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What Is OCT Imaging?

OCT Imaging: Protecting Your Vision at Every Visit

Conditions OCT Helps Detect and Monitor

OCT has become the most important diagnostic imaging tool in retina care because it can reveal disease changes that are invisible during a standard eye exam. Our team relies on OCT to diagnose, monitor, and guide treatment for a wide range of retinal conditions.

OCT is essential for evaluating both forms of age-related macular degeneration (AMD), the leading cause of vision loss in adults over 50. In dry AMD, OCT tracks the presence and size of drusen and monitors for signs of geographic atrophy (an advanced stage where retinal cells are permanently lost). In wet AMD, OCT detects the fluid and abnormal blood vessel growth (choroidal neovascularization) that signal active disease and guide decisions about treatment.

For patients with diabetes, OCT is one of the most critical monitoring tools available. It can detect diabetic macular edema (swelling in the central retina caused by leaking blood vessels) before vision changes are noticeable. OCT also helps our team assess the severity of diabetic retinopathy over time and measure how well the retina is responding to treatment.

When a vein in the retina becomes blocked, fluid can build up and threaten central vision. OCT allows our Retina Specialists to see the extent of that swelling and monitor changes with each visit, helping determine the right treatment approach and timing.

OCT is the definitive imaging tool for diagnosing macular holes (a full-thickness break in the center of the retina), epiretinal membranes (a thin layer of scar tissue that forms on the retinal surface), and vitreomacular traction (when the vitreous gel pulls on the macula). Each of these conditions has a distinct appearance on OCT, allowing for precise diagnosis and surgical planning when needed.

How OCT Guides Your Treatment

Beyond diagnosis, OCT plays a central role in managing ongoing retinal treatment. Our team reviews OCT images at every visit to understand how your retina is responding and to make informed adjustments to your care plan.

For patients receiving intravitreal injections (medications delivered directly into the eye), OCT is the primary tool for tracking how well treatment is working. Anti-VEGF medications, including Eylea, Lucentis, Vabysmo, and Avastin, are used to reduce fluid and control abnormal blood vessel growth in conditions like wet AMD and diabetic macular edema. By reviewing OCT images at each visit, our Retina Specialists can see whether fluid is resolving, whether retinal thickness is returning toward normal, and whether treatment intervals can be safely extended or need to be shortened.

OCT also informs decisions about treatments beyond anti-VEGF injections. For diabetic macular edema and retinal vein occlusions, OCT helps our team evaluate whether a steroid implant such as Iluvien may offer additional benefit. For geographic atrophy, OCT tracks the rate of retinal cell loss over time, which is important information when considering treatments such as Izervay (avacincaptad pegol), which can slow the progression of this advanced stage of dry AMD.

One of the most powerful aspects of OCT is the ability to compare current images directly to previous ones. Our team documents a retinal photo comparison at every visit as a standard part of care. Even subtle changes in retinal thickness or fluid levels become visible when images are placed side by side over time. This ongoing record allows us to catch changes early and respond before vision is affected.

Who Benefits Most from OCT Imaging?

OCT is useful for any patient with a retinal condition, but certain individuals benefit especially from regular monitoring. Understanding your personal risk factors helps you and your Retina Specialist determine the right frequency for imaging.

Regular OCT monitoring is particularly valuable for patients with the following risk factors.

  • Diabetes, especially with a history of poor blood sugar control over time
  • Age over 50, which increases the risk for age-related macular degeneration
  • High myopia (severe nearsightedness), which raises the risk for myopic macular degeneration and retinoschisis (splitting of retinal layers)
  • High blood pressure and cardiovascular disease, which are associated with retinal vein occlusions
  • A personal or family history of retinal disease
  • Prior retinal surgery, which can sometimes lead to epiretinal membrane formation

If you are currently receiving anti-VEGF injections or another form of retinal treatment, OCT imaging is typically performed at every appointment. The information it provides is essential for our team to evaluate whether treatment is working and to personalize your care plan over time. For patients in a monitoring phase with stable or early-stage disease, scans may be scheduled every few months or annually, depending on the situation.

