Undiagnosed Age Related Macular Degeneration

With the benefit of early diagnosis and treatment, seniors can manage their risk of vision loss from Age Related Macular Degeneration (AMD) and protect their sight and lifestyle. The key is early detection and diagnosis by having regular eye exams as recommended by your eye doctor. Age Related Macular Degeneration (AMD) is the leading cause of irreversible vision impairment in older adults in the United States, yet little is known about whether AMD is appropriately diagnosed in primary eye care. Many seniors visit their primary care physicians for various health issues and then assume that everything is fine when the primary care physician looks into their eyes with the bright light and doesn’t remark or comment about any problems. Unfortunately, results of a recent study published in JAMA Ophthalmology suggest that a large number of cases of Age Related Macular Degeneration (AMD) are going undetected and undiagnosed even with the observation of primary care physicians. According to the study, by examining patients and comparing the eye exams to their primary care health records, 320 of 1288 eyes had AMD despite no diagnosis of AMD in the primary eye care medical record!  This study strongly indicates that under diagnosis of AMD can easily occur. If early AMD treatment is to be useful, seniors need to be sure to have regular dilated eye exams to help us help you avoid central vision loss.

If you or someone you know has a family history of Age Related Macular Degeneration (AMD) and is over 50 years of age or is a senior who has not had regular eye exams, please schedule and eye exam to help us help you avoid vision loss. Please call Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County, Google+ 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.           

Glaucoma, Eye Pressure & Inhalers: No Need to Worry!

Glaucoma, Eye Pressure & Allergy Steroid Inhalers

For certain patients taking oral steroid medications for asthma or severe arthritis can actually elevate their intraocular pressure (IOP) and cause them to develop glaucoma. In the recent past, it has become very common to treat the symptoms of season allergies-such as a runny nose, itching and sneezing, with Flonase® (Fluticasone) which is administered with an inhaler. In fact Flonase® inhalers are now available “over the counter” without a prescription at your local pharmacy so that you can just buy them and begin treating yourself.  Is it safe to use Flonase® inhalers if you are at risk of high eye pressure and are you at even greater risk if you have ocular hypertension or already have glaucoma? According to the results of a clinical study, called the ICOUGH Study presented in the Journal of Glaucoma, there was no clinically significant increase in the average eye pressure in patients with well-controlled open-angle glaucoma and ocular hypertension after 6 weeks of twice-daily inhaled Flonase®. Thus, it is generally regarded as safe to use OTC inhalers of Flonase® without causing an increased risk of glaucoma.

If you or someone you know is concerned about their risk of glaucoma or needs to schedule and eye exam including glaucoma testing, please call Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County, Google+ 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.

Glaucoma: Diet, Health & Lifestyle

Glaucoma: Diet, Health & Lifestyle: What You Need to Know!

As glaucoma is a chronic eye disease, we are often asked by glaucoma patients what diet, health and lifestyle factors can helpful or harmful to their eye health. There is a need to separate fact from fiction on recommendations and yet we can all take away some useful and practical information about the effect of diet, health and lifestyle on glaucoma.

Exercise and Glaucoma

One of the typical findings in glaucoma is that patients have an elevated intraocular pressure (IOP). Results from a number of studies indicate that aerobic exercise is associated with IOP lowering and according to the findings the change is greater among sedentary individuals than those who were already active and is independent of exercise duration or intensity. So, even a little aerobic exercise has a positive impact on lowering IOP! For anyone who feels they cannot incorporate exercise into their lifestyle-any kind of movement, even walking, may be beneficial. But, the key is consistency as you have to maintain your regimen because there is evidence showing as well that the effect of exercise on IOP does not continue when deconditioning occurs.

