Q: Does having Genital Herpes (HSV), or taking Valtrex for such a condition, have any bearing on candidacy or outcome of LASIK surgery? A:  No. But if there is a history of HSV in the eye, then great caution is needed. Andrew Caster, MD Caster Eye Center Beverly Hills, California www.castervision.com

Q: It has been a week after my LASIK surgery and my right eye is not as clear as my left eye. My doctor did say this would be normal but i have also noticed that my right eye feels either strained or pressure. Is this normal? I thought it might be because it is trying to keep up with the left eyes vision. Is there something i can do to help not have this feeling? Thank you. A: It is common for the two eyes to heal differently. I would be patient. Andrew Caster, MD Caster Eye Center Beverly HIlls, California www.castervision.com

Q:  Hi, I'm considering LASIK and understand that better results are obtained with the Ladar over the Visx machine. If this is true, why would you still be using the Visx. Are there special situations where the Visx would be a better choice? Thanks, Josh A: I prefer the Ladarvision for most procedures, and use the Visx only in special situations. For patients who have had cataract surgery, or other unusual situations, the Visx is preferable. Andrew Caster, MD Caster Eye Center Beverly HIlls, California

Q: Why do some doctor push the intralase (laser flap opening) and some are so against it and prefer the blade opening? I have a +5.50 and a lot of stigmatism. I also have horrible night vision with halos and starbursts. Does the flap realy make any difference? A: I personally don't think that there is much difference at all between the Intralase and the keratome. I generally prefer the keratome, but will use the IntraLase in certain specific stiuations. Andrew Caster, MD Caster Eye Center Beverly HIlls, California

Q: I have been told that after having lasik surgery sometimes you may need another surgery to see 20/20; does the risk go up on the 2nd surgery? A: No, the risk is actually smaller for each additional surgery. There are still some risks; however, they are small. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Q: I'm interested in getting eye surgery but have multiple family members who feel the process may have worsened or accelerated their presbyopia. I know the condition is unavoidable at a certain age, but if it is possibly worsened or accelerated, could it be a problem for someone 21 years old? In other words, could my close-up vision get worse to correct my far-sightedness? Thanks, Kara A:  Lasik does not speed up or slow down presbyopia, which is the reading glass problem that begins in your 40s. Of course, a person who is nearsighted has, by definition, better near vision than far vision without glasses, and Lasik changes your eye so that it is similar to wearing glasses. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Q: Hi doctor I have a question regarding the use of injected steroids before the lasik procedure is preformed.Will there be any dangerous side effects aside from the obvious ones,thank you very much A: Extensive use of steroids can raise the pressure in the eye and cause cataracts. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Q:  I am 49 years old. I have fibromyalgia and my thyroid was hyperactive in 1987. I drank radioactive iodine in '87 to correct my thyroid and it has been fine ever since. I also take a number of medications: Wellbutrin, Flexeril, hydrocoddone, Ambien and Xanax. I wore contacts until three years ago when I stopped because my eyes were too dry. However, wearing glasses I never have any problem. I never use tear drops or anything. The doctor I am considering uses the VISX Wavescan technology. Does any of this preclude me from having the LASIK procedure? Thank you, Jeanne I also got t A: I don't see anything in what you have described that would be a problem. Andrew Caster, MD

Q: Dear Doctor, I recently underwent Lasik Eye surgery (Nidek Baush and Lomb) procedure. It has been almost 3 weeks and I am still seeing blurry most of the time. I can see letters and objects but without any clear definition around them. It is definitely worse than when I use to wear glasses and/or contacts. My previous prescription was 2.5 in my right eye and 2.75 in my left eye, with astigmatism of .4 in each eye. According to my eye surgeon, what I am experiencing is completely normal. However, from my conversations with other people that had similar procedures done these symptoms were only experienced the first 4 days. The problem is worse at night when I can barely read signs on the highway or stores (all the letters are fussy). Within a week and according to my first week post-operation exam, I was 20/30 on the left eye and 20/25 in the right eye. Are these symptoms normal, if not what are your recommendations?. Best regards and thanks in advance, Markus A: There is a very wide variation in the reaction to the surgery during the first few weeks, so what you are experiencing is probably normal. After 2-3 months it will be clear whether you need an enhancement. Andrew Caster, MD Caster Eye Center Beverly Hills, California

Q: I am a pilot by profession. 8mm pupils and -3.25 in each eye. All other factors eg corneal thickness are fine. Initial consultation 2 years ago suggested not a good idea to undergo LASIK. It has now been suggested that if 7mm of the cornea is treated plus the "fade area?" given a relatively mild dose of myopia that this should be fine!? Please would you give me your opinion. With my livelyhood at stake am I crazy to even consider the procedure. Many thanks Trevor Warner A: There is a lot of confusion and contradictory scientific evidence regarding the impact of larger pupils (yours are larger) on the creation of glare after Lasik. Since we don't know for sure, I always take the conservative approach and advise patients that larger pupils may increase the risk of glare and halos. We cannot predict who will get glare and how much they will get. Andrew Caster, MD Caster Eye Center Beverly Hills, California www.castervision.com