Ophthalmology: Eye CenterPhysiciansLocations

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The Starling Physicians Eye Center offers two fully integrated optical shops. Our certified optometrist will work with your specific vision correction need to determine if glasses or contact lenses are better for your lifestyle.

Our optical shops are located at:

1 Lake Street, New Britain: (860) 827-3340

1345 Farmington Ave., Bristol:  (860) 585-0000, option 4 

Our Optical Shops are open Monday-Friday from 8:30am to 5:30 pm. We are also open 2 Saturdays a month from 9am-12pm. Please call for Saturday details.

Offering the leading brand lines and frame styles, the experts at the Optical Shop can help fit you for the glasses that will not only increase your sight, but enhance your life. Staring Physicians Eye Center also offers a variety of contact lenses to fit your need.

Lens Technology Available to Patients

Starling Physicians Optical Shop offers many different lens technologies available to our patients with the purchase of their glasses.

• Crizal® Anti-Reflective Lenses: Virtually eliminate glare; great for eliminating headline glare in night time driving
• Varilux® Progressive Lenses (no line multi-focal): The nearest to natural vision with a sense of constant clarity at all viewing distances; ideal for first time multi-focal lens wearers.
• Transition® Lenses: Lenses that automatically darken in sunlight and lighten indoors, giving the wearer the convenience of one pair of glasses for all conditions.
• Xperio® Polarized Lenses: Eliminate all indirect reflection from water or snow, to view greater depth perception and visual acuity. Ideal for many sports including boating and skiing.
• DriveWear®: The first changeable polarized outdoor lens that darkens outside as well as behind the windshield, reacting to all different outdoor weather and light conditions.
• High Index (Thin Lenses): Considerably thinner and lighter lenses that weigh much less, resulting in more comfortable wear.
• UV Filter: Recommended for the ability to protect the retina from the harmful effects of ultraviolet light, and generally required for all post-operative cataract patients.
• Polycarbonate Lenses: The most impact resistant lens made of a thinner and lighter material. Used exclusively for glasses in children under the age of 14 for their superior safety features.
• Bifocal Lenses: A common style of multi-focal lenses that allow you to see distance and close-up with one pair of glasses.
• Computer Lenses: Variable focus lenses that help correct vision for the computer screen and the immediate vicinity.

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A cataract is a clouding of the eye’s normally clear lens. The lens focuses light rays on the retina (the layer of light sensing cells lining the back of the eye) to produce a sharp image of what we see. Cataract development is a normal process of aging, but cataracts also develop from eye injuries, radiation, certain diseases, medications or long-term exposure to sunlight. A cataract may not need to be treated if your vision is only slightly blurry, however if glasses cannot correct your vision, the cataract may need to be surgically removed. Fortunately, cataracts are treatable through an outpatient surgical procedure. With the use of an operating microscope and specialized tools, a small incision is made in the eye to remove the cloudy lens, and replace it with a synthetic lens.

Ophthalmologist training includes four years of medical school and three years in a residency program. Additionally, Drs. Stern, McDonald, and Seremet have completed fellowship training in their selected subspecialty of eye care. Our doctors use the latest, most up-to-date and modern medical equipment available to complete over 1,000 cataract procedures a year. Dr. Seremet completed a fellowship in glaucoma and anterior segment surgery. Drs. Stern and McDonald completed fellowships in Cornea, Anterior Segment and Refractive Surgery.

Types of Cataract Surgery:

• Standard cataract surgery – utilizes a mono-focal lens to correct blurry vision for either distance or reading, in some cases glasses may still be needed.
• Premium cataract surgery – utilizes a new technology, a multi-focal intraocular lens to correct blurry distance and reading vision, lessening the dependence on glasses.
• Toric lenses – designed for people with astigmatism
  www.alconsurgical.com/Resource-Center.aspx
• Crystalens lenses – accommodative multi-focal lens
  www.crystalens.com
• Tecnis lenses  – defractive multi-focal lens
  www.amo-inc.com/products/cataract/refractive-iols/tecnis-multifocal-iol
• ReStor lenses – Apodized Diffractive multi-focal lens
  www.alconsurgical.com/Acrysof-IQ-Restor-IOL.aspx
• Bladeless cataract surgery (Femtosecond Laser surgery) – utilizes a specialized laser to execute the cataract surgery versus traditional tools and equipment using either a mono-focal or multi-focal lens. The use of the Femtosecond Laser often allows for astigmatism correction during the surgery if needed.

