Eye Injuries & Radiant Energy

Radiant energy such as ultraviolet radiation, X-rays and infrared radiation can cause eye injuries.

Ultraviolet Radiation

The most common radiation injury encountered results from the absorption of ultraviolet by the cornea. The ultraviolet of the sun is absorbed mainly by the atmosphere. With ultraviolet burns to the cornea there are no immediate symptoms but a few hours later the recipient's eyes begin to water and feel gritty. Later, as the symptoms progress, the foreign body sensation becomes extreme and the patient is in a great deal of pain. Tearing, congestion of the globe and marked photophobia (inability to tolerate light) occur. Staining of the cornea with fluorescein reveals slight pitting of its surface that is caused by erosion of the superficial epithelium.

Infrared Rays

The most common infrared calamity to the eye is an "eclipse burn" to the retina. This follows direct observation of a total eclipse of the sun. The effect of this injury to the retina is marked reduction in visual acuity that is permanent. Ordinary protective devices such as tinted glass, Polaroid lenses and usual filters are of no value in protecting against this hazard. Direct viewing of eclipses should be avoided.

X-Rays

X-rays are of very short wavelength, shorter than ultraviolet radiation and considerably shorter than the visible violet end of the spectrum. Exposure to x-rays can produce many ocular complications, including glaucoma, cataracts, necrosis of the skin, loss of lashes and Iritis. Consequently great care has been taken in the clinical use of x-rays exposure about the eye, to protect the patient from excessive dosage and the hospital staff from unnecessary exposure to dangerous radiation. As a result, the incident rate of eye complications among x-rays and radium workers is extremely low.

Please protect your eyes and your vision and should you be exposed to excessive ultraviolet, infrared or x-rays please do not hesitate to call Doctor & Associates at 203-227-4113.

History of Spectacles

You might be surprised to learn about the history of spectacles. No one knows when the earliest vision aids were used. There are no written recordings from early times. The ancients were aware of the optical effects of water or glass, e.g. the magnifying effect of a drop of water, the enlarged view of a leaf vein seen through a dew drop or the visual effect through a spherical transplant jewel of the underlying surface. Recent findings have shown that the Egyptians and Babylonians knew and utilized rules of optics. The oldest description of sunglasses was made by Pliny (23-79 B.C.). He wrote that the Roman emperor Nero used a polished emerald to view the gladiators. He does not mention if the optical surface was spherical but it is apparent that the light-absorbing nature of the gem made viewing in bright sunlight more pleasant. From the same era one can read complaints by older Roman statesmen that the condition of their eye made reading of legal texts difficult. It is sure that presbyopia was considered a disease in ancient Rome but no one documented any treatment with usual aids. The earliest mention of a visual aid was the reading stone. The stone was a polished hemisphere of the semi-precious gemstone beryl which, when laid on a page, enlarged the text in all directions.

The inventor of spectacles, meaning glasses worn directly on the eye, is unknown.

Classic spectacles that are worn directly over the eyes appeared in more recent times when clear, transparent glass became available at a reasonable price. The first occurred on Murano, a small island near Venice still famous for the production of glass. Developments from spectacle manufacturers no longer required that the lens be placed on the text in order to read; it could now be held in front of the eye.

There were minor improvements made during making: better lens polishing, new methods of stabilizing the positioning of spectacles for reading and some improvements in lens coating. The 16th and 17th centuries saw the appearance of lens expensive spectacles, usually +3D intended for presbyopia (reading), that were framed in leather or iron. Products with horn and copper frames were made for the clergy or public officials while those frames in gold, silver or ivory were rarities reserved for the very wealthy.

It is amazing that the use of curved earpieces is only 100 years old. The history of spectacles is the history of scientific progress. Spectacles have enabled millions of people with visual problems to take part in daily life and to acquire an education. From their beginning as a reading lens made of the gemstone beryl, glasses have improved to include multifocal lenses, contact lenses and implants into the living eye. 

If you have questions about spectacles or eyewear please feel free to ask us at Doctor & Associates-203-227-4113.

What are Prisms?

We sometimes use prisms in both your eye exam as well as in your eyeglass prescription. A prism is a triangular, or wedge-shaped, piece of plastic or glass that has the property of displacing a bundle of light toward the base of the prism. A prism has flat sides, an apex, and a base. If the prism is placed before the eye, an object viewed in front of the prism will appear to be displaced toward its apex. Prisms are employed in measuring the presence of the amount of any tropias (an obvious misalignment of the eyes) or phorias (a tendency toward ocular misalignment that is held in check by the fusion effort of the extra ocular muscles). 

Types of prisms that are available are loose prisms, horizontal and vertical prism bars and Risley's rotary prism. The loose or individual prism is made of plastic or glass. These prisms are supplied in low powers in standard trial lens sets and in full range of powers in individual prism boxes.

Horizontal and vertical prism bars are fused prisms amalgamated into a single bar of gradually increasing strengths. These prisms may be set in a horizontal direction (base in or out) or in a vertical direction (base up or down). The prism bar is principally employed to measure the amplitude or power of fusion.

Risley's rotary prism consists of two counter-rotating prisms mounted in rings, one in front of the other. These rings are easily rotated in opposite directions by a small thumbscrew. Risley's rotating prism provides a rapid and simple increase in prism power strength so that a deviation may be rapidly adjusted and measured without the delay in introducing individual prisms before the eye.

If you have questions about eye exams and how we use prisms please feel free to contact us at Doctor & Associates-203-22-4113.

Prevention of Eye Injury in Industry

Prevention of eye injury in industry settings is an important consideration for many people. The use of safety glasses has been of greatest importance inasmuch as the glass itself becomes a protective shield for the eye. Although ordinary glasses for street wear and industrial glasses may look alike, the similarity ends there. The difference between the two of lenses and frames is vast.  Regular street glasses, for example, can shatter easily into the eye. In contrast, industrial safety lenses are thicker and hardened so that they resist, without shattering. The best safety glasses are made of polycarbonate plastic. The frames of safety glasses also are of different construction. In addition to being flame resistant, they are designed to retain the safety lenses under heavy impact.

Contact lens wear may be hazardous in the fume-and chemical-laden environments of some industries. They must wear protective goggles as well as protection against flying missiles.

