Q: I have had chronic dry eye for many years, which is the predominant reason that I never became a contact lens wearer. I really want to get Lasik done as it is covered by my health plan only until April (at which time I graduate University and am off my father's plan). My eyes have been doing better with flaxseed oil intake, however my eye doctor has told me I am still at a higher risk. How much higher is this risk and is it a sufficient reason NOT to go ahead with the surgery. I am only 21 years old and my eyes are extremely precious as I have my whole life ahead of me. However I know of four family members who don't have chronic dry eye, have had the surgery and have experienced no problems. Is dry eye a common complaint of patients who have had the surgery, or are other complications more common? Please let me know as I do not have any idea of what to do. My sincerest thanks, Sheen M. A: When dry eye is a concern, you may be better off having Lasik without a flap, also known as PRK, Lasek, or EpiLasik. Andrew Caster, MD

Q: I am 47 years old and have been told by my past eye doctors that I'm not a good candidate for LASIK because of my degree of nearsightedness (-14 and -12.75). I also have an astigmatism. A few days ago, however, I had a LASIK exam and was told I am an excellent candidate and that my vision could be corrected to 20/20. My cornea thickness is normal. Can you give me your opinion? Thank you. A:  Lasik can be used for this range of nearsightedness, but the odds of difficulties -- including need for enhancement, as well as postop glare/halos -- is definitely higher than for lower corrections. The phakic intraocular lens is also a possibility. It involves permanently placing a plastic lens inside the eye. Andrew Caster, MD

Q:  I have gone to (2) different vision correction centers for consultations. "A" Company (the least expensive by $2k) said I had minor astygmatism and a slightly thin cornea, so I should have PRK. "B" Company said my cornea thickness was average and recommended traditional Lasik. I went to an independent opthamologist, and had my corneas re-measured for thickness, which resulted in 551 & 559. I am near sighted (my contact prescription is -5.5 & -4.75), 30 year old female, and have occasional mild dry eye (long days on the computer). This is all very confusing, what would you suggest - PRK or Lasik? A: For what you have told me about yourself, I would recommend Lasik. Andrew Caster, MD

Q: I am seriously considering laser surgery, I had the exam and was told I was a great candidate for the broad beam VISX STar S4. The doctor is trying to get me to pay for the lifetime acuity plan where I get free enhancements for life. This will cost me an extra $1000. I would like to know if its worth paying the extra $1000 or could I get away with just the regular laser procedure with 1 year of free enhancements? A: There is no correct answer to this question. Most likely, you will not need an enhancement after the first year, but it is possible. Andrew Caster, MD

Q: My Daughter who is 13 years old has one eye that is very lazy. If she covers her good eye she struggles to see out of the lazy one. Is there a possibility she could have laser treatment to correct it? Thank you for your time. Mrs. Paula C. A: The answer is yes, but it depends on the exact degree of laziness as well as other factors. Andrew Caster, MD

Q: When discussing this surgery with my eye doctor, he is mostly turning me against having it done. I have an astigmatism and nearsighted. One eye is worse than the other. He said that I am close to not being able to wear contact lenses, and looking at no night driving. What do you think about this? I would really like to get my vision corrected. I hate wearing glasses and can't afford contact lenses anymore. A:  If your doctor is saying that there will be no night driving after Lasik, then your doctor is not telling you the truth. With the most advanced lasers and software, studies show that less than 1% of patients note diminsihed night driving abilities, while over 10% say that their night driving is improved compared to glasses or contacts. Andrew Caster, MD

Q:  I had LASIK surgery on Aug. 2004 at age 50. I was told that if it wasn't successful, a revision was guaranteed. Within 1 year my vision was the same as pre-op. & the surgeon said a revision was possible but chances were fair that it could do more harm than good but the decision was ultimately up to me. Given those odds I chose not to revise & I believe that the original guarantee is moot & I should receive a refund. Do you agree? Thanx! A: This is an issue between you and your doctor. Andrew Caster, MD

Q:  Is there anyway someone could be put to sleep when this is done. My kid has this eye thing and it makes him sick when people play with there eyes. People always tease him because they put there finger on there eye and he throws up. Thanks! A: No you must be awake. However, you can be medicated fairly heavily, which takes away a great deal of the fear. Andrew Caster, MD

Q: I had the Lasik (flap and zap) procedure in June of 2002. I had -7.50 in one eye and -8.00 in the other. My surgeon at UCSD, Dr. Schanzlin, indicated I would more than likely need a follow-up procedure. Is it safe to have another one 5 years later? If so which would be the best kind to have? I have astigmatism, but no other cornea issues. I have noticed my vision has changed in the past 2 years. What would the best option be for me? A: The best option is probably Lasik or Lasik without a flap (Advance Surface Treatment). this would depend on your exact measurements. Andrew Caster, MD

Q: Hello, I have a question regarding LASIK eye surgery. I really want to get my eyes corrected, as I hate wearing glasses. I wore contacts for about 5 years and suddenly one day had a lot of trouble with itchy and uncomfortable eyes and have since been wearing glasses. I've been to numerous optometrists and none of them have been able to find contacts that don't irritate my eyes or tell me what the problem is. My current optometrist diagnosed me with dry eyes and said I would probably have to continue with eye drops for the rest of my life. My eyes only get really dry when I use computers for long periods of time. In your opinion, could I ever be a candidate for eye surgery. How would you go about fixing the dry eye problem? Thanks very much, anything you can tell me would be great! Jennifer A: There are many medications that can be very helpful with dry eye. Patients with dry eye can have laser eye surgery. For some, Lasik will be better, and for some, Lasik without a flap (Advanced Surface Treatment) is preferable. Andrew Caster, MD