Email: September 24, 2004 Q: Dr. Caster, are there any pre-Lasik tests that could determine if I may experience dry eye side effects? I've had trouble finding contacts that don't dry my eyes out and I wonder if this puts me in an at-risk category. Thank you for your time. -Scott Smith A: There are no tests that can absolutely tell us if a person will have dry eye after Lasik, but we can get some indication of who is more likely to experience this problem. The most important information has to do with the degree of dry eye before Lasik -- those with severe dry eye who cannot wear contacts and who have dry eye with their glasses are at the highest risk, and should consider PRK/LASEK, which do not increase dry eye. Tests such as the Tear Breakup Time and the presence of corneal stippling are also important. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Email: September 24, 2004 Q: Is LASIK eye surgery safe for teens? A: Lasik is safe for teens, but it is not recommended for most teenagers. It is best to have Lasik only when you have stopped growing and your eyes have stopped changing, which is frequently in the very late teenage years or during your twenties. If you have Lasik before your eyes stop changing, you will need to come back and have further Lasik after your eyes stop changing. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Email: September 24, 2004 Q: my age is 54 years old use contact lens for 20 years my vision is -5 there is some difficult in using contact lens due to some dryness in cornea i want to treat myopia by LASIX what is your addivis? A: You need to see a laser vision correction specialist to determine if you are a good candidate. Everything that you have mentioned so far indicates that you are a suitable candidate. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Email: September 25, 2004 Q: I had a bad blade RK in 1987, allergic reaction to gentamycin swelling, result +7diopters with 4 cylinder. Purse string redo and followups. very irregular now. Can wave front with PRK work. Just burn it down to good shape? Regards Steve Safken A: Wavefront is not yet available for your prescription. In fact if is not yet available for any + prscription, but should be within a few years. Andrew Caster, MD Beverly Hills, California

Email: September 26, 2004 Q: At my first consultation I was told that I have 8mm pupils and that they would have to use a custom laser which would also double the price, is this custom laser an actual tool for me or is it just there marketing department trying to get more money out of me? I appreciate your response. Thanks A: People with large pupils are at more of a risk of developing night vision problems. The wavefront decreases this risk. Andrew Caster, MD Beverly Hills, California

Email: September 27, 2004 Q: How much will the procedure cost? How long will I be down? Is there any office's located in San Diego? A: The procedure costs betwwen $1000 and $6000, depending on where you go and exactly what technique is used. I would highly, highly recommend that you avoid the low cost places. Your vision is not a place to cut corners in order to save money. The higher priced places are much more careful and thorough. Andrew Caster, MD Beverly Hills, California

Email: September 27, 2004 Q: I am near sighted in one eye and far sighted. i am wondering if it is still possible for me to get the surgery. A: Yes, it is possible. Andrew Caster, MD Beverly HIlls, California

Email: September 28, 2004 Q: So I had Lasik done just about a year ago. Being an actor I some times need to bring tears up and when ever I do my eyes get really red. What does this mean? If anything. A: The redness really has nothing to do with your Lasik. Most people get red eyes when they cry. Andrew Caster, MD Beverly Hills, California

Email: September 28, 2004 Q: My 19 year old daughter had lasik surgery.It has been 4 days and she says she still cant see very well things are still blurry and she cant see at a distance . Is this normal healing or should we be concerned?we cant get any answers from the doctors office she went to they say everyone heals differently and they will know more on her first week check up. this is my baby girl and I am nervous about this whole thing. A: Her doctor should be much more helpful to you and should explain what is going on. Call and demand that the doctor explain how your daughter is doing. Otherwise, go obtain a second opinion with another doctor. Andrew Caster, MD Beverly HIlls, California

Email: September 30, 2004 Q: I'm a 44 year old female residing in Gauteng, South Africa. I was diagnosed with keratoconus at the age of 20. Since then, I have had a corneal transplant in my right eye (approx 19 years ago) and also lasik in the same eye approx 7 years ago. Neither the transplant nor the lasik improved my vision, in fact my eye is extremely sensitive to light and eye strain (as I am writing this e-mail I have to cover my eye as the "scratchy" feeling is unbearable). I have been told that I cannot have lasik done on the left eye as the cornea is too "thin" and that I might have to have another transplant in the right eye. I also suffer from some sort of "double vision" which I have been told is attributable to the keratoconus condition. I have tried on numerous occasions to wear contact lenses but my right eye (after the transplant) is just to sensitive and with a lens on only the left eye my vision is not good enough. The sensitivity in the right eye is apparently caused by some scar tissue from the transplant. I would love to throw the glasses away and be able to wear lenses. When both my eys are strained, I develop a tiny blister on the inside of the eyelid which contributes to the sensitivity. I normally remove this blister by simple scratching it off with my nail. Any suggestions ? A: If you are not satisfied with your current doctor then I would recommend that you find a new doctor, or at least get a second opinion. Andrew Caster, MD

Email: September 30, 2004 Q: Can i box after the lasik procedure is done &healing is complete? A: I would not recommend boxing, ever, after Lasik. If you want to box you should have PRK or LASEK instead. Andrew Caster, MD Beverly HIlls, California

Email: September 30, 2004 Q: What is the difference between the Ladar and Nidek laser? It seems the Ladar is more expensive. Is it just as good? Is there that much of a difference? Thank you so much A: The lasers are manufactured by different companies and have different characteristics. I have my own personal opinion, but it would not be appropriate for me to comment on that in this forum. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Email: October 02, 2004 Q: If I has a hole in my retina repaired would I stll be able to get corrective laser surgery? A: Possibly, depending on how well your vision can be corrected with glasses or contacts. Andrew Caster, MD Caster Eye Center Beverly Hills, California