Diabetic Retinopathy What is diabetic retinopathy? Diabetic retinopathy is a complication of diabetes mellitus which causes abnormalities in the tiny blood vessels nourishing the retina. These vessels weaken, leak fluid and blood, and fail to provide nutrients necessary for good health in the retina. Left untreated, diabetic retinopathy can result in severe visual loss, including blindness. Back What is the retina? The retina is a thin layer of delicated nerve tissue which lines the back portion of the eye. Light enters the eye and is focused by the lens through the transparent gel-like fluid (vitreous) onto the retina. The retina then changes the image into electric impulses which are carried to the brain by the optic nerve. The retina has two main parts - the macula and the peripheral retina. The macula is located in the middle portion of the retina close to the optic nerve. The macula is responsible for central vision and color vision. The peripheral retina is the outer region of the retina and is responsible for side vision, as well as night vision. What is background (non-proliferative) diabetic retinopathy? Diabetic retinopathy can take two forms, background retinopathy and proliferative retinopathy. During the early stage of the disease (background retinopathy), small blood vessels in the retina leak a clear fluid (serum) into the surrounding tissue which can cause swelling. Abnormal blood vessels may also hemorrhage or leak fats and proteins which form deposits. If fluid collects in the macula, diminished or blurred vision will result. However, if leakage or deposits occur in the outer edges of the retina, no symptoms may be noticed. What is proliferative diabetic retinopathy? Proliferative diabetic retinopathy is the more advanced stage of the disease. New abnormal blood vessels grow over the retina and may grow into the clear vitreous. These new vessels bleed into the vetreous, blocking light from reaching the retina and causing vision to become cloudy. Connective tissue growing along with abnormal blood vessels may contract, pulling the retina off its underlying structures and toward the vitreous (retinal detachment). Proliferative retinopathy affects approximately 5% of all diabetics and becomes more likely with increased duration of diabetes. If left untreated, proliferative retinopathy can lead to blindness What are the symptoms of diabetic retinopathy? Though vision may gradually become blurred, significant loss of sight does not usually occur with background retinopathy. Since the patient does not experience pain or external symptoms such as bloodshot eyes or discharge, changes in the retina can go unnoticed unless detected by an eye examination. When bleeding occurs in proliferative retinopathy, the patient can have complete (potentially reversible) loss of sight. Connective tissue pulling on the retina causes distortion and blurring. However, if abnormalities occur in the peripheral retina, the patient may not experience any symptoms. How is diabetic retinopathy diagnosed? A comprehensive eye examination is the best protection against the progression of diabetic retinopathy. The disease can be detected by viewing the retina with instruments and cameras which illuminate and magnify the structures of the eye. If diabetic retinopathy is found, fluorescein angiography is sometimes performed to determine the extent of blood vessel leakage. In this procedure, a series of photographs are taken as a dye travels through the retinal vessels. In some cases, ultrasound equipment may be used to check for retinal detachment. What causes diabetic retinopathy? The cause of diabetic retinopathy is not completely understood. However, it is known that diabetes weakens small blood vessels in various areas of the body, including the retina. Unfortunately, the development of diabetic retinopathy cannot be prevented. Prevention is the best medicine Early detection and management of diabetic retinopathy is important to arrest or slow the development of the more sight damaging stages of the disease. Even when no symptoms are noticed, the diabetic patient should have frequent eye examinations, as recommended by their doctor. Non-diabetics should also have their eyes examined periodically to help detect the presence of diabetes and other diseases. With careful monitoring, treatment of diabetic retinopathy can usually be started before sight is affected. If you are diabetic or have diabetic retinopathy or other vision problems, you should obtain a complete eye examination. If you have diabetes mellitus, you should have a dilated eye examination at least once a year for the rest of your life. If diabetic retinopathy is at a stage requiring treatment, laser and injections of certain medications are often very effective to help prevent severe vision loss.

