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Common Reasons for Referral

Why Was I Referred to a Retina Specialist?

Preparing for Your First Visit

A little preparation before your appointment goes a long way toward making your first visit efficient and thorough. Knowing what to bring, how to plan your day, and what to expect during the exam helps reduce anxiety and ensures your Retina Specialist has everything needed to make an informed assessment.

Bring your current eyeglasses and a complete list of all medications you take, including prescriptions, over-the-counter medications, vitamins, and supplements. If your referring eye doctor provided imaging results, printed records, or a referral letter, bring those as well.

It is also helpful to have a summary of your personal and family eye health history ready, including any previous eye surgeries, known eye conditions, and any history of eye disease in close relatives. Writing down your questions in advance ensures you do not forget anything once you are in the exam room.

Your pupils will almost certainly be dilated during the visit so your Retina Specialist can fully examine the retina. Dilation causes temporary blurring and increased sensitivity to light that can last several hours after your appointment.

Because of this, you should arrange for a driver to take you home. Bringing a pair of sunglasses will help with light sensitivity afterward. If you work on a screen or read for long stretches, plan for reduced productivity for a portion of the day following your visit.

A first visit to a Retina Specialist is typically longer than a routine eye exam and may last one to three hours, depending on the testing required. The appointment will include a review of your history, a check of your visual acuity, a dilated examination, and one or more imaging studies.

Our team uses a range of advanced imaging tools to get a complete picture of your retinal health. These include optical coherence tomography, or OCT, which creates detailed cross-sectional images of the retinal layers; OCT angiography, which maps retinal blood flow without an injection; fluorescein angiography, which photographs blood vessel circulation using a safe dye; fundus photography and autofluorescence; wide-field imaging; and B-scan ultrasound when needed. Serial retinal photographs are taken at every visit so our team can compare images over time and detect even subtle changes in your condition.

After Your Evaluation

Once the exam and imaging are complete, your Retina Specialist will walk you through the findings and explain what they mean for your vision and your care. This conversation is an important part of the visit, and you should feel comfortable asking questions until you have a clear picture of what comes next.

Your Retina Specialist will explain what was found, how advanced or stable the condition appears to be, and how it may affect your vision going forward. Some conditions are in early stages and may not yet be causing noticeable symptoms.

If anything about the diagnosis or the recommended plan is unclear, ask for clarification. Understanding your condition is the foundation for making confident, informed decisions about your care.

Treatment recommendations will depend entirely on your specific diagnosis and its severity. Some of the most common approaches include intravitreal injections, in which medication such as an anti-VEGF agent (including options like Avastin, Lucentis, Eylea, or Vabysmo) is delivered directly into the eye to treat conditions like wet AMD, diabetic macular edema, or retinal vein occlusion.

Laser treatments such as focal laser, panretinal photocoagulation, or endolaser may be used for diabetic retinopathy, retinal tears, or other vascular conditions. Vitreoretinal surgery, including pars plana vitrectomy, scleral buckling, pneumatic retinopexy, or cryopexy, may be recommended for detachments, macular holes, or vitreous hemorrhage. In some cases, careful monitoring without immediate treatment is the right approach, and your specialist will explain exactly why and how often follow-up is needed.

After your visit, our team will send a report to your referring eye doctor so all of your providers stay informed. You will typically continue seeing both your regular eye doctor for routine care and your Retina Specialist for ongoing retinal management.

If you have diabetes, coordination with your primary care physician or endocrinologist is also an important part of protecting your vision over time. Our team is committed to clear communication across your care team so nothing falls through the gaps.

Frequently Asked Questions

Here are answers to questions patients commonly have when they receive a retinal referral for the first time.

Not necessarily. Many referrals are made because an eye doctor noticed subtle changes during a routine exam and wants a specialist to take a closer look before any symptoms develop. Think of a referral as a proactive step, not a cause for alarm. A Retina Specialist can determine whether the finding is stable and low risk or whether it warrants treatment, and that early clarity often leads to better outcomes.

The timing depends on what your referring doctor found. Conditions such as retinal detachment, suspected wet AMD with sudden vision changes, or significant vitreous hemorrhage may need evaluation within days. Stable conditions like early dry AMD, mild diabetic retinopathy, or an asymptomatic epiretinal membrane may allow a few weeks. If your referring doctor marked the referral as urgent, call promptly and mention that urgency when you schedule. When in doubt, contact your referring provider directly to clarify how quickly you should be seen.

It depends on the condition and how active it is. For urgent situations, such as a retinal tear or active wet AMD, a Retina Specialist may recommend starting treatment right away to protect your vision. For most conditions, the first visit centers on a thorough evaluation and diagnosis, with treatment planned at a follow-up if needed. Some patients will not need any treatment at all and will be placed on a monitoring schedule instead. Your specialist will tell you ahead of time what to expect so there are no surprises.