Industrial safety lenses should be employed when work or hobbies are pursued that involve lathing, chiseling, grinding or hammering. The hazard to the eye is even greater than in industry, because home lighting conditions are not always optimal and built-in safely guards are now always found in home machinery.

If you are interested in purchasing safety glasses Willows eyewear will be happy to help. Please call 203-227-9380 with any questions.

Scratched Cornea & Corneal Abrasions

Corneal abrasions are superficial scratches and erosions of the cornea. They are found after corneal foreign bodies have been removed, either spontaneously or with treatment. They are most commonly found after injuries caused by paper, fingernails, wires and so forth. A corneal abrasion, unless it is large, cannot be seen with the naked eye. Patients with a corneal abrasion complain of a foreign body sensation of the eye. Often these patients are seen by a nurse or a friend and told that there is nothing in their eye and as a result they suffer until they are finally seen by the ophthalmologist; any person who complaints about a foreign body sensation of the eye should be seen. Fluorescein strips should be placed in the eye to stain the area of the corneal defect and the eye should be examined with magnifying glasses. Corneal abrasions are treated by firm patching for 24 hours; the larger the abrasion, the longer the time to heal. The bandage soft contact lens may minimize the pain. Usually corneal abrasions are very uncomfortable with the eye tearing and difficulty to keep the eye open. It is important to address the issue as soon as possible.

Protect your eyes and be careful while working outdoors. If you have any questions regarding scratched cornea or corneal abrasions please schedule an appointment for an examination at Doctor & Associates by calling 203-227-4113.

What is Anti-Reflective AR Coating?

An anti-reflective coating (also known as AR coating or anti-glare coating) improves both your vision through your lenses and the appearance of your eyeglasses. Both benefits are due to the AR's ability to eliminate reflections of light from the front and back surface of eyeglass lenses. AR coating is especially beneficial when used on high index lenses, which reflect more light than regular plastic lenses. Generally, the higher the index of refraction of the lens material, the more light that will be reflected from the surface of the lenses.

For example, regular plastic lenses reflect roughly 8% of the light hitting the lenses, so only 92% of available light enters the eye for vision. High index lenses can reflect up to 12% allowing only 88% of available light to the eye for vision. This can be particularly troublesome in low light conditions, such as night driving. Today’s modern anti-reflective coating can virtually eliminate the reflection of light from eyeglass lenses allowing 99.5% of available light to pass through the lenses and enter the eye for good vision.  By eliminating reflections, AR coatings also make your eyeglass lenses look nearly invisible so people can see your eyes more clearly. Anti-reflective coatings also make you glasses look more attractive so you can look your best in all lighting conditions.

Unlike the older generation of AR coatings, today’s premium coatings include a “hydrophobic" and "oleophobic" surface. These surfaces repel water and skin oils which make the surface much easier to keep clean.

If you have any questions or are interest in having AR coating our Opticians at Eyewear at Willows will be happy to help. Please call them at 203-227-9380.

What is Refraction?

Refractometry is defined as the measurement of refractive error and it should not be confused with the term refraction. Refraction is defined as the sum of steps performed in arriving at a decision as to what lens or lenses (if any) will most benefit the patient. These steps include, in addition to Refractometry, measurements of visual acuity, measurement of accommodative ability and the exercise of clinical judgment. Refractometry, on the other hand, is strictly limited to clinical application of optical principles. This measurement function can be performed at the highest level of precision by technicians and, in some cases, even by sophisticated instruments and computers.

The exercise of clinical judgment included in the foregoing definition of refraction refers to a consideration of such factors as the patient's occupational requirements, muscle balance, impairment of vision by other than refractive error (such as cataract, macular degeneration or amblyopia), the extent and type of refractive error present and even the emotional "set" of the patient with respect to wearing glasses. For some patients, even though there may be a significant error, the maximum benefit will be achieved by prescribing no lenses at all.

If you have any questions regarding refraction or measurement of refractive error please schedule an appointment for an examination at Doctor & Associates by calling 203-227-4113.

Types of Ophthalmic Eyeglass Lenses

The many types of ophthalmic eyeglass lenses can sometime be confusing. Too often, eyeglass wearers do not spend enough time selecting their lenses. Most do not realize that all eyeglasses are different. Your eye care professional can tell you about the variety of materials, coatings, styles and thicknesses of lenses available to help make your glasses look and perform their very best. As for the different types of lenses, these can be divided into four main categories; single vision lenses, bifocal lenses, progressive lenses and occupational lenses.

Single vision lenses have the same focal power throughout the entire lens and can be used to correct myopia, hyperopia, and astigmatism. Single vision lenses are usually used by eyeglass wearers under the age of 40.

Bifocal lenses used to be the only option for people with presbyopia who also require a correction for myopia, hyperopia and/or astigmatism. They are lenses that carry two distinct optical powers in each lens. As that is an old technology, progressive lenses are now the new option for better aesthetics and comfort.

Progressive lenses are also designed to counter presbyopia. They correct the effects of presbyopia with a gradual change of power from near to distance vision, restoring natural vision without the unsightly segmentation lines or image jump experienced with standard bifocals. Progressive lenses offer comfortable vision at all distances.

Some lenses are specially designed for specific functions, as opposed to regular, everyday use. For example, keeping pace with the computer use where reading lenses for both near and intermediate vision are being used.

Nowadays we can offer better quality of lenses. Digital lenses are available for patients who were not successful with progressive lenses in the past. Good candidates are people with high prescriptions and a lot of astigmatism. Digital lenses require extra measurements from the optician to make progressive glasses prescription more accurate and better fit for the person's needs.

If you have any questions about lenses or interested in trying digital lenses please call Eyewear at Willows at 203-227-9380.

Crossed Eyes or Strabismus

Crossed Eyes are called Strabismus. Strabismus is a misalignment of the eyes that may cause vision to be disturbed and results from the extra ocular muscles of the eye not working in a coordinated manner.

One of the first things we address in treating Strabismus is the elimination of any coexisting Amblyopia which is often referred to as “Lazy Eye.” Some forms of Strabismus can be corrected by improving the vision in the Amblyopic eye inasmuch as the eye muscle control may improve at the same time. In addition, the eyes may straighten in some patients with Strabismus who require glasses to correct vision or Amblyopia.

