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

What LASIK is

According to the American Academy of Ophthalmology (AAO), LASIK treats nearsightedness, farsightedness and astigmatism. The surgeon uses a laser to reshape the cornea, and the surgery may reduce your need for glasses or contact lenses.

The procedure involves a hinged flap in the cornea, which the FDA mentions when it describes what can go wrong during surgery. Patients can have LASIK on both eyes at once or on one eye at a time, according to the FDA. Ask your surgeon which approach they suggest for you, and why.

Who is a good candidate

The AAO lists these requirements for LASIK:

• A prescription that has not changed much in the past year.
• A refractive error that LASIK can treat.
• Corneas that are thick enough and healthy, and generally good eye health.
• Realistic expectations about the result.

The AAO adds that some conditions can rule LASIK out, including severe dry eye and a history of certain eye infections. If a surgeon raises one of these, ask what it means for your options. Our comparison of SMILE, PRK and ICL explains the alternatives you may hear about.

When the FDA says to pause

The FDA's page When is LASIK not for me? is unusually direct. It says you are probably not a good candidate for refractive surgery if you are not a risk taker, because some complications cannot be avoided in a percentage of patients and there are no long-term data for current procedures. It also lists these reasons not to proceed, or to take extra care:

• Refractive instability, meaning a change in your glasses or contact lens prescription in the past year. It is more likely in people in their early 20s or younger, people whose hormones fluctuate because of a disease such as diabetes, people who are pregnant or breastfeeding, and people taking medications that can make vision fluctuate. The FDA says these patients should discuss the added risks with their doctor.
• A disease or medication that may affect wound healing.
• Age: no lasers are approved for LASIK on anyone under 18.
• Previous eye injuries or eye surgeries, which the FDA lists as precautions.

Risks to understand before you sign

• Long-term data are limited. The first laser was approved for LASIK in 1998, so the FDA says long-term safety and effectiveness are not known.
• Things can go wrong during surgery. A device malfunction or other error, such as cutting the corneal flap all the way through instead of leaving a hinge, may stop the procedure or cause irreversible eye damage.
• Monovision is a trade-off. Here the goal is for one eye to see worse than 20/20, and the FDA advises a trial with contact lenses first to see whether you can tolerate it.

None of this means LASIK is a poor choice. The FDA also says that carefully screened candidates with an experienced doctor, reasonable expectations and a clear understanding of risks and alternatives are likely to be happy with the results. The aim is to go in informed.

What LASIK costs in San Francisco

Most medical insurance will not pay for refractive surgery.

U.S. Food and Drug Administration, When is LASIK not for me?

That makes the practice's written quote the most important cost document you will see. We do not publish LASIK prices for San Francisco. We have not found dated, verifiable price data, and an undated figure from an ad can mislead more than it helps. Compare quotes line by line instead. Ask each practice:

• Is the price per eye or for both eyes?
• Which procedure and which laser does the price cover?
• Are the screening exam and all follow-up visits included? The AAO notes that follow-up usually continues for six months or longer.
• If vision problems remain after six months and another laser surgery is recommended, is it included, and for how long?
• Which payment methods do you accept, and what is the total cost if I use financing, not just the monthly payment?

If you plan to use a health savings account (HSA) or flexible spending account (FSA), confirm eligibility with your plan administrator before you book. We have not yet reviewed the IRS rules for this guide, so we do not summarize them.

Recovery, according to the AAO

The AAO's guide to recovery after laser surgery, published May 25, 2023, describes a typical course:

• In most cases, patients can return to work and drive the day after LASIK.
• Blurry or changing vision for several weeks, or even months, is normal.
• Follow-up visits usually continue for six months or longer.
• Vision is usually stable at about six months.
• If vision problems remain after six months, the ophthalmologist may recommend another laser surgery.

Plan around that six-month window if you have travel, a new job or anything else where your vision matters. Your surgeon's written instructions always take priority over a general timeline, including this one.

Where LASIK is offered in San Francisco

Among the city's hospital-based eye departments, two list LASIK or refractive surgery on their own pages:

• UCSF Ophthalmology lists refractive surgery among its services. Its eye clinics are at the Wayne and Gladys Valley Center for Vision, 490 Illinois St. in Mission Bay, and the Ambulatory Care Center, 400 Parnassus Ave., 6th Floor. The main patient line is (415) 353-2020.
• Kaiser Permanente Vision Essentials at the Geary Campus, 1635 Divisadero St., lists LASIK among its services. Kaiser runs a closed HMO system. Phone: 415-833-2020.

Many independent practices in San Francisco also offer LASIK. We do not list, rate or rank them, and the checks below work for any of them.

A checklist for comparing practices

1. Verify the surgeonLook up the California license with the Medical Board of California and board certification with the American Board of Ophthalmology. Our step-by-step guide shows how.
2. Ask who does whatAsk who takes your screening measurements, who performs the surgery and who sees you at follow-up visits.
3. Ask about your measurementsAsk whether your prescription has been stable, whether your corneas meet the requirements, and which alternatives were considered.
4. Ask about both eyesAsk whether both eyes will be treated on the same day or separately, and why.
5. Compare written quotesUse the cost questions above so each quote covers the same items.
6. Take your timeIf an offer expires the same day, treat that as a reason to slow down, not to hurry.