What Happens During a SMILE Pro Consultation?

If you have only ever had a standard eye test, a refractive consultation will feel substantially different. It is longer, it involves instruments rather than just a chart, and (importantly) its purpose is to determine whether you should have surgery at all, not to schedule one.

Before the appointment

Contact lenses. Soft lenses change the shape of your cornea and need to be out for a period before measurements are reliable; the duration depends on the lens type and how long you have worn them. Rigid gas-permeable and scleral lenses need considerably longer. Clinics will give you instructions: follow them, because turning up in lenses is the single most common way to waste the appointment.

Bring your history. Old prescriptions, records from previous eye care, and a list of medications and any medical conditions. If you have had any previous eye surgery, say so at the start.

Expect possible dilation. Some clinics dilate your pupils to examine the retina, which leaves near vision blurred for a few hours. If you are driving yourself, ask in advance.

Bring your question list. See our list of questions to ask a surgeon: a written list gets far better answers than trying to remember.

What gets measured

Refraction. Your prescription, measured carefully and usually more than once, because repeatability matters.

Corneal topography. A map of the corneal surface. This is where irregularities, including subclinical ones, show up, and it is a key reason an assessment cannot be done remotely.

Pachymetry. Corneal thickness. Together with your prescription, this determines how much tissue a correction would need and therefore whether it is feasible.

Tear film assessment. Dryness is measured rather than assumed, both because it affects comfort afterwards and because it affects the reliability of the other measurements.

Retinal examination. An examination of the back of the eye, because refractive surgery does not treat retinal problems and a short-sighted eye carries a higher background risk of certain retinal conditions. Finding something here is a good outcome of an assessment.

Pupil and eye pressure measurements, and in some cases wavefront or other additional imaging.

What the results mean

Three outcomes are possible, and all three are normal:

You are a candidate. Your measurements fall within ranges where the procedure is appropriate. That is a starting point for a decision, not a decision.

You are not a candidate. Either permanently (an irregular cornea, insufficient thickness for your prescription) or for now. Being declined is information, and it is the outcome a thorough assessment is designed to be able to produce.

You are a candidate for a different procedure. A clinic that offers several options may recommend one over another based on your measurements. Ask specifically which measurement drove the recommendation.

What you should leave with

• Your measurements, ideally as a printed or emailed report
• A clear explanation of which procedure is recommended and why, in terms of your numbers
• A written, itemised quote covering both eyes, medication, follow-up and the enhancement policy
• Clear pre-operative instructions, including contact lens guidance and any drops to start
• A named point of contact for questions
• No pressure to decide on the day

Warning signs

A consultation that is missing any of the following is worth questioning:

• No topography or no thickness measurement
• No retinal examination
• A quote given before the assessment rather than after it
• A recommendation made without reference to your specific measurements
• Reluctance to give you copies of your results
• A same-day discount or time-limited offer
• No discussion of risks, dry eye, or what happens if the result is imperfect

None of these is proof that a clinic is unsafe. Collectively, though, they describe a process organised around selling rather than screening, and that distinction is the reason the consultation exists.

What this means for you

Treat the consultation as the main event, because it is. The procedure is short; the assessment is where the decisions that matter get made, and it is the only part of the process where you can tell whether the clinic’s standard of care matches its advertising.

Book more than one if you can. Attending two assessments, and comparing the answers rather than only the prices, is the most reliable way to make this decision well.