Email: December 19, 2004 Q: I am 40 wks pregnant and for the second time ever, my vision has gone awry. I have a severe astigmatism w/ soft lenses -4.75. It is as though there is gasoline in the air and is making everything wavy. (even w/ my eyes closed.) Difficulty focusing, definite light headedness, but horribly affected vision. This has happened recently with contacts on, and today with glasses. Is this directly related to the pregnancy? Last month when it happened it lasted almost an hour. What should I do? A: You should see an ophthalmologist immediately.There may be a serious problem that needs attention. Andrew Caster, MD

Email: December 19, 2004 Q: I¿m nineteen and I have amblyopia. I know it¿s harder to treat adults with amblyopia, but can laser eye surgery improve my vision? If it is possible, is there also hope of straightening my lazy eye? I¿ve had two surgeries with no success. I know this problem isn¿t as severe as other eye conditions. I¿m very thankful to have one functioning eye, but I¿m tired of explaining to people why I have a ¿weird eye,¿ the headaches, and the eyestrain. A: You may be able to have another surgery to straighten the eye, but the amblyopia cannot be fixed at this time. Andrew Caster, MD

Email: December 20, 2004 Q: I had lasik surgery done approximately 5 months ago. My vision was 20/20 after the surgery now it is 20/40. I was blind before the surgery, but is this normal? I'd rather wait at least another six months to a year before I get my eyes fine tuned. Should I get glasses in the meantime? A: If you think that you need glasses to drive safely, then you should get them. It is not uncommon for the eyes to change in the post-op period; that is why touch-ups are sometimes needed. Andrew Caster, MD

Email: December 20, 2004 Q: I have the dry AMD in the earlier stages and I am also nearsighted. I would like to undergo a laser surgery to correct the nearsightedness. However I am hesitant to pursue this as I would like to keep my options for treatment open for the AMD. I wanted to know whether there is a technique to alter the focal point of the lense or cornea to redirect the field of vision to an area of the retina unaffected by AMD. If there is a procedure I would imagine reshaping the cornea to improve nearsightedness might preclude surgery to improve sight damaged by AMD. If you have any information in this matter I would appreciate your advice. Thank-you. A: There are experiments being tested to redirect the light rays, but nothing is available at this time. Andrew Caster, MD

Email: December 20, 2004 Q: I see that the visx laser was approved for custom ablations for hyperopic patients. I had lasik back in 1998 with an enhancement in 2000. I have poor night and low-light vision. I still have some residual astigmatism and far-sightedness in both eyes. I also have large pupils. Is the ladarvision a far superior product than the visx or would i be ok with having the customvue done now since it is FDA approved. I dont know how long i will have to wait for the ladarvision to be approved and i have been waiting quite a long time for this. THank you A: Neither laser is approved for custom ablations as enhancements, and although they can be used for that purpose, they are not yet optimized for that. That will take a few more years. Andrew Caster, MD

Email: December 20, 2004 Q: Hello Doctor I just did a corrective laser eye surgery in my left eye, 1 week and a few days ago. It was a failure. the doctor said that the center of the eye is all dried out. He put me on Restarsis ? for 2 weeks; he said he might have to do a redo in 3 months. My right eye was done very succesfully by another doctor in another region; I can see 20/15 ! with no fluctuation in vision from the get go. By all means, you imagine the dissapointment. At this point, I am in a mind set of just not letting the new doctor do anything for a year or so, and maybe, just maybe I might redo it after I get the advice of experts like you. Any advice doctor will be more than appreciated. god bless you. A: Go get a second opinion. Andrew Caster, MD

Email: December 21, 2004 Q: Six months have elapsed since Custom Wave Guide Lasik was performed on my eyes, medium correction for near sightedness. Monovision was chosen to preserve a measure of close up vision. The left eye for distance has regressed with minor astigmatism as a consequence of the healing process, and now the option of enhancement is to be considered. What are the risks and potential outcome. A: The potiential outcome is that your vision will be improved. The risks are very similar ot the first surgery, except that a new flap is not made; instead, the old flap is found and lifted. Andrew Caster, MD

