons we know and would send our own families to, and we match the procedure and surgeon to your specific eyes rather than to whoever advertises most.
- Pre-operative preparation
- Contact lens discontinuation for the right period beforehand, since lenses reshape the cornea and distort surgical measurements. Treating any dry eye first.
- Post-operative care
- The follow-up visits after surgery, monitoring healing, managing dry eye which is very common early on, and catching complications. Done here rather than requiring drives back to a surgical centre.
- Long-term follow-up
- Annual exams afterward. A post-surgical eye still needs monitoring, and it changes some things about how future measurements are interpreted, including cataract surgery calculations years later.
Realistic expectations
Modern laser vision correction has a strong safety record and most patients are very satisfied. That is a fair summary and it should not be inflated.
Some honest caveats. Surgery corrects the prescription you have now, and it does not stop presbyopia, so you will still need reading glasses in your forties. Dry eye is common for months afterward and occasionally longer. Night-time glare and halos occur, usually improving over months. Enhancement procedures are sometimes needed. And a small number of patients do not reach complete spectacle independence.
None of that is a reason not to have it. It is a reason to go in with accurate expectations, which is a large part of what determines whether a patient describes an outcome as excellent or disappointing.
Who this is for
- Anyone considering LASIK, PRK, SMILE or an implantable lens
- People who want an independent opinion before a surgical consultation
- Patients told elsewhere they are not a candidate who want a second assessment
- Anyone who has had refractive surgery and needs ongoing care
- Patients who had surgery years ago and now have changing vision
Our process
Every patient goes through the same sequence, so you always know what happens next.
- 1
Comprehensive evaluation
Full examination, refraction and prescription stability review.
- 2
Corneal topography and thickness
Mapping and measurement to screen for keratoconus and confirm adequate tissue. The most important part of candidacy screening.
- 3
Tear film assessment
Because untreated dry eye materially worsens the post-operative experience and is better treated first.
- 4
Honest candidacy discussion
Whether you are a good candidate, which procedure suits your eyes, and the realistic outcome. Including advising against it where appropriate.
- 5
Surgeon referral and preparation
Referral with your full records, and pre-operative instructions including contact lens discontinuation timing.
- 6
Post-operative care
Follow-up visits here, monitoring healing and managing dry eye, with ongoing annual care afterward.
Related care
- Ortho-KOrtho-K lenses reshape your cornea overnight so you see clearly all day without glasses or contacts. Fitted in Phoenix by optometrists doing this since the 1990s.
- Dry EyeBurning, gritty, watery or tired eyes in the Phoenix desert climate. We diagnose the actual cause of your dry eye and treat it, rather than handing you drops.
- Cataract Co-ManagementCataract evaluation, lens implant guidance and post-operative care in Ahwatukee, so recovery visits happen close to home rather than across the valley.
LASIK Consultation and Co-Management questions, answered
Do you perform LASIK?
No. LASIK is performed by ophthalmic surgeons. We provide the candidacy evaluation, the referral, and the pre and post-operative care. Any optometry practice claiming to perform LASIK is describing co-management inaccurately.
Why get evaluated here rather than at the surgical centre?
Because we have no financial interest in the answer. A surgical centre is also the business that benefits if you proceed. We will tell you when we think surgery is a poor idea for your eyes, and that is a more useful opinion precisely because we do not sell it.
What if I am not a candidate?
There are usually alternatives worth discussing. Orthokeratology gives glasses-free daytime vision without surgery and is fully reversible. Implantable lenses work where corneal thickness rules out laser procedures. Modern contact lenses handle prescriptions people assume they cannot. Not a candidate for LASIK is not the same as out of options.
Will I still need reading glasses after LASIK?
Yes, eventually and unavoidably. Presbyopia is the lens inside your eye stiffening with age, and corneal surgery does not affect it. If you are over forty, this is an important part of the conversation, and monovision or a lens-based procedure may suit you better.
How long is the recovery?
For LASIK, most people see well within a day and return to normal activity quickly, with healing continuing for months. PRK takes several days of genuine discomfort and blurred vision, with visual recovery over weeks. We schedule your follow-up visits around whichever procedure you have.
Is dry eye after LASIK permanent?
Usually not. The procedure disrupts corneal nerves, which reduces tear production signalling, and most patients improve substantially over three to six months. A minority have longer-lasting symptoms. Having healthy tear film before surgery is the best predictor, which is why we assess and treat it first.
Book an appointment with a doctor who has time for you
We schedule 2 patients an hour, so your exam is unhurried and your questions get answered. Most patients are seen within a few days.