LASIK in Seattle: Candidacy, Cost, Recovery and How to Choose a Surgeon

What LASIK does

The FDA describes LASIK as a procedure meant to reduce your dependence on glasses or contact lenses. It permanently reshapes the cornea with an excimer laser after a flap is cut, either with a blade called a microkeratome or with a laser (FDA).

According to the AAO, LASIK treats nearsightedness, farsightedness and astigmatism. It cannot correct presbyopia, although some people choose monovision instead (AAO).

Who qualifies, and who should think twice

The FDA's page When is LASIK not for me? says you are probably not a good candidate if:

• You are not a risk taker.
• LASIK could jeopardize your career.
• Cost is an issue, since most medical insurance won't pay for it.
• Your prescription has changed in the past year.
• You are under 18. No lasers are approved for LASIK in people under 18.
• You have blepharitis or dry eyes, or you've had refractive surgery before.

The FDA adds that some groups are more likely to have an unstable prescription: people in their early 20s or younger, people with hormone changes from conditions such as diabetes, people who are pregnant or breastfeeding, and people taking medicines that can change vision. It also lists diseases or medications that affect wound healing as a reason LASIK may not be suitable (FDA).

The AAO says your prescription shouldn't have changed much in the last year and your corneas must be thick enough and healthy. Severe dry eye or a history of certain eye infections can rule you out. Its questions-to-ask page also names uveitis or other eye inflammation and past eye injuries or surgeries, notes that vision can change after age 40 to 45, and points out that not everyone ends up with 20/20 vision.

What LASIK costs

Expect to pay yourself: the FDA lists cost as a reason LASIK may not be for you, because most medical insurance won't cover it. We could not find a published Seattle price. The national figures below come from an industry group and from businesses that sell LASIK, financing or LASIK information, and they don't agree.

The sources use different methods, and several don't show when their figures were collected. Treat them as a rough frame for reading quotes, not as what a Seattle practice should charge.

What to ask about any quote

• Is the price per eye or for both eyes?
• Does it include the pre-surgery evaluation?
• Which laser will be used, and is the flap made with a blade or a laser?
• Which follow-up visits are included, and for how long? The FDA advises regular visits for at least six months.
• If you need further treatment later, is it included, and if not, what does it cost?

HSA, FSA and financing

We haven't verified the IRS rules on whether LASIK counts as an eligible expense, so check with your HSA or FSA administrator before you plan around it. Financing companies such as CareCredit offer LASIK financing and publish their own cost figures; compare the interest rate and repayment terms as you would for any loan.

Before, during and after surgery

1. Stop contact lenses earlyThe FDA says to stop wearing soft contact lenses 2 weeks before your evaluation and hard lenses at least 4 weeks before.
2. Expect detailed measurementsFDA-approved labeling for one laser says pupil size in dim light and dry eye should be checked first, and vision should have been stable for at least a year.
3. Skip eye makeupThe FDA advises no eye makeup from one day before surgery until two weeks after.
4. Line up ridesThe FDA says to arrange a ride to surgery and to your first follow-up visit.
5. Surgery dayThe FDA says the operation should take less than 30 minutes.
6. Follow-upSee your doctor within 24 to 48 hours, then regularly for at least six months. Vision may fluctuate for the first few months.

These steps come from the FDA's page on what to expect before, during and after surgery. Your surgeon's own instructions take priority.

Risks to understand before you sign

The FDA has issued draft guidance saying LASIK patient labeling should clearly describe risks such as dry eye, pain and discomfort, and visual symptoms (AAO). FDA-approved patient labeling for one laser lists these risks (FDA):

• The blade could cut completely through the cornea, which could lead to fluid loss from the eye, cataract or infection.
• Pain may last up to 7 days.
• LASIK may make dry eye worse.

Labeling for another laser, the MEL 90, notes that the eyelid may droop after LASIK and that corneal thinning may affect future cataract surgery (FDA). Keep your surgical records for any eye surgeon you see later.

Ask your surgeon for the patient labeling of the specific laser they'll use, and check that the laser appears on the FDA's list of approved LASIK lasers on its LASIK site.

Comparing Seattle LASIK practices

We couldn't confirm from official pages which Seattle hospital systems offer LASIK, so ask any practice directly. Whoever you consider, the same checklist works:

1. Look up the surgeon's Washington license and any disciplinary actions on the Department of Health Provider Credential Search.
2. Confirm ophthalmology board certification with the American Board of Ophthalmology's free search.
3. Ask which laser they use and check that it's on the FDA's list of approved LASIK lasers.
4. Work through the FDA's checklist of questions to ask your doctor.
5. Ask whether they'll measure corneal thickness, pupil size and dry eye before deciding, and what result would make them say no.
6. Ask who handles your follow-up visits and whom you call after hours.
7. Get the full price in writing, per eye or for both eyes, with what's included.

Our guide to checking an eye surgeon walks through the license and certification lookups step by step.