An eye condition in which the direction that the eyes are pointing is not consistent with each other is called heterophoria. Patients with well-controlled heterophorias may need no treatment at all. Some forms of Strabismus, such as nerve palsies, are temporary and will resolve with time. Other forms, such as convergence problems that cause reading difficulties, will respond to exercises. Sometimes patients who have double vision may experience relief of the double vision and regain fusion and single vision through the use of prisms. Both permanent and temporary types of prisms are available to help patients.

If none of these treatments is indicated or is successful in straightening the eyes, then two options are available. One is eye muscle surgery, which involves the strengthening of weak eye muscle and weakening of overactive or tight muscle. The other option is the injection of Botulinum toxin into the eye muscle, which paralyzes them and straightens the eyes with certain forms of strabismus.

If you have any questions regarding Crossed Eyes or Strabismus or Lazy Eye or Amblyopia please schedule an appointment for an examination at Doctor & Associates by calling 203-227-4113.

What are Floaters?

A lot of patients ask us, “What are these floating spots in my eye that I sometimes see sometimes?” Some of them are black spots that look like cobwebs or some light color spots that move together with your vision.
 

Virtually everyone has seen these at some time or another, tiny spots before our eyes. They may appear singly or in clusters; they may be punctate or linear; they may travel with the movement of the eye or against them. These particles and vitreous collagen fibers are called floaters. Floaters are most apparent when the illumination is high and when one is gazing at a clear surface. The most common situations in which they are seen include looking up at a clear summer sky, gazing against a blank white wall and reading.
 

Floaters are usually caused by the formation of small particles in the vitreous body and generally are innocuous. However, floaters may, on occasion, be indicative of a more serious derangement within the eye. They may be secondary to a retinal tear, hemorrhage or a detachment. Protein condensations in the vitreous or separation of the vitreous gel from the retina may occur as part of the normal aging process. No treatment is required in most of the cases unless they suddenly increase in number. In that event, dilated fundus exam is necessary.

If you have any questions about floaters or have a family history of retinal detachment please do not hesitate to call Doctor & Associates at 203-227-4113. 

Monovision: Is It Permanent?

Monovision, where one eye focuses for distance and the other for near, is a great option to decrease dependency on glasses or contact lenses when having Cataract Surgery or Laser Eye Surgery such as Laser Vision Correction including LASIK.

The ideal candidates for monovision correction with cataract Surgery or LASIK are those who have already adapted to monovision in contact lenses. That is, those who are successfully wearing two different contact lenses, one correcting distance vision, the other correcting near vision. Particularly appropriate for consideration are those occupations that require intermittent focusing between distance and near, such as sales representatives, school teachers, lawyers or business individuals who are frequently involved with meetings.

For monovision, we typically focus the dominant eye to correct for distance. A number of different tests can be used to determine ocular dominance. A simple one is to hand a person a camera and ask him or her to pretend to take a photograph of some distant object. The eye he or she uses to look through the viewfinder is the dominant eye.

If you express an interest in monovision, a trial with contact lenses may be in order. The trial will determine your suitability for monovision and indicate the appropriate power for each eye. A satisfactory, well-tolerated contact lens trial is a good indicator of probable success of surgically created monovision. If the contact lens trial is not well tolerated and the trial has been adequately long (approximately two weeks), we avoid using this approach.

If you have any questions regarding monovision or want to know if you are possibly a good candidate for monovision cataract Surgery or monovision LASIK please call Doctor & Associates at 203-227-4113.

'Tranquileyes' Can Help Dry Eye

'Tranquileyes' might be able to help you with Dry Eye. Over 60 million Americans suffer from dry eye symptoms. 10 million suffer from Dry Eye Syndrome. The most common cause of severe dry eye is the normal aging process. However,  some factors that may cause and contribute to Dry Eyes include excessive contact lens use, infrequent or incomplete blinking typically incurred by computer users, allergies, certain diseases like Sjorgrens Syndrome, Rheumatoid Arthritis and Lupus as well as the use of a number of different medications. There is no quick cure for Dry Eye and if left unattended Dry Eye can lead to scarring of the Cornea and even vision loss.

'Tranquileyes' eye hydrating therapy goggles are highly recommended for people suffering from Dry Eyes. They are soft flexible goggles with reusable sponge and a gel pack. They are used to create a humid, warm environment for around the eyes that helps to stimulate tear production and slow the evaporation process. They are meant to be worn while sleeping or just relaxing.

If you have dry eye problems and seem to be frustrated with current eye situation 'tranquileyes' might be an option for you. Please call Doctor & Associates at 203-227-4113 to find out what kind of treatment would help to resolve your Dry Eye problem.

Corneal Transplant

The Cornea is the clear portion in the front part of the eye that is similar to the transparent covering on a watch. When injury, degeneration or infection occurs that causes the Cornea to become cloudy, vision will be disrupted. Only by replacing a portion of the Cornea with a clear window taken from a donor eye can vision be restored.

Not everyone with a corneal disease can be helped by corneal transplantation. The Cornea, because it is free of  blood vessels, is one of the few tissues in the human body that may be transplanted from one human being to another with a large degree of success. The absence of blood vessels in both the donor and host cornea reduces the allergic reaction, in which immunoglobulins are carried through blood flow, and permits the body to retain and not reject the "foreign" Cornea. Thus only conditions in which the Cornea is free of blood vessels are suitable for transplantation.

In the postoperative period the most common complications include a wound leak, suture breakage and wound dehiscence, infection and graft rejection. If detected early and managed appropriately, these complications can be controlled or eliminated, enabling a high level of success for the operation. Thus, careful monitoring by the surgeon is required.

Dr. Leslie Doctor is a Board Certified Ophthalmologist at Doctor & Associates. If you or someone you know has suffered from Cornea disease or trauma and would like to learn more or schedule a consultation regarding Corneal Transplants please feel free to contact us at 203-227- 4113.

Teenage Drivers, Vision & Eye Exams

Traffic crashes are the leading cause of death for teenagers across the United States. For both men and women, drivers aged 16 to 19 years of age have the highest average annual crash and traffic violation rates of any other age group.

