Monday, January 26, 2015

Postmenopausal Hormones can Reduce Glaucoma Risk

We know that early menopause, with the associated declines in certain hormones such as estrogen, can result in an increased risk of glaucoma. Now, there is reason to believe that certain postmenopausal hormone therapy (PMH) may actually reduce the risk of glaucoma.

According to researchers publishing in JAMA Ophthalmology taking estrogen only postmenopausal hormone (PMH) treatment may help reduce the risk for primary open-angle glaucoma (POAG). By reviewing data from 152,163 women 50 years or older the researchers found that 1.9 percent of enrollees developed POAG. Each additional month of use of PMH containing estrogen only was associated with a 0.4 percent reduced risk for POAG whereas each additional month of use of estrogen + progesterone or estrogen + androgen hormones did not affect risk for POAG. This is interesting information and will require further prospective clinical studies to understand fully but may offer some novel treatments for primary open angle glaucoma (POAG), an insidious sight threatening eye diseases and the most common type of glaucoma.

If you or someone you know has questions or concerns about glaucoma and postmenopausal hormone therapy, please call Doctor & Associates-203-227-4113, visit Doctor & Associates or facebook.com/doctorandassociates to schedule an appointment. Doctor & Associates offices are located at 129 Kings Highway North, Westport, Connecticut 06880, 195 Danbury Road, Wilton, Connecticut 06897 and 148 East Avenue, Norwalk, Connecticut 06851.

Facial Wrinkles: Are They All the Same?



Facial wrinkles vary from fine surface lines to deeper creases and folds.  Their development is the result of accumulated skin damage and inevitable loss of bone, fat and collagen, as well as repetitive use of facial muscles. Premature wrinkles and aging of the face is accelerated by excessive exposure to the sun, smoking, poor nutrition and some skin conditions.

Horizontal forehead wrinkles, brow furrows and eye lines such as crow’s feet are produced by specific muscles repeatedly creasing the skin. By reducing the function of these muscles with products such as BOTOX®, Xeomin® or Dysport®, the wrinkles are eliminated or reduced and without repetitive use, new wrinkles are prevented.  The same products can be used for a “chemical brow lift” to contour the eyebrow area.

Injectable gel fillers are substances that are used to replace lost volume in certain areas of the face. When used appropriately, the results can be substantial and fairly long lasting. They are not replacements or alternatives to BOTOX®, Xeomin® or Dysport®, in that they treat a different set of problems: deeper creases and folds that are not due to muscle activity. Different fillers have specific properties that make them appropriate for different areas of the face such as the cheekbones, lips, tear troughs, temples, deep folds along the sides of the mouth and jowls.

If you or someone you know would like to learn more or schedule a consultation for help with facialwrinkles of fine lines using nonsurgical treatments, please call Doctor &Associates at 203-227-4113 to schedule a consultation with Cosmetic Eye Plastic& Reconstructive Surgeon Flora Levin, M.D.

Monday, January 19, 2015

Eyelid Surgery: How Will It Affect the Way I Look?

About Eyelid Surgery
Bleph Post-Op
Cosmetic eyelid surgery is a wonderful and powerful option in facial rejuvenation. Following upper blepharoplasty, more of the upper eyelid is visible making the patient look refreshed and “more awake.” Patients who could not wear makeup because the eyelid was covered by excess skin can wear it again. The youthful eyelid contour is restored, more hollow in the inner aspect, and fuller at the tail of the brow. To ensure the best outcome, is it important to discuss individual expectations and often helpful to review photographs when the patient was in the 20’s or 30’s.  Following lower eyelid blepharoplasty, the puffiness of the lower eyelid is improved and the skin appears smoother and tighter. Overall, the face looks more youthful and rejuvenated. For many patients, their appearance matches more closely how they feel (younger than their true age).

If you or someone you know would like to learn more or schedule a consultation for cosmetic eyelid surgery or blepharoplasty, please call Doctor & Associates at 203-227-4113 to schedule a consultation with Cosmetic Eye Plastic & Reconstructive Surgeon Flora Levin, M.D.


