Connecticut
Glaucoma Associates
Highest quality glaucoma diagnosis and care.
Glaucoma (pressure damage to the optic nerve)…. perhaps it runs in your family or you’ve been told you might have it?
We will assess the extent of any glaucoma damage by considering: your family history, intraocular pressure (measured 2 ways), corneal thickness, visual fields, OCT scans of the nerve fiber layer, contours of your optic nerve, and size of your eyeball.
Knowing the extent of damage crucially determines how much to lower your intraocular pressure. And we have special expertise in lowering your pressure without making your eyes red and irritated — unfortunately common side effects of standard therapies.
Contact Us
111 East Avenue, suite 335
Norwalk, CT 06851
(203) 853-2020
Cataract surgery by a glaucoma doctor?
If you live long enough, the lens inside your eye will become cloudy and will need to be replaced by a clear plastic lens implant. Cataract surgery is usually performed when the patient notices intolerable glare while driving or when general blurriness is no longer correctable with glasses.
Cataract surgery is a necessary component of many glaucoma surgeries because the natural lens can crowd the drain that keeps eye pressure down. And the most difficult cataract surgeries of all are in patients with pseudoexfoliation glaucoma. So, glaucoma surgeons become accustomed to challenging cataract surgeries — it is impossible to be an excellent glaucoma surgeon without also being an excellent cataract surgeon.
Our Doctors
Peter E Libre, MD
Dr. Libre earned his undergraduate degree from Yale (Biology) and his MD from the University of Maryland; he served his ophthalmology residency at Columbia U Medical Center and glaucoma fellowship at Cornell NY Hospital. He has been on the Columbia faculty since 1994 and authored peer-reviewed articles in glaucoma and cataract surgery. He has performed many thousands of cataract surgeries, glaucoma surgeries (including trabeculectomy, Ahmed valve implant, IStent, Kahook, Hydrus) and laser treatments (SLT, iridotomy, iridoplasty, cyclophotocoagulation, micropulse cyclophotocoagulation).
He speaks fluent Swedish, passable Spanish and Italian, and bit of ophthalmic Haitian Creole.
Getting outside is a priority: he bikes, roller skis or kayaks to work; tends hens and vegetable gardens; loves snow, mountains, wind and water.
Top Doctors list: Castle-Connolly, CT Magazine, NY Magazine
Anita A. Singh, OD
Dr. Singh earned her undergraduate degree from University of California, San Diego (Biochemistry) and her Doctor of Optometry degree from State University of New York, College of Optometry. She completed clinical training at Woodhull Hospital in Brooklyn, Somers Eye Center and West Point Military Base. After graduation, Dr. Singh practiced medical optometry in the Bronx and Westchester County, and later worked as the clinical director of a refractive surgery center in CT before joining CT Glaucoma Associates.
Dr. Singh is experienced in managing glaucoma, cataracts, macular degeneration, corneal disease and dry eye. She speaks conversational Spanish. When not at work, Dr. Singh enjoys spending as much time outside as possible, caring for her flower garden, and tackling home improvement projects with her husband.
“Everything should be made as simple as possible, but not simpler.”
– Albert Einstein
Expensive and complicated is often worse than inexpensive and simple.
For example, most styes are blocked, not infected, glands. So the right treatment is hot compresses to melt the oil plugs, not antibiotics trying to treat an infection that is not there.
Similarly, most dry eye is due to inadequate oil flow through the oil glands. Hot compresses melt the oil plugs, and improve the flow of oil, which protects the cornea and slows evaporation of the tears. Unfortunately, expensive patented dry eye medications, so marginally effective that they were never approved in Europe, are commonly prescribed without even trying hot compresses — which are usually more effective.
Many glaucoma patients with chronically red, uncomfortable eyes are told to add more products to their eyes: allergy drops, lubricating drops, anti-inflammatory drops. However, the effective approach is less, not more: use the fewest drops possible and prescribe only preservative-free medication — plus hot compresses at least a few times a week to keep the oil glands flowing.
Cataract patients often pay about $300 for postoperative drops: a non-steroidal anti-inflammatory, a steroid, and an antibiotic — but this expense and complexity may be of no value. The non-steroidal drop is very important, but there is no evidence that the expensive new products are better than the older generic ones. The expensive steroid drop can be easily replaced with an inexpensive injection at surgery — or a very expensive steroid implant that has not been shown to be better than injection. And there is growing evidence that antibiotics injected into the eye at surgery are critical, but that antibiotic drops are useless. (Dr. Libre, with technician/student Sean Matthews, published a study of injectable antibiotic effectiveness: “Endophthalmitis prophylaxis by intracameral antibiotics: in vitro model comparing vancomycin, cefuroxime, and moxifloxacin” (Journal of Cataract and Refractive Surgery, 2017).
RED EYES from glaucoma treatment?
Many glaucoma patients have chronically red eyes due to glaucoma medications and the preservatives used to keep bacteria from growing in the bottles.
Treatments that help avoid red eyes:
SLT laser, so that pressure control is not completely dependent on drops
low doses of 3 or 4 medications, instead of maximal doses of 1 or 2 medications
preservative-free medications
application of a hotpack to the closed lids (2 minutes, several times a week) to unblock the oil glands — the oil slows evaporation of the tears