Q: Dr. Caster During the time before Lasik eye surgery when your eyes are being tested (when you look through different lenses to read letters on the wall), is it better to have your eyes dilated, undilated or do the test in both circumstances? If the answer is both and the results are a little different, which answers do you go with (the dilated or undilated)? What kind of results (numbers) would be considered close together enough not to worry? What numbers would want you to take the test again? A: Both should be used. If the numbers are different, I believe that you should redo the undilated and then use that number. Andrew Caster, MD

Q: Hello Dr. Caster. I am 16 and I have Macular Degeneration, and I was wondering if this will effect my sight in the next few years. It was diagnosed about a year ago, and I'm starting to notice that my eyes are getting really tired at around 4:00 pm. Is this a side effect of the macular degeneration? Thank you for your time, Faith Elderkin A: Yes, the tiredness may be a sign. You should see a retinal specialist. Andrew Caster, MD

Q: I have completed the lasik eye surgery, with 20-20 and 20-30 vision the preceding day after surgery.After two weeks of eye drops 3 times a day and no physical exercise, my eyes have worsened. 20-50 20-50 after 1 month 20-100 20-100 after 3 months. I have a rigorous jogging and weights routine after my intial 2 weeks of relaxing and eye drops. I was told my eyes have healed too quickly which have given this outcome. What is your opinion.? Is there an eye drop that could slow down the healing then? Does the steriod eye drop speed up the healing? A: Your result probably had nothing to do with your exercise. You may need an enhancement. No further drops will help. Andrew Caster, MD

Q: My vision is a+4.75 with astigmatisim in both eyes, how many procedures with my vision type have been performed with lasik and was sucessful? intially laskik was more for nearsightedness candidates? A: Lasik for your range is at or slightly above the maximum what most doctors recommend. Andrew Caster, MD

Q: I found your name on the All About Vision Web site and had a quick question for you. I was wondering if you had any first hand knowledge of who is the largest (in sales volume) Lasik provider to individuals in the U.S. or in the world. I am trying to do some market research as I am trying to introduce an idea to help them generate revenue. I would appreciate any help or suggestions. Thanks so much, Dave Gilman A: TLC is a chain and may be the largest.

Q: I recently had a Lasik exam. My left eye is -1.75 and right eye is -1.25 with a slight stig. Cornea thickness in left is 501 and right is 504. I read that a thickness of 500 is considered borderline, is my cornea too thin??? A: No, your cornea is not too thin for Lasik. Andrew Caster, MD

Q: Is it true that there is a higher chance of overcorrection with custom PRK than with conventional PRK in the case of a patient with mild myopia? (Right Eye: Sphere -2.25, Cylinder -2.00, Axis 15) (Left Eye: Sphere -2.25, Cylinder -0.25, Axis 170) Thanks! Sulman A: No, there is no difference in overcorrection rates, if the proper adjustments are made. Andrew Caster, MD

Q: I plan to have Lasik next week. I have been approved. My age is 55. I have a congenital nestagmas. Do you think I should have the BLEND or far away correction. Thanks Doug A: Whether to have monovison or not is a very personal decision. Pleasediscuss this thoroughly with your eye surgeon. Andrew Caster, MD

Q: I have -3.5 vision in both eyes and am interested in having LASIK surgery when I visit the states. Is it safe for this procedure to be carried out the day before a long haul flight. Do you need to have a referral from a US based specialist. and what are your rates? Thank you in advance. Ms McKenzie A: Many of our patients do travel to us from outside of the United States. Please contact Diane in our office. Andrew Caster, MD info@castervision.com

Q: I had laser treatment on both eyes now three times. The first time the right eye semed to be ok the first two times but this third time my left eye is better. The reason they weren't able to finish all at once is because i had bleeding inside of my eye and now it's been two weeks since my last laer operation and i see the blood spot and it blocks my vision on the right eye. Is that normal? The doctor told me to sleep in a 45 degree angle at all times but i was wondering if i could also sleep sideways or if i MUST sleep almost sitting up? A: These laser treatments are not for getting rid of glasses, but are for another condition in your eye. You should consult with a retianl specialist. Andrew Caster, MD