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

According to the American Academy of Ophthalmology (AAO), LASIK is done in an outpatient surgery center or an ophthalmologist's office. This guide doesn't tell you whether to have it. It sets out what the FDA and the AAO say about candidacy, risks and recovery, and it gives you a way to compare California practices on more than price.

Who is a good candidate, according to the FDA

The FDA lists four situations in which you are probably not a good candidate for refractive surgery:

• You're not a risk taker. Some complications can't be avoided in a percentage of patients, and there is no long-term data for current procedures.
• It could put your career at risk. Some jobs and military services ban certain procedures.
• Cost is a problem. Most medical insurance does not pay for refractive surgery.
• Your glasses or contact lens prescription changed in the past year.

The FDA adds that people in their early 20s or younger, and people who are pregnant or breastfeeding, are more likely to have an unstable prescription. It also flags blepharitis, which raises the risk of corneal infection or inflammation; previous refractive surgery such as RK, PRK or LASIK; and dry eye, which LASIK tends to make worse. One example of FDA device labeling was indicated for patients 21 or older whose prescription had been stable over the prior year.

Conditions the AAO highlights

The AAO's LASIK page lists people who may not be candidates: those with severe dry eye, corneal scars or disease, keratoconus, advanced glaucoma, or a cataract affecting vision. If you hear any of these at a screening, our guide to SMILE, PRK and ICL explains how official sources describe the alternatives. Only an exam can tell you which, if any, fits your eyes.

What LASIK costs and what drives the price

We haven't verified current California prices, so we don't publish a number here. The only figures we found came from an older AAO article, and they're too dated to use as a guide to today's prices.

Two facts from the FDA do apply. Most medical insurance does not pay for refractive surgery, so you should plan on paying yourself unless your plan documents say otherwise. And the FDA advises against choosing a doctor based on cost alone.

Questions to ask about any quote

• Is the price per eye or for both eyes?
• Does it include the screening exam and all follow-up visits? The AAO says follow-up usually continues for 6 months or more.
• What happens, and what does it cost, if I still need glasses or contacts afterward? The FDA lists this among the labeled risks.
• Which laser will be used, and can I read the manufacturer's patient handbook?
• Are medications, eye drops or eye shields billed separately?

HSA, FSA and financing

Many people ask whether a health savings account (HSA) or flexible spending account (FSA) can pay for LASIK. We haven't yet verified the IRS rules on this, so confirm with your plan administrator before you count on it. If a practice offers financing, ask for the interest rate, the term and the total you'll repay, in writing.

Recovery: what official and hospital sources describe

The AAO also notes that blurry or changing vision can last weeks or months. Your surgeon's instructions take priority over any general timeline, including the ones above. The AAO recovery page and Kaiser Permanente's at-home guide are worth reading before surgery day.

Risks listed on every LASIK laser label

In a 2012 letter to the AAO, the FDA noted that the approved labeling for every laser approved for LASIK lists these risks:

• Dry eye, which can be severe
• Possibly still needing glasses or contact lenses
• Halos, glare, starbursts and double vision, which can be debilitating
• Loss of vision

The FDA adds that some patients develop glare, halos or double vision that can seriously affect night vision, and that dry eye can make vision blurry on and off. The AAO lists eye pain, glare, double vision and light sensitivity among the risks, with infection and blindness as rare ones. It also reports that in the 2016 Modern LASIK Outcomes study, 99.5% of eyes saw 20/40 or better, while a small number of patients have lasting side effects.

A checklist for comparing California practices

1. Verify the licenseLook up the surgeon in the Medical Board of California's license search, or with the Osteopathic Medical Board of California if they're a DO.
2. Compare more than one practiceThe FDA advises against settling for the first center or doctor you look into.
3. Ask where surgery happensThe AAO says LASIK is done in an outpatient surgery center or the ophthalmologist's office. Ask which applies to you.
4. Ask about your own risk factorsAsk how your corneas, tear film and prescription history affect your candidacy, and whether another procedure might suit you better.
5. Read the patient handbookThe FDA recommends reading the device manufacturer's patient handbook before you decide.
6. Get it in writingAsk for the total price, what it covers and the follow-up schedule before you commit.

Our step-by-step license-check guide shows how to read the Medical Board's results, and the referrals and insurance guide covers how to check what your plan will and won't pay.