Many retinal diseases cause damage long before a person notices any change in vision. OCT can reveal these early structural changes, giving our team the opportunity to begin treatment before significant vision loss occurs. For wet AMD, early anti-VEGF treatment can help preserve the vision you have. For diabetic macular edema, catching swelling early allows for timely intervention that may prevent further harm.

Symptoms That May Lead to OCT Testing

Certain visual changes are signals that your retina needs a closer look. Our team may recommend OCT imaging based on your symptoms or as part of a routine monitoring visit.

A Retina Specialist may recommend OCT imaging when you report symptoms such as blurry or distorted central vision, difficulty reading, straight lines that appear wavy or bent, or a dark or gray area in the center of your vision. Even mild or intermittent changes are worth evaluating, as OCT can determine whether a retinal condition is responsible before the problem worsens.

Some visual symptoms are urgent and require same-day or emergency evaluation. Please seek immediate care if you experience any of the following.

  • A sudden increase in floaters (spots or strands drifting across your vision)
  • New flashes of light, particularly in your side (peripheral) vision
  • A shadow, curtain, or dark veil moving across your visual field
  • Sudden loss of vision in one eye

These symptoms may indicate a retinal tear, a detached retina, or another sight-threatening emergency. OCT and other diagnostic tools allow our team to identify the cause quickly and determine whether urgent treatment is needed.

What to Expect During Your OCT Scan

An OCT scan is a simple, painless process that most patients find straightforward. Knowing what to expect can help you feel comfortable from the moment you arrive.

Most OCT scans require no special preparation. In some cases, your eyes may be dilated with eye drops to give the device a clearer view. Many modern OCT systems can produce high-quality images without dilation. If dilation drops are used, your vision may be temporarily blurry and light-sensitive for a few hours afterward. Bringing sunglasses and arranging a ride home after dilated appointments is always a good idea.

You will sit comfortably in front of the OCT device and rest your chin on a support to keep your head steady. The device will scan your eye with a beam of light. Nothing touches the eye, there is no bright flash, and the process is entirely painless. Each scan takes only a few seconds per eye.

Your results are available almost immediately. The OCT system generates detailed images and measurements that your Retina Specialist reviews with you during the same visit. There is no recovery time from the scan itself. If your pupils were dilated, the effects typically wear off within a few hours, and you can return to your normal activities once your vision clears.

Frequently Asked Questions

Below are answers to questions our patients commonly ask about OCT imaging and how it fits into their retinal care.

Yes, OCT is very safe and has no known risks from repeated use. The technology relies on low-energy, near-infrared light rather than radiation or X-rays, and nothing ever contacts your eye during the scan. This is precisely why our Retina Specialists can perform OCT at every appointment without concern, even in patients who require close monthly monitoring.

OCT has significantly reduced the need for fluorescein angiography in many clinical situations, but the two tests serve different purposes and can be complementary. Fluorescein angiography involves injecting a dye into a vein to reveal blood vessel leakage patterns and flow timing in ways that OCT alone cannot always capture. Your Retina Specialist will recommend the combination of imaging tests that gives the most complete picture of your specific condition.

Yes, and this is one of its greatest clinical advantages. Structural changes in the retina often develop weeks or months before a person notices blurriness or distortion. Conditions such as early macular degeneration, mild diabetic macular edema, and a forming macular hole can frequently be identified on OCT well before symptoms appear. This window of early detection gives your care team the best opportunity to act before vision is affected.

Standard OCT creates structural images of the retinal layers, revealing thickness, fluid, scar tissue, and other tissue-level changes. OCT angiography (OCTA) is a specialized extension of the same technology that maps blood flow in the retina and choroid without any injected dye. OCTA is particularly valuable for detecting abnormal new blood vessels in wet AMD and for assessing areas of poor circulation in diabetic retinopathy. Both tests are non-invasive and can often be performed during the same visit.

Many OCT reports include color-coded thickness maps that give a visual summary of your retinal measurements. Warmer colors such as red and orange typically indicate areas that are thicker or swollen, while cooler colors such as blue and green represent areas that are thinner or within a normal range. Your Retina Specialist will walk you through these maps and explain what the findings mean for your specific diagnosis and treatment plan, so you do not need to interpret them on your own.

