Surgical Co-Management · Refractive
LASIK Co-Management screening, referral and the post-op months.
LASIK reshapes the cornea under a hinged flap. Patients usually ask their own eye doctor first whether they qualify, and the answer depends on findings your practice already measures: refractive stability, corneal shape, tear film and pupil size.
Quick answer
The screening exam is where co-management starts.
FDA lists a changed prescription in the past year, disease or drugs that slow healing, contact sports, and being under 18 as reasons LASIK may not be right. It also asks doctors to screen for blepharitis, large pupils, thin corneas, prior refractive surgery and dry eye. Most of that is routine data in a comprehensive exam, which makes the referring practice the natural first filter.
Key takeaways
- Confirm refractive stability with your own records.
- Treat blepharitis and dry eye before topography and wavefront.
- Flag keratoconus suspects for tomography before any laser referral.
- Explain that LASIK does not fix presbyopia.
- Agree on the post-op visit schedule with the surgeon in advance.
Screening points and where they come from.
A short list your team can run before sending the patient for a surgical consult.
| Finding | Why it matters | Source |
|---|---|---|
| Prescription changed in the past year | Refractive instability; higher risk in the early 20s, pregnancy and fluctuating diabetes | FDA |
| Autoimmune disease, immunodeficiency, retinoids or steroids | Can affect wound healing | FDA |
| Blepharitis or dry eye | LASIK tends to aggravate dry eye | FDA |
| Large pupils | Glare, halos, starbursts and ghost images in dim light | FDA |
| Thin cornea or keratoconus | Raises complication risk; consider other procedures | FDA, NEI |
| Glaucoma, cataract, ocular herpes | Raise the risk of complications | NEI |
What post-op LASIK care covers.
NEI lists dry eye, glare, halos, double vision, blur and light sensitivity as common side effects that usually fade within months.
- Early flap check
- Dry eye management
- Refraction once stable
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Flap and interface
Look for flap position, debris, inflammation and infection at early visits.
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Ocular surface
Manage dryness actively; FDA warns some patients develop severe, sometimes permanent dry eye.
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Refractive outcome
Under- or over-correction can leave a need for glasses or an enhancement.
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Long term
Presbyopia still arrives; patients will need near help later.
Give every LASIK candidate the FDA risk list in writing before referral. The FDA advises patients to be wary of 20/20 guarantees and package deals, and a practice that says so earns trust either way.
RescueLink
Dry eye before and after laser vision correction.
LASIK tends to aggravate dry eye, and severe cases can persist. When the surgeon clears it, send patients an eligible over-the-counter list of preservative-free drops, lid care and night protection through RescueLink. Your practice earns a 15% participation credit on eligible OTC orders on VisionRescue.com.
- No setup fee, subscription or quota
- One-tap ordering for the patient
- Optional auto-ship on recurring items
- Contact lenses and prescription products are excluded
Frequently asked questions
Is there an age minimum?
Yes. FDA states that no lasers are currently approved for LASIK on people under 18.
Does insurance cover LASIK?
FDA notes most medical insurance does not cover it, so cost is a common barrier.
Can LASIK correct presbyopia?
NEI states LASIK can't fix presbyopia; monovision is an option FDA says patients should trial first.
Is same-day bilateral LASIK riskier?
FDA says having both eyes treated the same day is riskier than two separate surgeries.
Who sets the co-management fee?
LASIK is elective and usually self-pay, so the surgeon and co-managing doctor each bill for the services they provide. See the refractive co-management guide.
References
- FDA. When is LASIK not for me? FDA
- FDA. What are the risks and how can I find the right doctor for me? FDA
- FDA. LASIK. FDA
- National Eye Institute. Surgery for refractive errors. NEI
- Every source behind this guide is listed on the Vision Rescue sources page. All sources
About this guide
Written for licensed eye care practices by the Vision Rescue team from manufacturer, FDA, CMS and peer-reviewed sources. Questions: providers@visionrescue.com or 1-855-692-8024.
Important notes and disclosures
Information only. Candidacy, technique and outcomes are decided by the operating surgeon. Refractive surgery fees and co-management arrangements must follow federal and state law. Vision Rescue is a licensed pharmaceutical wholesale distributor.
Be the first, honest filter.
Screen with data you already collect, treat the surface, and refer the patients most likely to do well.
Device and procedure names are trademarks of their respective owners. See the FDA patient information for each approved laser.