Some patients who are not good candidates for LASIK can benefit from a new procedure called epi-LASIK, in which doctors use a special wavefront laser to examine the eyes beforehand.

Epi-LASIK is similar to the more common procedure, but it uses a different type of blade to peel back the cornea, and it cuts a thinner layer.

Some patients are repelled by the idea of a blade being used on their eyes. About 14 percent of eye surgeons now use an IntraLase laser. The laser gives doctors more control over how much of the cornea they peel away, and it offers slightly better results, says James J. Salz, a Los Angeles ophthalmologist.

The cost of laser procedures varies widely, and insurance generally does not cover the surgery.

Before the surgery, a wavefront laser, which is different from the laser used to reshape the cornea, can measure each eye so that the LASIK procedure is customized. The technology can help reduce the glare or halos that some patients see at night after LASIK.

Seeking 20/20 vision

Surgery, often with lasers, can fix most of these common vision problems. Presbyopia, however, requires glasses or contacts.

* Myopia (nearsightedness). The shape of your eyeball is too long or the cornea is too curved. Myopia keeps you from seeing faraway objects clearly.

* Hyperopia (farsightedness). The shape of your eyeball is too short or the cornea is not curved enough. You cannot see close-up objects clearly.

* Astigmatism. The cornea has irregular or uneven curves. If it's severe enough, both close-up and faraway vision can be blurry.

* Presbyopia. Around age 40, the eye's lens loses some of its flexibility, which makes it hard to focus on close objects.

Beyond the laser

There have been other advances in eye care during the past couple of years:

* Phakic intraocular lenses. These are surgically implanted in the eye, sort of like a contact lens placed on top of your natural lens. They can be helpful for severely nearsighted people who aren't candidates for LASIK.

* Cataract-replacement lenses. The old replacement lenses only corrected distance vision, not near vision. New lenses can correct both.

Nature's helpers

A diet rich in dark, leafy greens and brightly colored fruits and vegetables can help improve your eye health. Recent studies show that foods rich in certain nutrients can reduce the chances of cataracts and age-related macular degeneration. For example:

* Lutein and zeaxanthin. Kale, collard or turnip greens, spinach.

* Vitamin C. Citrus fruits and their juices; green peppers; tomatoes and tomato juice; strawberries; broccoli.

* Vitamin E. Nuts, including almonds, peanuts and pecans; vegetable oils; peanut butter; sunflower seeds.

Whom do I see?

* Ophthalmologist. This type of doctor finishes four years of medical school after college and has years of additional training in eye care, including surgery. He or she can prescribe eyeglasses and contacts, diagnose and treat illnesses of the eye, and perform LASIK.

* Optometrist. This type of doctor finishes four years of optometry school after college and may have additional training. He or she can measure and treat vision problems with eyeglasses and contacts, prescribe some medications, and treat some eye conditions, such as dry eyes.

* Optician. Special programs or on-the-job training teach opticians to order, examine and fit prescription eyeglasses and contacts.

About reading glasses

You might consider buying a pair at the drugstore. But if you have any of the following issues, you should order glasses from your doctor, says Maurice E. Zadeh, a Georgia optometrist.

* You have a different level of vision in each eye.

* You have other vision problems, such as astigmatism.

* The center of the lens does not coincide with the center of your eyes.

Ask

Here are some questions your doctor should be able to answer:

* Why is this procedure best for me?

* What training have you received in this procedure?

* How many surgeries have you performed?

* Do you use an FDA-approved laser? How many patients have you operated on with this laser?

* Will I experience discomfort or pain? How fast should I heal?

* How long before I can see clearly?

* What risks arise from this procedure?

* Are all pre-operative and post-operative visits included in the cost of the initial procedure?

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