Dear Patients:

Due to the COVID-19 virus (coronavirus), our office will be open for medical and visual eye care necessities, and ocular emergency care (new onset flashes, floaters, eye pain, vision loss, red-eye, foreign body, etc..). Please call our office during our posted business hours with any questions, concerns, orders or general information. You may also email us.

1. 1. 1. Office Phone (203) 924-2175

      2. Email 190coram@gmail.com

      3. After Hours EMERGENCY ONLY (860) 770-1550

If you have any symptoms of fever, fatigue, cough or general sickness, call to reschedule your appointment.

We are also asking that patients attend appointments alone or bring no more than one additional person to accompany you to your appointments in effort to limit the amount of people in our waiting area.

Protecting our Patients from Coronavirus

Steps our Practice is taking:

• If any team member becomes sick, we will close the office.

• We sanitize all equipment and patient contact surfaces upon opening, after every use and each patient and again at the end of the day.

• Our team members wash their hands and use sanitizer after contact with each patient and throughout the course of the day.

• We have sanitizing stations in our office.

Thank you for your cooperation. We are here for you and your eye care needs. Please remember to practice constant hygiene, wash your hands often, do not touch your face. We hope you and your family stay well.

As of today, March 19th our office is still open.

Due to recent concerns regarding the spread of the COVID-19 virus (Coronavirus) throughout the United States and Connecticut, we are requesting that all patients with any symptoms of fever, fatigue, cough or general sickness reschedule their appointments for a later date. If you exhibit any of these symptoms while in the office, we will have to ask you to reschedule.

We are asking patients to attend their appointment alone or bring no more than one additional person to accompany you to your appointments. Furthermore, we are trying to schedule our appointments in such a way that our waiting room remains as empty as possible.

Our office has adopted specific measures to protect our patients and staff from potential exposure to COVID-19 during this time of uncertainty.

To reschedule an appointment, please call 203-924-2175 and we would be happy to assist you. If you are healthy we will see you at your scheduled appointment! We will continue to update our postings regarding any potential decisions to close our office.

Our office will be closed the following days:

Friday 3/20-open 8:30-12:00
Saturday, March 21
Wednesday, March 25
Saturday, March 28

Thank you and stay healthy!

Dr. Joseph Madrak, Dr. Howard Cohen and Staff

Dr. Joseph S. Madrak, O.D. Diplomate, American Board of Optometry
Dr. Howard R. Cohen, O.D.

190 Coram Ave.
Shelton, CT 06484
Tel: 203-924-2175

190coram@gmail.com
www.yourvisionct.com

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.

Hey women! Did you know that women are more likely to suffer from vision problems and are at higher risk of permanent vision loss than men? Well 91% of the women surveyed recently didn’t know that, which means that many of them aren’t taking the necessary precautions to prevent eye damage and vision loss.  

According to a recent study, the statistics for many of the major vision problems show that women have a higher percentage of incidence than men. These include:

• Age-related Macular Degeneration 65%
• Cataracts 61%
• Glaucoma 61%
• Refractive Error 56%
• Vision Impairment 63%

Women are also more susceptible to develop chronic dry eye, partially because it is often associated with other health issues that are more common in women such as ocular rosacea which is three times more prevalent in women.  Hormonal changes during pregnancy and menopause can also contribute to dry eye.  

It’s important for women to know the risks for eye-related diseases and vision impairment and the steps they can take to prevent eventual vision loss.  Here are some ways that you can help to protect your eyes and save your eyesight:

• Find out about family history of eye diseases and conditions.
• Protect your eyes from the sun by wearing 100% UV blocking sunglasses when outdoors.
• Don’t smoke.
• Consume a healthy diet with proper nutrition and special eye health supplements as prescribed by an eye doctor.
• Adhere to contact lens hygiene and safety.  
• Adhere to cosmetic hygiene and safety precautions. 
• Protect your eyes against extended exposure to blue light from computers, smartphones and LED lamps. 
• If you are pregnant or planning to become pregnant and have diabetes, see an eye doctor for a comprehensive eye exam. In women who have diabetes, diabetic retinopathy can accelerate quickly during pregnancy and can present a risk for the baby as well. 