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MEET THE TEAM The Perlman Center Team Our eye care professionals are passionate about providing high-quality care to our family of patients. Schedule an appointment today and meet the team. Jonathan P. Perlman, M.D. Board Certified in Ophthalmology Dr. Perlman established The Perlman Center for Eye and Eyelid Surgery on November. 1st 2002. Prior to opening the Perlman Center, Dr. Perlman practiced Ophthalmology & Ophthalmic Plastic Surgery with Woodland Clinic Medical Group and was the founder and director of The Eye Institute at Woodland Healthcare. Dr. Perlman received his Bachelor of Science degree "with Distinction" from Stanford University in 1982. He received his Medical degree from the University of California at San Diego School of Medicine in 1986. Dr. Perlman then completed a transitional internship at Tuscon Hospitals Medical Education Program in Tuscon, Arizona. His Ophthalmology residency was at White Memorial Medical Center in Los Angeles from 1987 to 1990. Dr. Perlman completed a post residency year of training with Drs. David & Richard Tenzel in Ophthalmic Plastic Surgery in North Miami Beach, Florida from 1990 to 1991. Dr. Perlman is a Clinical Professor of Ophthalmology at UC Davis. He also serves as Medical Director for Vision Service Plan (VSP). He is a member of the American Academy of Ophthalmology, The California Association of Ophthalmology and the ALTA California Eye Society. Dr. Perlman is the father of three daughters, all in the medical field. Rachael is a Clinical Psychologist, Brenna is an RN in Portland Oregon, and Hallie is in nursing school. Elaine Ho, O.D . Optometrist Dr. Elaine Ho Joined Perlman Center in August of 2024 and is certainly a patient favorite! She describes herself as dedicated to providing compassionate, personalized eye care and helping patients maintain healthy vision at every stage of life. Dr. Ho earned her Bachelor of Science in Biochemistry from UCLA before completing her Doctor of Optometry degree at UC Berkeley. She later completed a residency in Primary Care and Ocular Disease at the University of Rochester Medical Center. She has gained experience caring for a diverse patient population through externships at VA Muskogee in Oklahoma, Walter Reed National Military Medical Center, VA Fresno, and Eastmont Wellness Center in Oakland. Outside of work, Dr. Ho likes to travel, hike, crochet, and play pickleball. Nicole Nuha, O.D. Optometrist Dr. Nicole Nuha is a compassionate optometrist dedicated to providing personalized, patient-centered care that improves her patients’ daily lives. She is committed to promoting ocular health awareness through education and preventative care. Dr. Nuha earned her Bachelor’s degree in Neuroscience from the University of Nevada, Reno, and her Doctor of Optometry degree from the Southern California College of Optometry, graduating summa cum laude. She completed her residency in Ocular Disease at Azul Vision in Los Angeles, where she developed a special interest in ocular disease and dry eye management. In her leisure time, she enjoys cooking, exploring new cuisines and cultures through travel, and values spending quality time with family and friends. Blake Snyder, M.D. Ophthalmologist We are delighted to welcome Blake Snyder, MD, an ophthalmologist with subspecialty training in uveitis, medical cornea, and global ophthalmology who completed his residency at UC Davis in 2024, where he served as Chief Resident, followed by fellowship training at the UCSF Francis I. Proctor Foundation and additional training at Stanford University. He has cared for patients across academic medical centers, county hospital systems, pediatric hospitals, and international outreach programs, and welcomes patients with both routine and complex ophthalmic conditions. Dr. Snyder is committed to providing thoughtful, individualized care grounded in trust, clear communication, and strong patient relationships. An avid skier and passionate about global ophthalmology, he enjoys time outdoors, travel, and live music outside of medicine. Our Wonderful Staff At The Perlman Center, our friendly and professional staff is committed to providing exceptional care and customer service to every patient who walks through our doors. We are honored to be part of Woodland’s close-knit community and take pride in offering personalized care, while spending the time needed to ensure each patient feels comfortable, informed, and valued. Our eye care professionals are passionate about delivering high-quality care to our extended family of patients. We invite you to visit The Perlman Center, meet our team, and schedule an appointment today. Jaimie Littlejohn Office Administrator Jaimie has been the Office Administrator at The Perlman Center almost since the practice opened in November 2002. Over the years, she has become an essential part of the office and is capable of stepping into nearly any role when needed — probably even the doctor’s role, if she had