Preparing for LASIK: Contact Lenses, Medication and the Day Itself

The assessment is the appointment that matters

Preparation starts before treatment day, with the assessment, and the most common way to waste an assessment is to arrive having worn contact lenses up to that morning. Contact lenses sit on the cornea and press it into a slightly different shape; the cornea takes time to return to its own shape, and until it does, the measurements that decide eligibility and the treatment plan are describing a cornea that is not quite yours.

The same appointment is where the plan is actually agreed: which technique, which eye first, what the quote includes, and what the follow-up schedule will be. Treat it as a decision appointment rather than a test you pass or fail.

Contact lenses: stop them before the assessment

How long you need to leave them out depends on the type of lens and how long you have worn them: soft lenses are usually measured in days, rigid gas-permeable lenses in weeks. Your clinic will give you a specific number for your lenses, and it is a question worth asking when you book rather than on the day.

The reason is worth understanding, because it explains why the instructions are firm. Topography and pachymetry measure the curvature and thickness of the cornea, and both are distorted by a lens moulding the surface. A cornea that still bears the imprint of a lens can look thinner or more irregular than it is, which can either rule out a procedure that would have been suitable, or, worse in the other direction, make an unsuitable eye look acceptable.

What to tell the clinic

Bring a list rather than a memory. The clinic needs to know about anything that affects healing, bleeding, the tear film or the measurement of the eye, and a short list of the categories is enough to work from.

• All medication, including things you do not think of as medicine: blood thinners, acne treatments such as isotretinoin, hormone treatments, and any supplements you take regularly.
• Eye history: previous laser surgery or other eye surgery, injuries, recurrent infections, a scratched cornea, or a family history of keratoconus.
• Other conditions: diabetes, autoimmune conditions, uncontrolled high blood pressure, and any condition that affects how you heal.
• Pregnancy, breastfeeding or plans for either in the near term, because the refraction is not stable enough to treat during that period.
• Your own expectations: what you want to be able to do without glasses afterwards, including reading and night driving. It shapes the technique and sometimes the answer.

The days before treatment

The clinic will give you a schedule of drops to start, usually an antibiotic, and possibly a lubricant. Beyond that, the practical arrangements are what make the day uneventful.

• Arrange transport. You will not be able to drive home, and for the first night the less you have to organise the better.
• Arrange the time off. Ask the clinic for a realistic date rather than estimating from what someone else experienced, and remember that the recovery differs between techniques.
• Rest your eyes the day before. Not a medical requirement; it just means an eye that is not already dry and strained on the day.
• Shop for the drops, or check what is included. If the clinic's quote covers medication, that is one less errand; if not, you want it in the house before you are using it.
• Plan the first evening. Something undemanding and a dark room are more useful than a plan to work late.

On the day itself

The clinic will tell you what to do about food, and any instruction they give overrides the general pattern. In most cases a light meal beforehand is fine, the procedure does not require fasting, and coffee is usually discouraged simply because it is a stimulant and you are about to sit under a microscope holding your eye still.

Arrive with a face free of makeup, no perfume or scented products, no contact lenses, and your medication list. Makeup around the lashes is a source of particles and bacteria at exactly the wrong place, and perfume droplets carry the same problem into the treatment room. Wear comfortable clothes, and expect the preparation to take longer than the treatment.

The procedure itself is with drops rather than an injection, so you are awake and can follow instructions. The eye is held steady by a suction interface for the part where the laser works, which is the part people describe as the strangest: pressure, and vision dimming for a short period. You will be asked to look at a light and to keep still, and the surgeon tells you what is happening as it happens.

The first night

The eye is often scratchy, watery and light sensitive for the first few hours after any of these procedures, and this is expected rather than a complication. What helps is unremarkable: the drops on the schedule, the lubricants, a darkened room, and rest. Some clinics ask you to wear a protective shield or clear goggles for the first nights, which is partly to stop you rubbing the eye in your sleep.

Vision on the first evening is usually not what it will be, and judging the result that night is pointless. Most people are surprised by how much better the next morning is, and by how much it still fluctuates in the weeks after that.

Preparation questions, answered

Each question below opens the page that answers it in full, where the long version of the answer is. The direct answer is printed here so you can tell whether it is the question you are asking.

• How long should I stop wearing contact lenses before an eye examination?

  Soft lenses are usually stopped for a few days before an assessment and rigid lenses for considerably longer, because contact lens wear changes the shape of the cornea and can make the measurements wrong.

• What tests are needed before LASIK?

  Before LASIK, the assessment usually includes refraction, corneal topography and tomography, measurement of corneal thickness, an assessment of the tear film and ocular surface, eye pressure, and a retinal examination with dilated pupils.

• What medications should I tell my eye doctor about?

  Tell the clinic about all of them, including anything bought over the counter and any supplements, with particular attention to blood thinners, acne medication such as isotretinoin, and medication for diabetes or autoimmune conditions.

• What should I bring to an eye consultation?

  Bring your current glasses or the prescription for them, any contact lens details including the type and how long you wear them, a list of your medications, and any previous eye records or scans.

• How should I prepare for laser eye surgery?

  Preparation is mostly about stopping contact lenses for the period you were given, arranging not to drive home, following any instructions about makeup, perfume and medication, and having someone available afterwards.

• Can I eat before laser eye surgery?

  Eating normally is usually fine before laser vision correction, because sedation is rarely used. If your clinic plans to use sedation, it will give you fasting instructions, and those take priority.

• Can I drink coffee before laser eye surgery?

  Tea and coffee are not usually restricted before laser eye surgery. If you are taking anything to help you relax, or if your clinic has advised otherwise, follow the clinic.

• Can I wear makeup before laser eye surgery?

  Eye makeup is usually avoided immediately before surgery to reduce the chance of debris or bacteria reaching the treated surface. The period is a clinic instruction rather than a universal rule.

• Why are perfume and aftershave restricted before eye surgery?

  Perfume and similar products are restricted because airborne particles from them can affect the laser’s environment and, in some facilities, the treatment room’s air quality requirements.

• Can I drive myself home after eye surgery?

  No. Vision is typically blurred and light sensitivity is common immediately after treatment, so you need someone to take you home. The same applies after a consultation where your pupils were dilated.

• Should someone come with me on the day?

  It is worth having someone with you for the journey home and for the first evening, when vision can be blurry and the eye may be uncomfortable. It also means details of the aftercare instructions are heard by two people.

• How stable does my prescription need to be before surgery?

  Clinics generally look for a prescription that has been stable for a period rather than for a specific number, because operating on a moving prescription risks treating an eye that will not match the plan a year later.

The mistakes people most often make

None of these is a disaster, and all of them are avoidable.

• Wearing contacts up to the assessment, which wastes the appointment or invalidates the numbers.
• Not mentioning a medication or an eye condition because it seems unrelated.
• Booking the treatment without asking what the quote includes, then discovering the follow-up visits or the drops are separate.
• Planning to drive, or to work the next morning, because someone else managed it.
• Stopping the drops early because the eye feels fine, which is the point at which they still matter.
• Rubbing the eye in the first weeks, out of habit rather than intention.