LASIK Co-Management - What to Expect Before and After Surgery

What is LASIK co-management?

When you have refractive surgery (LASIK, PRK, or SMILE), two providers are typically involved:

• Your ophthalmologist (eye surgeon) performs the procedure
• Your optometrist handles the assessment beforehand and the follow-up care afterward

This is called co-management, and it is the standard model for refractive surgery in Canada. Your optometrist already knows your eyes, your prescription history, and your health background — which makes them well positioned to guide you through the process.

What happens before surgery?

Pre-operative assessment

Before you can be referred for surgery, your optometrist will do a thorough evaluation to determine whether you are a good candidate. This typically includes:

• Comprehensive eye exam — vision, eye health, and refraction
• Corneal measurements — thickness (pachymetry) and curvature (topography)
• Tear film evaluation — dry eye can affect surgical outcomes
• Pupil size measurement — relevant for night vision after surgery
• Prescription stability review — your prescription should be stable for at least 1 to 2 years

If everything looks good, your optometrist will refer you to a refractive surgeon and share the relevant clinical data.

What makes a good candidate?

You may be a good candidate for refractive surgery if you:

• Are over 18 (most surgeons prefer 21+)
• Have a stable prescription for at least 1 to 2 years
• Have healthy corneas with adequate thickness
• Do not have significant untreated dry eye
• Have realistic expectations — surgery reduces dependence on glasses but may not eliminate it entirely, especially for reading as you age

Not everyone is a candidate. Thin corneas, high prescriptions, certain corneal conditions, and active eye disease may make surgery inadvisable. Your optometrist will be straightforward about this.

What is the difference between LASIK, PRK, and SMILE?

Procedure	How it works	Recovery	Notes
LASIK	Creates a thin corneal flap, reshapes tissue underneath with a laser, replaces the flap	Fast (days)	Most common; not suitable for thin corneas
PRK	Removes the surface layer of the cornea, reshapes with a laser	Slower (weeks)	No flap; may be better for thinner corneas or active lifestyles
SMILE	Removes a small lens-shaped piece of tissue through a tiny incision	Moderate	Smaller incision; newer procedure

Your surgeon will recommend the best option based on your prescription, corneal measurements, and lifestyle. Your optometrist can help you understand the trade-offs before your surgical consultation.

What happens after surgery?

Post-operative care is where co-management matters most. After your procedure, you will have several follow-up visits with your optometrist to monitor healing:

• 1 day after — check that the cornea is healing properly
• 1 week after — assess early visual recovery and comfort
• 1 month after — confirm vision is stabilizing
• 3 months after — longer-term assessment
• 6 to 12 months after — final check (if needed)

At these visits, your optometrist checks:

• Visual acuity (how clearly you see)
• Corneal healing and integrity
• Eye pressure
• Dry eye symptoms (common after surgery and usually temporary)

Most patients see well within a few days of LASIK, though vision can fluctuate for several weeks as the cornea heals.

Does OHIP or insurance cover LASIK?

LASIK is elective and not covered by OHIP. The surgical fee is paid out of pocket to the surgical centre.

However:

• Some private insurance plans offer partial refractive surgery benefits or negotiated discounts
• The pre-operative assessment and post-operative follow-up with your optometrist may be covered under your regular vision benefits
• Check with your employer plan for details

For more on insurance coverage, see Insurance, OHIP, and eye exam pricing.

Do I need a referral?

You do not need a referral from a family doctor. Your optometrist can assess your suitability and refer you directly to a refractive surgeon. This is the most common path to refractive surgery in Ontario.

If you are considering surgery, the best first step is a comprehensive eye exam. We can evaluate your eyes, discuss whether surgery makes sense for you, and connect you with a trusted surgeon.

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Related

• Optometrist vs ophthalmologist — who does what in eye care
• Understanding your eye prescription — what the numbers mean
• Insurance, OHIP, and eye exam pricing — coverage details