Stamford Ophthalmology

Our practice provides comprehensive eye care to patients of all ages. Our doctors are fully trained and experienced in the diagnosis, treatment and prevention of a variety of conditions that include: Myopia Hyperopia Glaucoma Diabetic eye care Dry eye Cataracts Macular degeneration We strive to provide our patients with safe, minimally invasive treatments that effectively relieve symptoms and preserve vision and overall eye health. As a comprehensive ophthalmology practice, our services include not only laser vision correction and small-incision cataract surgery but also treatments for a range of conditions such as glaucoma, the diabetic eye, dry eye and macular degeneration. The Importance of Regular Eye Exams Regular eye exams are a valuable tool to maintaining the health of your eyes by detecting and preventing disease. Some diseases develop slowly and painlessly before causing vision loss. Early detection of these problems can reduce the risk of further harm and allow for a choice of treatment options. We regularly screen for diseases such as glaucoma and diabetic retinopathy, which can develop without any noticeable symptoms. Macular Degeneration Treatment | Dry Eye Treatment Stamford CT | Greenwich CTDepending on their age, risk of disease and overall physical condition, patients should be seen by their doctor for a comprehensive eye exam every one to three years, Children should have regular tests to ensure the proper development of their vision and prevent any interference with their academic achievements. Older adults are often at a higher risk for eye conditions such as glaucoma, macular degeneration and cataracts. Even if your eyes are healthy, you should have a regular eye examinations to detect any problems as soon as possible so that you may begin necessary treatment. Common Eye Conditions Within our comprehensive practice, we treat vision conditions such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism through visual aids and surgical procedures if desired, as well as conditions that affect the cornea, iris, lens, vitreous, retina, eyelid and surrounding areas. Some of the most common eye conditions include: Cataracts Glaucoma Diabetic retinopathy Macular degeneration and dystrophies Dry eye Blepharitis Flashing lights and floaters Conjunctivitis Ocular trauma Surgical Treatment Certain advanced eye conditions may require surgery in order to restore or maintain vision and prevent serious complications. Surgery for cataracts, glaucoma, corneal disease and other serious conditions are an effective means of correcting these diseases and returning the eyes to a more optimal state of health. Our doctors perform surgery only when needed to reduce invasive treatment and any associated trauma or downtime, and after less invasive treatment methods such as medication, eye drops and laser procedures have failed. In addition, we perform laser vision correction procedures that improve vision and eliminate or reduce the dependence on contact lenses and glasses. To learn more about the comprehensive eye care services provided at our practice, please call us today to schedule an appointment.

Cataract surgery is a procedure performed to improve vision by replacing the lens of an eye clouded by a cataract. Cataracts affect millions of people in the United States each year. Most cataracts are the result of aging, though some form as a result of genetic factors or because of disease or injury. Candidates for Cataract Surgery Commonly, the development of cataracts through aging is a gradual process. Patients may not notice early changes in vision and may only become aware of the condition when it is more advanced. Ophthalmologists, however, can detect cataracts by finding the lens opaque upon medical examination. Only medical professionals can rule out other causes for visual disturbance, such as glaucoma or macular degeneration. Patients who become aware of visual difficulties related to cataracts usually experience clouded, blurred or dim vision especially at night. Benefits of Cataract Surgery The benefits of cataract surgery are many and have been proven to greatly enhance the quality of life. Patients who have successful cataract surgery may experience several advantages. Improved Quality of Vision Patients experience improved vision after cataract surgery, reporting sharper images and brighter colors, They have less difficulty with many routine tasks, particularly night driving. Decreased Dependency on Eyeglasses Many people who have cataract surgery find that they no longer need to wear glasses or that their dependency on glasses is greatly reduced. Greater Sense of Self-confidence Cataract surgery most often results in an increased sense of independence, regardless of the age of the patient. Marked improvements have been recorded even in patients with dementia or extreme hearing impairment. Greater Safety Research indicates that the improved vision provided by cataract surgery reduces the possibility of falls, making exercise, sports and hobbies more possible. This results in improved physical health, sociability and longer life expectancy. Procedure of Cataract Surgery After the pupil is dilated and the area in and around the eye is numbed with