A Retina Specialist has completed medical school, a full ophthalmology residency, and then an additional one to two year vitreoretinal surgical fellowship focusing exclusively on diseases and surgery of the retina, vitreous, and macula. Your regular eye doctor provides essential general eye care including glasses prescriptions, cataract screening, and routine exams. When a retinal condition is identified, the Retina Specialist takes over management of that specific condition while your regular eye doctor continues to handle the rest of your eye health. The two work together as part of your broader care team.

Yes, in most cases you will continue seeing both providers. Your regular eye doctor manages general eye health concerns that fall outside the scope of retinal care, such as glasses and contact lens prescriptions, glaucoma screening, and cataract monitoring. Your Retina Specialist focuses on your retinal condition. If it turns out that no ongoing specialist care is needed, your Retina Specialist will communicate that clearly to your referring provider and recommend a plan for continued monitoring through routine eye care.

For certain patients, particularly those with intermediate dry AMD or AMD in one eye, specific nutritional supplements have been studied and shown to reduce the risk of progression. Your Retina Specialist will advise you on whether supplementation is appropriate based on your diagnosis and its stage. Not every retinal condition calls for supplements, and taking them without guidance may not be helpful. Our team can recommend the appropriate formulation if it applies to your situation.

Schedule Your Evaluation at Atlantic Retina Center

If you have received a retinal referral, our team is here to guide you every step of the way. Atlantic Retina Center is a single-specialty vitreoretinal practice serving patients across the Eastern Shore of Maryland and central and southern Delaware, with clinic locations on the Delmarva peninsula for your convenience. Our fellowship-trained, ABO board-certified Retina Specialists bring full-scope expertise to your care, from advanced imaging and diagnosis to medical treatment and surgery, with a genuine commitment to protecting your vision for the long term.

What Our Patients Say

  • “Everyone was very pleasant. I felt at ease and not nervous. Would recommend to family and friends.”

    Janice Cockerille

    Milford, Delaware

  • “Dr. Paul is passionate about patient care, listens closely, and always puts patients first. I travel to see him; he and his team provide unbelievable service and support!”

    Kathleen Calvert

    Easton, Maryland

  • “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

  • “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.”

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    Dover, Delaware

  • “Dr. Schwartz and his staff are friendly, professional, and efficient. Highly recommend for excellent eye care.”

    Melanie Dement

    Easton, Maryland

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

    J M

    Dover, Delaware

  • “Dr. and staff are WONDERFUL! Eye emergency on while on vacation. They saw me right away, thorough exam, sent drops to pharmacy, printed records. So thankful!”

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    Milford, Delaware

  • “Dr. Paul was very attentive to my concerns and questions, providing professional and caring eye care. Highly satisfied with my visit.”

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    Easton, Maryland

  • “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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    Milford, Delaware

  • “Professional courteous staff, listens to my feedback. Dr. Paul is thorough, understanding and patient.”

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    Easton, Maryland

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    Dover, Delaware

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

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    Milford, Delaware

  • “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.”

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    Easton, 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

  • “Friendly staff Dr.Schwartz explains things very well. Very clean facility”

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    Salisbury, Maryland

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    Ocean Pines, Maryland

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    Ocean Pines, Maryland

  • “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

  • “First visit nerves went away because of kind services. Laser part was my concern but there wasn’t any problem. Pleasant experience.”

    Jean Jamison

    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. 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

  • “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

  • “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

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

    John Harrison

    Easton, Maryland

  • “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

  • “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

  • “Extremely satisfied from check-in to check-out. Nurses were pleasant and thorough. Dr. Rial clearly explained my MRI results and next steps. Very grateful for the excellent care.”

    Wayne Robinson

    Easton, Maryland

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

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    Easton, Maryland

  • “Dr. and office staff were friendly and professional. Love the layout of the building and hi-tech equipment. Highly recommend.”

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    Milford, Delaware

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

    Mar Ker

    Dover, Delaware

  • “Dr. is a kind, and patient Dr. Nice to see in younger generation. Back staff girls funny & kind. Reception kind too. Thank you for a good experience!”

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    Milford, 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.”

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    Easton, Maryland

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    Dover, Delaware

  • “I’ve seen Dr. Rial for 8–9 years. I appreciate his professionalism, respect, and thorough care. I have full confidence in his diagnoses and guidance.”

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    Easton, Maryland

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    Virginia Evans

    Milford, 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.”

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    Milford, Delaware

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    Milford, Delaware

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    Salisbury, Maryland

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

    Bonnie H

    Salisbury, Maryland

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    Milford, Delaware

  • “Appointment was kept on time and Dr. was attentive to my needs and cared about my health.”