a license! It would be fair to say the office could not function without her. Jaimie shares, “I love our patients and having known many of them over the years. It’s rewarding to be able to help solve their problems.” Outside of work, Jaimie enjoys spending weekends with her pet Chihuahua, oil painting, and spending time with family, including frequently babysitting a three-year-old. Lynette Gallego Optician Lynette joined our team in January 2023. She enjoys helping patients choose frames and lenses that not only help them see well, but also feel confident in their look and style. Lynette has lived in Woodland since 1996 and is the proud mother of two sons and one daughter. She is happily married to her husband, Ruben. Outside of the office, she enjoys singing, dancing, reading, and spending quality time with her family. Beatrice Kumar Ophthalmic Technician Beatrice loves her role as an ophthalmic assistant for many reasons. Since joining the practice in January 2022, she has enjoyed building relationships with patients who recognize and appreciate her when they return for follow-up visits. One of the most rewarding parts of her work is “getting to see the miracle of restored sight!” Beatrice graduated from U.C. Davis in 2021 with a major in Neurology, Physiology, and Behavior, along with minors in Public Health and Communication. Her dream is to become a Physician Assistant, and she is currently in the process of applying to various programs. Outside of work, Beatrice enjoys spending time with her mom, sister, and boyfriend, as well as traveling and volunteering. She has participated in several medical missionary trips to Mexico with Dr. Perlman, serving as a surgical and clinic assistant. She also volunteers monthly with a night ministry that provides phone support and counseling for people in need. Katia Diaz Opthalmic Technician Katia studied Molecular Environmental Biology at the University of California, Berkeley and graduated in May 2025. She joined the team in June 2025 and has truly enjoyed gaining hands-on experience in patient care. Working in this field has strengthened her appreciation for accessibility, patient-centered care, and community outreach, while allowing her to make a direct and meaningful impact on patients’ quality of life. She finds it especially rewarding to be part of a team dedicated to protecting and restoring vision through compassionate, high-quality care. As a bilingual English and Spanish speaker, she strives to create a welcoming, comfortable, and informative experience for patients from diverse backgrounds. Outside of work, she enjoys spending time with family and friends, traveling, playing soccer, attending live music events, and baking. April Straub Surgery Educator and Coordinator April takes great care of our surgical patients, handling everything from scheduling to educating them about cataract and eyelid procedures. A dedicated member of our team since 2016—originally joining us as an optician—she loves helping patients improve their vision and, ultimately, their quality of life. Outside of work, April enjoys cooking, reading, camping, and spending time with her husband and teenage son. Frances Bustillos Ophthalmic Technician Frances has worked as an ophthalmic technician at Perlman Center since 2023. She earned her Bachelor’s degree from UC Davis in 2022, majoring in Psychology and minoring in Neuroscience. Frances was born in the Philippines and moved to the United States as a young child. She spent most of her childhood growing up in the Bay Area. Frances loves her job and the people she works with, and she enjoys having the opportunity to help improve her patients’ lives. She doesn’t have a car and takes the bus to work from Davis—and is never late! Her career goal is to become an optometrist, and she hopes to earn her degree from UC Berkeley. When she’s not working, Frances enjoys reading, walking, and cooking. Isela Zavala Senior Medical Receptionist Isela plays an important role in creating a welcoming and positive experience for patients at The Perlman Center. She enjoys helping people, supporting patients throughout their visits, and being part of a caring team environment. As the very first employee hired when the practice opened in 2022, Isela has become an essential part of the office and is affectionately known by many as “the GOAT.” She is part of the glue that holds everything together and can almost always be seen hard at work helping patients and supporting the team. Her friendly personality, strong work ethic, and dedication to patient care help make each visit feel comfortable, organized, and supported from the moment patients arrive. Maria Robles Optician Maria joined our team in August 2024 and quickly became an essential part of the practice. Although she began with limited experience in the field, she stepped up immediately when her mentor took an extended leave of absence. Through hard work, dedication, and a strong willingness to learn, Maria rapidly gained knowledge and confidence