Email: September 20, 2005 Q: Can u become blind from lasik surgery? A: It is theoretically possible, though I am not aware of any situation in which it has happened. Andrew Caster, MD

Email: September 26, 2005 Q: I have been diagnosed as a glaucoma suspect. I've done a visual field and HRT and my doctor tells me I'm ok to receive lasik to correct my vision; however, I'm concerned that lasik may aggravate glaucoma. I'm concerned about the high pressure experienced during the surgery. Are there any studies done correlating onset of glaucoma with lasik? Do you recommend lasik surgery? A: There is no proof regarding this, but most Lasik surgeons that I have spoken to believe that it is okay to have Lasik if you are a glaucoma suspect. If you have advanced glaucoma with extensive visual field loss, then Lasik should be avoided. Andrew Caster, MD

Email: September 26, 2005 Q: I am 49. I have always had a mild nystagmus, am nearsighted, and have an astigmatism. My best vision is achieved looking slightly out the right side. If I had to guess, I would say about 5 degrees or so. At that angle my eyes do not twitch too much. I wore hard contacts for 20 years, and my vision was 20/30 with hard contacts. During the other years when I wore glasses, the best vision correction that I could get was 20/40. The difference in my vision with hard contacts as compared to my vision with glasses was quite noticeable to me. I had LASIK surgery in 2000, and my vision after is 20/40. I would love to get my vision to 20/30, as it was when I wore hard contacts. Why did hard contacts give me better vision than glasses? Someone once told me that it was because I had two problems: (1) bad focal length (near-sighted) and (2) a poor quality, not smooth lens surface. He told me that I had a very bumpy outer eye surface. Glasses only treated problem number one. Hard contacts helped with both problems. If this is true, then I was hoping that PRK might be an option for me to get a better quality "lens surface". Since my LASIK, my eyes are drier than before, but I am able to get by with no eye drops. Any general advise? Any idea if it is worthwhile for me to look into PRK? Thanks. A: I would suggest that you get an opinion in person from a very experienced Lasik/PRK surgeon. It may be possible to further improve your vision. Andrew Caster, MD

Email: September 28, 2005 Q: what is the most current or up to date machine for having custion surgery done on your eyes? A: There are several machines that are all current and up to date for custom lasik. These include Alcon LadarVision, Visx, and Bausch and Lomb. Andrew Caster, MD

Email: September 29, 2005 Q: Which treatment is best for someone whos vision is very farsighted? A: There are several treatments, and this would depend on the exact details of the patient. Lasik, PRK, and natural lens replacement are all options. Andrew Caster, MD

Email: September 30, 2005 Q: My 11 year old daughter is nearsighted. At 7she started wearing glasses prescribed at SPH ( distance) R -1.50 & L-1.50 At 9 years old she went to R-2.00 & L -1.75. At 11 she's at R-2.25 & L-2.50. 8 months after her last check-up, she thinks she needs new glasses again because the distance is becoming difficult to see. I'm very concerned. Is there a solution to correct this progressive problem? Thanks-MC A: There are some theories that wearing hard contact lenses may slow progression. Also, some studies have shown that certain eyedrops may slow progression. But the answers are not clear. Andrew Caster, MD

Email: September 30, 2005 Q: I'm trying to verify a eye surgeon told me a laser could correct me +6.75 left eye R eye 3.75 astigmatism Is this true. A: Yes, a laser could be used, but many doctors would recommend against using a laser for that prescription. Andrew Caster, MD

Email: October 01, 2005 Q: What percentage of people stay out of glasses for more than six years on a surgery that has successfully removed your glasses? A: The vast majority, well over 95, are not using glasses for distance six years after successful Lasik surgery. Andrew Caster, MD

Email: October 02, 2005 Q: I'm considering have some type of eye surgery to correct my vision, I currently wear bifolcols and using contacts with monovision. I have never been comfortable using contacts they irritate my eyes. I seem to adjust to the monovision but I'm not sure if I could sit down and read a book. I'm wondering if monvision would be a solution for me and that if my inability to read for long periods of time is secondary to the contacts irritation or my inability to adjust to monovision? What type of surgery would you suggest? A: You might try testing with monovision glasses to see how you tolerate the monovision. If you like the monovision, then I would do Lasik with monovision. It may not solve all your reading needs, but monovision will help with many reading situations. Andrew Caster, MD

Email: October 04, 2005 Q: I am 6 months post-Wavefront. Overcorrected by 1 diopter. Enhancement being blocked by complications. Recently diagnosed with keratitis sicca secondary to LASIK.Don't know if this diagnosis means dry eye is chronic and incurable or still amenable to healing with time to pre-surgery level.Am being referred to cornea specialist. One eye care pro said the doc's (not the original surgeon) who gave me the most recent diagnosis did not want to say Lasik-induced dry eye (fear of being asked to testify in a lawsuit), so instead said "secondary", as if it appeared out of the blue. Can you advise and/or do an enhancement? A: Dry eye is common after Lasik, and it typically goes away after several months. There are many treatments available for the dry eye, including anti-inflammatory drops, lubricating drops, tear outflow blockage, and (one of the best things) flaxseed oil pills. Andrew Caster, MD

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