Q: Dear Dr. Caster, I'm a 28yo man living in Italy. I'm writing to ask a question I hope you'll be so kind to answer soon, as it is really important for me. Let's figure that a man you have never seen before is sitting in front of you in your office. Would you (or an average colleague of yours) be able to state and certify, without any doubts: 1) whether the man had laser surgery or not 2) what kind of surgery he had (LASIK, LASEK, PRK, epiLASIK, bladeless LASIK or others)? I'm asking this because I want to have optical surgery and I would choose LASIK, but this kind of surgery is not allowed where I work. We are checked up once per year and I wish to know whether an average doctor, visiting me four or five months after the surgery, would be able to say with no doubts "you had LASIK", or would he be compelled to ask me "which kind of surgery you had?" to be sure. Obviously the greatest thing would occur if the doctor wouldn't be able to state you had laser surgery at all! Thanks in advance for your reply, that I hope to receive the soonest you can. Dr. Maccaus A:  By performing a corneal topography test, it can usually (but not always) be determined that a person had some form of laser vision correction. Looking at the eye under a microscope, an eye doctor can sometimes (but not always) see the edge of the corneal flap, whether the flap is made with a keratome or the IntraLase laser (it is typically easier to see the edge of the IntraLase flap). In the case of LASEK, PRK, or epiLasik, you can sometimes see the minor haze that often occurs, but of course that haze could be due to other things, so a doctor could not say for certain that these procedures took place. Andrew Caster, MD

Q: I am asking on behalf of my girlfriend. She was told that her cornia are too steep to have lasik eye surgery done on her. I was wondering if this is true, and/or if this will be possible in the future. Any help or information will be greatly appreciated. Thank you and I hope to hear from you soon. Sincerely, Walea K. A: There are certain levels of steepness of the cornea which would preclude a person from having laser eye surgery. However, it is important to view these in terms of the overall correction needed, as well as the overall curvature. So I cannot answer your question without examining the patient. Andrew Caster, MD

Q: Hello, I want to get my glasses removed. Current LASIK machine available is VISX STAR S4, can you please tell me if it is the right/best machine to for LASIK treatment. My glass number is -5. It would be nice getting your expert advise. Thanx! kapila A: -5 is certainly correctable with the Visx laser, which is an excellent laser. Andrew Caster, MD

Q: Dear Dr. Caster: While I am aware you are not a veterinarian, I am hoping you may be of some help to me. My 13 year old Siberian Husky was recently diagnosed with a severe cataract in one eye, and a small one starting in his other eye. I have made arrangements for a consultation but not until October-vet extremely bogged down. I am taking him in for a second opinion Thursday, but for the record, would such a severe cataract allow the human eye to see? My husband nor I see any cloudiness at all. And would you feel that $3500.00 to be a bit much to remove one cataract, and $500.00 for the other eye if done at the same time, plus $165.00 for evaluation, plus more for preop work up? And what say you about waiting until October? A: With severe cataracts you can often see shapes, but little detail. Extremely severe cataracts, which you might be able to appreciate as a whiteness where the usual black pupil should be, will cause only an ability to discern light from dark, no more. Whether you choose to have your dog undergo the surgery is only a choice that you can make. Andrew Caster, MD

Q: I am a 23 year old and very near sighted in one eye. My doctor says that the use of a glasses will give me a double vision. According to him, since only one eye is affected, the use of a corrective lens will only affect the other eye. Is LASIK an alternative? What do you Suggest? RTA A: Lasik may indeed be a good solution to your problem. The double vision caused by the glasses is much less likely with a contact lens, or with Lasik. Andrew Caster, MD

Q: I already have dry eyes but would like PRK surgery, what are the possible effects of going ahead with the surgery? Does having dry eyes increase the risk of infection permanently? A: Dry eyes are very unlikely to be made worse with PRK. Dry eyes, at least after the first 3 months, are also very unlikely after Lasik, but even more so after PRK. Andrew Caster, MD

Q: I am a insulin dependent diabetic for 25 years, been on the insulin pump for a little over 4 years. Is Lasik surgery even an option for me? I have worn glasses for 10 years. No retinopathy. A: In the absence of retinopathy and other indications of problems from diabetes, and under good control, I believe that lasik is a viable option. Andrew Caster, MD

Q: I am having lasik surgery done on both my eyes tomorrow with Drs. Rose in Costa Mesa, CA. I have been told that I have slight dry eyes (which has made wearing contacts awful). I have been taking flax seed oil and using sustain eye drops for the last week to help. Do I have a high chance of having severe dry eyes after lasik? Will they be uncomfortable? My doctor did not mention any risk of severe dry eye after lasik to me, so I am guessing that isn't a concern? Any advice would be great! Thanks, Hillary A: Dry eyes are a concern after lasik, and are more of a concern in people who already have dry eyes. The key question is: how dry are your eyes without any contact lenses? If they are dry without contact lenses, then you should consider having "lasik without the flap", as this is much less likely to worsen the feelings of dryness. Andrew Caster, MD

Q: I got my LASIK eye surgery done 5 weeks before. My left eye is perfect (20/20), but I am not even able to read the first E in the eye chart with my right eye. I was told that my right eye should heal and it may take up to a max of 6 months. Can you please advise me on this. Thanks. Narmada A: I would obtain a second opinion to determine exactly what is going on. Andrew Caster, MD

Q: After getting PRK are your chances higher for needing reading glasses? I thought I read that somewhere.........that later on in life when you are older your chances of needing glasses for seeing up close increase. Is this true? Is it a definite or just a small possibility? (I know it's natural at a certain age to need reading glasses anyway). Thanks. A:  Any person who has good distance vision in both eyes -- either because they wear contact lenses, have laser vision correction, or wear glasses for distance -- will have trouble with near vision starting on average around age 45. Laser vision correction does not change this at all. If you wear glasses, then you can get bifocals. If you wear contacts or have laser vision correction, then you can use reading glasses when needed. However, people who are nearsighted and who use glasses or contacts can remove the glasses or contacts and they will have close up vision, depending on their prescription and age. Andrew Caster, MD