in ophthalmology and optical care. She is well loved by both her co-workers and patients for her positive attitude, compassion, and professionalism. Outside of the office, Maria enjoys teaching Zumba classes and spending quality time with her husband and two daughters. She is bilingual and proudly assists patients in both English and Spanish. Sara Ocegueda Medical Receptionist I enjoy my role as a receptionist at The Perlman Center because I genuinely like helping people and being part of a positive, supportive environment. I appreciate getting to interact with patients each day and helping create a welcoming experience from the moment they walk through the door. Outside of work, I enjoy watching movies with my husband, reading whenever I get the chance, and relaxing at home with my three cats, Yume, Rene, and Nora. Jasmine Smith Medical Office Receptionist Jasmine first joined the Perlman Center for Eyes in 2011 as a Medical Assistant Intern. After gaining over a decade of diverse experience across the customer service and medical fields, she returned to our team in 2023 as a Medical Office Receptionist. Jasmine brings an abundance of expertise, deep understanding, enthusiasm, and compassion to our practice daily. She is also fully bilingual, serving our patients fluently in both English and Spanish. Demonstrating her dedication to lifelong learning, Jasmine returned to school after 11 years to graduate from Woodland Community College (WCC) in 2024, earning her Associate Degree in Behavioral and Social Sciences. Outside of the office, she loves to dance, travel, and cherish quality time with her family and friends. Maleny Gonzalez Opthalmic Technician Maleny Gonzalez hails from the small town of Delano, California, in the Central Valley near Bakersfield. She joined Perlman Center after earning her Bachelor of Science degree in Biological Sciences from UC Davis in 2025. Maleny comes from a large family with five children. Very active in her church, Grace Valley in Davis, Maleny values connecting with others and helping those around her while following the teachings of the Bible. When asked what she enjoys most about working at Perlman Center, Maleny shared: “I love working here, and I like it more and more the longer I’ve been here. I love my coworkers and the drama-free work environment. I always leave with a smile on my face. I love the way our patients share their lives with us.” When she’s not working or attending church, you’ll likely find Maleny playing soccer or volleyball, running, rock climbing, going to the gym, spending time with friends, or trying something new.

Eye Injuries Eye Injuries There are many different types of eye injuries. Eye injuries can range from simply irritating your eye, such as when you get soap in your eye, to those injuries that threaten your vision, such as splashing a chemical into your eye. The bony structure around your eye is designed to absorb shock and protect your eye from injury. The eyelids close quickly to form a barrier against foreign objects. But accidents still happen every day. The most common causes of vision threatening injuries are industrial, chemical, sport injuries, paint ball injuries, car accidents, fireworks, yard work, and strong exposure to ultraviolet light. Simply wearing safety goggles or protective eye wear can prevent loss of vision. Dr. Perlman advises that if you experience an eye injury an immediate call to our office is always the best medicine. Individuals experiencing pain, redness, swelling, excessive tearing, or sensitivity to light should be seen immediately in our office by our board-certified ophthalmologist or go straight to the emergency room. These precautionary steps can prevent loss of vision from injury. Back

Flying Doctors of Mercy Dr. Perlman has given generously of his time over the past twenty years to treating indigent patients in rural Mexico. He participates in about 50 medical missionary trips to San Blas, Sinaloa, Mexico and El Fuerte, Sinaloa, Mexico. Together with his team, he has performed countless cataract surgeries on indigent patients at no charge. The sponsoring organization for this work is LIGA International "The Flying Doctors of Mercy ". If you would like to make a donation to support this work contact Dr. Perlman. 1/2