Mothers are often charged with caring for the eye health of the entire family, but too often their own eye health needs fall to the wayside. It is critical that mothers take care of their eyes and overall health so that they can be in the best condition to care for their families. 

Speak to your eye care professional about your personal eye health and vision risks and the precautions and measures you should take to protect your eyes.  Encourage the other women in your life to do so as well.  Once vision is lost, it often can’t be regained and there are many steps you can take to prevent it with proper knowledge and awareness.  

The most important way to prevent vision loss is to ensure you schedule regular eye exams. Don’t wait for symptoms to appear as many eye issues are painless and symptomless, and sometimes by the time you notice symptoms, vision loss is untreatable. 

Eye color is a hereditary trait that depends on the genes of both parents, as well as a little bit of mystery. The color of the eye is based on the pigments in the iris, which is a colored ring of muscle located at the center of the eye (around the pupil) that helps to control the amount of light that comes into your eye. Eye color falls on a spectrum of color that can range from dark brown, to gray, to green, to blue, with a whole lot of variation in between. 

Genetics

The genetics of eye color are anything but straightforward. In fact children are often born with a different eye color than either of their parents. For some time the belief was that two blue-eyed parents could not have a brown-eyed child, however, while it’s not common, this combination can and does occur. Genetic research in regards to eye color is an ongoing pursuit and while they have identified certain genes that play a role, researchers still do not know exactly how many genes are involved and to what extent each gene affects the final eye color.

The Iris

Looking at it simply, the color of the eye is based on the amount of the pigment melanin located in the iris. Large amounts of melanin result in brown eyes, while blue eyes result from smaller amounts of the pigment. This is why babies that are born with blue eyes (who often have smaller amounts of melanin until they are about a year old) often experience a darkening of their eye color as they grow and develop more melanin in the iris. In adults across the globe, the most common eye color worldwide is brown, while lighter colors such as blue, green and hazel are found predominantly in the Caucasian population. 

Abnormal Eye Color

Sometimes the color of a person’s eyes are not normal. Here are some interesting causes of this phenomenon.

Heterochromia, for example, is a condition in which the two eyes are different colors, or part of one eye is a different color. This can be caused by genetic inconsistencies, issues that occur during the development of the eye, or acquired later in life due to an injury or disease. 

Ocular albinism is a condition in which the eye is a very light color due to low levels of pigmentation in the iris, which is the result of a genetic mutation. It is usually accompanied by serious vision problems. Oculocutaneous albinism is a similar mutation in the body’s ability to produce and store melanin that affects skin and hair color in addition to the eyes.

Eye color can also be affected by certain medications. For example, a certain glaucoma eye drop is known to darken light irises to brown, as well as lengthen and darken eyelashes.

Eye Color – It’s More Than Meets the Eye

It is known that light eyes are more sensitive to light, which is why it might be hard for someone with blue or green eyes to go out into the sun without sunglasses. Light eyes have also shown to be a risk factor for certain conditions including age-related macular degeneration (AMD).  

Color Contact Lenses

While we can’t pick our eye color, we can always play around with different looks using colored contact lenses. Just be sure that you get a proper prescription for any contact lenses, including cosmetic colored lenses, from an eye doctor! Wearing contact lenses that were obtained without a prescription could be dangerous to your eyes and your vision.  

 

 

 

Nerf guns or blasters come in a remarkable number of shapes and sizes and have become incredibly popular for use in the home and even in large scale “Nerf Wars”. However publicity surrounding the toy has not been all positive. Many parents out there are questioning the safety of the toy foam guns, particularly to the eyes, before making the purchase.

