Regular eye exams are essential to health and wellness. Eye exams help ensure that you maintain your vision and ocular health.
Initially, you will be evaluated in the pre-testing area. If you have glasses, your current prescription will be assessed. If you choose to have a picture of your retina taken with the Optos machine (Optomap), it will be performed in the pretesting area. The Optomap is a sophisticated digital imaging system that takes an image of your retina in high detail without having to dilate your pupils.
If you need contact lenses or glasses, a refraction will be performed by Dr. Coates to determine your prescription(s). Then a test on eye muscles, pupils and peripheral vision will be performed, and Dr. Coates will examine your eyes carefully. A glaucoma test is also performed during routine exams. Your Optomap image is reviewed in the exam room and discussed with you. Alternatively, a dilated retinal exam can be performed on patients who do not wish to have an Optomap done for any reason.
Juvederm® is an example of a dermal filler. Juvederm® is a clear gel which restores volume and fullness to the skin. It is injected into areas of the face where moderate to severe facial wrinkles and folds occur. It temporarily adds volume to the skin and restores a smoother appearance to the face. It can be used in conjunction with Botox®.
Juvederm® is composed of hyaluronic acid, which is naturally found in the skin. Hyaluronic acid helps to hydrate the skin by holding in water and acting as a cushioning agent. Juvederm® contains the highest concentration of cross-linked hyaluronic acid of any dermal filler currently available. This helps to provide optimal results with a single treatment in the majority of patients and deliver sustained results for up to 12 months or longer.
Emergency Eye Care
For established patients, Dr. Coates offers 24 hour emergency eye care, 7 days a week. Please call our office: 203 894-9700 if you have an eye emergency.
Knowledgeable and friendly staff will assist you quickly during normal business hours. The answering service will call Dr. Coates should you need help after hours.
Eye emergencies include, but are not limited to: trauma of the eyes, or bones / tissues around the eyes, lacerations (large cuts) requiring stitches of the eyelids or eyebrows, sudden loss or change of vision, sudden increased pressure in the eye, corneal abrasions (scrapes on the surface of the eye) and small foreign bodies (ex. metal, sand, plastic, plant material etc.) caught under the eyelids or on the eye.
Oculoplastic surgeons are fellowship-trained in surgery which focuses on the tissues around the eyes. Oculoplastic or ophthalmic plastic surgery is the surgical discipline of functional and cosmetic eyelid surgery.
Eyelid malpositions and eyelid lesion, both benign and malignant, excisions and reconstructions, tear drainage surgery are some of the types of functional surgeries that an oculoplastic surgeon performs.
Cosmetic oculoplastic surgery include upper and lower lid lifts (blepharoplasty). Training in oculoplastic surgery requires a one year internship after medical school in either internal medicine or general surgery, a three year residency in ophthalmology, and a fellowship in oculoplastic and reconstructive surgery.
Blepharitis is an inflammation of the eyelids. It usually affects the margins (edges) of the eyelids. It is usually not serious, but may become an uncomfortable, irritating problem. Blepharitis usually affects both eyes and is typically chronic (lasts longer than 6 weeks).
Blepharitis may make the eyelids look inflamed (red and slightly swollen). Sometimes tiny flakes appear on the eyelids which look like small flakes of dandruff. Crusts may develop at the base of eyelashes.
The exact cause of blepharitis is not known but it has a tendency to flare and then ease off in severity. There is no cure for blepharitis as the inflammation tends to recur. However, symptoms can usually be eased with regular treatment of warm compresses and diluted baby shampoo scrubs. Antibiotic eye ointment or drops may be advised for a period of time if an eyelid becomes infected. Artificial tears may be advised as well, as patients with blepharitis may have dry eye syndrome. Rubbing your eyelids may make inflammation worse.
Dry Eye Syndome
Dry Eye Syndrome causes a decrease in the amount of tears that are naturally produced by your eyes. There is often inflammation of the glands that produce tears. The front surface of your eye is normally kept moist by a thin layer of tears, so when a decreased amount of tears is produced, it will result in dry areas on the corneal surface.
If symptoms persist and aren’t treated, dry eyes can cause discomfort and a gradual, mild loss of vision. As we get older, the body naturally produces fewer tears. Dry Eye Syndrome can also be caused by hormonal changes, particularly in women, as well as thyroid disorders and rheumatoid arthritis. Certain medications including Visine (“get-the-red-out”) drops, anti-depressants, antihistamines, and birth control pills and can also play a role in the development of this condition.
The first way to treat dry eyes is through moisturizing eye drops (ex. Refresh, Systane, Optive, or Blink drops) used two to four times a day. A nighttime ophthalmic ointment may be added and can be prescribed based on your individual needs. Tiny punctal plugs can be inserted into the tear ducts in a few minutes in the office if the above strategies prove ineffective. In addition, prescription eye drops (ex. Restasis) may be used to alleviate the inflammation of the tear-producing glands in the eye. Nutritional supplements (ex. flax seed oil) and improved hydration may also be of benefit.
A purified protein, BOTOX® Cosmetic is administered in a simple, nonsurgical procedure that temporarily improves the appearance of moderate to severe frown lines between the brows, on the forehead and on laugh lines.
BOTOX® has been used therapeutically in more than 75 countries for years to treat a variety of medical conditions. Dosing specific for moderate to severe frown lines was approved in 2002 as BOTOX® Cosmetic. Because frown lines are caused by overactive muscles beneath the skin, they can usually be treated by administering very low doses of BOTOX® Cosmetic directly into the muscles with a few tiny injections. Results may naturally vary from person to person. Dr. Coates can administer BOTOX® in a simple, 10-minute in-office procedure. No anesthesia is required and most patients experience minimal and brief discomfort.
Dr. Coates can numb the treatment areas with a cold pack or anesthetic cream prior to injecting if a patient wishes. Patients should not lose the ability to laugh, smile, or otherwise show expression. Visible improvements in the treated areas may be seen within a few days and the areas may continue to improve for up to a week. The most common side effects are headache, eyelid drooping and nausea.
Glaucoma is the second leading cause of blindness in the United States. More than two million Americans have this disease. Nearly half of those affected are not aware that they have the glaucoma. It is referred to as a “silent” disease because patients often feel virtually no symptoms until the disease is very advanced. It is a disorder that is associated with increased pressure in the eye, typically caused by a backup of fluid. Over time, increased pressure can cause damage to the optic nerve.
Detecting the disease in its early stages is essential to stopping it before damage is significant. The only way to detect glaucoma is to have a comprehensive eye examination on a regular basis. The disease is much more common in adults over 60, and often runs in families, so it’s important to be closely monitored before damage occurs. Unfortunately, once vision is lost, it can never be regained.
There are several common ways to treat glaucoma including: eye drops, prescription pills, laser treatments and surgery. If you are diagnosed with glaucoma based on increased eye pressure, optic nerve damage and / or changes on visual field testing, Dr. Coates will work with you to create an individualized treatment and follow-up plan that will help preserve your vision and prevent future vision loss.