Welcome to the Perlman Center's Optical Shop! Check out our wide selection of eyewear and improve your vision in style! The Perlman Center takes pride in offering a wide variety of top styles and name brands for you to choose from for children, men & women. Our Opticians, Lynette Gallego and Maria Robles look forward to helping you find stylish eyewear and explaining lens options to help you see your best. RayBan, Giorgio Armani, Tiffany, Dolce & Gabana, Prada, Jimmy Choo, Versace, Caviar, Cazal, Oakley, Polo, Guess, Chopard, Carolina Herrera, Woow, Dragon, Michael Kors, BVG ...just to name a few! Need help finding the right frame or lens? The Perlman Center works closely with our optical laboratories to make sure we provide you with a premium product! Come into our Optical Shop to let our Opticians assist you to find the right pair of glasses for you. Find glasses that look best with the shape of your face and which colors work well with your skin tones. Learn more about options that are right for you Anti-Glare Coatings, Premium Progressive Lenses, Thinner Lighter Lenses, Transitions, Polycarbonate, Polarized Sunware, Protective Eyewear for Work & Sports, Goggles, Accessories, Adjustments and Repairs. Choosing the Right Frames Glasses say so much about your personality and personal style. At Perlman Center for Eye & Eyelid Surgery, we are happy to work with you in selecting frames that complement your features. Our experienced optometry professionals work closely with you to select the proper frames to fit your budget as well as your cosmetic, lifestyle, and vision needs. While working with our experienced staff enables you to select the appropriate frames, we invite you to learn more about which frame styles complement various face shapes. Square Face A square face is often characterized by a strong jaw line, a broad forehead, and a wide chin and cheekbones. The width and length of the face are close to being equal. Frames should be selected to make the face look longer and to soften the square angles of the face. Choose frames that are slightly curved (like an oval shape) and that have more horizontal than vertical real estate. Oval Face The oval face is identifiable by its balanced proportions. The forehead is slightly wider than the chin and cheekbones are high. Frames should complement the natural proportions of the oval. Choose frames that are wide or wider than the broadest part of the face and that follow your brow line. Often, diamond or rectangular shapes work best for oval shapes. Oblong Face Although fairly similar to an oval shape, an oblong face is longer than it is wide. The ideal frames will shorten the face by creating a break in the length of the face. Choose frames that have depth and a low bridge to shorten the nose. Try frames that are round, deep, have low-triangle shapes, or that have strong vertical lines. Round Face A round or full face is characterized by having the same width and length. For round faces, frames that add length to the face often work best. Frames that lengthen the face are typically angular, narrow and are wider than they are deep. It is best to avoid round style frames as these will exaggerate the roundness and curves of the face. Heart Shaped Face (or Base-up Triangle) A heart shaped face looks like a heart or a triangle with the point facing down. The forehead is very wide and cheekbones are high while the face narrows towards the chin. Counterbalance the narrow chin by choosing frames that are wider at the bottom. Generally, light colored and rimless frames work best, although aviator, butterfly and low-triangle styles also work well. Base-down Triangle Face A base-down triangle face has a narrower forehead with full cheeks and a broad chin. To offset a broad chin, select frames that widen at the top. Great selections include frames that have heavy color accents and detail on the top part of the frames. Cat-eye shapes also work well to add width and emphasize the narrow upper part of the face. Diamond Face A diamond shaped face is often characterized by high, dramatic cheekbones with a narrow eye line and jaw line. This shape is the rarest of all the shapes. Oval frames that are soft in style typically work best to highlight the eyes and cheekbones. Select frames that have detailing, distinctive brow lines, are rimless or a cat-eye shape for best results. This is a general guide and is only intended for reference. Our experienced and trained staff will assist you in selecting frames what work best for your lifestyle. Accessories Cleaner Clip-ons Fit Overs Optical Cords Readers

Botox and Xeomin The Perlman Center is proud to offer two different brands of Botulinum toxin: Botox and Xeomin. Back How Does it Work? When you squint or frown, the muscles between your brows contract, causing the skin to furrow and fold. These lines are referred to as dynamic lines. Over time, as your skin ages and loses some of its elasticity, these repeated contractions can cause persistent frown lines. BOTOX® Cosmetic: Is a purified protein. It is a nonsurgical, physician-administered treatment that can temporarily reduce moderate to severe frown lines between the brows in patients 18 to 65 years of age. During treatment, very low doses of BOTOX® Cosmetic are administered via a few tiny injections directly into the muscles that causes those stubborn lines between the brows. XEOMIN® in Aesthetics: Botulinum toxin type A – the active ingredient in XEOMIN® – is used in facial aesthetic treatment to treat dynamic lines like glabellar frown lines. It acts on nerve endings in muscles to prevent muscle fibers from contracting. By reducing these contractions, XEOMIN® can temporarily reduce the frown lines on your forehead between your eyes.