Diet and Glaucoma

There are many studies that suggest eating a healthy diet that includes a variety of fruits and vegetables-especially green leafy vegetables-is beneficial. This advice comes from studies showing that consumption of a diet rich in green leafy vegetables, or with a higher dietary nitrate intake (for which green leafy vegetables are an excellent source), seemed to protect against glaucoma. In general there is no harm in increasing your intake of green leafy vegetables–EXCEPT that for patients taking the blood thinner Coumadin® or warfarin, you need to be aware that green leafy vegetables are high in vitamin K and should you should discuss any increase in their green vegetable intake with their primary care doctor so that medication dosages can be adjusted if necessary.

Acupuncture and Glaucoma

Today, many patients express an interest in alternative therapies such as acupuncture for managing treating their glaucoma.  In general according to the results of a well designed clinical study reported on acupuncture treatment for glaucoma in the American Journal of Ophthalmology, acupuncture is unlikely to be beneficial. 

Welcome Spiro Combest, M.D.!

Please join all of us at Doctor & Associates in welcoming Dr. Spiro Combest to our practice. At Doctor & Associates, Dr. Combest  sees patients of for routine eye exams for eyeglasses and contact lenses, evaluation and management of chronic and acute eye diseases, including cataracts and cataract surgery with multifocal lens implants to provide a range of far, arm’s length and near vision as well as astigmatism correcting lens implants,  medical, laser and surgical treatment of glaucoma, diabetic eye disease,  age related macular degeneration (AMD), dry eyes and eye allergies as well as exams and consultation and surgery for the correction of nearsightedness, farsightedness and astigmatism such as LASIK.

About Spiro Combest, M.D

Spiro Combest, M.D. is a Comprehensive Ophthalmologist & Eye Surgeon and earned his Medical Degree from Spartan Health Sciences School of Medicine followed by a Residency in Ophthalmology at Nassau University Medical Center (NUMC), a teaching hospital of the Health Sciences Center of Stony Brook University where he served as Chief Resident. Dr. Combest is affiliated with Bridgeport Hospital-Yale New Haven Health System, an affiliate of Yale School of Medicine.

Early Detection Critical to Treating Glaucoma

Glaucoma is a major cause of vision loss worldwide. It affects more than 3 million people in the United States with nearly half being unaware they have the disease. During Glaucoma Awareness Month in January, the American Academy of Ophthalmology is reminding the public that early detection and treatment can help protect your sight. 

Glaucoma damages the optic nerve, which transmits visual information from the retina to the brain. Typically, the disease initially has no signs or symptoms. If left untreated, glaucoma can cause irreversible blindness. 

The American Academy of Ophthalmology recommends that everyone have a comprehensive eye exam at age 40. This exam provides eye doctors an opportunity to carefully examine the eye including the optic nerve for signs of damage and other possible problems that may affect vision. Individuals at greater risk for developing glaucoma include people: 

• over age 40;
• who have a family history of glaucoma;
• of African, Asian or Hispanic heritage;
• who have high eye pressure detected during an eye exam;
• who are farsighted or nearsighted;
• who have experienced eye trauma or eye injury;
• whose corneas are thin in the center;
• or who have health problems such as diabetes, migraines, high blood pressure or poor blood

Early detection, diagnosis and treatment are critical to managing this disease and preventing vision loss and blindness. If you or someone you know has not had a recent eye exam and glaucoma testing please call and schedule an appointment at Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County, Google+ 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.           

Cataract Experience from Max K

“To all the patients thinking about having cataract surgery: Do it !Dr. Leslie and her office staff and the staff at Wilton Surgical Center were amazing. The operation was quick and painless. It has been 2 weeks since the first eye was done and less than a week for the second and i now have 20-20 vision in both eyes. What a difference it makes not relying on my eyeglasses any more. With warmest regards and Thanks!”-Max K

If you or someone you know is experiencing cataract symptoms such as cloudy foggy vision, glare or difficult night driving and would like to learn more about cataract surgery & lens implants please call Doctor & Associates-203-227-4113, visit Doctor & Associates in Fairfield County, Google+ 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.