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Am I a Candidate

Choosing the right vision correction procedure for your specific visual needs can make the difference between a successful outcome and a poor one. Take a few minutes to answer the questions below to see if you are a good candidate for Wavefront guided LASIK eye surgery. After you submit your answers, you will be able to print the results.

  1. What is your current age?

    2. Under 18
    18 to 40
    41 to 55
    over 55

  2. Has your prescription for glasses or contact lenses changed in the last 2 years?

    3. Yes  No

  3. Do you have any of the following eye conditions: thin corneas, corneal scarring, glaucoma, cataracts, retinal disease?

    4. Yes  No  Don't know

  4. Do you have any of the following medical conditions: uncontrolled diabetes or a collagen vascular, autoimmune (e.g. lupus, multiple sclerosis, rheumatoid arthritis) or immunodeficiency disease (e.g. AIDS)?

    5. Yes  No

  5. Are you currently taking medications that may impair healing (e.g. steroids), or medications with ocular side effects (e.g. Accutane or Cordarone)

    6. Yes  No  Don't know

  6. Are you pregnant or nursing?

    7. Yes  No

  7. What type of vision problem do you have?



  8. Do you wear reading glasses or bifocals/trifocals?

    9. Yes  No  Don't know

  9. Do you have astigmatism greater than 6 D?

    10. Yes  No  Don't know

  10. What is your primary reason for considering LASIK?



  11. Have you made the decision to have laser eye surgery?

    12. Yes  No

  12. How soon would you like to have corrective laser eye surgery?



 

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Our Bay Area clinic located at 2107 N. First Street, Suite 101, San Jose, California 95131
Providing LASIK eye surgery to the following communities throughout the Bay Area—San Jose, Campbell, Santa Clara,
Mountain View, Palo Alto, San Mateo, San Francisco, Oakland, Piedmont, Walnut Creek and Gilroy
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