Teenagers tend to take more risks while driving partly due to their overconfidence in the driving abilities. Young novice driving are more likely to engage in risky behaviors like speeding, tailgating, running red light, violating traffic sings and signals, making illegal turns, passing dangerously, and failure to yield to pedestrians. Teenage drivers have not yet completely mastered basic vehicle handling skills and safe-driving knowledge they need to drive safely. They also have low risk perception which involves subjectively assessing the degree of threat posed by a hazard and one's ability to deal with the threat. Young drivers tend to underestimate to crash risk in hazardous situations and overestimate their ability to avoid the thread they identify.

Therefore, good vision is essential for the proper and safe operation of a motor vehicle.

Generally, available vision-testing instruments can be used to ascertain if a person has adequate vision to meet specific licensing jurisdictions. Because of the increasing injury and death toll resulting from traffic accidents, many of which may be related to visual impairment, physicians consider it a medical obligation to diagnose visual deficiencies and to inform the patient of potential hazards involved in driving with such deficiencies.

There is no practical way of testing alertness or cerebral perception of what the eye focuses on but it is important for drivers to have their eyes periodically examined for defects that can be evaluated.

If you are a teenager or a parent to a teenager please make sure his or her vision has been tested and is safe to drive. To schedule an eye exam please call us at Doctor & Associates-203-227-4113.

Anti-Reflective Coating & Eyeglasses

Anti-reflective or Anti-glare coating for eyeglasses is a clear multilayer coating applied to the surface of lenses to help reduce eye fatigue and eliminate most reflections, enhancing visual acuity.

These coatings help to: 

          

·         Eliminate ghost images and improve reaction time of the eye when adjusting back to normal after glare from oncoming traffic, making night driving safer.

·         Enhance contrast by allowing more light to pass through spectacle lenses to the eye as clearly as possible. Patients find this especially helpful when working under fluorescent lighting while working on a computer for extended periods of time. Now with so many schools using smart boards and other projector screens, children and students of all ages also find this feature          advantageous.

·         Enhance your cosmetic appearance. External reflections mask your eyes from a complete clear view when someone is looking at you. Anti-reflective coating reduces not just the glare that you see, but also the glare that others can see on your lenses. Direct eye contact is important. Patients that work with the public, such as in sales or customer service find this feature to be an added benefit.

Many anti-reflective coatings now are also hydrophobic and oleophobic, meaning that they repel water, dirt, and oils. These attributes make caring for your lenses easier and also make the need to clean them less frequent.

If you have any questions or would like to learn more about anti-reflective and anti-glare coatings for eyeglasses regarding AR coating please contact Eyewear at Willows at Doctor & Associates, 203-227-9380.

Fairfield County Diabetic Eye Disease Month

Doctor & Associates wishes to announce that Prevent Blindness America has designated November as National Diabetic Eye Disease Awareness Month. This is an important time to spread the word about this potentially blinding disease. We need to work to help patients avoid the complications of diabetic retinopathy, which blinds over 8,000 Americans each year. The vision loss from diabetic retinopathy can be prevented if it's caught and treated in time. A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.

As part of Diabetic Eye Disease Awareness Month we are urging people with diabetes to have a dilated eye exam every year. The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease.

Patients can help to reduce the risk of developing diabetic eye disease  by not smoking, controlling their cholesterol and lipid profile and blood pressure, as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables and exercising. 

The key to successful treatment of diabetic retinopathy is early detection and intervention. If you or someone you know has diabetes or is even prediabetic please feel free to schedule a diabetic eye examination at Doctor & Associates by phoning us at 203-227-4113.

Retinitis Pigmentosa

Retinitis Pigmentosa is a hereditary disorder that has a variable pattern of transmission. It can be passed on as a sex-linked trait or as an autosomal dominant or recessive trait. It is a disease of the rods (the retinal photoreceptor largely responsible for vision in dim light and for peripheral vision), so that the primary symptoms relate to a failure to see properly in dim illumination. The disease may be mild or may progress to cause total blindness, depending on the nature of the condition and its duration. It is not inevitable that each case will develop and cause constricting field loss. Some cases of retinitis pigmentosa remain stable for a lifetime.

At this time there is no specific treatment for this disease. Treatment with 15000 IU/day of vitamin A palmitate has been suggested. It is important to know your genetic tree so you could get help from genetic counseling.

Many causes of Retinitis Pigmentosa are mild and either do not appear to progress or do so quite slowly. Naturally, persons who develop the disease in their first decade are worse off than those who develop Retinitis Pigmentosa in their forties or fifties.

If you are concerned about Retinitis Pigmentosa or have a family member who has Retinitis Pigmentosa please call Doctor & Associates at 203-227-4113 for an eye examination.

Sports Eyewear and Glasses

Sports injuries account for around 40,000 eye injuries in the USA yearly, with the significant number of them happening to individuals under age 30. Children are more susceptible to eye injuries due to their undeveloped sense of depth perception and slower coordination. The sports that are most responsible for eye injuries are basketball, baseball and racquet sports. Eye injuries from sports can be minor or major form of trauma which could result in temporary or permanent vision loss. Although all eye injuries can be devastating most are preventable by choosing to wear the correct protective eyewear.

Sports glasses should be made with either polycarbonate or trivex lenses. The lenses should be inserted into sports frames that are specific to the sport they will be worn for and should meet ASTM (American Society for Testing Materials) specifications. Sport frames are light weight and usually made of nylon, Kevlar or a polycarbonate/nylon blend to provide durability. Large rubber nose pads distribute the weight evenly and prevent slippage. Frames should fit snug and be form fitting to diffuse the impact of a blow over a large area, away from the eye. A wrap fit is desirable with a strap behind the head to keep the frames securely in place.

If you have any questions regarding sports eyewear or would like to purchase a safe pair of sports glasses Eyewear at Willows will be happy to help, located at Doctor & Associates at 203- 227-9380.

Eye Watering and Tearing Problems

Tearing may be the result of lacrimation, which is excessive tear formation of the lacrimal gland, or it may be caused by epiphora (excessive tearing), which is defective drainage of tears. Lacrimation may result from psychologic stimuli (e.g. grief or sadness), from irritation of the eye by wind or dust or from irritative inflammatory disorders of the conjunctiva, cornea or lids. These causes of lacrimation usually are self-evident and desist once the stimulus has stopped.