If you notice new or worsening symptoms between scheduled visits, such as increased blurriness, new distortion, or a change in your central vision, contact our office promptly rather than waiting for your next routine appointment. For sudden symptoms including a burst of new floaters, flashes of light, a shadow moving across your vision, or sudden vision loss, seek emergency evaluation the same day. Early OCT imaging in these situations can identify the problem quickly and help guide urgent care decisions.

Visit Atlantic Retina Center for Expert Retinal Imaging

Our team of fellowship-trained, board-certified Retina Specialists has dedicated their entire practice to the care of the retina, vitreous, and macula, nothing else. At Atlantic Retina Center, OCT imaging is a cornerstone of every patient visit, giving us the precision and consistency needed to detect disease early, guide treatment effectively, and protect your vision for the long term. If you are experiencing visual symptoms or have been referred for a retinal evaluation, we welcome the opportunity to care for you at any of our convenient locations across the Delmarva peninsula.

What Our Patients Say

  • “Everyone was so pleasant and organized. And right on time! Dr. Rial took the time to answer my questions and explain what was going on with my eyes.”

    Karin Packard

    Easton, Maryland

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    Donna Spitz

    Easton, Maryland

  • “Staff is always friendly. Dr. Schwartz is very professional and informative. I was legally blind in one eye and can see now.”

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    Dover, Delaware

  • “Dr James Rial is always very friendly and professional. He spends whatever time it takes to carefully explain his diagnosis. Staff also very friendly and make me feel confident that they are the best.”

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    Salisbury, Maryland

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    Dover, Delaware

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    Salisbury, Maryland

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    Dover, Delaware

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    Easton, Maryland

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    Easton, Maryland

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    Dover, Delaware

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    Dover, Delaware

  • “Very nice assistant at the desk. Nurse practitioners were so nice and friendly. Dr. was a very nice doctor too and friendly. Very good Eye Specialists.”

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    Milford, Delaware

  • “The doctors and staff at Atlantic Retina Center are excellent. Dr Rial is thorough and tells you about the real deal in a way you can understand it. I couldn't ask for better treatment.”

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    Easton, Maryland

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    Ocean Pines, Maryland

  • “Nichole H. was patient, nice and thorough. Then Dr. came in, wonderful doctor. One of the best eye exams I have had. Highly recommend the Milford location.”

    Jackie H.

    Milford, Delaware

  • “Since 2018 I’ve had great experience with Dr. Rial and staff. Started with bleeding retinas, now no problems for almost a year.”

    Jim Burkart

    Dover, Delaware

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    Dover, Delaware

  • “It may have taken a little but worth the wait. Beautiful office, friendly efficient staff. ”

    Linda Foskey

    Milford, Delaware

  • “Dr. Paul is the best. The office is responsive and the care is the reason for my eyesight being the best it can be.”

    Susan Watkins

    Salisbury, Maryland

  • “Dr Schwartz and his team provide first rate care. I have wet AMD in both eyes and I depend on these folks to protect my eyesight -- and they do!!”

    Len Smith

    Salisbury, Maryland

  • “Office staff is very efficient and appointment with Dr. was great. He listened, addressed concerns, very professional. Highly recommend this practice.”

    Elizabeth DiCicco

    Milford, Delaware

  • “Dr. Paul Lagonigra is very knowledgeable, extremely competent and person centered. Even though he knows I am also a health professional and have been treated for macular degeneration for several years, he always makes sure that I am comfortable with my treatment.”

    Regina Cusson

    Salisbury, Maryland

  • “Dr. Paul is the best. The office is responsive and care is the reason for my eyesight being the best it can be.”

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    Dover, Delaware

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    Milford, Delaware

  • “Everyone professional, took time to explain. Nicole did a great job and was patient helping me understand. I really appreciate the overall experience.”

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    Milford, Delaware

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    shirley M S

    Dover, Delaware

  • “Highly recommend Dr. Schwartz and team. I called with an eye emergency and was seen within an hour. Anytime I’ve had an emergency, I’m seen same day. He’s professional and very knowledgeable.”