Email: December 22, 2004 Q: I am 26. My contacts are as high as -8.5. The worst thing is that 12 years ago i didn't even need glasses, but my eyesight just started getting worse and worse every year. I feel like I am getting blind. i went to the doctor in July, since then it got a little bit worse, i am still thinking to do the lasik, they say if it gets worse after the surgery you can do the touch ups ( I believe that's how it is called). I just hate myself for that fat glass in my glasses. Is it possible that I am getting blind? What do you think about the lasik for me? Noone in my family had a problem with eyes... I'd better have a couple of lasik, than keep on waiting for some miracle... Is there a possible disease that makes the eyesight dissapear? The eyes doctor checked everything and it was fine, he said everything seemed normal. He had trouble writing a prescription for me though, when I came a week later, he had to change it.. Please let me know what you think, I am really scared... I do not want to wait to be -20.00.... Thank you so much! A: At some point, your eyesight will stabilize. That is the best time for the Lasik, becasue the surgery will not stop your eyes from getting worse. Andrew Caster, MD

Email: December 22, 2004 Q: i'm medical student 21y i have myopia my vision is -8 and iwear contact lens since 3yearsand i want ask u "is LASIK suitable for me and it percentage of successful" A: Lasik may be suitable. You need to have other factors checked, such as corneal thickness and curvature. Also, Lasik will not stop your eyes from changing. Andrew Caster, MD

Email: December 23, 2004 Q: What are the pro's and con's of LASIK vs. PRK (LASEK?)? Specifically, for myself with myopia in the 6 diopter range (plus astigmatism), and normal cornea thickness which procedure would you tend to favor and why? A: I would tend to favor Lasik due to its faster healing time. Risks are slightly different but similar in degree and frequency. Andrew Caster, MD

Email: December 23, 2004 Q: I had Lasik surgery 4 years ago to correct nearsightness and astegmatism. I ended up with 20/40 vision and had a second surgery on both eyes after 3 months. Now I have had to start wearing glasses to drive and over the last couple of months my vision appears worse. What is the percntage of this happening after 4 years? A: It is very rare, but does happen in some cases. Andrew Caster, MD

Email: December 28, 2004 Q: Almost 4 years ago I had lasik done (one eye for reading and one for distance) in Camarillo, as was close to 20/20 afterwards. I am 50 years old now. Lately, I have noticed that my vision appears to be weaker/blurier at night. My question is: does lasik "wear out" or weaken over time? Is it possible that another procedure would be required? Thanks you. A: Another porcedure may be required. Lasik does not "wear out", but you are certainly getting older. Andrew Caster, MD

Email: December 29, 2004 Q: May i know what is the advantage of having a lASIK comparing to PRK A: The main advantage is speed of visual recovery. Andrew Caster, MD

Email: December 30, 2004 Q: I had LASIK surgery in 1997, with a "touch-up surgery one year later. I was exremely nearsighted, with a -14 in one eye and -15 in the other, so this surgery was truly a miracle for me. My vision aferwards was about 20/25, with night vision somewhat worse, but I was very happy with the outcome. Now, my vision has worsened to the point where I have to wear glasses much of the time , even to read words on a TV screen not far away. Do I need surgery again? Is this normal for someone who started out so nearsighted? I am 43 and am also having the beginnings of presbyopia. Thank you very much. A: You may have gotten a little more nearsighted, so you may need a touch-up. Andrew Caster, MD

Email: December 30, 2004 Q: I have around 1000 short-sight, I know that if I take the LASIK operation, my night-vision will be very likely to degrade. However, I can't image how will the picture I will be seen. Is it possible to give a picture about this? A: Unfortunately, it is not possible to simulate the results. Andrew Caster, MD

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