Since its development in the 1960s, lasers have played a crucial role in medicine. The term “laser” is an acronym for “Light Amplification by Stimulated Emission of Radiations,” coined by American physicists and Nobel Laureates Charles Townes and Arthur Leonard Schawlow. Ophthalmology was the first medical field to harness the therapeutic potential of lasers. The inaugural laser eye treatment, employing a ruby laser to address ocular lesions, occurred just a year after its 1960 inception.
In contemporary times, laser eye surgery is commonly associated with correcting refractive errors. However, lasers are employed to address various vision-threatening conditions. While there is no specific age limit for using lasers in eye treatments, the Food and Drug Administration (FDA) has set 18 as the minimum age criterion for individuals seeking to eliminate the need for glasses. This procedure, known as LASIK (Laser-Assisted In Situ Keratomileusis) or laser vision correction, has gained widespread acceptance.
In eye treatments, lasers are generally used to photoablate the targeted eye tissue. This involves using laser light to either reshape the tissue or seal off a leaky spot in the eye. Consequently, the indications for laser treatment are diverse. We recommend consulting with the best eye surgeon to make an informed decision about your treatment.
Laser treatments on the eyes induce irreversible changes, necessitating eye surgeons to ensure both good eye health and awareness of any underlying medical conditions. Providing a comprehensive medical history during your eye consultation is crucial. Regarding age considerations, the US FDA approves 18 years and older as the ideal age for undergoing laser eye surgery. However, laser treatment has been indicated in infants for different reasons.
Understanding why age is a vital factor in laser eye surgery is essential. Typically, children between 5 and 15 years of age develop eye conditions, particularly myopia or a minus number. This condition is often linked to excessive near work, especially prolonged screen time. During this age range, children are exposed to increased near work due to school, college, and general interaction with electronic devices. Consequently, myopia tends to progress every six months or yearly, a phenomenon known as myopia progression. This progression occurs due to a stimulus from the brain to the eyeball to elongate as the child grows in height or due to defocus on the peripheral retina.
Performing laser eye surgery on a child to correct eye conditions at a younger age may result in the recurrence of numbers. It is not advisable to conduct multiple laser corrections. Between the ages of 16 and 18, the numbers typically stabilize, and by the age of 18, most individuals have a stable prescription. Therefore, age stands as one of the most crucial criteria in determining candidacy for LASIK. Consequently, using contact lenses until the age of 19 is generally recommended for children insistent on being glasses-free until they become eligible for LASIK.
Understanding the correlation between age groups and laser eye treatment is crucial for tailoring interventions to specific needs. Let’s explore the nuances within each age bracket:
In this age group, indications for laser surgeries depend on the eye diseases that the children have. A retinal condition known as Retinopathy of Prematurity (ROP), caused by premature delivery of babies with low birth weight, results in abnormal formation of retinal blood vessels. This, in turn, leads to oxidative stress and the development of weak blood vessels. There is also a risk of retinal detachment. Thus, to salvage the vision of infants, laser photocoagulation is performed.
The US FDA has approved refractive surgeries for individuals aged 18 and above, precisely for those in this age group seeking freedom from glasses and contact lenses. Although FDA-approved, many surgeons often wait until individuals are in their early 20s to ensure that their glasses prescription has stabilized.
This age group predominantly undergoes the highest number of laser vision correction surgeries as they are mature enough to make informed decisions about their eyes, staying well within the age limits for laser eye surgery. The advantage is that, once LASIK is performed in this age group, they enjoy nearly 20 years of glasses-free vision until they reach 40 and begin to require reading glasses. One must exercise caution regarding candidacy for surgery, especially in females, as laser eye surgeries are contraindicated during pregnancy. This age group also sees a prevalence of high myopic prescriptions, increasing the likelihood of retinal breaks and lattice degeneration. Consequently, individuals in this age group often undergo retina laser surgeries.
This age group experiences the onset of presbyopia, characterized by the need for reading glasses. Therefore, undergoing laser vision correction may prove counterintuitive, as LASIK addresses distance vision while near glasses still remain. Some may consider this age group as the upper limit for laser vision correction; however, it is a subjective perspective, and certain patients are adamant about being glass-free. Consequently, some surgeons may opt for monovision correction in these patients to achieve a glasses-free state. In monovision, the surgeon corrects one of your eyes, usually the dominant eye for distance and the other eye for near vision. Beyond vision correction, individuals in this age group are also vulnerable to systemic diseases leading to ocular complications, which may require laser treatment. Many patients in this age group choose lens-based surgery, known as clear lens extraction. This procedure is essentially a cataract surgery performed before cataracts develop. It involves removing the clear natural lens inside the eye and replacing it with an artificial lens designed to provide freedom from glasses.
Individuals in this age group are commonly diagnosed with diabetes, hypertension, and possibly other systemic conditions that have ocular complications. The most frequently reported conditions include diabetic retinopathy, hypertensive retinopathy, and retinal vein/artery occlusions, leading to hemorrhages in the eye and causing visual disturbances. As a result, retinal laser photocoagulation is a common procedure in this age group.
As discussed earlier in the article, while lasers can be done on almost all the age groups, the implications depend on various factors rather than just one factor. Few important factors on which laser treatment is recommended are:
1. How does age affect the outcome of laser eye treatments?
Ans: There are certain physiological changes that occur in the eye, which may affect the final outcome after laser eye treatment. Hence, age is one of the most important factors to consider when contemplating laser eye surgery.
2. What is the age limit for laser eye treatment?
Ans: The FDA approves laser eye surgeries for individuals aged 18 and above, specifically for laser vision correction. However, there is no set age limit for using lasers to treat other vision-threatening eye conditions.
3. Who should not have laser eye surgery?
Ans: Individuals under the age of 18 years, those with insufficient corneal thickness, underlying corneal diseases, underlying retinal conditions, and pregnant females are contraindicated for laser eye surgery.
4. Can a 70-year-old get LASIK surgery?
Ans: Medically, there are no restrictions on performing LASIK in a 70-year-old; however, individuals undergo LASIK to become glasses-free, and at 70, they typically use reading glasses. LASIK can only eliminate distance correction, leaving individuals with their reading glasses. Additionally, the prescription may not remain stable in the elderly due to the progression of cataracts. These are personal considerations for someone in their 70s considering LASIK surgery.
5. Can you get LASIK twice?
Ans: There have been reports of LASIK retreatments done after a particular period following the first one. However, one must take into consideration the corneal thickness before and after the first LASIK surgery.
6. Which eye surgery is best?
Ans: The ideal surgical procedure will depend on an individual’s personal needs, expectations, and, of course, the age at which they choose to undergo laser eye surgery.
7. Are LASIK touch-ups safe?
Ans: Firstly, the likelihood of LASIK touch-up or enhancement is small. Still, in case one needs LASIK touch-ups, it is possible and has been reported with a good success rate.
8. Can LASIK cure myopia?
Ans: LASIK is merely a correction of myopia and not a cure. This means LASIK is a treatment that neutralizes myopia by reshaping the cornea. A cure for myopia has not yet been discovered.
HI