Welcome to The New Patient Center! We understand that your time is precious. In an effort to make you more comfortable when you arrive at our office and to streamline the new patient process, you will be able to complete The New Patient Health Form prior to your first visit. We strive to make sure the time we spend with you during your visit is quality time. Thank you for choosing our office, we look forward to seeing you. DOWNLOAD NEW PATIENT HEALTH FORM (English and Spanish) Download the required form(s). Print out the form(s) and complete the required information. Fax your printed and completed form(s) to our office or bring them with you to your appointment. FAX: (530) 666-0352

Ptosis Surgery Ptosis Repair Ptosis is defined as drooping of the upper lid, partly covering the pupil. Ptosis causes a tired, sleepy appearance and reduces vision. Repair is intended to provide a more youthful, vibrant appearance as well as to improve your sight. Some patients with ptosis also have excess skin and fat in the upper lid, which can be corrected at the time of ptosis repair with a simultaneous blepharoplasty. Dr. Perlman is a fellowship trained Oculoplastic surgeon that has been performing eyelid surgery for the last 35 years. He has performed thousands of procedures in Yolo county and would be happy to serve you. Back Causes of Ptosis Involutional – In most people, ptosis is caused by the gradual stretching of the tissue which supports the upper lid. Involutional ptosis usually occurs with aging. In addition, long-term rigid contact lens wear may weaken the tissue of the upper lid. Involutional ptosis is corrected by tightening the levator muscle. The function of the levator muscle is to raise the eyelid. Ptosis repair is commonly performed through an incision in the normal crease in the upper lid. TREATMENT PRE OPERATIVE PTOSIS REPAIR POST OPERATIVE PTOSIS REPAIR Age-related or acquired ptosis, the levator may be reattached or slightly shortened to correct the lid position.

Anti-Aging Therapy We can help you reclaim your youth! You can look the age you feel! Call us for your consultation today! Anti Aging Remedies can improve the look and feel of you skin; just ask us what Radiesse, Belotero or Juviderm can do for you. Regardless of the efforts you take to keep your youthful appearance, the most vital components in your skin's structure, hyaluronic acid and collagen, continue to decline as you age. These skin essentials are responsible for your skin's moisture, suppleness, fullness and elasticity. Without these key elements, your skin loses its glow and becomes lifeless and dull. The texture, once smooth and refined, is now thin and unforgiving. Couple these biological facts with the affects of the suns harmful rays, pollution, a depleted ozone and a busy lifestyle that fuels unhealthy eating habits, and the battle of keeping a youthful appearance seems unattainable. Almost. Cosmetic dermal fillers, wrinkle correction therapy, such as Botox© Cosmetic, Xeomin , Radiesse ©, Belotero © and Juvederm™, have revolutionized the anti-aging process. Skin, with inevitable loss of volume, is finding a supple and full appearance once again. Skin tone is being revived and the brilliance of young skin restored. Deep wrinkles that add years to your face are being diminished leaving a smoother, more vibrant you. Dr. Perlman provides anti-aging therapy using the best and most advanced treatment options. Attaining superior results is assured when receiving such treatments from an experienced and well respected physician who will provide an honest opinion regarding your expectations and the appropriate treatment for your needs. We offer Radiesse, Belotero and Juviderm learn more about these individual products in their own labeled tabs. Back