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The retina is the nerve layer at the back of your eyes that senses light and sends images to your brain. If you think of the eye as a camera, the lens in the front of the eye focuses light onto the retina, which acts as the film that lines the back of a camera. Retina care is a subspecialty of ophthalmology that deals with the posterior or back portion of the eye. Dr. Fitzpatrick is a retina specialist, with specific fellowship training in Vitreoretinal Disease and Surgery at Baylor University Medical Center in Houston, TX.

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 and the resulting vision is blurry or missing. A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.

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, with resultant retinal detachment.

The following conditions increase the chance that you may develop a retinal detachment:

• Previous cataract surgery
• Nearsightedness
• Glaucoma surgery
• Previous retinal detachment in your other eye
• Severe injury to the eye
• Family history of retinal detachment
• Weak area of the retina called lattice

There are some early signs that may indicate the presence of a retinal detachment. They are flashing lights, new floaters, increase floaters, a curtain coming across your field of vision. These symptoms do not always mean a retinal detachment is present, however, you should see an ophthalmologist as soon as possible to rule this out. Your ophthalmologist will dilate the pupils of your eyes and examine your eyes. Only after careful examination can your ophthalmologist tell whether a retinal tear or early retinal detachment is present.

Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. These treatments cause little or no discomfort and may be performed in your ophthalmologist’s office. Treatment usually prevents a retinal detachment.

Macular Degeneration

The macula is a small area in the back of the eye, which allows us to see fine details clearly. Macular degeneration is a breakdown of this area in the retina. When the macula is not functioning correctly, we may experience blurriness or darkness in the center of our vision. Since macular degeneration affects both distance and near vision, it can make some activities such as threading a needle or reading difficult or sometimes impossible. Macular degeneration reduces vision in the central portion of the retina, and therefore side or peripheral vision is not usually affected. For instance, one could see the outline of a clock, but may not be able to tell what time it is. Macular degeneration by itself generally does not result in total blindness. Most people continue to have some useful vision and are able to care for themselves.

Many older individuals may develop macular degeneration as part of the aging process. The two most common types of age related macular degeneration (ARMD) are “dry” and “wet”.

• “Dry” macular degeneration – The most common form of macular degeneration generally caused by aging and thinning of the tissues of the macula. Vision loss with this type of ARMD is usually gradual.
• “Wet” macular degeneration – Accounting for approximately 10% of all cases, this form of macular degeneration results when abnormal blood vessels form in the back of the eye. These new blood vessels may leak fluid or blood and blur central vision resulting in rapid and severe vision loss.

Intravitreal injections can be used in some cases of ‘wet’ macular degeneration to slow the development of abnormal blood cells, and shrink their size in the short term. The Eye Center of Starling Physicians utilizes intravitreal injections by Avastin, Eylea and Lucentis.

Diabetic Retinopathy

If you have diabetes mellitus, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send images to the brain. The damage to retinal vessels from high glucose is referred to as diabetic retinopathy.

There are two types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and Proliferative Diabetic Retinopaathy (PDR).

The early stage of diabetic retinopathy is commonly known as background retinopathy. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates. Many people with diabetes have NPDR, which usually does not affect their vision. When vision is affected it is the result of macular edema or macular ischemia.

Macular edema is swelling or thickening, of the macula, a small area in the center of the retina that allows us to see fine details clearly. The swelling is caused by fluid leaking from retinal blood vessels. It is the most common cause of visual loss in diabetes.