The question of safety ultimately comes down to the user. Nerf darts are relatively soft, foamy and not inherently dangerous, but if shot in the wrong way, they could cause pain or even serious injury. This is particularly true of the eyes because they are a vulnerable organ that can be damaged easily upon impact. Injuries from even a soft projectile could include corneal abrasions (surface scratches), bleeding, cataracts and even retinal detachment which can lead to permanent vision loss.

Nevertheless, Nerf guns are fun and can even be used to help motor development and other skills, so with the right guidelines, children can learn to use them safely and benefit from the enjoyment they provide.

Want surefire eye safety? Wear safety glasses!

The best defense for your eyes is safety glasses. This is the one way you can be sure that you or your child’s eyes are truly safe during Nerf shooting. We strongly recommend safety glasses be worn during any play that involves projectile objects, particularly for small children or during serious games such as Nerf Wars.

General rules of Nerf Gun play:

1. Never shoot at the face.
2. Never look into the barrel of the nerf gun, even if you think it isn’t loaded.
3. Avoid walking around with your finger on the trigger until you are ready to point and aim at the proper target.
4. Only shoot others that are “playing” and are aware that you are aiming at them.
5. Don’t shoot from a moving vehicle (including a bicycle, skateboard, rollerblades, etc.).
6. Don’t shoot at a moving vehicle.
7. Never shoot at a close range.
8. Never leave loaded gun in reach of a child or individual that is not able to use the toy properly and safely.

To be safe, all toy guns that shoot projectiles should be treated as a dangerous toy in order to ensure proper usage and precautions. Yes, Nerf guns can cause serious eye damage and even vision loss, but these type of injuries can be caused by many “harmless” objects as well. Before you purchase a toy like this for your child, ask yourself whether the child is old enough and mature enough to understand the safety issues involved and to be able to use it responsibly.

Why Are My Eyes So Dry?

Do you experience dry, scratchy, burning eyes, redness or pain, a gritty feeling like something is in your eye? Or perhaps, excessive tearing, blurred vision, eye fatigue or discomfort wearing contact lenses? There could be a number of causes for your symptoms including allergies, reactions to an irritant or medication or an infection. You could also have a chronic condition called Dry Eye Syndrome.

It’s estimated that one out of every eight adults suffers to some extent from dry eye syndrome, which can range from mild to severe. Despite the fact that it is one of the most common eye problems, a surprisingly large percentage of patients are not aware of it.

What is Dry Eye Syndrome?

Your eyes need a layer of tears to lubricate the surface and keep the eyes comfortable, clean and clear. These tears also wash away particles, dust and bacteria that can lead to infection and eye damage. Dry eye syndrome occurs when there is a chronic lack of lubrication on the surface of the eye either because not enough tears are being produced, the quality of the tears is weak or they evaporate too quickly. This causes the common uncomfortable symptoms including:

• Itching
• Burning
• Redness
• Soreness or pain
• Dryness (and sometimes even excessive tearing because the eyes are trying to compensate)
• Light sensitivity
• Eye fatigue
• Blurred vision
• Grittiness or a feeling like there is something in your eye
• Vision seems to change when blinking

Factors that Contribute to Dry Eye Syndrome

There are a number of factors that can increase your risk of suffering from Dry Eye Syndrome. While some of them are inherent, there are some environmental factors that can be changed to reduce your risk or symptoms. Risk factors include:

