Email: February 12, 2005 Q: Am 77 rys, had prisim in glass lens for one eye for double vision, 3 years ago, now have double again, is Lasik a good procedure for me will it cure double vision? A: It will not cure double vision. Andrew Caster, MD

Email: February 12, 2005 Q: Hello Dr Caster, My wife and I are planning on having vision surgery. We visited a surgeon in our area and the doctor said we are good candidates for either Lasik (with Intralase) or Epi-Lasek. My wife and I are arguing over which method to choose. I like the idea of Lasik and she like Epi-Lasek. My wifes perception is that Epi-Lasek is safer, and she is willing to take the extra recovery time. I don't like the idea of longer recovery time, plus having the to wear the eye bandage (contact). My only conern with Lasik is complications with the flap. Assuming we are good candidates for both, which option is preferable? Thanks in advance, RG A: They are both good options, with pros and cons, so you each should choose whichever you personally prefer. Andrew Caster, MD

Email: February 13, 2005 Q: I am considereing PRK as a mean to correct my vision, and I am scheduled to have my final measurments taking soon. However, I need to know the difference in the LADAR vs VISX and which one is of these machines is recommended to treat both myobia and astigmatism. I know the LADAR uses a flying spot to trac the movement of the pupil. what about the VISX? what does it use to tract the slightes movement of the pupil and whcih one removes the least amount of corneal tissues. I am -4.75 in my right eye, and -5.00 in my left eye. A: Both are excellent machines, and both have their advocates. Choose the doctor you like and then use the machine he or she prefers. Andrew Caster, MD

Email: February 14, 2005 Q: I had RK in 1984 when I was 42 to correct near sightedness. Distance vision was good for about 10 years but I gradually began needing reading glasses. After the 10 years my distance vision began getting worse. My eyes had become farsighted and I began wearing bifocals for distance and close correction. Three years ago I went to a lasik surgeon to see if he could restore my distance vision - I play golf and glasses distort my depth perception. He at 1st scheduled me for an operation, but before the appointment came he called and cancelled saying because of my RK he didn't think I was a good candidate. My question is, has technology changed in the last 4 years sufficiently to hope I might be able to get distance correction for my RK/farsighted-now eyes? Thanks, Dennis A: Yes. Andrew Caster, MD

Email: February 15, 2005 Q: Hi. I am aspiring to be a pilot. However, the reqirements is that the astigmatism must be less than 75 degrees in each eye. Is it possible that after LASIK, my astigmatism (about 400) will go down to 75? or hopefully less than 75? Pls reply asap and thank you for your time. I appreciate your help. A: Yes, there is a very good likelihood. Andrew Caster, MD

Email: February 16, 2005 Q: Hi, I have mild hyperopia and mild astigmatism. What is the best laser eye treatment on the market today for this type of problem? I.e., what "laser machines" or procedures are my best options? I don't want somebody to persuade me to settle for second best. Cost is not an issue. Thank you, Anders Olsson A: There is disagreement within the profession as to which is best. With your prescription, you should do very well with the Alcon or the Visx lasers. Andrew Caster, MD

Email: February 17, 2005 Q: I am 54yo PA. I want Lasik. I was hit under L eye several weeks ago. I have a floater but Opthal. M.D. said no retinal tear or detachment. Any problems for lasik surgery? A: Not from what you have mentioned so far. Andrew Caster, MD

Email: February 18, 2005 Q: I had lasik about 4 weeks ago, using the wavefront technique. I still have halos and starbursts at night, along with some rainbows (prisms). It improved a bit after the first week, but now it doesnt seem to be getting much better. Any thoughts? A: Be patient. It may take several, up to 6, months. Andrew Caster, MD

Email: February 18, 2005 Q: I had lasik 5 years ago. My L eye still has dim vision ( loss of contrast ) and R eye, ghosting. Would a custom lasik redo help ? S. Cheng A: It might. Also, a non-custom treatment might help. Andrew Caster, MD

Email: February 18, 2005 Q: If I can read and read a computer screen without my glasses will that be affected by having laser surgery? A: It depends on your age. People over 45 cannot have distance and near in the same eye. Andrew Caster, MD

Email: February 19, 2005 Q: What is the yongest age for this procedure A: Around 18, or when the eyes stop changing. Andrew Caster, MD

Email: February 19, 2005 Q: In October, I had Lasik eye surgery with the latest surgery they have. I forgot what it is called. Before surgery I had very, very poor vision. I know my contacts were -9.00. I could not read the alarm clock. I also had thin cornea's. The doctor performed the surgery and mentioned I would have mono vision to help w/reading, etc.I was not sure if I would like the mono vision or not. They did not give me a contact lens to show me an example. Well, I do not like the mono vision. He mentioned that we could possibly do an enhancement and would see me months later and then more months later. He now says he took 30 of my corneas off and feels that he does not want to risk me getting in the future a detached retina. He then mentioned that in 2-3 years we could maybe do it. My left eye is seeing 20-30, not sure what my right eye is seeing. But, it is blurry. Why couldn't he just upgrade that right eye 1.0 diaopters? Or even a 1/2? Thank you Diane A: I suggest that you get a second opinion. Andrew Caster, MD

Email: February 20, 2005 Q: im having my lasik surgery done soon, will it be necessary for me to get a lifetime assurance plan that will cost me $400 per eye additional. A: No. But Lasik will not stop your eyes from changing. So if you want to buy some type of insurance, just make sure that they will be there for your lifetime to honor the commitment. Andrew Caster, MD

Email: February 20, 2005 Q: I have a 450/20 and astigmatism.And my eyes are becoming weak and seem to not move normally.I have a problem when I.m looking sideways and one eye sems to get stuck and I have to try to correct my vison to see right.I have a stronger correction in the one eye that does not have the problem.And when asked to look at an on coming object my eyes cross very easily.I often get very bad headaches and it seems to get worse than better at my perscription. A: I owuld recommend that you see a strabismus specialist. Andrew Caster, MD

Email: February 20, 2005 Q: This is re: cataracts. Can you tell me where I can find information to support how a trauma based cataract is formed? A: There is lots of info on the web. Some of it is accurate. Andrew Caster, MD

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