anesthesia, a tiny incision is made to insert an ultrasonic probe. The probe emulsifies, or breaks up, the cloudy lens into tiny pieces which are suctioned out of the eye. Once the cloudy lens has been removed, a new artificial lens is implanted. The new lens, known as an intraocular lens or IOL, is often inserted through the original incision. Surgery usually takes only a few minutes to perform, is usually performed outpatient in the doctor's office and is relatively painless. A very high percentage of patients demonstrate improved vision after the procedure. A wide range of replacement lenses are available to cataract patients, each offering different advantages for post-surgery vision. The most effective lens to use depends on the patient's individual preferences and goals for their vision. The lenses eliminate the need for glasses or contacts after cataract surgery, providing most patients with convenient, effective results for their specific vision conditions. MULTIFOCAL INTRAOCULAR LENSES (IOLS) Acrysof iq panoptix IOL The AcrySof® IQ PanOptix IOL is an intraocular lens that provides good near, intermediate and distance vision for patients who want to significantly decrease their dependence on glasses or contacts after undergoing cataract surgery. The PanOptix IOL is a soft, foldable acrylic lens. There is no need for stitches because a smaller incision is made in the eye. The PanOptix IOL corrects for both cataracts and presbyopia. The implant filters blue light without affecting the quality of vision. TORIC IOLS FOR ASTIGMATISM Intraocular lenses are used during cataract surgery to replace the damaged lens of the eye with an implant that clears up and corrects vision, oftentimes leaving patients with little to no dependence on glasses. Up until now, patients with astigmatism did not have the same opportunities that other cataract patients have had in correcting their condition with the types of IOL lenses that were available. Typically, the astigmatic patient would need an additional surgical procedure, such as refractive surgery or LASIK, to correct their vision after the procedure. If the patient did not want to undergo another surgical procedure, the only option for correction would be the use of either contact lenses or glasses to address their astigmatism. Toric IOLs are able to accommodate for the condition of astigmatism. Toric IOLs are specially designed to correct astigmatism along with overall vision during cataract surgery, offering complete vision correction. Risks of Cataract Surgery While cataract surgery is a common procedure and is considered quite safe, any surgery poses risks to the patient.

Clear vision and healthy eyes are important not only to a child's overall health and well-being, but are also directly related to their academic performance in school. While vision screenings given at a child's school each year may identify children who are at risk for problems with their vision, vision screenings do not test the overall health of the child's eyes. A professional eye examination performed by a certified eye doctor tests vision, while also evaluating the child's eyes for more serious conditions and diseases. Our practice performs eye examinations and vision screenings for children of all ages, including school-age children whose performance is dependent on strong, healthy eyes. The Pediatric Eye Examination A comprehensive eye examination is essential in the diagnosis and treatment of vision problems, injury and disease. Early detection allows treatment to begin before the child experiences difficulties in school due to poor vision, or before any permanent damage occurs. Children's eye examinations usually include testing for the following: Visual acuity Eye tracking Focusing skills Near vision Distance vision Amblyopia Strabismus Color blindness Slit-lamp examination Peripheral awareness These vision aspects are assessed through traditional eye charts, including charts that use special symbols instead of letters for young children; retinoscopy, which shines a light into the eye to examine the retina; and random dot stereopsis, which uses dot patterns to detect any differences between the two eyes. Older children may undergo testing similar to those tests used for adults, including: A visual field test Dilation Slit-lamp examination Cover test Retinoscopy Refraction Treatment After a Pediatric Eye Examination After the exam and an accurate diagnosis a treatment plan will be developed that may include: A prescription for eyeglasses Medication Vision therapy Surgery Common Pediatric Eye Conditions In addition to detecting vision problems, our eye examinations check for common childhood conditions such as: Amblyopia, or lazy eye Strabismus, or crossed eyes Glaucoma Cataracts Astigmatism Nearsightedness, or myopia Farsightedness, or hyperopia These conditions are often present at birth as a result of genetic factors, and should be treated early to reduce the risk of complications. Treatment may include glasses to improve focus or eye exercises to correct improper vision habits. It is important for parents to explain the importance of professional eye care and treatment to their children in order to promote proper eye health and a lifetime of strong, healthy eyes.