    Livn “Liv” Lyfe

    Salisbury, Maryland

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    anthony scalia

    Dover, Delaware

  • “Everyone was professional, pleasant, and competent. Dr. Schwartz was thorough, patient, and answered all questions about my first laser procedure. I appreciate them seeing me and protecting my vision.”

    Nancy White

    Salisbury, Maryland

  • “Well organized office. Great staff. First visit involved emergency repair of torn retina by Dr. Schwartz for which I was very appreciative. He and the staff continue with follow up care. Many thanks.”

    Diane Malone

    Salisbury, Maryland

  • “I’ve been treated for macular degeneration 7+ years. This was the first painless treatment as assistant used generous numbing drops. I plan to request extra numbing in the future.”

    teri gray

    Dover, Delaware

  • “Love the Dr. He always treated me with respect, was personable, listened to my complaints, never just rushed me through a visit and assured me that the problem would be resolved. Great doctor and bedside manner as it is called, is "5 stars" WORTHY!”

    Virginia Evans

    Milford, Delaware

  • “A long time patient, Always been impressed with Atlantic Retina Center and Dr. Rial’s care. Professional, courteous, and Dr. Rial always addresses any concerns. Grateful to have such wonderful care.”

    Kelley Rouse

    Salisbury, Maryland

  • “If it weren’t for Dr. Schwartz and his staff, I would’ve lost my most precious gift. Thank you a billion times over for your incredible care!”

    Darrell

    Easton, Maryland

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    Bernard B

    Salisbury, Maryland

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    Janet Moore

    Easton, Maryland

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    Kenny Snider

    Milford, Delaware

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    Joseph Gordon

    Milford, Delaware

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    Wayne Robinson

    Easton, Maryland

  • “Everyone was cordial and professional. Dr. Paul Lagonigro was personable and performed an outstanding eye exam with modern equipment. He explained results clearly and outlined future treatment paths.”

    John Elko

    Salisbury, Maryland

  • “Dr. Rial is a great Doctor. He takes care of his patients and even though he is very busy he is friendly and takes his time with each of us to help us with our eye problems.”

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    Easton, Maryland

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    Milford, Delaware

  • “Staff is always friendly. Dr Schwartz is very professional and informative. I was legally blind in one eye and can see now.”

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    Salisbury, Maryland

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    Easton, Maryland

  • “I want to say thank you to the Drs and team for getting me in on short notice for an emergency appointment and a shout out to Laura for keeping me updated on my appointment and calling me back in a timely manner thank you all.”

    Sharon Price

    Milford, Delaware

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    Milford, Delaware

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    Easton, Maryland

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    Dover, Delaware

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    Michele Finn

    Milford, Delaware

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    Milford, Delaware

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    Vernon Spear

    Easton, Maryland

  • “Thank you. We had an exceptional experience and our concerns were addressed with compassion and understanding.”

    Mar Ker

    Dover, Delaware

  • “Everything went well with new format for signing in. Thrilled to be back with Dr. Thanks.”

    Harry Talley

    Milford, Delaware

  • “Dr. was very thorough in explaining my glaucoma condition and treatments. Much more than 2 ophthalmologists I saw in NY for 8 years. He's a 10-star doctor!”

    Maryann Durant

    Milford, Delaware

  • “Dr. Rial is awesome! I travel 6 hrs for my annual retina evaluation. Eyes thoroughly examined, eyesight better because of Dr. Rial. I trust his evaluation completely.”

    Mary Jo Vasil haines

    Dover, Delaware

  • “Thank you to the entire staff who are professional, kind and caring. A special shout out to Lauren who always makes me feel so comfortable and cared for.”

    Susan de Faria

    Milford, Delaware

  • “Dr. Rial is exceptional! I travel 6 hours for my annual retina evaluation. He thoroughly examines my eyes, compares yearly images, and always addresses my concerns.”

    Mary Jo V.

    Salisbury, Maryland

  • “I thought it was an eye emergency. Bayhealth had no time. These guys took me in right away, squeezed me in, great care when I needed it. Use these guys!”