• Aging: While it can occur at any age, dry eye is more common in individuals over age 50.
• Women: Likely related to hormonal fluctuations, women are more likely to develop dry eyes than men, especially during pregnancy, menopause or when using birth control pills.
• Digital screen use: Whether it is a computer, a smartphone or a tablet, when our eyes are focused on a digital screen we tend to blink less, increasing tear evaporation and increasing dryness, blurriness and discomfort. Remember to regularly take a break, look away from the screen and blink several times.
• Medications: A number of medications – both prescription and nonprescription – have been found to cause dry eye symptoms including certain blood pressure regulators, antihistamines, nasal decongestants, tranquilizers and antidepressants.
• Contact lenses: Dry eyes is a common problem in contact lens wear. Several manufacturers have started offering lenses that hold more moisture to combat this common issue.
• Dry air: Whether it is the air conditioning or forced-air heating inside or the dry, windy climate outside, the environment of the air around you can contribute to dry eyes by causing your tears to evaporate too quickly.
• LASIK: One side effect of LASIK and other corneal refractive surgery is dry eyes, which usually lasts about 3-6 months and eventually resolves itself.
• Eyelid conditions: Certain conditions which prevent the eyelid from closing completely when sleeping or even blinking can cause the eye to try out.
• Allergies or infections: Chronic inflammation of the conjunctiva which is often caused by allergies or infections such as Blepharitis can result in dry eyes.
• Systemic diseases: People with autoimmune diseases or systemic conditions such as diabetes, thyroid disease, Sjogren’s syndrome, rheumatoid arthritis and lupus are also more prone to Dry Eye.

How do you treat dry eye symptoms?

If you have dry eyes, you don’t need to suffer. There are a number of treatment options that can help, depending on the severity and cause of your condition, which can reduce symptoms and enhance your comfort.

Treatments for dry eyes can include non-prescription or prescription eye drops, omega 3 supplements, special lid therapies, punctal plugs, ointments, different contact lenses, goggles or ergonomic changes to your work station. Speak to your eye doctor to discuss the cause of your dry eye and the best remedy for you. Even when it comes to the seemingly straightforward treatments like over-the-counter eye drops, they aren’t all the same. Different ingredients are tailored towards different causes of dry eye.

Get Help for Dry Eyes Today!

If you are experiencing the symptoms above, schedule an appointment with your eye doctor to find out the best solution for you.

Diabetes is a growing health crisis in North America as an estimated 29 million Americans and 3.4 million Canadians are currently living with the disease. Chances are it affects you or someone you know. November has been dedicated as a time to spread awareness about the disease, its risk factors and the effects it has on your body, your daily life and the lives of your loved ones.

Diabetes and Your Eyes

Diabetes is a systemic disease that causes fluctuations in glucose (blood sugar) levels which can affect blood vessels throughout the body including those in your eyes and visual system. People with diabetes are at higher risk for blindness than the general population, however with regular eye exams and proper care, most of the complications are minor and treatable.

Minor changes in glucose levels could result in complications such as blurred or double vision, floaters or even visual field loss. These conditions are usually quite treatable. Diabetics are also at greater risk for developing eye diseases such as glaucoma (40% increase risk) and cataracts (60% increased risk). With early detection, both of these conditions can be treated and the majority of vision restored.

Diabetic eye disease often has NO noticeable symptoms or pain, so comprehensive eye exams that include dilating the pupils are essential to detect signs of diabetes. Online vision assessments will not detect diabetic eye disease.

The condition that is the most concerning risk of diabetes is called diabetic retinopathy which can lead to blindness if not diagnosed and treated.

What You Need to Know About Diabetic Retinopathy

Diabetic retinopathy occurs when the tiny blood vessels or capillaries in the back of the eye develop weakened vessel walls. If not treated, the vessels leak fluid and become blocked. This can progress to hemorrhages in the retina, and over time the eye does not receive enough oxygen and nutrients. As a result, new fine blood vessels start to grow. These proliferating vessels leak and can cause further bleeding, scarring and potentially lead to blindness. A special zone in the central retina called the macula is especially susceptible to diabetes. Diabetic macular edema (when fluid seeps into the macula) can cause permanent vision loss if not promptly detected.

There are treatments for stopping the progression of the disease such as laser therapy or intraocular injections, although once damage to vision has occurred, it is often permanent. This is why the condition must be diagnosed and treated early on.