Persistent tearing, with overflow onto the cheek, usually is caused by obstruction somewhere in the lacrimal drainage system from the punctum situated on the medial aspect of the lower lid to the nasolacrimal duct. It is important to mention that dry eye is a common reason of tearing as well.

Regardless of the cause, the treatment of tearing caused by defective drainage structures is largely surgical. The decision to have surgery for excessive tearing due to drainage structure problems really depends on the distress of the patient created by the mechanical reflux of tears and the association of secondary infections.

If you are bothered by constant tearing and you are not sure why your eyes are watering all the time please call Doctor & Associates at 203-227-4113 for a consultation.

Polarized Sunglasses & Eyeglasses: How They Work?

For years, boaters and fisherman have used polarized sunglasses to reduce glare from the water that they spend so much time on. In the past few years, however, the benefits of polarized sunglasses have been realized by a variety of outdoor sports enthusiasts as well as drivers and general use wearers. These sunglasses can be used for driving and in fact can reduce the glare that comes off a long, flat surface such as the hood of the car or the surface of a road. Polarized sunglasses can also be used indoors by light sensitive people such as post cataract surgery patients or those exposed to bright light through windows. The popularity of polarized lenses has increased dramatically as has the availability.    

The principle of polarized light reduction is best illustrated by thinking of a polarized lens as a Venetian blind. The blind blocks light at certain angles while allowing light to transmit through selected angles. Polarizing filters are aligned 90 degrees to the angle of the polarized light. As spectacle lenses are designed to eliminate the polarized light in the horizontal plane, the filter is placed vertically in the eye wire or eye rim. This means that the filter must be properly aligned during surfacing edging and layout, otherwise the filter will not work properly.

Today’s polarized sunglass lenses represent the best sun wear and outdoor lifestyle options available. If you have any questions regarding polarized lenses please call Eyewear at Willows at 203-227-9380 located at Doctor & Associates.

Eyelid Problems-What is Blepharitis?

Blepharitis is a common inflammation of the lid margin. Patients usually complain of a sandy or itchy feeling of the eyes, especially in the morning. There usually is redness, as well as a thickening and irregularity of the lid margins. The disease may occur at any age.

The two most common types of chronic inflammation of the lids are staphylococcal blepharitis, and seborrheic blepharitis. Seborrhea is a common cause of dandruff. The base of the eyelash usually is caked with a greasy type of scale that comes off easily, leaving an intact lid margin.

At times blepharitis can be infectious in origin. When this is the case it invariably is a result of staphylococcus aureas. The lid margins become ulcerated and congested and adhesive exudate forms on the base of the follicles and or the lid margin. The ulcerative type of blepharitis is more serious because if the inflammation reaches down to the base of the follicles, it can cause permanent scaring, with either loss of lashes or misdirection of lash and regrowth. Also, the cosmetic consequences are undesirable because the lids become thickened, heavily vascularized and unattractive. The most common treatment for chronic blepharitis is lid hygiene. Warm water and compresses as well as lid scrubs become daily routine for blepharitis patients.

If your eyes feel uncomfortable all the time and you have the above symptoms please call Doctor & Associates at 203-227-4113 for help.

LASIK Monovision and Near Vision

Although LASIK is typically used for the correction of nearsightedness, farsightedness and astigmatism to help patients see at a distance, there are some patients who might benefit from a technique called monovision LASIK to help correct their near vision needs as well. Presbyopia is a normal condition of aging where the crystalline lens inside your eye that is typically soft and flexible begins to lose that flexibility and thus limit your ability to change focus from far to near and near to far. Patients with presbyopia typically report that their “arms are too short” and that near objects and reading material are becoming fuzzy or blurry.

Using monovision LASIK it is possible to “blend” the vision for near and far by correcting your dominant eye for far and your non dominant eye for near. Thus, the need for glasses with two different focal lengths is resolved by focusing each eye at a different focal length. Monovision LASIK can be effective for some patients with the need for mild near vision correction. Depending on the amount of close work you do at work and for how long each day, monovision LASIK may be a good alternative. One way to get a sense of how you will do with monovision LASIK is to mimic the effect with a temporary pair of contact lenses.

To find out if you might be a good candidate for monovision LASIK please feel free to schedule a consultation with Corneal Specialist & LASIK Surgeon Leslie Doctor, M.D. by calling Doctor & Associates at 203-227-4113.

Fairfield County Eye Injury Prevention Month

Doctor & Associates wishes to announce that October has been designated Eye Injury Prevention Month by the American Academy of Ophthalmology. When most people go out to mow the lawn, jump-start the car or get ready to do some spring cleaning, the last thing they think about is protecting their eyes, but it should be first on their mind. It is a good idea to think about protecting your eyes from the extraordinary damage often caused by the most ordinary of activities.

Many household chemicals, such as cleaning fluids, detergents and ammonia, are extremely hazardous and can burn the eye's delicate tissues. When using chemicals, always read instructions and labels carefully, work in a well-ventilated area and make sure spray nozzles point away from you and others before spraying. Be sure to wash your hands thoroughly after use.

Before using a lawnmower, power trimmer or edger, check for debris. Stones, twigs and other items can become dangerous projectiles shooting from the blades of a lawnmower, potentially injuring your eyes or those of innocent bystanders. Prevention is the first and most important step in avoiding serious eye injuries, so be sure to protect your eyes with appropriate protective eyewear. Please feel free to phone Doctor & Associates at 203-227-4113 to schedule a consultation and examination.

Lucentis for Diabetic Eye Disease

There is positive news for patients with Diabetes who have Diabetic Retinopathy. Favorable results were reported of a two-year clinical study of the anti- vascular endothelial growth factor (VEGF) drug Lucentis when used to treat Diabetic Macular Edema (DME) a cause of significant vision loss in patients with diabetes. Patients with Diabetic Retinopathy in the form of DME who received the drug experienced rapid and sustained improvement in vision compared to those who received a placebo injection.

