Q:  My prescription is =10.25 -1.50x040 and -11.25 -2.00x165. (My corneas are in the normal range, but on the thin side of normal...although I don't know the exact size) I have sought two opinions for LASIK -- but received conflicting advice. One surgeon advised that he would only do PRK because of the amount of correction required; a second surgeon said that I'm not a candidate for PRK but am a borderline candidate for LASIK (although not wave-front). Can you explain why I would get such opposite advice? A: Your correction is at the higher range for laser vision correction. One doctor may have felt that your corneas were too thin for lasik. Some doctors do not like to perform PRK for higher corrections, whereas others feel comfortable. Andrew Caster, MD www.CasterVision.com

Q: I just had lasik done 3 days ago. My prescription was very high with astigmatism. They said I don't have enough cornea to do a touch up surgery. In time, can the cornea heal enough to do a touch up? A: Often, when a touchup is not advisable with Lasik, a touchup can be done using the PRK laser technique. Andrew Caster, MD

Q: Just out of curiosity. If someone was to receive LASIK, would it be detectable during any of the standard eye examinations (months after surgery)? A: It is possible that the edge of the flap could be seen months later, though often it is very, very difficult to see. A topography test will usually show that the procedure was performed. Andrew Caster, MD

Q: How many enhancements can be done? Can overcorrection be corrected? A: Overcorrections can be corrected. It is possible in most cases to perform several enhancements, if needed. It will depend on the thickness of the cornea. Andrew Caster, MD

Q: My daughter wants the laser eye surgery and she is only 13. Is it possible to sign an agreement stating that she is allowed to get it done? A: It would not be wise to perform the surgery on a 13 year old. The odds are very high that her eyes will significantly change over the next few years, so it is best to wait until her eyes have stopped changing. Andrew Caster, MD

Q:  I am very nearsighted and I have astigmatism. I'm 25. My vision is: o.d. -13.75 -0.50 55 o.s. -12.00 DS What kind of results could I expect with Lasik? A: You are at the very upper end of what is treatable with Lasik, and many doctors would say that a person with your prescripton should not attempt to achieve a full correction. In such a case, only a partial correction would be possible, which would make you much better but still leave you with thin glasses or contact lenses. Another possibility is the phakic implants, commonly called intraocular contact lenses. Andrew Caster, MD

Q: Hello Dr. Caster, Background: I am currently wearing glasses, but I have a contact prescription written. I don't know what my glasses prescription is, as it's 2 years old, but I am pretty sure that it was along the lines of -10.75 and -11.25, whereas my contact prescription reads -8.00 and -9.5. I'm not sure if my memory is wrong, or if this is actually how prescriptions vary between glasses and contact lenses, but either way I have a question regarding to laser eye surgery: My prescription, as one can see, is pretty high. I haven't been LASIK examined. As far as I know, I have either zero, or a pretty small amount amount of astigmatism. If you are able from this information, could you tell me: -The best type of surgery for me? -Would I need astigmatic correctional surgery if I have a small amount? (I've never noticed it, but I've been wearing glasses since I was 6.) -About what is the cost of this surgery/surgeries? I know it varies depending on where you go, but a ballpark estimate (i.e.: 2500-3000, or whatever) in view (pun unintended) of one of the 'better' places would be fine. Hopefully you are able to answer these questions for me, at least as to whether or not I can get surgery. There is a huge medical center and school on campus (UCSD), so I could probably go ask for whatever test I would need for a doctor to determine what I've asked. (I just don't trust getting a student in med school to diagnose or test me!) Thank you very much, David P. A: Glasses and contact lens prescriptions vary. You may or may not be a candidate; it is difficult to say from the information given. I would recommend that you go to a Lasik doctor for an evaluation. The fee for treatment in both eyes varies from around $4500 to $6500 dollars. Andrew Caster, MD

Q: I was diagnosed with having mild keratoconus. My ophthalmologist said that if I have LASIK and my keratoconus gets worse, I would have to wear hard contact lenses permanently. Would you suggest that I not proceed with the LASIK? A: It is recommend that people with even mild keratoconus do not have Lasik. However, it is not clear whether Advanced Surface Treatment, which is Lasik without a flap, is a good idea or not in people with keratoconus. It may or may not cause the keratoconus to advance. Andrew Caster, MD

Q: I have been wearing bifocals for about four years. For the last year I mainly wear reading glasses and use a another pair for distance. I hated the bifocals. Will laser surgery eliminate the need for reading glasses? A: Laser surgery can eliminate much of the need for reading glasses if you opt for the monovision version. Monovision can also be created with contact lenses. One eye is adjusted for distance, one eye for near. You will need to try this with glasses as a test in the office, to see if you like it, before having laser treatment. Andrew Caster, MD

Q: I play soccer year round and am looking at getting Lasik done. I was planning on not playing for at least one month and then starting up again. Would you recommend this or not? If not, why not? I guess the only problem would be that I may get hit in the face. Will this be dangerous to the flap? A: If the ball were to hit the flap, it could cause the flap to move, particularly in the beginning. Even after one month, it could conceivably cause the flap to move, but it is much less likely. If the flap moved, you would note a lot of pain and blurred vision, and the flap would need to be smoothed back into place, typically with no permanent effect. Andrew Caster, MD