Q: I was told that I qualify for Intralase and that my astigmatisms could be causing my migraines... Is this possible? A: Astigmatism is not caused by migraines. Andrew Caster, MD

Q: I am now 50 days after lasik. I was a high myopic. -7.50 was my soft contact lense prescription. I am overcorrected after lasik (using +0.75 reading glasses at the moment.) and have problems seeing in dim light. What are my chances of NOT needing enhancement? On day 2 I had double vision and the doctor reduced my steroid drops to 3X per day to be used for 1 month. A: Thre is still a chance, but most likely you will need a small enhancement. Andrew Caster, MD

Q: hi- I had lasik in 1997, and achieved 20/15 vision for approximately 3 years, then regressed to 20/50 (R) and 20/60(L) over the last few years. I had an eye exam recently and was told i was a good candidate for 'enhancement', and would like information on which procedures would most likely be used. Thank you Danielle McCabe, PhD A: Usually, Lasik is used. Andrew Caster, MD

Q: I had lasik surgery (monovision) 1-13-05. I have not been able to see clearly since. In fact, my vision is worse now than prior to the surgery. My distance vision and close vision is blurred and ghosty, and night vision is very "halo'd." My surgeon has put me on FML drops 4x a day; and Systane as needed. He has given me a prescription for reading glasses and distance glasses, and indicates that he feels at the end of 6 months, my brain should be in "sync" and I will see clearly. My eyes are very dry to the point that when I wake in the a.m., I cannot open them all the way--no discharge, just "squinty" until I can get my drops in. My doctor is aware of all these problems, but just says to wait it out, and if not better in 6 months, he will do another surgery putting both eyes to distance and I'll have to wear glasses again for close work--back where I started from. It is becoming very frustrating since I work with documents all day! Should I seek another opinion or does this sound common? A: It is common, but i would also get another opinion. You might try Refresh PM eye ointment at nighttime to help with the dryness while you are sleeping. It is thicker than the other drops. Andrew Caster, MD

Q: Dear Dr., Would you please tell me what are the cons and pros of intralase and convential way to cut the flap? Thanks. Regards Lee A: There is a great deal of disagreement over this. I actually prefer the conventional way, but the makers and users of the intralase promote it as better. If there is a difference in favor of either one, it is very minor indeed. Andrew Caster, MD

Q: I was recently declined as a candidate for LASIK; the surgeon admitted he was conservative, but did not feel comfortable doing the procedure due to my larger than normal pupil size (7mm), high degree of both nearsightedness and astigmatism, and steeply curved corneas. He said there might be another surgeon who was more aggressive and/or familiar with different technologies who would be willing to do the surgery. Are there technologies that would minimize risks associated with my issues? Is it worth it to take the risk, if it would help minimize my dependence on contact lenses? A: Go get another opinion. It depends on the exact measurements. Andrew Caster, MD

Q:  77 yrs old. Have 20/20 good frwy driver. Approved for custom cornea. Can l have monovision? Used Boston gas permeated mono for many yrs. THANX!!!!! A: Yes. Andrew Caster, MD

Q: My husband just had lasik done and I am considering it. I have been reading alot about the procedure and theres a few questions that I just can't seem to find an answer for. I'm 27, will I have to be extra careful with my eyes the rest of my life? (I mean like getting hairspray or gel in my eyes on accident, etc. And what about getting hit in or around my eye.) I sleep on one side or the other and my pillow presses on my eyes (not hard), will this cause any problems after the procedure? I wear contacts and I try to be careful with my eyes, but I still every once in a while get things in my eyes. How long after the procedure will I have to be careful about rubbing my eyes? A: You will need to be careful for a few weeks. After that things will be essentially normal. Serious trauma, such as getting punched in the eye, can be slightly different after Lasik. I would assume that you would avoid that either way. Andrew Caster, MD

Q:  I recieved wavefront LASIK surgery 5 weeks ago and although my vision seems perfect I am still struggling with light,headlights,looking at people with daylight behind them through a window,my pupils are a little larger than normal,could this still improve? would wearing AR coated glasses help at all,THANKS for your time A: AR coatings may help. Things should get better over the next 3 months. Andrew Caster, MD

Q:  I had Lasik back in November. My original vision was pretty bad. After Lasik, things improved greatly. After a few months, my eyes were stable and we decided that I was a candidate for an enhancement. I had that surgery on Friday. I have noticed that my vision is a little hazy and not quite as good as it was before the enhancement, granted it is only 3 days since the enhancement. I am wondering what the recovery time is and will I be able to see at or better than pre-enhancement. A: It usually takes about 3 months after an enhancement to reach your final vision. So don't worry. Andrew Caster, MD