Diabetic Macular Edema or DME is the swelling of retina in people with diabetic eye disease called diabetic retinopathy, which causes damage to the blood vessels of retina. The DME patients suffers fluid leak from the damaged blood vessel to the central portion of retina, causing it to swell leading to blurred vision, severe vision loss and blindness.

Of the 26 million U.S. people with diabetes, a portion of up to 10 percent tends to develop DME during their lifetime, and up to 75,000 new cases of DME are estimated to develop each year. Currently, DME patients are treated with laser surgery that helps seal the leaky blood vessels to slow the leakage of fluid and reduce the amount of fluid in the retina.

Lucentis is approved for use by the U.S. Food & Drug Administration (FDA) for the treatment of “Wet” Age-Related Macular Degeneration (AMD) and for Macular Edema following Retinal Vein Occlusion. In 2011, Lucentis was approved for treatment of visual impairment due to DME in Europe.

The key to successful treatment of Diabetic Retinopathy is early detection and intervention.

If you or someone you know has Diabetes or is even prediabetic please feel free to schedule a diabetic eye examination at Doctor & Associates by phoning us at 203-227-4113.

Headaches and Your Eyes

Headaches are one of the common reason patients are referred to see an Ophthalmologist. The causes of headaches in or around the eye are numerous. They can include such varied conditions as sinusitis, tooth abscess, migraine, hypertension and brain tumor. They also appear as a symptom of chronic anxiety and tension. Of all of the causes of headaches, ocular dysfunction is quite low on the list.

Ocular headaches usually appear after prolonged periods of close work or after performing other tasks that require visual concentration, such as driving or watching movies or television. The pain is mild and is not associated with such symptoms as nausea, vomiting or muscular weakness. It usually is relieved by rest, weekends, vocations and so on. The site of the headache can be virtually anywhere in the cranium but most often the headaches appear in or behind the eyes, around the eyes or in the temporal regions. Commonly the patient with an ocular headache has recently changed activities, thereby becoming bothered by uncorrected refractive errors or disturbances in oculomotor balance. For example, such a patient often has decided to finish a university degree at night, been promoted to a desk job or returned to the workforce. Part of the discomfort may be visual but the factors of anxiety in doing unfamiliar activities, in forced concentration and in learning can be of significance as well.

If you are concerned about any these symptoms related to headaches and your eyes and have not had an eye exam recently, please call Doctor & Associates at 203-227-4113 to schedule an appointment.

Causes of a Painful Red Eye

A painful red eye is a very common symptom and sometimes deserves immediate attention.  One of four conditions is usually responsible for a painful red eye.

1.         Acute Glaucoma (a congested tense eyeball caused by sudden blockage
            of the aqueous outflow)

2.         Acute Conjunctivitis (inflammation of the outer eye)

3.         Acute Iritis (inflammation of the inner eye)

4.         Acute Keratitis (which generally is caused by a corneal infiltrate or ulcer)

After an attack of angle-closure glaucoma, the patient is treated with a number of pressure lowering drugs followed by a laser treatment or surgical procedure.

Conjunctivitis is an inflammation of the conjunctiva that causes swelling of the small conjunctival vessels, making the eye appear red; it may be caused by bacterial or viral infection, allergy, or exposure to environmental agents such as chlorinated swimming pool water, also called pink eye.

Diagnostic investigation may be required in the case of acute Iritis, because this condition maybe an incident in the course of a general body disorder, in particular tuberculosis, syphilis, sarcoidosis, arthritis or other diseases.

Keratitis or corneal inflammation is not commonly present as an isolated entity. It may result from a preexisting conjunctivitis or may be the initiating cause of a secondary Iritis. Among the causes of a painful eye, Herpes Simplex Keratitis warrants special mention. It is commonly diagnosed as a simple conjunctivitis because the eye is red, is sensitive to light and has a watery discharge. The person experiences a gritty sensation of the eye that actually decreases in severity as the condition becomes worse. If the eye is left untreated, many complications can develop, including corneal scaring, secondary Iritis and glaucoma. Early treatment in the form of antiviral drops may reduce the frequency of those late complications.

If you wish to learn more about or experience a painful red eye please call Doctor & Associates for an appointment at 203-227-4113.

Do Cataracts Grow Back?

“After a patient has had a Cataract removed during cataract Surgery it does not grow back,” said Fairfield County Cataract Surgeon Leslie Doctor, M.D. “Occasionally patients do experience a clouding of their vision sometime after their Cataract Surgery that gives them the impression that their Cataract has reformed.” This is typically due to a condition called “posterior capsular opacification.” The crystalline lens of the eye is where a Cataract forms. The crystalline lens has a soft protein center and is surrounded by a capsule. A Cataract forms because the protein becomes cloudy.

During Cataract Surgery Dr. Doctor uses microscopic instruments to break up and remove the cloudy material, as this is what blurs your vision. However, she leaves the “capsule” intact and places the intraocular lens implant (IOL) to correct vision inside the capsule to help correct your vision. In some patients the capsule become “opacified” sometime after surgery leaving the patient’s vision cloudy and often with glare sensitivity, much like the symptoms they had from the Cataract. Fortunately, using a YAG Laser Dr. Doctor is able to quickly, safely and effectively create an opening in the capsule along the visual axis that restores the vision almost instantly. This procedure called a “YAG Capsulotomy” takes only a few minutes and is often performed using simple eye drop anesthesia without discomfort.

If you think you have a Cataract or have been told you have a Cataract and would like to learn more about Cataracts, Cataract Surgery or Lens Implants please feel free to schedule an appointment by calling Doctor & Associates at 203-227-4113.

Eyelid Swelling-Common Causes

The most common cause of an acute lid swelling is an infection of the tiny sweat and oil glands emptying into the margin of the lids. The person with an infection of a sweat gland, commonly known as a stye, usually exhibits diffuse swelling of the lid with a tiny raised nodule on the lid margin that indicates the actual site of involvement. Inflammation of the meibomian or oil glands will result in an internal hordeolum (an infection of the sebaceous gland of the eyelid) that can also result in diffuse lid swelling. With time an internal hordeolum may resolve in the formation of a capsule in the tissue of the lid. The patient then has a firm lump that can be felt through the skin surface of the eyelid. The lump, or chalazion, is an eruption of the contents of the meibomian glands into the tissues that results in a granulomatous response with a cystic change. If the initial infection is minimal, a chalazion may develop without any history of a swollen lid. If the lump does not resolve with treatment advised by the ophthalmologist excision or drainage is usually recommended.