Glaucoma is a group of related diseases that damage the optic nerve resulting in vision loss and blindness. Some of the diseases or conditions that contribute to the development of glaucoma include the following: Increased pressure within the eye Severe eye infection Injury to the eye Blocked blood vessels Inflammatory conditions of the eye Glaucoma is a leading cause of blindness and visual impairment in the United States. Glaucoma can affect patients of all ages. Known as the "sneak thief of sight," many people affected with glaucoma do not experience any symptoms and may not be aware that they have the disease until they have lost a significant amount of vision. With early detection and treatment, eyes can be protected against the serious loss of vision or blindness. Types of Glaucoma There are several types of glaucoma. Primary Open-Angle Glaucoma Primary open-angle glaucoma, or POAG, is the most common type of glaucoma. The fluid in the eye drains too slowly through the network of tiny drainage channels, known as the trabecula. The pressure in the eye increases as the fluid in the eye continues to build. Loss of vision occurs gradually and vision loss is not always noticed until it becomes irreversible. About 95 percent of glaucoma cases are due to open-angle glaucoma. Angle-Closure Glaucoma Angle-closure glaucoma occurs when the tiny drainage channels, known as the trabecula, become blocked which then causes a sudden rise in pressure in the eye. This condition is not common but when it occurs it requires immediate medical attention. Low Tension Glaucoma Low tension glaucoma, or LTG, is a form of open-angle glaucoma. LTG occurs when the optic nerve is damaged despite the existing normal level of pressure in the eye. A reduction in the blood supply to the optic nerve may be the cause of this condition. Congenital Glaucoma Congenital glaucoma affects children who have a defect in the angle of the eye that causes the fluid to drain slowly from the eye. With prompt surgery, this condition can be corrected. Secondary Glaucoma Secondary glaucoma develops as a complication from another medical condition such as diabetes, cataract, eye tumor, eye injury or uveitis. Secondary glaucoma may also be the result of previous eye surgery. Pigmentary Glaucoma Pigmentary glaucoma occurs when pigment from the iris blocks the trabecula, resulting in the slower drainage of fluid. Pseudoexfoliation Glaucoma Pseudoexfoliation glaucoma develops when extra material in the eye blocks the trabecula, resulting in the slower drainage of fluid. Risk Factors for Glaucoma There are several factors that contribute to the risk of developing glaucoma. They include some of the following: Age Ethnicity Family history of glaucoma Myopia Hyperopia Thin corneas Elevated eye pressure Diabetes Low blood pressure Medication Eye injury Eye condition Symptoms of Glaucoma Symptoms of glaucoma vary depending on the type of glaucoma. Glaucoma can develop in one eye or both eyes. Some of the symptoms of two types of glaucoma are as follows: Open-Angle Glaucoma Blank spots in the vision that enlarge Loss of peripheral vision Tunnel vision in one or both eyes Angle-Closure Glaucoma Severe eye pain Nausea Vomiting Blurry vision Rainbow halos around lights Red eyes Headache Diagnosis of Glaucoma The diagnosis of glaucoma is determined after a comprehensive medical examination of the eye and a review of the patient's medical history. Tests will be conducted to confirm the diagnosis. Testing may include some of the following: Tonometry Dilated eye examination Visual field test (perimetry) Retinal evaluation Pachymetry Gonioscopy Visual acuity test Treatment of Glaucoma Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage. Some of the treatment methods for glaucoma are as follows: Medication Eye drops or oral medication may be used to either reduce fluid production in the front of the eye or to help drain excess fluid. Side effects of the medication may result in redness, stinging, irritation or blurry vision. Patients should advise their doctor about any medications they are taking or any allergies they have to minimize the risk of side effects. While glaucoma often has no symptoms, regular use of the medication is needed to keep the eye pressure under control. Laser Surgery Trabeculoplasty, iridotomy or cyclophotocoagulation are procedures that aim to increase the outflow of fluid from the eye or eliminate fluid blockages through laser. Surgery A trabeculectomy may be used to create a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is performed only after medication and laser procedures have been unsuccessful.

CORNEA The cornea is a thin, clear, spherical layer of tissue on the surface of the eye that provides a window for light to pass through. In a healthy eye, the cornea bends or refracts light rays so they focus precisely on the retina in the back of the eye. There are many diseases that can affect the cornea, causing pain or loss of vision. Disease, infection or injury can cause the cornea to swell (called "edema") or degrade (become cloudy and reduce vision). Common diseases and disorders that affect the cornea include: Allergies Bullous Keratopathy Conjunctivitis ("Pink Eye") Dry Eye Fuchs' Dystrophy Inherited Corneal Dystrophies (Granular, Lattice) Glaucoma (High Eye Pressure) Infections Keratitis (Viral Inflammation) Keratoconus Ocular Herpes Pterygium Shingles (Herpes Zoster) Stevens-Johnson Syndrome Treatment for corneal disease can take many forms, depending on the underlying problem, as well as the patient's preferences. Some conditions resolve on their own and many can be treated with medication. If the cornea is severely damaged or if there is a risk of blindness, a corneal transplant may be recommended to preserve vision. Corneal Transplants The cornea is the clear covering of the front of the eye which bends, or refracts, light rays as they enter the eye. For clear vision to occur, the cornea must have the correct shape and clarity to focus incoming light rays precisely on the retina at the back of the eye. When the cornea becomes cloudy or misshapen from injury, infection or disease, transplantation may be recommended to replace it. Penetrating Keratoplasty- PKP; Deep Anterior Lamellar Keratoplasty - DALK There are several