Email: May 11, 2006 Q: I am 19 years old and my eye doctor said I have a lazy eye. I for some reason, at my age, had to have strabismus surgery a year ago and again 2 months ago because my double vision came back. Is this due to my lazy eye? I am not sure what caused it (lazy eye). It might be strabismus or that my right eye is much worse than my left. I have heard that past 17 it is hard to correct. I am looking for a surgical option to try to correct it. What can I do?   A: It is hard to correct lazy eye after the age of 8 or so, though some recent studies have shown some improvement in adults. You should see a pediatric/strabismus specialist -- they are the ones who most commonly treat amblyopia. Andrew Caster, MD

Email: May 12, 2006 Q:Hello, I had my PRK done last saturday - may 6 2006. I was nearsighted, -4.75, -5.25. I had done PRK because my cornea is too thin to do lasik. Everything went well, however it was very painful the first couple days. Now my eyes are just fine, no swelling, no watering or whatever. Yesterday my band-aid contacts were removed and the doctor says the healing procces is going just right. My big concern is: My left eye (20/45) is much worse than the right one (20/25). It makes me very dizzy and gives me headaches. Is it normal? Is it going to even it up? I am worried that I will have to get 1 contact lens. My doctor says yes, it will even up but I am just asking for a second opinion. How long do I have to wait. Will I be able to do enhancement on this one eye. After how long can another surgery be done? Thank you for your time. I really appreciate it. Sincerely, Karolina J. from Chicago A: I wish that your doctor had taken more time to explain things to you. It is very common for the two eyes to differ from one another during the healing phase. You vision is quite normal for this stage of the healing from PRK. Andrew Caster, MD www.CasterVision.com

Email: May 13, 2006 Q: I currently wear progressive lens for mild myopic astigmitism with low power reading lenses. I want correction for good binocular distance vision and am willing to still use reading glasses. I am 50 years old. Should I expect to still use about the same power reading glasses (I can read without glasses but have to strain) or will my presbyopia get significantly worse since I am getting myopic vision correction. Also would someone with hyperopia and presbyopia see improvement in their presbyopia with hyperopic correction? Thank you Bob T. A: You should need about the same power reading glasses as the difference between the top and bottom of your current glasses (what we call the reading "add"). This is because lasik does not affect presbyopia. Some people with hyperopic lasik get a slight "multifocal effect" which helps a small amount with near vision limited by presbyopia. Andrew Caster, MD Beverly Hills, California

Email: May 13, 2006 Q: I am 49 and considering Lasik - I am nearsighted with astigmatism- I also have had eye allergies which seem to constantly irritate my eyes. I have two concerns - I was told if I go forward I will need reading glasses?? Why and what affect will the eye allergies have. I currently, once a month, put antibiotic salve in my eye to relieve irritation. A: The allergies should have little or no effect upon your lasik. You will need reading glasses unless you get monovision because of your age. We don't currently have a cure for presbyopia, which affects everyone over 45 whether or not they have lasik. Andrew Caster, MD

Email: May 16, 2006 Q: Do you think it would be safe to use a Lasik surgeon who has the laser machine brought in once a month for the procedure? Is there risk of damage to the equipment when it is being transported? A: No, I would never recommend such a doctor, because the laser is very delicate and such a laser will not be in the finest condition. Andrew Caster, MD

Email: May 17, 2006 Q: Dear Dr. Caster: How much do the eye numbing drops numb the eye? My eyes are very sensitive. Also, that lid speculum looks like a torture device. Will the numbing drops help? A: The eye drops are very effective. They eliminate the sense of pain, but do not eliminate the sense of touch. The eye speculum would be very uncomfortable if it were used without the numbing eyedrops, but with the drops it does not hurt. The procedure is really very quick and easy on the patient. Andrew Caster, MD

Email: May 19, 2006 Q: Hello. I was wondering if the lasik procedure can be done by putting the patient to sleep? A: No, we do need you to look at the fixation light, which you would not be able to do when asleep. You can be medicated, however, which greatly lessens the anxiety. Andrew Caster, MD