Joyce L. Sacramento, CA Came for Xeomin Consultation after hearing good reviews from friends and left a happy camper! Dr. Perlman wasn't pushy about the injections. I started with just 20 units for my frown lines and above my brows. Recommended to come in every 4 months if I like it and can add a little more if I want. Did some research before I came and decided I would rather have an MD w/more experience do my injections than a nurse. Glad I chose Dr. Perlman it was quick and painless (kinda like a prick?). Afterwards, theres a little swelling; it went down pretty quickly for me, but everyone is a little different. I'm already super excited about my next appointment. Plus, a shout out to Jaimie thanks for helping me r/s my appointments and Mandy for being such a sweet tech! Olga S. Davis, CA Perlman Center for Eye and Eyelid Surgery is an excellent establishment. I've never had an eye exam myself, but had to take my both parents to different ophthalmologists before many times and this was the best experience by far! Check in was very quick and receptionist was friendly and professional. What impressed me the most was how quickly I was called to the examination room. Dr.Perlman came in shortly after technician left and he was very knowledgeable and nice. After my examination I talked to optical and even though I didn't get glasses at the time, I will definitely buy it there in the future. This was the best and the shortest ophthalmologist appointment ever, they are right on time. I highly recommend Perlman Center for Eye and Eyelid Surgery. Fred E. M. Woodland, CA Went today to get my eye prescription. Loved the way they follow covid safety protocols. I felt everything was cleaned and sanitized. The staff was very professional and explained everything throughly. I definitely reccomend this place to anyone who is looking for glasses or an eye check up. Roy K Albany, CA Dr Perlman operated on both my cataracts and I had excellent results He and his staff were fabulous I would recommend his office for your eye care I live in Davis and care was well worth the short drive Todd S. Fairfield, CA I had my surgery with Dr Perlman on 9/10/2019. If you are on the fence about getting this procedure done I can tell you that it's almost painless . If I had it to do all over again I WOULD definitely do it. Dr Perlman and his team sure made me feel like I was in good hands. Thanks so much Dr Perlman. Lori P. Davis, CA My whole family (husband and two kids) all see Dr. Perlman. He is awesome, friendly, knowledgeable, and professional. The staff is fast and efficient and they have a great inventory of glasses. Highly recommend. Ramsey T Woodland, CA My provider allows me a free pair of lenses every year so I take well advantage of that, from my 3 years of experience I have not had a bad experience. by far very professional kind and very prompt on receiving my new lenses best in town I am always referring people here. Making my son a apt for his first pair of lenses on Monday. Sue F. Vacaville, CA I am SO incredibly impressed with Dr. Perlman and his staff! Recently had blepharoplasty done on upper and lower lids and the entire process was perfect. The professionalism and care that was given was second to none and the results are superb!! Would HIGHLY recommend them to anyone and as a healthcare professional myself I am more than a bit particular about both who I will see and additionally who I will send my patients to. Totally 5 star experience ;) Bob M. Davis, CA Dr. Perlman has a great reputation for doing charity work in Mexico, and he shows equal compassion right here in Yolo County. He is skilled, efficient, and trustworthy. I'm saddened to see that Yelp has chosen to "not recommend" so many of the 5-star reviews, because they illustrate the excellent care that Dr. Perlman brings to the greater Woodland region. Strongly recommended!! Wayne W. Elk Grove, CA I recently had blepharoplasty done on both my upper and lower lids and I am impressed with Dr. Pearlman and his staff. The entire process was stress free and was completed with perfection. Because of their professional approach to patient care and the excellent results, I have no hesitation in recommending Dr. Perlman and his staff. Excellent service, professional integrity and patient care. When Doctor Becomes Patient by Patricia Sierra, M.D. Our eyes are an expressive feature and one people notice first. As the skin around the eyes ages, excess folds appear in the upper and lower lids making us look older and more tired. It's something I speak to patients about all the time. It was something different to experience this aging problem myself! About 3 Years ago, I became aware of the excess skin on my upper lids. As an ophthalmologist, I knew eyelid surgery could rectify this problem and restore a more youthful, rested look. I was somewhat anxious to undergo a procedure that was not "medically necessary" so I kept delaying this alternative