Email: July 03, 2005 Q: I am 47 f and my prescription has remained -250 R-L since 20's. I was just getting ready to do Lasik when I developed a macular pucker in the R eye. My correction remains the same but I have that weird distortion. Can I still do Lasik for my nearsightedness or will it cause further problem. A: The Lasik will not improve the distortions from the macular pucker. It should not affect it. Andrew Caster, MD

Email: July 07, 2005 Q: my doctor has like 2 procedure he does, i didn't realize there are much options out there. he does lasik / intacs. how do i choose what will be best. im soo scare if anything were to go wrong, can i still see, if the worse does happen? from reading the post im interested in something that does not require minimum cutting and also correctin my stigmatism. please advise A: Lasik is much more popular and in general better than Intacs. Intacs is reversible, however, if you are not satisfied, while Lasik can be enhanced but not reversed. Andrew Caster, MD

Email: July 07, 2005 Q: My doctor has recommended PRK surgery - I am just wondering if anyone has ever gone blind from this surgery. I guess I'm kind of scared. A: I am not aware of any cases of blindness. It is normal to be afraid; you must feel comfortable enough, though, before you go through the procedure. Andrew Caster, MD

Email: July 10, 2005 Q: so that i can make an informed decision what is the difference between a standard & a delux lasik procedure? thanks A: Custom (also known as wafefront-guided) Lasik treats the eye with a more complicated pattern that is custom determined for each patient. Both use the same laser and other equipment. There is a lot of information on the web about this. Andrew Caster, MD

Email: July 11, 2005 Q: I HAVE A FRIEND IN MEXICO WHO HAS A SEVERE MYOPIA. SHE`S BEEN TOLD THAT SHE HAS NO CURE. I WONDER IF YOU COULD GIVE HER ANY HOPE. A: There are several procedures for people with severe myopia. she needs to see a specialist who is up on the newest techniques. Andrew Caster, MD

Email: July 12, 2005 Q: My greatest concern regarding post-surgery is "halo effect". Will using the Interlase reduce the likelyhood and or risk of having this complication/effect? Thanks. I am scheduled for surgery this Thursday, July 14th. A: IntraLase will not have any impact on halos. Wavefront guided treatments, and large diameter treatments, are the most effect techniques to decrease halos. Andrew Caster, MD

Email: July 13, 2005 Q: COULD YOU PLEASE SEND ME AN ADRESS OR PHONE # OF A SEVERE MYOPIA SPECIALIST? THANK YOU. A: There are many doctors who specialize in treating sever myopia. Currently the treatments are laser vision correction and phakic implants. You should try to find one through the internet or other means. Andrew Caster, MD

Email: July 13, 2005 Q: I have a lazy eye, and I'm only 14. Does this mean I have to wait another 4 years or so before I can think about getting it corrected? A: On the contrary, lazy eyes need to be treated as soon as possible. The treatment involves patching of the good eye. If the eyes are not straight, surgery to straighten the eyes can be done at any time. Andrew Caster, MD

Email: July 14, 2005 Q: I was diagnosed as having myopia at the age of 8 or 9, and have worn glasses and contacts lenses ever since. Now, at my mid-40's I have presbiopia too. Will LASIK surgery work for me? Will it correct my nearsightedness, my presbyopia, or both? A: Lasik can correct nearsightedness, but not presbyopia. You can have both eyes adjusted for good distance vision, or you can choose monovision -- one eye for far, one for near. Andrew Caster, MD

Email: July 15, 2005 Q: Wheather LASIK (refractive error correction) affect seterophonic vision? A: Lasik does not affect the ability to see stereoscopically. Andrew Caster, MD

Email: July 18, 2005 Q: Thank you for your help. I am wondering; if my vision is not 20/20 after the surgery, will contacts still be an option for me? A: Yes. Or you could probably have an enhancement laser procedure. Andrew Caster, MD

Email: July 18, 2005 Q: I am 15 years old and I have coloboma and cataracts in both eyes. I also have a type of fold in my retina, lazy eye, and am myopic. I would like to know if there are sugery options that could help me. I am not asking for 20/20 vision but my optometerist has told me I'm legally blind with my left eye and my vision in my right eye with glasses couldn't pass the driving test. But I feel that I am not that hopeless. A: If your cataracts are significant then cataract surgery may help. I would suggest seeing an eye surgeon (ophthalmologist) for another opinion. Andrew Caster, MD

Email: July 18, 2005 Q: I am a fellow southern californian who now lives in Kauai, mostly in part to surfing. How long will I need to stay out of the water(surfing wise) considering the nature of the sport (lots of strong water contact with the eye)? A: There is no definite answer. I tell my patients to be careful for a month with surfing. Andrew Caster, MD

Email: July 20, 2005 Q: dr. caster, here is just a general question: i just returned from an optomologist or optometrist with the first eye-exam of my life ¿ results = slight astigmatism & some near-sightedness (if i understood correctly): right +.75 ¿1.25 x 100 left +.50 ¿ 1.25 x 90 both / m + 1.50 (i have only a basic clue what these numbers mean) i was told that lasik would not be usefull to me ... with my astigmatism. is this correct? please advise. thank you, rupen A: Your main problem is the presbyopia, which lasik cannot correct. Lasik could correct your distance vision, but with your prescription I doubt that your distance vision is much a problem, so lasik is probably not needed. Andrew Caster, MD

Email: July 25, 2005 Q: I am 50 years old, and had bilateral lasik in April 1998. I was quite myopic in both eyes; -9.0D in my left eye along with about -1.5D astigmatism and -10.0D in my right eye also about -1.5D astigmatism. I had an enhancement procedure in November of 1998. In my left eye, I had some irregular astigmatism from the initial procedure and ever since then have had reduced contrast in that eye. It has been quite annoying to have what almost feels like a haze come over my left eye as light levels are reduced. both eyes also had quite a lot of starburst and irregular halos. The starbursts went away after about 6 months or so, but the haloes have persisted. If memory serves me right, the laser used was a Technolas 116. Since then, I had several years where I almost did not need glasses at all, but in the last year or so, my nearsightedness has progressed to the point where I have to wear glasses contiuously. From what I have seen described, it seems to me that custom lasik might solve the contrast problem I have in my left eye. My thoughts are that I would have my left eye slightly overcorrected for distance vision and leave my right eye as it is. With my right eye I can read easily, and it can be corrected to 20/25. I would anticipate that during the day I could easily get by with no glasses, and would probably want to use glasses for driving at night. What do you think? A: Your idea to have monovision -- one eye for far, one for near -- is a good one. This could be accomplished with an enhancement. However, at this time in 2005, I do not recommend custom lasik for enhancements. The software has not been designed for this purpose, and in my opinion the results for enhancements with custom are more variable. Andrew Caster, MD

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