Email: March 30, 2005 Q: What is the price for an operation with lasik for 2 eyes thank you A: It varies, from around $1000-$6500. There are many factors that affect the price, but to a great degree you will get what you pay for. Andrew Caster, MD

Email: March 30, 2005 Q: I wear colored contacts to correct my vision and astigmatism. I would like to continue to wear colored contacts with no vision correction after having LASIK (or similar) surgery. Is it possible, is it healthy for your eye considering the "flap" that remains? A: It is fine to wear contacts after Lasik. Andrew Caster, MD

Email: March 31, 2005 Q: Hi, my biggest concern about Lasik is reduced night vision. I feel like I could deal with it on a temporary basis though. Do you have a rough estimate of the percentage of patients that experience night vision problems (halos, glare) at one month, two months, three months, etc post-op? Thank you for your help. -Tim A: It really depends on your degree of correction, and maybe on other factors such as pupil size. Overall, the percentage with today's lasers is very low after 3 months, but at least 30 during the first 3 months. Andrew Caster, MD

Email: March 31, 2005 Q: Hi Doctor, I am 46 year old and has been wearing contact lens for over two years. I been thinking about having lasik surgery done to my eyes. Before making a decision I have few questions I would like to ask you: 1.) Should I trust a lasik center that advertises $400/eye? 2.)Which one should I pick, traditional lasik or custom view lasik? 3.) Should I select distance vision or mono-vision? What are their pros and cons. 4.) What are the most important things should I look for at a lasik center before making a decision? 5.) Last question, I live in Riverside area, which doctor or lasik center would you recommend and my budget is around $1200 for both eyes. Thank you in advance for your help. Nghia Ho A: I would not trust a Lasik center that advertises $400 per eye, and then tries to do a bait and switch. These are your eyes and I would look for a reputable medical professional to treat them. You will get what you pay for, nothing more or less. When you find they right doctor, they can advise you about monovision and whether to have custom treatment or not. Andrew Caster, MD

Email: March 31, 2005 Q: i am slightly nearsighted,i have been using the same pair of glasses for about 7 years.i know i need a new pair as i am sure my prescription has changed maybe slightly.is this a problem if i want to get LASIK done right away?Also,i take medication for high blood pressure,i am 37 years old,any problems with that and LASIK. one last question,any opinions on Laser Eye Center? thanks for your help. roy A: If the eyes are changing, then Lasik will not stop them from changing. Laser Eye Center is known as the low cost, low quality provider. Andrew Caster, MD

Email: April 02, 2005 Q: Dear Dr. Caster: My prescription is -7.00 = -0.50 x 175 in both eyes. I am 44 yrs. old. My lasik surgeon recommends monovision. What is the probability that I can be corrected to 20/20 vision in both eyes with my prescription? Should I opt for full correction in both eyes instead of monovision if I may not be able to be corrected to 20/20 anyway? I don't know how "bad" my prescription is except I use glasses for everything I do. I have not experienced presbyopia yet. If I can be corrected to 20/20, I read that I may experience sudden presbyopia. I have no other eye problems, astigmatism, etc. - just myopia. What are my chances? Should I choose monovision? Thank you. A: Choosing monovision is a very personal choice. You should have your surgeon show you what it would be like before choosing. Andrew Caster, MD

Email: April 02, 2005 Q: I had lasik in June 2001 and now suffer from higher order aberrations-coma and spherical-which now prevent me from driving in the dark or in poor light unless I use brimonidine tartrate eyedrops, whose effectiveness is now greatly reduced from what it was when I first started using the drops, so I really can only drive in daylight. The halos and starbursts and ghosting seriously impede my ability to live a normal life. Can this new wavefront technology improve my night vision? (Even going into a restaurant is difficult because of the dim lighting). At what risks? I also now suffer from dry eye and live on refresh tears eyedrops all day. Are there any clinical trials or any data on patients like me receiving enhancement surgery? The winter months with the limited daylight make it difficult for me to commute to work on time and I believe my only option is to try another surgey with wavefront technology. Does it matter what laser? i.e. the Alcon Ladar Vision 400 vs the Visx Star?? Or is it all about the Wavefront technology? In short-are the odds in my favor of getting my life back with another surgery? If so-does the type of laser matter? Thank you very very much for your time. I know I am in a small minority of affected post-op lasik patients. I really appreciate hearing from you. A: Wavefront enhancements are bing done on an off-label (non-FDA approved) basis. There is more work to be done to make them better, but they have helped others like you. Andrew Caster, MD

Email: April 03, 2005 Q: Although Im not sure of the correct medical term, I have suffered from a 'lazy' eye since childhood. I am a fit & healthy 29 y o male. My 'good' eye is begining to weaken. Can lasik surgery correct this problem? A: Not recommended if the lazy eye is very lazy (amblyopic). Andrew Caster, MD

Email: April 05, 2005 Q: Would a person with astigmatism benefit from Lasik or Lasek, and which one would be best? Would this procedure prevent from having to have reading glasses to paint or read? Thanks! A: Both Lasik and Lasek correct astigmatism. You can do without reading glasses if over 45 only if you get monovision, one eye for near and one for far. Andrew Caster, MD

Email: April 06, 2005 Q: I only started wearing glasses at 43 years old. I started noticing reduced vision prior to that. Since then, I have changed my prescription once, one year after my first visit, and now they seem to have changed again. If I have Lasik, will my vision be permanently corrected, or keep changing? A: It depends. You sound as if you are hyperopic, and if so, Lasik will probably correct your distance vision without furher significan change. Andrew Caster, MD

Email: April 06, 2005 Q: If you have had lasik surgery in the past and find yourself depending on eye glasses again, can you have lasik eye surgery again? If you can, are there any complications that you know off and have other people experienced the same problem? A: Yes, you can have repeat Lasik. The possible complications are very similar to the first surgery. Andrew Caster, MD

Email: April 07, 2005 Q: I had lasik about one year ago. I am noticing my vision at night time is starting to not be quite as clear, is this normal and what should I do? A: I would return to get an evaluation. Andrew Caster, MD

Email: April 08, 2005 Q: Dear Dr. Andrew, Frist thank you very much for your reply to my email before my surgery in San Diego. Now I have a couple of more questions about the post-operation recovery. 1. My vision right after surgery were 20/20. And the surgeon told me due to my prescription (left eye, -4.84D, -0.41 astigma, right eye, -5.81D, -1.43 astigma), it will take 3 months for my visions to stablize. Will my vision get better or worse with time passing by in this 3 months? 2. Should I reduce the usage of computer, especially CRT monitor? I feel dry eyes and poorer (relatively) visions after working on computer the whole day for couple of days. If I swicth to a flat panel monitor or a laptop, will that help? What else can I do to prevetn my visions from going worse when my eyes are healing? Really appreciate your help. Regards Lee A: Your vision will take several months to stabilize. Sit farther from the computer, and rest your eyes every 30 minutes for 5 minutes. Andrew Caster, MD

Email: April 10, 2005 Q: Hello doctor, This is srikanth.My eye sight is (-10).I have been wearing contact lenses for 3 years.I am a software engineer and i have to work with system for minimum 6 hours a day.In this situation what will be the good treatment for me to avoid contact lenes.and specify how much it will cost.Thank you very much doctor for considering my plea. Bye, srikanth. A: Lasik or phakic intraocular lenses. Andrew Caster, MD

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