Q: My brother had lasik 1 year ago, but complains that his eyes get tired and vision gets blurry after reading or watching t.v. for awhile. Is this normal? A: Your brother should have a re-evaluation to see what his eye status is. Andrew Caster, MD

Q: My Corneal Thickness is 468u. I was told that I would qualify for either CustomVue Lasik or CustomVue PRK. My choice. What do you recommend? Also which procedure would give me better results? A: It really depends on a lot of other factors. With the thinner corneas that you have, unless your prescription is low, I would lean towards PRK. Andrew Caster, MD

Q: My question is - can LASIK harm the endothelium? I have 'endothelial changes' but not Fuch's Dystrophy at the moment. My corneas are healthy. One eye doctor that I have seen (Ultralase, Tottenham Court Road, London) is of the opinion that LASIK can cause the rate of degeneration of the cells in the endothelium to accelerate and will not perform the LASIK procedure on me for that reason. This is also the opinion of Adrian Chorley, the optician at Gatwick AMD. Another eye doctor in Cambridge has advised me that there is no real risk of this happening and said he would be happy to perform the LASIK procedure, leaving me pretty confused. He also diagnosed that my eyes had 'subtle discreet anterior lesions that were not characteristic of Fuch's Dystrophy'. So what do you think? If there is a risk, are you able to give me any idea how much of a risk it is? Many thanks - my career hangs in the balance. A: Patients with Fuchs dystrophy should probably not have the surgery, because the results tend to be slightly unpredictable. Also, people with Fuchs dystrophy who had Lasik can have some additional problems with the Fuchs in the future. But Lasik does not affect the health or degeneration of the endothelium. So other minor irregularities with the endothelium are probably not a risk. Andrew Caster, MD www.CasterVision.com

Q:  I went in for a consultation yesterday to see if I qualified for Lasik surgery. After a few tests were run the surgeon came into the room and told me that I didn't qualify for the surgery. He said that because my eyes are cone shaped instead of round they can't do the surgery. I asked if there were other options and he said that there weren't, and that I would have to wear contacts or glasses for the rest of my life. Can you explain what he meant when he said that my eyes were cone shaped? A: It sounds as if you may have keratoconus. This is a condition in which the tissue of the cornea is weaker than it should be. Thre is no surgery for this condition, unless it becomes severe, and laser vision correction in most cases is not performed. Andrew Caster, MD www.CasterVision.com

Q: I have lasik in my right eye( -3.25 _ -1.25 _ 20) on 3/12/2006 and after that i did have astigmatism = 0.7 so I did enhancement on 4/15/2006. I think it is ok but I still find that as I try to read text it is still not clear and difficult. Is this normal and how do I know that there is nothing wrong this time or that I may have irregular astigmatism or any thing else? A: I like to wait three months before reaching any decisions. The eye is changing as it heals, and it really teakes at least three months before things are usually reasonably stable. Andrew Caster, MD www.CasterVision.com

Q:  I had lasik surgery 4 years ago, I'm 49 now. I had my left eye done for distance and the right for reading. The reading eye is now becoming less functional. Can I have it re done for reading again or can it be re done for distance, and I'll just get reading glasses or a contact lense. Melody A: It can probably be adjusted either way: for better distance, or better reading vision. It is your choice. Andrew Caster, MD www.CasterVision.com

Q: How long do the results of lasik last for? I have friends and coworkers who have had lasik performed several years ago. A couple of them still see great, but a couple of my other friends say that their perfect vision is slowly fading. One friend had lasik performed 3 years ago but needs to wear glasses again when driving. What causes the results of lasik to fade away? A: Lasik will not stop the eyes from any naturally occurring changes that they are programmed to develop. Therefore, we want to wait until the eyes stop changing, as they often do, in the teenage years and which can sometimes continue into the twenties. Sometimes people in other age groups will experience a change in their vision, which Lasik cannot stop. Also, Lasik will not stop the loss of near vision (presbyopia) that occurs in midlife for which people use reading glasses. Andrew Caster, MD www.CasterVision.com

Q: Is there any way at all to change the color of one's eye through surgery or any other way? Recently I have heard that there are eye drops that can change the color of one's eye. Is this possible? A: There are glaucoma eyedrops that can change the color of the eyes in some people, but this is an unwanted side effect. There are no drops to purposefully change the eye color. Andrew Caster, MD www.CasterVision.com

Q: I am 20 years old and I want to know if I can have LASIK surgery. I have astigmatism. A: You need to be evaluated by a Lasik specialist. One of the issues for a 20 year old is that it is best to wait until your eyes have stopped changing. Sometimes this happens at age 15, but sometimes not until age 25 or so. Andrew Caster, MD www.CasterVision.com

Q: I am planning to go into the US Army in about a year. I do not want to worry about having glasses on while doing different activities, since no contacts are worn in the army. A: Many, many people in the armed services have had Lasik or Lasik without the flap (PRK). Andrew Caster, MD www.CasterVision.com