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.