and thinking "maybe next year". Last summer, while applying eye makeup, I noticed how the eyeliner and mascara would frequently smear over this upper eyelid excess fold. I knew this problem would only worsen over time so I consulted Dr. Perlman, our oculoplastics specialist about my concerns. He said, "Patty, we can easily fix that." I have been fortunate to work closely with him and observe his excellent outcomes, so I was very comfortable having him perform my surgery. Last December, I underwent bilateral upper eyelid blepharoplasty. The surgery was performed as an in office procedure under local anesthesia. I had some mild swelling around the eyes, which lasted about 3–5 days. I had no pain during or after the procedure and was back to work in one week. A friend of mine recently called me to ask me for advice as she was contemplating having blepharoplasty surgery in New York. I told her about my experience and how satisfied I was with the results. "There is only one thing I regret", I said. "I should've done it three years ago!"

Tear Duct Surgery Tearing in Adults Excess tearing in adults may be caused either by poor tear drainage or an overproduction of tears. Tears are produced in the tear gland. By lubricating the eyes, tears play a vital role in the maintaining the health of the eye. When the eye is irritated excess tears are produced. People are not always aware of the eye irritation, but instead may notice the overproduction of tears. Tears normally drain into small holes located in the inside corner of the upper and lower eyelids called puncta. The tears then collect in the tear sac. The tear sac lies under the skin between the corner of the eye and the nose. Next, the tears flow through a small tube, called the nasolacrimal duct, into the nose. The tears are pumped through this drainage system by the opening and closing of the eye. A blockage in any part of this drainage system can prevent tear drainage and lead to excess tears running out of the eye and down the cheek. Back It is very important to properly diagnose which part of the tear drainage system is blocked in order to determine the proper treatment. As part of the exam, a cannula might be placed in the tear duct, then the doctor then will attempt to flush water through the nasolacrimal duct into the nose in order to determine if the nasolacrimal duct is open. In some patients excess tearing is caused by several different causes. Patients may have a partial blockage of the tear drainage system, poor pumping of tears because of eyelid weakness and excess tear production due to eye irritation, all at the same time. Treatment of Tear System Blockage When the nasolacrimal duct, the tube which drains tears into the nose, is blocked a surgical procedure is usually required. During this procedure, called a DCR (Dacryocystorhinostomy), a hole is created between the tear sac and the inside of the nose. When the punctal openings are narrow or scarred, Dr. Perlman will often attempt to widen the opening by dilating them and removing a small wedge of tissue on the posterior surface of the punctal opening "punctoplasty". This can be a very simple and effective way to reduce or eliminate tearing in the appropriate candidate. When the tubes, called canaliculi, which drain the tears into the lacrimal sac are blocked surgical therapy is more complicated. In some cases both a DCR and reconstruction of the canaliculi will be performed. Eyelid weakness or malposition may be treated by surgically tightening and repositioning the lids. DCR (Dacryocystorhinostomy) – Surgical Procedure DCR is a same-day procedure. It is most commonly done under general anesthesia, but occasionally can be done under local. A DCR is performed through a skin incision, which is made on the side of the nose. The bone between the tear sac and the nose is removed, and the lining of the tear sac is then attached to the lining of the nose to form a permanent drainage for tears. In some people, during surgery, a clear plastic tube is placed from the inside corner of the eye into the nose. The tube is used to stent the tear drainage system and prevent scarring. This tube is easily removed in the office in a few months. Sutures are placed in the skin and removed in about a week. The scar produced will initially be red, hard and raised but will smooth out over the months after surgery.