All diabetics should have a regular comprehensive eye exam to catch any early signs of diabetic retinopathy or other vision threatening conditions. Because risk factors vary, speak to your eye doctor about how often you should have an exam. Risk factors for diabetic retinopathy include:

• Length of time living with diabetes
• Uncontrolled blood sugar levels
• High blood pressure
• Smoking
• Alcohol consumption
• Pregnancy
• Genetics

Although blindness from diabetes is preventable it is still a leading cause of blindness among working-age adults. If you or someone you know has the disease, make sure that proper eye care is a priority.

Red, itchy, watery eyes and swollen eyelids (along with sneezing, congestion or a runny nose)… these symptoms are a clear indication that allergy season has arrived. These allergic symptoms are caused by a reaction to allergens, which are substances in the environment that are usually harmless. If, however, you are one of the unlucky that is predisposed to allergies, these substances can illicit a serious and sometimes even debilitating allergic response.

As opposed to food, medicine, or insect allergies which don’t often affect the eyes, eye allergies are a common symptom of airborne allergens including mold, pollen (from trees and flowers), dust and pet dander. The summer fall and spring are often the worst times for a high pollen count and many individuals suffer during these seasons.

An allergic eye reaction occurs when your eye releases histamines in an effort to protect itself from a perceived threat (an allergen such as dust, pollen, animal dander, mold spores, eye drops or airborne chemicals). The release of the histamines causes the symptoms of redness, itchiness, burning and tearing. This response is also sometimes known as allergic conjunctivitis.

The most common type of eye allergies are perennial and seasonal allergic conjunctivitis. Perennial eye allergies are a response to household allergens that exist all year round such as pet dander, mold, or dust mites. Seasonal allergies usually result from pollen from plants, grass and trees that are found in the air and depend on the season and the types of pollens in the environment. Seasonal allergic conjunctivitis is often more severe than perennial and can cause puffy eyelids and itching which can make symptoms worse.

The best way to reduce discomfort and prevent an allergic reaction is to stay away from allergens as much as possible. Here are some tips on how to reduce exposure:

• Minimize outdoor exposure during pollen season:
• Stay inside when pollen counts are particularly high or during a windy day.
• Keep windows closed and use air conditioner with a clean filter.
• Wear sunglasses outside to keep irritants from entering the eyes.
• Reduce indoor allergens:
• Wash bedding frequently in hot water and use mite-proof covers on pillows, blankets and mattresses.
• Prevent household mold by reducing humidity and keeping areas that are subject to humidity or dampness (such as bathrooms, kitchens or basements) clean. Use a dehumidifier when necessary and clean any mold you see with bleach.
• To reduce dust, clean floors and surfaces with a damp rag or mop rather than sweeping or dry dusting.
• Wash your hands and clothes after coming into contact with animals.
• DO NOT rub your eyes as this can worsen symptoms, greatly aggravating swelling and itchiness, and can sometimes even cause an infection.

If you have severe allergies, avoid contact lens wear or reduce wear time when allergies flare up, as contact lenses can worsen symptoms and do not fit as they normally would when the eyes are swollen. This is why having back up glasses is so important. Changing to one day single use disposable contacts can also sometimes reduce allergy symptoms.

There are some steps you can take to alleviate symptoms of eye allergies. Over-the-counter solutions include artificial tears, decongestant eye drops (which shouldn’t be used for longer than a week) or oral antihistamines (which can sometimes worsen symptoms). If no eye drops are available, cool compresses (avoid heat) will also help to reduce the itch. If these treatments don’t work, you can get a prescription for stronger eye drops (antihistamine or short term steroid drops to reduce symptoms), oral antihistamines or possibly immunotherapy (such as allergy shots).

If you are experiencing symptoms of allergic conjunctivitis, don’t just assume they are allergies. See your eye doctor to determine the cause to ensure that it is not a more serious eye condition.