Email: May 22, 2006 Q: Hi, I'm a candidate for lasik however I own a small dog and have allergies towards dogs. If I physically handle her too much and have too much close physical contact and get her saliva/fur on me then I get EXTREMELY itchy eyes that itch like CRAZY. Sometimes during an itch attack you can actually see that the conjunctiva on my eye is literally swollen! I got some Visine eye drops from the drug store (non-prescription) and when I put a couple drops in my eyes then my eyes stop itching and I'm fine. I'm very worried about what to do because I want to get lasik a.s.a.p... but will it be dangerous for me to have lasik with itchy allergy eyes? I'm only allergic to my dog... nothing else... ONLY my dog. So if I remove my dog from my home even for a couple of days then my allergies (itchy eyes) completely goes away. There is no way in heck that I will have my eyes done with lasik when my eyes are itching like this so I know that I must remove my dog from my home completely for a while before getting lasik and after getting lasik. So if I remove my dog at least 3 days before I have my lasik exam and lasik surgery... and then keep my dog removed from my house for an entire week after getting lasik... do you think this sounds like a safe solution to my problem? Is it more important for me not to have itchy eyes BEFORE getting the lasik or AFTER getting the lasik? I would really like to find the answer to this question. My guess is that it's very important to not have itchy eyes BEFORE getting lasik, right? And then immediately after I've had lasik if I can keep my eyes itch free for at least a WEEK and then I can bring my dog back home? I mean, after I've had lasik how soon can I start using anti-itch drops... a week later? If you could please offer me advice on this question because I'm very concerned about this issue. I only have one set of eyes and I don't want to take any chances with my eyes just because of my dog.. Thanks for your time, Juliet A: First of all, I would recommend that you see a doctor and get a prescription for a more effective allergy drop. In fact, many allergy drops can be used daily, even when you are not having an attack, to decrease the risk of severe attacks. I think if you could go a week before and a week afterward without an attack, that should be sufficient. You can take these prescription drops during this time, but I always recommend that you start with a new bottle after your Lasik. Andrew Caster, MD

Email: May 23, 2006 Q: A have a lazy eye (Amblyopia). My left eye has 20/25 vision and my right eye, the lazy eye, is 20/80. I am 19 years old and my eye does not have a misalignment of my eyes, my lazy eye was caused only by the poor vision in my right eye. I am interested in having LASIK done on my bad eye only. Am I a candidate for this? A: We can only improve the lazy eye to the level of vision that can be achieved with the perfect pair of glasses. So if your lazy eye is coreectable to 20/80 with the perfect glasses prescription, that is the best that could be achieved with lasik. Andrew Caster, MD

Email: May 23, 2006 Q: Sir, I am very much suffering from high power and night blindness. Is it possible to cure night blindness through LASIK? A: Sometimes, wavefront lasik can improve the night vision. However, I would never promise that to a patient. Andrew Caster, MD

Email: May 23, 2006 Q: I am writing on bahalf of my aunt. She is in Pakistan 15 years ago, she has lost her vision and she has diagnosed with optic nerve atrophy when she was pregnant. At her labour the blood preasure was so high, so at that time she started to lose her vision slowly. Slowly, one by one eye. I am wondering if her condition is treatable or not or do you think it is kind of glaucoma or something else. Please reply to me. I will be very thankful to you Or refer me to somewhere else where she can be treated. Suleman A: Sadly, I think there is no treatment that could return your aunt's vision. Andrew Caster, MD

Email: May 24, 2006 Q: Sir, Does an eye transplantation overcome the problem of night blindness? A: There is no eye transplantation that can be done. There is corneal transplantation, in which the cornea (the clear window in the front of the eye) is taken from a deceased donor and sewn into the eye, replacing the exisiting damaged cornea. This typically will not cure night blindness. Andrew Caster, MD

Email: May 29, 2006 Q: The lens in my right eye was damaged when I was 4 years old and I have had very poor vision in that eye since. I am 53 years old. Since I am basicaly blind in my right eye, is it safe to have Lasik on my left eye for reading purposes? Thanks, Steve A: I would suggest that you don't have lasik. Most experts suggest against this elective procedure when you have only one functioning eye. Andrew Caster, MD

Email: May 30, 2006 Q: How long does your newfound vision last after LASIK surgery? If you do not need an enhancement, does your vision last forever? I've been told that it only last about 10 years, and you have to have it done again. A: The results of the Lasik procedure are permanent. However, Lasik will not stop your eyes from any changes which they would have undergone in the future without the Lasik. But once you reach your early 20s, it is unusual to have changes in your distance vision. Andrew Caster, MD

Email: May 30, 2006 Q: I am told I have 6.5mm pupils with myopia of -3.75 (cylinder 0.5 diopeter) in my left eye and -4 (cylinder 0.25 diopeter) in my right. Corneal thickness is aprox 552 in my left eye and 538 in my right. I am considering treatment using Intralaze (for corneal flap) and a "Wavefront-optimised" ("Alegretto") lazer. However, having read about "Wavefront-guided" laser supposedly giving better all round results including night time vision and contrast sensitivity I don't know if I should be considering this instead...especially as I have most problems driving at night whilst currently wearing contact lenses. I don't care about the cost so much as my eyesight. Which alternative is likely to be better for my prescription? A: Wavefront-guided and wavefront-optimized give fairly similar results in the average patient. For patients with larger amounts of higher order aberrations, the wavefront-guided is superior. Andrew Caster, MD

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