If you are concerned about swollen eyelid and have questions you would like to ask questions please call Doctor & Associates for help at 203-227-4113.

Retinal Detachment-What Is It & What Causes It?

The retina is a nerve layer at the back of your eye that senses light and sends images to your brain. An eye is like a camera. The lens in the front eye focuses light onto the retina as the film that lines the back of a camera.

What Causes Retinal Detachment?

A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred like a camera picture would be blurry if the film were loose inside the camera. It is a very serious problem that will cause blindness unless it is treated.

What Causes Retinal Detachment?

The vitreous is a clear gel that fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, like wallpaper can peel off a wall.

The following conditions increase the chance that you might get a retinal detachment:

•           Nearsightedness

•           Previous cataract surgery

•           Glaucoma

•           Severe injury

•           Previous retinal detachment in your other eye

•           Family history of retinal detachment

•           Weak areas in your retina that can be seen by your Ophthalmologist  

If you are concerned about your risk of retinal detachment please call Doctor & Associates at 203-227-4113 to schedule an eye examination.  

What is Presbyopia?

Presbyopia is a gradual lessening of the power of accommodation due to a physiologic change that becomes noticeable about the age of 40 years. The accommodation ability decreases because of loss of the strength of the ciliary muscle and hardening of the lens. The primary feature of presbyopia is an inability to do close work. Initially it manifests as difficulty in seeing the menu in dimly lit restaurants. Bright light always helps because it adds contrast and constricts pupils to a pinhole aperture. Some people complain that they have to hold the print farther away and eventually they are reading with an uncomfortable reach, complaining that their arms have become too short. Other symptoms include fatigue with reading, grittiness of the eyes with prolonged close work and trouble with threading a needle.

However, not everyone who is 45 or older needs reading glasses. Myopic (nearsighted) persons do not because they can simply take off their glasses to read. Those who are nearsighted in one eye may not be aware of this anomaly and may carry on happily without a reading aid indefinitely. Also, the needs of people differ. A pharmacist will require reading glasses long before the waiter will. Some people do not read or sew and have little use for a reading assist at any time.

If you are frustrated about your inability to read comfortably please call Doctor & Associates at 203-227-4113 to schedule an appointment for an eye examination.

How Safe Is LASIK?

LASIK has been very appealing for many patients who have wanted to be free of the hassle of eyeglasses and contact. Yet, LASIK is surgery and so patients want to really understand the facts about LASIK safety before proceeding. The two main factors that can and instrumentation used to perform the treatment and even more so, the skill and experience of the LASIK Surgeon.

Long Term Track Record
Eye Surgery for the Laser Vision Correction of nearsightedness was first performed in the United States upon Food and Drug Administration (FDA) approval of the Excimer Laser on October 20, 1995. The Excimer Laser was specifically FDA approved for LASIK in 1998. So as of 2011, Laser Eye Surgery for Laser Vision Correction has been performed for over 15 years and the LASIK procedure has been performed under FDA approval for just over 11 years. It is estimated that some 22 million patients worldwide have had LASIK and LASIK is considered one of the most successful and safe types of eye surgery performed. In skilled, experienced hands nearsighted patients can expect to achieve 20/40 vision more than 98 percent of the time, and uncorrected vision of 20/20 or 20/25 in more than 90 percent of cases. Instances of loss of best corrected vision are rare with vision loss worse than 20/40 occurring in about only 3 per 1,000 cases and serious complications, such as infection or corneal damage, occur even more infrequently in fewer than 1 in 1,000 cases.

Safety is the Hands of the LASIK Surgeon
FDA approval does not indicate that a Lasik Surgeon is going to provide a thorough evaluation and consultation, indicate or imply that LASIK Surgeons will provide a complete review of the possible risks and complications of LASIK-nor does it imply that a LASIK Surgeon will use the appropriate screening and decision criteria to be sure that a patient is in fact a good candidate for LASIK or any Laser Eye Surgery for that matter.

That is why choosing a LASIK Surgeon is the most important decision a patient makes in deciding to have LASIK and is a significant part of making LASIK a safe and effective procedure. You should not choose a LASIK Surgeon based on slick advertising or low price. You should choose a LASIK Surgeon based on reputation in the community, the length of time they have been performing LASIK and the comfort and rapport established during your consultation. While the equipment used may provide a slight advantage or disadvantage in safety, it is ALWAYS the skill and experience of the surgeon that contributes the most to the overall safety of Laser Eye Surgery for the correction of nearsightedness, farsightedness and astigmatism.
To find out if you are a good candidate for LASIK please feel free to schedule a consultation with Corneal Specialist & LASIK Surgeon Leslie Doctor, M.D. by calling Doctor & Associates at 203-227-4113.

Photochromic Eyeglass Lenses

Photochromatic eyeglass lenses are lenses that darken when exposed to ultraviolet rays and adjust their color in different lighting situations. These lenses offer 100% UVA and UVB protection. They are most commonly available in brown and gray tints. These lenses are a great option for everyday day dress eyewear, but are not intended to replace prescription sunglasses. A reason for this is that the windshields in automobiles block the UV rays necessary for these lenses to darken.

Photochromic lenses are often referred to as PhotoGray or Transitions®. These are actually brand names of the lenses. PhotoGray glass was developed by a company named Corning in the 1960’s. The Transitions® name came to us from Transitions Optical in 1991 when they introduced to us the first commercially successful plastic photochromic lens.

Photochromic lenses are now available in a variety of materials such as glass, conventional plastic, polycarbonate, trivex, and hi-index plastics. When choosing the right material for you, it is wise to take into consideration factors such as your daily lifestyle, your prescription range, and your frame selection.

Photochromic lenses are available in single vision, bifocal and progressive lens styles, so people of all ages can enjoy the benefits of these lenses.  If you have any questions regarding photochromatic lenses please call Willows Eyewear at Doctor & Associates at 203-227-9380.