Macular ischemia occurs when small blood vessels (capillaries) close. Vision blurs because the macula no longer receives sufficient blood supply to work properly.

PDR is present when abnormal new vessels (neovascularization) begin growing on the surface of the retina or the optic nerve. The main cause of PDR is widespread closure of retinal blood vessels, preventing adequate blood flow. The retina responds by growing new blood vessels in an attempt to supply blood to the area where the original vessels closed. The new, abnormal blood vessels do not supply the retina with normal blood flow. They are fragile and tend to break and bleed.

Vitreous Hemorrhage are the fragile new vessels that may bleed into the vitreous, a clear, jelly-like substance that fills the center of the eye. If the vitreous hemorrhage is small, a person might see only a few dark floaters. A very large hemorrhage might block out all vision. It may take weeks, or months to reabsorb the blood, depending on the amount present. If the eye does not clear the blood in a reasonable time, vitrectomy surgery may be recommended.

Traction Retinal Detachment occurs when PDR is present; scar tissue associated with neovascularization can shrink, wrinkle and pull the retina from its normal position. Macular wrinkling can cause visual distortion.

Neovascular glaucoma is the result of occasional, extensive retinal vessel closure that causes new, abnormal blood vessels to grow on the iris and block the normal flow of fluid out of the eye. Pressure in the eye builds up, resulting in neovascular glaucoma, a severe eye disease that causes damage to the optic nerve.

Other Retinal Disorders

Retinal Tear – The vitreous fluid is attached to the retina around the back of the eye. If the vitreous changes shape, it may pull a piece of the retina with it, leaving a retinal tear. Once a retinal tear occurs, vitreous fluid may seep between the retina and the back wall of the eye, causing the retina to pull away. This results in a retinal detachment.

Retinal Holes – Retinal holes are small breaks in the retina which will not likely result in immediate vision loss. Overtime, retinal holes may cause problems if they allow fluid from the vitreous to seep behind the retina. The more fluid that gets behind the retina, the higher the chances are that the retina can separate from the wall of the eye. Problems that may increase the risk of retinal holes and tears in an eye include: nearsightedness, eye injuries, cataract or certain other types of eye surgery, or a history of retinal holes in your other eye.

Macular Pucker – The macula normally lies flat against the inside back surface of the eye, however, sometimes cells can grow on the inside of the eye contracting and pulling on the macula. Occasionally, an injury or medical condition creates strands of scar tissue inside the eye. These are called epiretinal membranes, and they can pull on the macula. When this pulling makes the macula wrinkle, it is called macular pucker. In some eyes, this will have little effect on vision, but in others it can be significant leading to distorted vision.

Vitreous Floaters – Floaters are small specks or clouds that move about in your field of vision. They can appear as different shapes such as little dots, lines, clouds or cobwebs. While these objects look like they are in front of your eye, they are actually floating inside of it. The shapes seen are the shadows the gel clumps leave on the retina. When people reach middle age, the vitreous gel may start to thicken or shrink, forming clumps or strands inside of the eye. The appearance of floaters may be alarming, especially if they develop very suddenly. You should contact your ophthalmologist right away if you develop new floaters, especially if you are over 45 years of age.

Floaters may be a symptom of a tear in the retina, which is a serious problem. If a retinal tear is not treated, it may detach from the back of the eye. The only treatment for a detached retina is surgery. Other floaters are harmless and fade over time or become less bothersome, requiring no treatment. Surgery to remove floaters is almost never required.

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Glaucoma is the leading cause of blindness in the United States with older people most at risk. Loss of sight from glaucoma can be prevented if you get treatment early enough. Glaucoma is a disease of the optic nerve, damaging nerve fibers and causing blind spots to develop. The optic nerve is made up of a huge number of nerve fibers that carries the images we see to the brain. The higher the pressure is in one’s eye, the greater the chance of damage to the optic nerve over time.