Better Glaucoma Diagnosis & Treatment Reduces Blindness

Each January we begin the New Year with a strong emphasis on patient education and awareness on glaucoma prevention. This along with a number of improvements in diagnosis and treatment of glaucoma has had a meaningful impact on reducing blindness from glaucoma. A recent study from Mayo Clinic suggests that there is good news for those with glaucoma or at risk of getting glaucoma in that all of these efforts and the advances in diagnosis and treatment have lowered the risk of blindness from glaucoma by nearly half.


About Glaucoma
Glaucoma is a condition where the eye does not drain fluid properly, resulting in high pressure in the eye that can damage the optic nerve. In the United States, 2.7 million people age 40 and older have the condition. If left untreated, glaucoma reduces peripheral vision and eventually may cause blindness. According to the Mayo Clinic study, the likelihood of losing sight in one eye was 28 percent for patients diagnosed with glaucoma between 1965 and1980. That number fell to 13.5 percent for patients diagnosed between 1981 and 2000.

Patients have an important role in scheduling regular eye exams with glaucoma testing as this is the best way to detect glaucoma early and initiate treatment as quickly as possible. At Doctor & Associates we  use in office high technology diagnostic imaging called Optical Coherence Technology (OCT) as well as high resolution digital photography for diagnostic purposes along with in laser treatments for glaucoma-all of which has contributed to our ability to prevent vision loss and blindness from glaucoma.

If you or someone you know is concerned about glaucoma, has any risk factors for glaucoma or needs to schedule a glaucoma eye exam, please feel free to call Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County or facebook.com/doctorandassociates to schedule an appointment.

Doctor & Associates offices are located at 129 Kings Highway North, Westport, Connecticut 06880, 195 Danbury Road, Wilton, Connecticut 06897 and 148 East Avenue, Norwalk, Connecticut 06851.

Monday, January 12, 2015

Remember Glaucoma Eye Exams & Screenings

With January being designated at Glaucoma Awareness Month we wanted to ask patients to remember the importance of having regular glaucoma eye examsand screenings. With Primary Open Angle Glaucoma (POAG), the most common type of glaucoma we see at Doctor & Associates-there are no symptoms! Thus, the importance of early detection, diagnosis and treatment are the keys to preventing vision loss from this type of glaucoma.

Eye exams for glaucoma should begin by checking your visual acuity with and without your eyeglasses or contact lenses. Then, the tonometry test should be performed. This is a method of measuring your Intraocular Pressure (IOP) and gives us the first piece of important information in determining whether you might have glaucoma. Ophthalmoscopy is another examination procedure used to detect and diagnose glaucoma. Ophthalmoscopy is a method of carefully examining the inside of the eye-especially the optic nerve-in order to detect glaucoma. We might also perform a high magnification contact lens exam to look at the optic nerve. It is necessary to have some eye drops placed in your eyes in order to dilate your pupils so that the doctors can make a clear and direct observation of the optic nerve by either examination technique.

Glaucoma Testing
If either the Intraocular Pressure (IOP) is elevated or the optic nerve appears unusual, additional tests will be necessary in order to complete the glaucoma examination. These may include Visual Field Perimetry, Gonioscopy, Optic Nerve Computer Imaging and Pachymetry. Should you need any of these tests we explain them fully to you and answer your questions so that you understand how they allow us to detect and diagnose glaucoma.

If you are under 40 years of age and do not have any family history or risk factors, then having a glaucoma eye examination every two years should be sufficient. If you have ocular hypertension or any glaucoma risk factors such as high blood pressure, diabetes, vascular diseases, sleep apnea, early menopause, a family history of glaucoma-especially a sibling-or are over 40-particularly if you are of African-American or Hispanic descent, then a glaucoma eye exam each year is recommended. If you or someone you know has questions or concerns about glaucoma, glaucoma risks or needs to schedule a glaucoma eye exam, please call Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County or facebook.com/doctorandassociates to schedule an appointment.


Doctor & Associates offices are located at 129 Kings Highway North, Westport, Connecticut 06880, 195 Danbury Road, Wilton, Connecticut 06897 and 148 East Avenue, Norwalk, Connecticut 06851.