Q: I would like to know if I am a candidate for Lasik surgery if I wear bifocals. A: You can have both eyes corrected for distance and then wear reading glasses, or you can have monovision, in which one eye is corrected for near and one eye for far. Testing will determine which works better for you. Andrew Caster, MD

Q: Hello Doctor, I have -14.0 myopia in both eyes. Which would be the most suitable vision correction procedure for me? A: The implantable contact lens (phakic intraocular lens) is the best treatment for you. Andrew Caster, MD

Q: I am 36 yrs. old ,got myopia of -2d in left eye and -3d in right eye .I am a known case of rheumatoid arthritis for last 3 years, on hydroxychloroquinine 200mg for 3 yrs., and methtrexate 10 mg for the last 3 months. I recently got a detailed eye examination by my ophthalmologist. Everything is normal except myopia. Can I have lasek eye treatment? A: It is probably best not to have laser vision correction until your condition is more quiet, without the need for the methotrexate. Andrew Caster, MD

Q: Hi dear, I'm a 25 year old man. I'm Iranian. My eyes have astigmatism and I have passed all of the pre lasik tests and have been told that I'm suitable for a lasik operation. But my eyes have gotten worse in the last two years, and since I can't trust my doctor I really appreciate your help and suggestions. sincerely, M.karimi A: If your eyes are changing, it would be best to wait until your eyes have stabilized. In that way, you will be less likely to need an enhancement procedure in the future. Andrew Caster, MD

Q:  I had PRK done on my eyes 11 years ago. My left eye corrected with monovision to 20/200. My dominant eye was corrected to 20/25. Since then, my eye with the monovision has gotten worse with the distant vision, from -2 to -3. I am having a hard time with distant vision even with my prescription eye glasses. Now I want my monovison eye to be corrected, could Lasik help me? The doctors I have called so far had refused to take patients whose eyes had been 'worked on' by other doctors. How do I find a doctor who will take up my case? A: Many of the most experienced doctors will take you as a patient. Lasik or PRK could be used to further correct your vision. Andrew Caster, MD

Q: I had lasik almost 5 months ago and my vision is a crisp 20/20 during the day. However, when its dark out, I get the worst glares off lights imaginable. My doctor thinks I may have high oder aberrations and prescribed drops to constrict my pupils. These drops have not really lessened the problems. However, my doctor is very much against additional surgery since I read the 20/20 line with no problem. However, I can't tolerate not being able to drive at night and do other activities at night. Do I have any chance of correcting my problems through additional surgery and should I seek out someone who is a professional in correcting lasik induced problems? A: I would get a second opinion. Further treatment may be in order. Andrew Caster, MD

Q:  I would like to know if I am a good candidate for LASIK or if any of the information below represents contraindications. 52-yr. old male OD: -5.25, -1.25 x 173 deg. OS: -5.00, -1.50 x 174 deg. Schirmer's Test: 4mm each eye. Colvard Pupillometer: 4mm each eye. Orbscan pachymetry: 643, 599, 636, 645, 595 (center): thinnest = 585 microns. I'm especially concerned about the low Schirmer's test result (4mm) and also about my small pupils. I read in the VISX literature that the safety of LASIK (using the VISX excimer with CustomVue) performed on pupils smaller than 6mm has not been evaluated. I also read that dilating the pupils can affect the accuracy of a CustomVue scan. A: Your Schirmer's test is a little low. You should consider PRK as a possible alternative to Lasik. Small pupils can limit the ability to perform wavefront on some laser systems; other lasers can perform wavefront on eyes with naturally small pupils, because they are designed to have the treatment with the pupils dilated. Andrew Caster, MD

Q:  Approximately 8 months ago I had surgery to repair a detached retina in my left eye. The surgery entailed a sceleral buckel (Sp) procedure as well as laser treatment to produce scar tissue to hold the retina in place. In addition they injected a gas bubble to also help hold the retina in place while the scar tissue developed. Although it appears that the retina has held in place the surgery resulted in producing considerable myopia in the affected eye. In addition I have considerable number of floaters which also negatively affects my vision in that eye. Iam wondering if Lasik might be a possible procedure to consider for improving my vision. Thank you , Jeff R. A: Lasik could be used to improve the myopia, but it will not improve the floaters. There is no acceptable treatment for the floaters. Andrew Caster, MD

Q: I'm currently 15 and I want to have a lasik surgery. I am wondering if this age is okay to have a lasik surgery. My parents have said that it's fine but they need to know how old you need to be or what requirements you need. A: 15 is a little young. You should wait until your eyes have stopped changing for 1-2 years, which often isn't until 18 or older. Andrew Caster, MD

Q:  I am currently 35 years old and was told I was a good cadidate for the LASIK procedure. I currently wear contact lenses for nearsightedness. I am concerned about presbyopia in my 40's. My main reason for wanting to get the LASIK procedure is to get rid of my contacts and glasses due to dry, irritated eyes. If I get the procedure done, would it still be possible to wear contact lenses later on in life when presbyopia becomes a problem? Also, is monovision an option after having LASIK? A: After having Lasik, you can certainly wear contacts, if you so desire. Monovision is also an option with Lasik, and when you get older you can come back to have an adjustment to your Lasik to create monovision. Bifocal contacts only work in a small proportion of people as a solution for presbyopia. Andrew Caster, MD