Glaucoma can damage nerve fibers, causing blind spots to develop. People really don’t notice these blind areas until much optic nerve damage has already occurred; if the entire nerve is destroyed, blindness results. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and the resulting blindness from glaucoma. 

Cause of Glaucoma

Clear liquid, called the aqueous humor, circulates inside the eye. A tiny amount of the fluid is produced constantly and an equal amount flows out of the eye through a microscopic drainage system (this liquid is not part of the tears on the outer surface of the eye). You may think of the flow of aqueous fluid as a sink with the faucet turned on all the time. If the “drainpipe” gets clogged the water collects in the sink and the sink may overflow. The eye, itself, is a closed structure so the excess fluid cannot overflow if the drain is clogged. If the drainage area of the eye- called the drainage angle is blocked, the fluid pressure within the inner eye may increase, which can damage the optic nerve.

Types of Glaucoma

• Chronic open angle glaucoma – the most common type of glaucoma in the United States, occurs as a result of aging. The drainage angle of the eye becomes less efficient with time, and pressure within the eye gradually increases. If this increased pressure results in optic nerve damage, it is known as chronic open-angle glaucoma. It is estimated that 90% of adult patients have this type of glaucoma. Chronic open-angle glaucoma damages vision so gradually and painlessly that you are not aware of trouble until the optic nerve is already badly damaged.
• Angle-closure glaucoma – a less common type of glaucoma, the drainage angle of the eye may become completely blocked. It is as though a sheet of paper floating near a drain suddenly drops over the opening and blocks the flow out of the sink. In the eye, the iris may act like the sheet of paper closing off the drainage angle. When eye pressure builds up suddenly, it is called acute angle-closure glaucoma. Symptoms may include blurred vision, severe eye pain, headache, rainbow haloes around lights or nausea and vomiting.

If you have any of the above-mentioned symptoms, call your ophthalmologist immediately. Unless an ophthalmologist treats acute angle-closure glaucoma quickly blindness can result. Acute angle closure glaucoma is more common in Asian people then in people of European descent; it is rare in people of African descent. In some patients glaucoma has features of both the chronic open angle type and the acute angle closure type. This may be called chronic angle closure glaucoma or mixed mechanism glaucoma. It occurs more frequently in people of African and Asian descent.

The Eye Center of Starling Physicians offers several different types of treatment for glaucoma, including medicinal treatment, laser treatment of glaucoma, minimally-invasive glaucoma surgery and traditional filtration and shunt surgery. Your Starling ophthalmologist can recommend the best treatment option for you and complete the procedure quickly and easily.

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Oculoplastics, or oculoplastic surgery, is the medical and surgical treatment of conditions affecting the eyes and surrounding areas. Oculoplastic surgery can correct deformities and abnormalities, and can also be used to rejuvenate the areas around the eyes. In some cases, oculoplastic surgery can address both medical and cosmetic needs.

Starling Physicians is proud to have a board-certified ophthalmic plastic and reconstructive surgeon; an eye surgeon who has completed additional training in plastic and reconstructive surgery as it relates to the eyes and their surrounding structures.

Click here to learn about the wide range of medical and cosmetic treatments that are available.

OCULOPLASTIC SURGERY >>

Watch informative videos about different conditions, learn about treatment options, and find out what to expect pre- and post-surgery.

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The Eye Center of Starling Physicians offers a full range of comprehensive eye care services to meet your needs. This includes general routine eye care along with second opinions and Independent Medical Evaluations (IME).

Our ophthalmologists can provide consistent routine care for your eyes, screening for disease or other concerns outside of vision loss. Many people do not think to go to an ophthalmologist for reasons other than vision loss, however consistent review and ‘maintenance’ result in the best eye health.

Your eye examination will consist of a thorough evaluation of your vision and ocular health. This usually includes refraction (an evaluation of your need for glasses or contact lenses) and screening for common conditions such as dry eye, cataracts, glaucoma, and macular degeneration and retinal diseases such as those associated with diabetes and high blood pressure. A review of your medical history and symptoms will be considered along with the findings of your eye examination. We will discuss our findings with you, and communicate with your primary care physician or other doctors as needed.

