Dr. Shalu Pal

  • "If you want quality and wonderful service, please go to Dr. Shalu Pal! The patience, care, and true concern that Dr. Pal has for her clients is wonderful. "

    --Seleena J
  • " I was pleasantly surprised by finding a hidden gem within Dr. Pal's office"

  • "Finally a doctor who is extremely knowledgeable, patient and explains things clearly. She is a wonderful human being who really takes the time to care for your needs. The office has a wonderful atmosphere and the staff are just as helpful as Dr. Pal. "

  • "I couldn't ask for a better Optometrist. She is a delight to deal with, very patient, helpful and extremely knowledgeable. She was very good with my kids who can be very fussy at times.. And who could ask for a more beautiful location. Highly Recommend! "

    --Natalie M.
  • "My wife and I, highly recommend Dr. Pal. The staff, the service, the merchandise, are all top notch. They really make you feel welcomed. It has been several years since I have been able to see this well !!! You and your staff are the best !!!! "

    --Steve and Maria L.
  • "We barely go to optometrists so when we do, we should look for the best! I am super pleased I chose Dr. Pal\'s office. They were helpful from beginning to end, from booking on the phone to my actual visit. Dr. Pal was very detailed and went in-depth about my eye health. She is very patient and made me feel calm. The optician helped me pick a great pair of glasses, they were genuinely friendly which is a huge bonus."

    --Ahmad S
  • "I have been going to Dr. Pal for several years now. My most recent visit on June 6, 2016 was the best experience there that I have ever had. Firstly, the women on the desk were friendly and efficient - a very good prelude to my examination. Dr. Pal, herself, was, as usual, very thorough and encouraging in her examination. And she puts you at ease before we get into the eyes examination by discussing other things in life. That helps to ease any stress I may have. And they now have a man in the office who does that difficult examination (name of which I do not know!). He is so patient and encouraging and made the exam not so difficult for me this time. After all that, I saw Dr. Pal again before I left and she told me my eyes were good! Even had the news been not so good, I believe that I would be able to handle it because I truly believe that Dr. Pal and her staff would have taken good care of me. I will always go back to Dr. Pal and members of her team because I truly believe"

    --A. Howlett
  • " I have been to a few appointments at Dr. Pal\'s office over the last year for dry eye issues and every time it has been a very positive experience. The 3 receptionists at the front desk are warm and friendly. They are attentive and provide a very high level of customer service. I appreciate that they call me by name and remembered conversations we had at previous visits. I find Dr. Pal to be an excellent practitioner who is very thorough with her exams, has a lovely personality and takes the time to answer any and all questions that may arise. I am happy with the computer glasses I purchased and value the honest opinions I received from the staff when selecting frames. It was refreshing to have multiple opinions on styles and I felt they truly wanted me to walk out with a frame that was best suited to me. I highly recommend Dr. Pal \'s office! As a health care practitioner myself, I think all health care experiences should be this personilzed and friendly!"

    --A. Mclean
Fluorescein Angiography


Fluorescein Angiography


Most people do not know that the only place in the human body where blood vessels can be viewed in their natural state, without cutting something open, is in the back of the eye. For this reason, the eye is one of the best places to evaluate diseases and conditions that affect the circulation; what is happening in the ocular blood vessels is also happening elsewhere in the body.

For this reason, Fluorescein Angiography (FA), a test in which the vegetable dye called fluorescein is injected into an arm or hand vein and allowed to circulate through the body is an important diagnostic procedure, not only for eye disease but systemic conditions as well. When the dye reaches the eye, photographs are taken to see the retinal arteries and veins. In some cases, photos may be taken very early in the process, when the dye is just reaching the eye, until the dye is completely out of view. These angiograms may be referred to as being “early,” or “late,” and provide different types of information to the specialist interpreting them. As the dye circulates and perfuses into the ocular area, it is much easier to view exactly what the vessels are doing, or if they are leaking at all.

FA is used whenever there may be a question of blood leakage into the back of the eye; it is extremely useful because the fluorescein glows brightly under the flash of a camera, showing any leakage of blood, the location of the site, and how extensive the leak may be.

This diagram shows a pair of retinal photos taken under normal conditions, and what the blood vessels look like under fluorescent light, in blue. Any leakage from the vessels would be visible.

The retina can be affected by many disorders that involve the circulation of blood, such as may be found in retinopathy of diabetes, arteriosclerosis (thickening of the artery walls), atherosclerosis (plaque formation within the vessels), macular degeneration and many others. FA can be used to assess and document a present condition prior to treatment or it can be used to evaluate whether treatment has been effective.

What to Expect

Fluorescein angiography is not painful and is relatively quick to perform.

First, the patient having the procedure will have dilating drops inserted into his or her eyes to enlarge the pupil and make viewing the interior of the eye easier. Once the pupils have dilated, the dye is injected, usually into a vein in the hand or the arm. In just a few seconds, the dye will become visible in the eye via the blood vessels that provide circulation there. Photographs will be taken from the time of the first visible trace of dye, until it is almost completely gone.

Sometimes, different filters are used on the camera, to reveal different aspects of circulation; the filters make the dye fluoresce, or glow, so the tiniest amounts can be seen, even the smallest leakages from the blood vessels in the eye.

The entire FA procedure takes less than half an hour, although it may take longer for the dilating drops to work; it will also take up to several hours for them to wear off, making vision blurry. The skin may appear to be slightly yellowed and urine will be bright yellow for about 36 hours after the test.

What Does Fluorescein Angiography Reveal?

Often, when the circulation within the eye is compromised, a hormone called 'vascular growth factor (VGF)' is released, causing the formation of new, extremely fragile arteries and veins. Such newly-formed vessels are very easily broken (a coughing spell might do so, for example) and should be treated with a laser to seal them, or with medications called anti-VGFs to prevent their formation.

If there are any circulation difficulties such as swelling, leaking or otherwise abnormal blood vessels, they will be visible from the photographs. If there are new vessels forming, these are also apparent and can be treated before they begin to break and bleed into the eye.

To a specialist treating such conditions, knowing that such leakages are present and their exact location makes it much more effective to treat them.

Fluorescein angiography is a very effective tool to visualize and treat circulation problems within the eyes.

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