    Tony Dagostino

    Milford, Delaware

  • “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

  • “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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    Karen Harrington

    Dover, Delaware

  • “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

  • “A routine eye exam found a problem. My optometrist referred me to ARC, and they scheduled me the next day. Dr. Rial and staff were exemplary; professional, skilled, and caring.”

    Lee Karrh

    Easton, Maryland

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

    K R

    Dover, Delaware

  • “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

  • “Everyone is polite and friendly. They make you feel like you’ve known them for years. Really comfortable.”

    anthony scalia

    Dover, Delaware

  • “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 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

  • “My visit at Atlantic Retina was good as usual. Shorter wait time, overall very good.”

    William Wooters

    Dover, Delaware

  • “Excellent staff and doctors, professionalism paramount. Treatment detailed, very effective. I chose them for a second opinion and they should have been first.”

    Bernard B

    Salisbury, 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

  • “Great practice with nice staff and professional service. Dr. Paul Lagonigro listens to you and helps you understand what is going on. I'd recommend them to anyone”

    Vicky Heeger

    Salisbury, 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

  • “Doctor Paul and the entire staff were absolutely over the top with concern and care. We need more doctors in any branch of medical care to take lessons from the Staff and Doctor Paul!”

    Vernon Spear

    Easton, Maryland

  • “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

  • “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

  • “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

  • “The staff is very nice at the desk and Dr. was nice, knowledgeable, and punctual!”

    Holley Porter

    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

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

    Bill Schaefer

    Dover, Delaware

  • “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.”

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    Easton, Maryland

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    shirley M S

    Dover, 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

  • “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

  • “Visit was calm and enjoyable. Staff professional and friendly. Impressed with high-tech equipment. Wait minimal. Never felt rushed with the doctor.”

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    Milford, Delaware

  • “Friendly staff. Dr. Schwartz explains things very well. Very clean facility.”

    Ray T

    Dover, Delaware

  • “Dr. Lagonigro was patient and understanding. His office staff professional, courteous and very helpful.”

    John Moschitta

    Dover, Delaware

  • “The staff were very friendly and professional. Ikea was nice and thorough. Dr. Paul is wonderful and answered my questions.”

    Paul Shultz

    Salisbury, Maryland

  • “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

  • “Courteous & competent staff. My concerns and questions were answered and easily understood.”

    Susan Grant

    Milford, Delaware

  • “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 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

  • “So good to know Dr. is back in Milford. Office is beautiful and relaxing. Staff, especially Nicole, is amazing.”

    Bishop Marion L. Hendricks

    Milford, Delaware

  • “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

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

    Bonnie Hillwig

    Dover, Delaware

  • “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

  • “My first visit, all staff were very polite and informative.”

    Nancy Graves

    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.”

    Priscilla Matthews

    Milford, Delaware

  • “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

  • “The staff are friendly. Dr. Schwartz is nice and kind.”

    Karen Cassese

    Dover, 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

  • “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.”

    Jenna peters

    Milford, Delaware

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

    Susan W

    Dover, Delaware

  • “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

  • “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

  • “My 92-year-old mom with dementia needed an eye injection for macular degeneration. The staff and doctor were kind, professional, and made the procedure quick, gentle, and comfortable.”

    Donna Spitz

    Easton, Maryland

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

    Linda Foskey

    Milford, Delaware

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

    Rina Morgan

    Salisbury, Maryland

  • “Staff very friendly and professional. Waited 3 minutes. Ikea was nice and thorough. Dr. Paul is wonderful and answered all my questions.”

    Paul S

    Dover, Delaware

  • “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

  • “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.”

    Steve Trowbridge

    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

  • “My experience was awesome! The staff are fantastic, and Dr. Lagonigro is the best. I would highly recommend this office to anyone seeking quality eye care.”

    Janet Moore

    Easton, Maryland

  • “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

  • “Dr. Schwarz is always thorough and professional, and his technicians provide excellent, skilled support. Highly recommend this practice.”

    Sheega Beemom

    Easton, Maryland

  • “Staff extremely helpful and kind. Dr. was absolutely amazing, invested in my care and went the extra mile. If you want the best care then come here. Thank you!”

    Kenny Snider

    Milford, Delaware

  • “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

  • “Great eye care! Professional, thorough, and attentive. I would highly recommend this practice to anyone seeking quality eye care.”

    Matt

    Ocean Pines, Maryland

  • “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 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.”

    Deborah Reilly

    Easton, 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

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

    Lisa Parsons

    Milford, Delaware

  • “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

  • “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

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

    Cathy Catheu

    Salisbury, Maryland

  • “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

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

    John Schmidt

    Dover, Delaware

  • “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

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