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The Eye Center of Starling Physicians is proud to affiliate with Precision Lasik Group to offer refractive surgery for laser vision correction. This type of surgery provides the opportunity for drastically improved vision for the patient, often resulting in better vision overall and reduced dependence on corrective lenses. Dr. Alan Stern is a senior member of the Eye Center of Starling Physicians practice, and a board-certified, fellowship-trained corneal surgeon, recognized as an authority on Laser Vision Correction. Dr. Stern is a founding partner of Precision Lasik group and currently serves as the group’s Medical Director.

Precision Lasik Group

Precision Lasik Group offers several different laser correction procedures including LASIK and PRK surgeries. During Lasik surgery, a thin flap of corneal tissue is created and the laser reshapes the area underneath. At the completion of the surgery, the cornea flap is put back in place to bond and heal naturally. Vision is noticeably improved with every hour that passes post-LASIK surgery. Bi-lateral LASIK surgery is also offered, where both eyes can be corrected by the laser simultaneously.

PRK (Photo Refractive Keratectomy) procedures provide a viable vision correction alternative for those patients who may not be candidates for LASIK, due to limited corneal thickness or other issues. During PRK, the surgeon removes the epithelium (outer layer of the eye) then applies the laser to the underlying layer of the eye where a new shape is given to the cornea in seconds. This new cornea shape allows images and light to properly enter and focus on the retina. The healing process for PRK is slightly longer than LASIK however the end results are just as great.

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The cornea is the clear front window of the eye that covers the colored iris and the round pupil. Light is focused while passing through the cornea so we can see. If the cornea is injured, its smoothness and clarity may be lost. Scars, swelling or an irregular shape can cause the cornea to scatter or distort light, resulting in glare or blurred vision.

Corneal Transplant & External Disease

A corneal transplant may be recommended if vision cannot be corrected satisfactorily with glasses or contact lenses, or painful swelling cannot be relieved by medication or special contact lenses. In corneal transplant surgery, the damaged cornea is removed and a clear donor cornea is sewn into place. In the days and weeks following surgery appointments are necessary for the Doctor to examine the outcome and provide any additional eye drops or pain medication as needed. Your doctor will determine when to remove the stitches from the surgery, but they will usually be in place for a full year before being removed.

For certain types of corneal diseases, a DSAEK procedure may be recommended. This option is a partial cornea transplant that often provides quicker vision correction without the long-term corneal sutures of a traditional corneal transplant.

Continued care and attention on the part of the patient and doctor are needed to monitor the success of a corneal transplant as well as to watch out for other external diseases.

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Cataracts:

http://eyewiki.aao.org/Cataract

http://www.geteyesmart.org/eyesmart/diseases/cataracts.cfm

Retina:

http://www.geteyesmart.org/eyesmart/diseases/detached-torn-retina.cfm

http://www.geteyesmart.org/eyesmart/diseases/amd.cfm

http://www.geteyesmart.org/eyesmart/diseases/diabetic-retinopathy.cfm

Glaucoma:

http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm

http://eyewiki.aao.org/Primary_Open-Angle_Glaucoma

Ocular Plastics & Cosmetic Surgery

http://eyewiki.aao.org/Category:Oculoplastics/Orbit

http://www.botoxcosmetic.com/

http://www.restylaneusa.com/

Comprehensive Routine Eye Care:

http://www.geteyesmart.org/eyesmart/living/eye-exams-101.cfm

Refractive Surgery:

http://www.geteyesmart.org/eyesmart/glasses-contacts-lasik/lasik.cfm

http://www.precisionlasikgroup.com/ under copy Precision Lasik Group

Cornea:

http://www.geteyesmart.org/eyesmart/diseases/corneal-transplant-surgery-options.cfm

Optical Shop & Contact Lenses:

http://www.drivewearlens.com/home.php?flashchange=8 link under DriveWear®: in copy