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    Milford, Delaware

  • “The staff was courteous and professional and I didn't have a long wait before I was seen. Dr. Rial was thorough with his tests and explained the results clearly.”

    Susan Griffith

    Salisbury, Maryland

  • “Long-time patient, impressed with Atlantic Retina Center and Dr. Rial’s professional, courteous care. Grateful for wonderful care.”

    K R

    Dover, Delaware

  • “Very helpful reception staff, efficient processing through the appointment, and very professional treatment.”

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    Easton, Maryland

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    Easton, Maryland

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    Charlie Leaver

    Easton, Maryland

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    Dover, Delaware

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    Easton, Maryland

  • “I like everyone at the surgery office. Everyone was attentive and explained in detail. Doctor was experienced and made me aware of everything. Thanks 😊.”

    William Morrow

    Milford, Delaware

  • “I had an emergency visit to Atlantic Retina Center before a Europe trip. Dr. Lagonigro and staff were efficient and caring, thoroughly examining my eyes and clearing me for travel.”

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    Easton, Maryland

  • “Dr. Paul is the BEST. Very professional, understanding, looks outside the box if there is a problem.”

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    Dover, Delaware

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    Milford, Delaware

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    Holley Porter

    Milford, Delaware

  • “I was scared about my eye injury, but they explained everything and helped me not worry.”

    J M

    Dover, Delaware

  • “I visited Atlantic Retina Center for macular degeneration. Dr. Schwartz and staff were professional and skilled, with excellent equipment and care. Highly recommend their services.”

    Chaz Farkass

    Easton, Maryland

  • “Dr. Paul Lagonigro and team gave me confidence. Grateful to Dr. Joseph Schwartz for surgery and Atlantic Retina team for excellent care.”

    Jean Dowding

    Dover, Delaware

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    Bishop Marion L. Hendricks

    Milford, Delaware

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    shirley m sands

    Salisbury, Maryland

  • “Dr. helped my boyfriend so much. On vacation he got an eye infection and Dr. made sure he got what he needed even though they were slammed. Very nice guy.”

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    Milford, Delaware

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    Paul S

    Dover, Delaware

  • “Very friendly staff, very helpful and very professional. Would highly recommend to family and friends.”

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    Milford, Delaware

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    Ray Thompson

    Salisbury, Maryland

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    Paul Shultz

    Salisbury, Maryland

  • “Preferred by my eye doctor and never disappointed. Customer service amazing. The Doctor listens and cares. Friendly people, blessed to find them.”

    Shonda Miller

    Dover, Delaware

  • “After frequent prescription changes and vision loss, Dr. Rial diagnosed macular pucker and prescribed drops. After 6 weeks, the bulge reduced by half. Excellent care and treatment.”

    Jeffrey Williamson

    Easton, Maryland

  • “Dr. Rial and staff were very personable, efficient, and explained each procedure before it was done. I felt very at ease and that I was in professional & capable hands. Thank you for such good care.”

    Patricia Harfeld

    Easton, Maryland

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    Karen Harrington

    Dover, Delaware

  • “I’m an orthopedic surgeon—often on the emergency side. This time, Dr. Paul Lagonigro cared for my mother in an eye crisis. His team was professional, the gear was state‑of‑the‑art; thank you!”

    William Doran

    Salisbury, Maryland

  • “Dr. Rial treated my diabetic retinopathy and retinal hemorrhage with laser and injection. One month later, my vision has improved significantly. I'm grateful for his expertise and care.”

    Sue Phillips

    Salisbury, Maryland

  • “All staff members were very pleasant. Dr. Paul is a God sent. I feel very comfortable with him. I trust his judgement of my treatment to my eye.”

    Mildred M

    Salisbury, Maryland

  • “Dr. Paul Lagonigro and staff gave me confidence and kept me informed. Forever grateful to Dr. Joseph Schwartz who performed my surgery and the entire Atlantic Retina Center team for excellent care.”

    J.D

    Salisbury, Maryland

  • “I have always had a great experience with Dr. Schwartz. Professional, thorough, and caring; highly recommend for eye care.”