different corneal transplant procedures available to help restore vision in patients with corneal problems. If your eye disease process involves all layers of the cornea, you may need a penetrating keratoplasty (PKP), or full thickness cornea transplant. PKP surgery consists of removing the entire cloudy cornea and replacing it with a full thickness human donor cornea from an eye bank, thereby replacing all layers of the cornea. The eye surgeon removes the damaged cornea by making a circular cut or incision and replaces the damaged cornea with the donor cornea, which is kept in place with stitches (sutures). These sutures are thinner than human hair. This type of surgery can be combined, if needed, with other eye surgeries, such as cataract removal surgery. The operation typically takes 45 to 60 minutes. The advantage of the traditional corneal transplant operation is its long and successful history of treating corneal blindness. The visual recovery after a PKP may take up to 6 to 12 months. Often, new contact lenses and/ or glasses are needed in order for the eye to reach its full visual potential. If your corneal problem is primarily located in the outer layers of the cornea, your surgeon may offer you a deep anterior lamellar keratoplasty (DALK), a partial corneal transplant, which will leave behind your innermost corneal layers (Descemet's membrane and endothelium) while replacing all of the outer layers of the cornea (stroma and epithelium). The advantage of a DALK (if your eye is eligible and if the structures of your cornea withstand the stress of the procedure) is that you will be able to keep your own healthy endothelium (innermost layer of the cornea), thus eliminating endothelial corneal tissue rejection (one type of corneal rejection that may occur after a PKP, which is the full-thickness corneal transplant). If your surgeon is offering you a DALK corneal transplant, that surgery involves more steps and therefore usually takes at least 1-2 hours to accomplish. Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and Descemet Membrane Endothelial Keratoplsaty (DMEK) In some corneal conditions, only the innermost layer of the cornea is damaged, while the other layers remain healthy. Technological and surgical advances have allowed for the development of specialized procedures that replace only the diseased part of the cornea, while leaving the healthy parts intact. Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) are both techniques used to replace only the damaged innermost layer of corneal cells, known as the endothelium, with healthy human donor corneal cells. The DSAEK graft consists of donor corneal endothelium along with a minimal amount of posterior stroma (additional donor corneal tissue), where as the DMEK graft is even thinner and consists of only a single cell layer of donor corneal endothelial cells. DMEK is a highly advanced, newer surgical approach which leads to the exact anatomic restoration of a patient's cornea after a partial transplant surgery. Both procedures are performed through a much smaller incision with much shorter recovery times and fewer risks than a traditional corneal transplant (PKP).

A contact lens is a thin disk which floats on the surface of the eye, providing vision correction. With advances in optical technology, almost everyone now can wear contact lenses, regardless of the type or extent of their vision problems. This includes patients with astigmatism and those who need bifocal or multifocal lenses. Our practice offers a comprehensive array of contact lenses to suit our patients' individual needs - from daily disposables or extended-wear soft contacts to rigid gas-permeable lenses. We can help you find out which contact lenses are best for you. There are two classifications of contact lenses - soft and rigid gas permeable lenses. All contact lenses require a prescription. Soft Contact Lenses Daily-wear Lenses Daily-wear soft contact lenses are by far the most popular type of contacts worn. Made of a flexible plastic polymer, daily-wear lenses are put in each morning and taken out each night. They are replaced according to an established schedule. Extended-wear Lenses Extended-wear soft contact lenses can be worn all the time, including while you sleep. Depending on whether you have 7-day (standard) or 30-day lenses, you only need to take out and clean your contacts once a week to give the eyes a rest and reduce the risk of a corneal infection. Extended-wear lenses are made of soft silicone that retains moisture longer than daily-wear contacts, allows more oxygen to reach the eye, and prevents bacteria and protein buildup. Although many patients prefer the convenience of 30-day contacts, be aware that they tend to be stiffer than 7-day lenses, scratch more easily and may be blurrier. Disposable-wear Lenses Disposable soft lenses are intended to be thrown out and replaced after you've worn them for a certain length of time. This makes them even easier to maintain than regular soft contacts. Many disposable lenses are designed for replacement each morning, every two weeks, or even every months. Daily-wear disposables are worn during waking hours only, while extended-wear disposables can be worn for longer periods. Healthy Soft Contact Lens Habits Gas-permeable Lenses Rigid, gas-permeable contacts offer several benefits over soft lenses. They: Can correct a wider range of vision problems, including a high degree of astigmatism; Provide sharper vision than most soft lenses; Allow more oxygen to pass through to the eye, reducing the risk of corneal irritation; Are more durable than soft lenses and don't need to be replaced as often, lasting as long as two or three years. Less likely to tear like soft contact lenses. Less prone to a buildup of deposit. Because they are much harder than flexible contacts, gas-permeable lenses may take some getting used to when you first start wearing them. They are also more likely than soft lenses to slip off the center of your eye and require adjustment, making them an inconvenient choice for patients who play sports or participate in other demanding activities. However, most patients soon grow accustomed to the feel of gas-permeable lenses and are satisfied with the improvement in vision they offer without the need for glasses.