Call Now 0800 093 1110 Free from mobile 0333 777 8499 Request call back Home Laser Eye Surgery Intraocular Lenses Treatment Costs Clinic Locations About Us Contact Request Call Back BOOK your FREE Consultation Your FREE Info Pack & DVD Request a free information pack & receive the latest special offers Title Title Mr Mrs Miss Dr. Ms. Other Forename Surname Address Post code Telephone Email Where did you hear about us? A Friend Internet Search Newspaper/Mag Radio Tesco TV Advert Other Are You Suitable for Laser Eye Surgery? Check your suitability for Laser Eye Surgery by answering the following questions: Are you over 21 years old? Are your eyes free from disease? Can you see well with your glasses? If 'yes' to all of the above then you are 95% likely to be suitable for treatment. Check Your Prescription Please fill in your prescription details. Don't worry if many of the boxes are empty. Ignore Axis. Sphere Right Eye -23.00 -22.75 -22.50 -22.25 -22.00 -21.75 -21.50 -21.25 -21.00 -20.75 -20.50 -20.25 -20.00 -19.75 -19.50 -19.25 -19.00 -18.75 -18.50 -18.25 -18.00 -17.75 -17.50 -17.25 -17.00 -16.75 -16.50 -16.25 -16.00 -15.75 -15.50 -15.25 -15.00 -14.75 -14.50 -14.25 -14.00 -13.75 -13.50 -13.25 -13.00 -12.75 -12.50 -12.25 -12.00 -11.75 -11.50 -11.25 -11.00 -10.75 -10.50 -10.25 -10.00 -9.75 -9.50 -9.25 -9.00 -8.75 -8.50 -8.25 -8.00 -7.75 -7.50 -7.25 -7.00 -6.75 -6.50 -6.25 -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +4.75 +5.00 +5.25 +5.50 +5.75 +6.00 +6.25 +6.50 +6.75 +7.00 +7.25 +7.50 +7.75 +8.00 +8.25 +8.50 +8.75 +9.00 +9.25 +9.50 +9.75 +10.00 +10.25 +10.50 +10.75 +11.00 Left Eye -23.00 -22.75 -22.50 -22.25 -22.00 -21.75 -21.50 -21.25 -21.00 -20.75 -20.50 -20.25 -20.00 -19.75 -19.50 -19.25 -19.00 -18.75 -18.50 -18.25 -18.00 -17.75 -17.50 -17.25 -17.00 -16.75 -16.50 -16.25 -16.00 -15.75 -15.50 -15.25 -15.00 -14.75 -14.50 -14.25 -14.00 -13.75 -13.50 -13.25 -13.00 -12.75 -12.50 -12.25 -12.00 -11.75 -11.50 -11.25 -11.00 -10.75 -10.50 -10.25 -10.00 -9.75 -9.50 -9.25 -9.00 -8.75 -8.50 -8.25 -8.00 -7.75 -7.50 -7.25 -7.00 -6.75 -6.50 -6.25 -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +4.75 +5.00 +5.25 +5.50 +5.75 +6.00 +6.25 +6.50 +6.75 +7.00 +7.25 +7.50 +7.75 +8.00 +8.25 +8.50 +8.75 +9.00 +9.25 +9.50 +9.75 +10.00 +10.25 +10.50 +10.75 +11.00 Cylinder Right Eye -23.00 -22.75 -22.50 -22.25 -22.00 -21.75 -21.50 -21.25 -21.00 -20.75 -20.50 -20.25 -20.00 -19.75 -19.50 -19.25 -19.00 -18.75 -18.50 -18.25 -18.00 -17.75 -17.50 -17.25 -17.00 -16.75 -16.50 -16.25 -16.00 -15.75 -15.50 -15.25 -15.00 -14.75 -14.50 -14.25 -14.00 -13.75 -13.50 -13.25 -13.00 -12.75 -12.50 -12.25 -12.00 -11.75 -11.50 -11.25 -11.00 -10.75 -10.50 -10.25 -10.00 -9.75 -9.50 -9.25 -9.00 -8.75 -8.50 -8.25 -8.00 -7.75 -7.50 -7.25 -7.00 -6.75 -6.50 -6.25 -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +4.75 +5.00 +5.25 +5.50 +5.75 +6.00 +6.25 +6.50 +6.75 +7.00 +7.25 +7.50 +7.75 +8.00 +8.25 +8.50 +8.75 +9.00 +9.25 +9.50 +9.75 +10.00 +10.25 +10.50 +10.75 +11.00 Left Eye -23.00 -22.75 -22.50 -22.25 -22.00 -21.75 -21.50 -21.25 -21.00 -20.75 -20.50 -20.25 -20.00 -19.75 -19.50 -19.25 -19.00 -18.75 -18.50 -18.25 -18.00 -17.75 -17.50 -17.25 -17.00 -16.75 -16.50 -16.25 -16.00 -15.75 -15.50 -15.25 -15.00 -14.75 -14.50 -14.25 -14.00 -13.75 -13.50 -13.25 -13.00 -12.75 -12.50 -12.25 -12.00 -11.75 -11.50 -11.25 -11.00 -10.75 -10.50 -10.25 -10.00 -9.75 -9.50 -9.25 -9.00 -8.75 -8.50 -8.25 -8.00 -7.75 -7.50 -7.25 -7.00 -6.75 -6.50 -6.25 -6.00 -5.75 -5.50 -5.25 -5.00 -4.75 -4.50 -4.25 -4.00 -3.75 -3.50 -3.25 -3.00 -2.75 -2.50 -2.25 -2.00 -1.75 -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +4.75 +5.00 +5.25 +5.50 +5.75 +6.00 +6.25 +6.50 +6.75 +7.00 +7.25 +7.50 +7.75 +8.00 +8.25 +8.50 +8.75 +9.00 +9.25 +9.50 +9.75 +10.00 +10.25 +10.50 +10.75 +11.00 Reading addition Right Eye -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 +4.25 +4.50 +4.75 +5.00 +5.25 +5.50 +5.75 +6.00 Left Eye -0.50 -0.25 0.00 +0.25 +0.50 +0.75 +1.00 +1.25 +1.50 +1.75 +2.00 +2.25 +2.50 +2.75 +3.00 +3.25 +3.50 +3.75 +4.00 Age -- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 Help with your prescription Plus and Minus Signs A minus sign (or dash above a number) means you are short sighted. A plus sign means you are long sighted. CLY means you have astigmatism. Axis is the angle of your astigmatism and is not related to suitability. Prescription Table If you are unsure of your exact prescription please use the table below to see the type of surgery that could be suitable for you: If your reading glasses prescription is +1, +1.5 or +2, you may be suitable for Monovision Laser Eye Surgery. Medical Conditions The following medical conditions may preclude you from treatment (which can only be confirmed on consultation): Blepharitis (eye infections) - your eyes need to be clear of infection Increased internal eye pressure - eye pressure needs to be under control Dry eyes, Epilepsy, MS - depending on the status of the condition Diabetes - OK if well controlled with healthy retinas Very large pupils with high correction Your prescription is low (under 0.75) and you do not have astigmatism If you are pregnant or breast feeding please wait three months after weaning before coming in for a consultation. You are probably not suitable if you suffer from: Rheumatoid Arthritis, SLE, Lupus Keratoconus Macular degeneration Crohn's or collagen disease Optic nerve damage Blindness in one eye or partial sightedness Glaucoma Herpes of the eye Iritis Corneal dystrophy A squint or prism which is not corrected by contact lenses As a results are not guaranteed, we cannot treat people who have great difficulty in finding glasses to correct their eyesight, nor those with an obsessive nature or those who suffer from acute depression. The UK's Longest Established Laser Eye Specialist Contact Information 0845 688 9555 enquiry@optimax.co.uk More Information Instant Answers My Optimax Privacy Policy Sitemap Terms Follow Us Copyright © 2014 Optimax. All Rights Reserved.