    Beverly Miller

    Easton, Maryland

  • “We went to Azar Eye Institute for an emergency due to my husband’s sudden floaters. They were prompt, caring, and fit us in immediately. Grateful for their excellent, attentive care!”

    Kirsten Krogen

    Ocean Pines, Maryland

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    Matt

    Ocean Pines, Maryland

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    Janice Cockerille

    Milford, Delaware

  • “Love new place the girls were great and the doctor was fast no complaints about the new location a lot better”

    K H

    Salisbury, Maryland

  • “Great personal patient attention. Very organized. They handled everything for my cataract surgery and follow-up appointments were informative. Great staff.”

    Lisa Calvert

    Milford, Delaware

  • “Always a comforting experience. Staff professional, kind, courteous and helpful. Dr. Rial is one of the best eye specialists. Highly recommend.”

    Lori Wood

    Dover, Delaware

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    Laura Petranto

    Milford, Delaware

  • “All staff very pleasant. Dr. Paul is a God sent. I feel comfortable with him and trust his judgment of my eye treatment.”

    Mildred Myers

    Dover, Delaware

  • “The staff is always friendly and knowledgeable. My doctor is thorough in her diagnosis, providing professional and attentive eye care. Highly recommend!”

    J 5

    Ocean Pines, Maryland

  • “I was a little scared about my eye injury, and they explained everything, and helped me to not be as worried.”

    Jomol Mo

    Salisbury, Maryland

  • “My husband was diagnosed with wet AMD. Thanks to a quick referral, he began treatment promptly. Dr. Lagonigro was professional, knowledgeable, and concise. We are so grateful. 5⭐️⭐️⭐️⭐️⭐️”

    JKC Maine

    Salisbury, Maryland

  • “I’ve been a patient at Atlantic Retina for years, referred by my optometrist after a retinal detachment. Dr. Rial and his team have been exceptional in monitoring and preserving my vision.”

    Mark Schotte

    Salisbury, Maryland

  • “Dr Rial and his staff are Amazing! Very nice and professional! I will recommend him to everyone!”

    Rina Morgan

    Salisbury, Maryland

  • “My wife had retinal detachment. Dr. did initial evaluation, Dr. performed surgery, skills impeccable, thorough and considerate. Staff top notch. Grateful!”

    Rich Durbin

    Milford, Delaware

  • “Always professional and engaging while getting me in and out quickly. Dr. Rial is the man!”

    John Schmidt

    Dover, Delaware

  • “First cataract eye was cloudy 24 hrs after surgery. Second eye surgery was a completely different experience! Super clear vision! Thank you Dr.!!!”

    Cindi Chaimowitz

    Milford, Delaware

  • “Dr. Paul is the BEST. Very professional, understanding, looks outside the box if there is a problem.”

    Cathy Catheu

    Salisbury, Maryland

  • “Dr. Paul has been fantastic. A few years back i had an emergency and he was very calm and helped me thru the process. I couldn't ask for a better ophthalmologist!”

    Jon Lipka

    Salisbury, Maryland

  • “Everyone is very pleasant. The Dr. gave me good news!”

    Bill Schaefer

    Dover, Delaware

  • “Very fast and efficient with a great staff. I truly enjoyed my appointment and received excellent care. Highly recommend!”

    Robin Gleason

    Ocean Pines, Maryland

  • “I’ve been a patient for 3+ years. Dr. Rial and his staff are excellent; pleasant, competent, and thorough. His injections are nearly painless, and my sight remains normal thanks to him.”

    Marilyn Mann

    Easton, Maryland

  • “Dr. Paul is a busy and compassionate doctor. He knows my husband's history of M. D. Now he has my own M. D. To deal with. As promised, the black dot disappeared by morning. I am very appreciative that Dr. P. Comes to Easton. Thank you.”

    Tom Knight

    Easton, Maryland

  • “Excellent staff and doctors. Treatment plans detailed and effective. I chose this office as second opinion, should have been first choice.”

    Bernard Bogan

    Dover, Delaware

  • “Dr. Paul Lagonigro is 5 Star! After an hour drive, the eye doctor is worth it. Excellent care at Atlantic Retina.”

    JKC M

    Dover, Delaware

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