Prevention of Diabetic Retinopathy

Diabetes is one of the most common chronic diseases among children and adults in the United States.  In diabetics, as we all know, there is too much sugar in the blood. When the blood sugar is constantly or frequently high, many complications occur: eyesight can suffer, heart attacks, strokes, and other blood vessel problems can occur. When blood sugar is maintained at a normal level (between 80 and 120) most of the time, the complications of diabetes can be reduced. Controlling blood sugar is the most important thing a person with diabetes can do to prevent or reduce the complications of diabetes.

Type one diabetes usually begins at a young age and patients must take insulin to survive and control blood sugar. They should test their own blood sugar with a blood sugar-monitoring device several times daily so they can adjust their diet, exercise, and insulin doses to keep the blood sugar under control. They should follow a diet controlled in carbohydrates and low in fat and cholesterol. Regular exercise is also very important as it helps reduce blood sugar.

Type two diabetes usually starts in adult life and is often not dependent on insulin. Maintaining normal weight and a diet low in calories, fat, and cholesterol is the key. Blood sugar can be controlled either with diet alone or in combination with pills to lower blood sugar. In some cases, insulin treatment is also necessary.

In addition to the importance of diet and exercise, there are other factors that can affect diabetes. High blood pressure increases the likelihood of complications and therefore should be strictly controlled and kept normal at all times.

All people with diabetes, especially those who have had diabetes for a long time, should have regular eye examinations with an ophthalmologist on a yearly bases or even more often. Please call for the appointment at one of Doctor & Associates' offices at 203-227-4113.

Macular Degeneration Symptoms & Diagnosis

Macular Degeneration is related to aging and therefore is called age-related macular degeneration (AMD). Patients with macular degeneration may begin to notice problems with eyesight sometime after the age of fifty. AMD could be hereditary so blood relatives should have their eyes examined every year after the age of fifty.

AMD usually starts with the appearance of yellow-colored spots in the macula. These spots, caused by the buildup of fatty deposits, are called drusen. Drusen do not usually change vision very much and only a few people with drusen alone develop severe AMD with loss of vision. When macular degeneration does lead to loss of vision, that loss usually starts in one eye but later may affect the other eye. When a person loses vision in one eye, the loss of vision may not be noticed because the healthy eye can still see detail. It is only when AMD severely affects both eyes that it will become difficult to do the kind of work that requires central vision, vision that can discern fine detail.

A person with advanced AMD, who has lost the ability to see detail with each eye, rarely loses peripheral vision and will still be able to get along fairly well. Macular degeneration almost never causes total blindness. Majority of patients can see well enough to take care of themselves and continue those activities that do not require detail central vision. The ability to look slightly off center usually improves with time, although eyesight will never be as good as before the macula was damaged.

If you are concerned about macular degeneration or have relatives who have it please call Doctor and Associates to evaluate the condition of your eye health.

Keratoconus

Keratoconus is a degenerative corneal disease in which the center of the cornea thins and assumes the shape of a cone. It is usually bilateral and is often found in patients who have hay fever, atopic dermatitis, eczema or asthma. Keratoconus creates irregular corneal astigmatism that defies correction by ordinary spectacles. Rigid contact lenses (RGP) have been used to correct the visual defect. If the patient is unable to be fitted properly with contact lenses because of very high irregular astigmatism, some surgical procedures are offered to restore vision.

The symptoms of keratoconus are decreased vision, monocular diplopia (one eye double vision) or ghost images, distortion and halos. Even when visual acuity is good, it is normal for keratoconics to describe visual distortions. Studies show that keratoconus patients have dysfunctional vision despite adequate visual acuity with contact lenses.

If you are concerned about having keratoconus or have a family member who experiences similar symptoms Doctor & Associates will be happy to help. Dr. Leslie Doctor is a Cornea Specialist who completed Fellowship in Cornea and Refractive Surgery in the Ohio State University. Please feel free to call us at 203-227-4113 with any questions.

Cataract & Prostate Cancer Treatment

Patients being treated for prostate cancer with Androgen Deprivation Therapy (ADT) may have a higher risk of developing cataracts according to a study from Karmanos Cancer Institute. The side effects of ADT such as weight gain, insulin resistance and blood lipid level problems have been linked to Cataract formation. Although further prospective study is necessary to truly understand the findings researchers from Karmanos Cancer Institute in Detroit used the Surveillance, Epidemiology and End Results Medicare database to analyze Cataract formation in prostate cancer patients and found a significantly greater risk of Cataract development.

If you think you have a prostate problem and are on Androgen Deprivation Therapy (ADT) and would like to be evaluated for Cataracts or would like to learn more about Cataracts, Cataract Surgery or Lens Implants please feel free to schedule an appointment by calling Doctor & Associates at 203-227-4113.

LASIK Evaluation-What to Expect

Having LASIK may be an excellent vision correction option for you. However, the only completely reliable way to determine whether Laser Vision Correction or Laser Eye Surgery of any type is going to help you achieve your personal vision correction goals is to have a thorough consultation.

Your LASIK consultation should consist of a number of clinical tests including:

Ø  Measurement of your uncorrected visual acuity

Ø  Measurement of your visual acuity with your current eyeglasses or contact lenses

Ø  Optical measurement of the current prescription that you are wearing in your eyeglasses and/or a review of your current contact lens prescription

Ø  A thorough review of your medical and eye history including all prescription and non-prescription medication that you have been or are currently taking

Ø  A refraction-automated or manual-to determine your current prescription

Ø  A topography measurement to digitally map the shape of your cornea

Ø  A pachymetry measurement of the thickness of your cornea

Ø   A measurement of pupil size

Ø  A microscopic evaluation of the health of your cornea and tear film including testing for dry eyes.

From this testing it can be determined whether you should proceed to the final level of testing whereby the actual preoperative measurements are taken for your treatment and a thorough examination of the Retina and Optic Nerve can be performed.

In addition to the actual clinical testing, your LASIK evaluation will include a full discussion of LASIK risks, benefits and complications and a thorough analysis of the personal goals and objectives that you feel are important to your success.

To find out if you are a good candidate for LASIK please feel free to schedule a consultation with Corneal Specialist & LASIK Surgeon Leslie Doctor, M.D. by calling Doctor & Associates at 203-227-4113.