August 22, 2008

                                       The Sharon Kleyne Hour

Radio Talk Show – www.workdtalkradio.com

Power of Water, Global Warming and Your Health

Mind – Eyes – Skin – Body

 

Show Summary

 

Date aired: August 18, 2008

 

Guest #1 – Laurie Barber, MD (Little Rock, AR), Professor of Ophthalmology, University of Arkansas.

“Dry Eye and Menopause”      

Guest #2 – Rebekah Jones (Boulder City, NV), Lake Mead National Recreation Area, Nevada.

“More about Lake Mead, Nevada”

Sharon Kleyne (paraphrased): Welcome to our show today. Our first guest is Dr. Laurie Barber, Professor of Ophthalmology at the University of Arkansas and a well known dry eye specialist. Good morning, Dr. Barber. How did you become interested in ophthalmology?  

Dr. Laurie Barber (paraphrased): Good morning Sharon. I guess I was always interested in eyes. My father was a doctor, what they used to call a “general practitioner,” and I had always wanted to be a nurse until my father sat me down one day and urged me to set my sights higher. I naturally ended up in ophthalmology.

S: I’m told that dry eye is the number one complaint these days that ophthalmologists see in their practices. How did you end up specializing in dry eye?

L: I don’t really. I practice in all areas of ophthalmology. But for the last ten years, I’ve been focusing on dry eye and doing research on corneal inflammation. There is no skin over the cornea and it is protected only by the corneal membrane and the tear film so it’s very delicate. If the tear film is healthy, the eye is likely to be healthy. But there are many important substances in the tear film aside from salt water – hormones, antibodies, mucins, lipids and so forth.

S: Tell us about the three tear film layers.

L: Actually, there are now considered to be only two distinct layers – the uppermost fatty or lipid layer and the aqueous layer that gradates into an adhesive mucin layer. In addition to protecting the cornea, the aqueous layer is critical to light transmission and the lipid layer lubricates and prevents evaporation. It’s all very complex.

S: There are a lot of environmental drying factors that work against the tear film. And people are often unaware that their eyes are dry. What are the main symptoms of dry eye? 

L: In younger people, there are very few symptoms. As we get older, after age 35 or so, we can lose the ability to keep the tear film in top-notch condition with out helping it along. This is more the case with women than men. Dry eye after age 35 is believed to be caused by a drop-off in androgen, a male sex hormone, that occurs in both men and women. Dry eye symptoms include  burning, itching, irritated, red eyes, and blurred vision. Also, what we call “eye fatigue.”

S: What is the earliest age for contact lenses? I’m told that most teenagers can’t tolerate them.

L: Teenagers can usually physically tolerate them but may not be responsible enough to maintain them and keep them clean. It’s a lot of work and keeping your lenses clean is very important. We’ve recently seen an increase in corneal fungus that can be very serious and is caused by dirty contact lenses.

S: According to Dr. Marguerite McDonald, who has been a guest on this show, if you ever want LASIK later in life, you need to take excellent care of your eyes and contact lenses when you are young. Tell us about dry eye and menopausal women. I’m sure dry eye also shows up in men of the same age.

L: Yes. Men who are on prostate medication can get extremely dry eyes. The hormonal changes leading to menopause start at around age 35 and men have some of the same hormone fluctuations as women. But women have a lot more hormones and a lot more dry eye.

S: Do you have any advice about artificial tears?

L: You need to limit it to four or five application a day, especially when using eye drops that contain preservatives, which can be an allergen.

S: You sound very concerned about vision care education. People are often unaware of the harm they can do to their eyes. Can you become addicted to eye drops?

L: That’s often talked about but I don’t think there have been any actual studies to determine whether using eye drops sets up a self-perpetuating need, as is the case with nose drops. Most people only use eye drops for a short duration.

S: Is there a test for dry eye?

L: The Shirmer test can be done by ophthalmologists or optometrists. They put a strip of blotting paper inside the eyelid for a specified amount of time and see how much liquid it soaks up.

S: What role does the skin around the eyes play in dry eye? Usually, when the eye is dry, the eyelids are inflamed and the eyelid skin is dry and flaky.

L: The lid margins are particularly problematic because that’s where the oil producing meibomium gland are located. The lids are also a “hot spot” for skin cancer. But any time you have serious symptoms, it’s time to see the doctor. They can recommend a pure water mist supplement like Nature’s Tears EyeMist, artificial tears, various medications, punctual plugs, etc.

S: And of course it’s important to keep eyes moist by drinking plenty of water – and I don’t mean coffee or soda.

L: Hydration and diet are critical. You should also eat green, leafy veggies, fruit and omega-3’s.

S: What about occupational health and eye care? Employers need to be taught about vision and forced air heating and cooling, computers, etc.

L: We all take our vision for granted until something bad happens. It’s human nature.

S: Could you talk about sleep and rest?

L: It’s very important to eye health, of course. It’s important to truly rest your eyes at night, and allow them to recover, which means not wearing contact lenses to bed. The tear film restores itself while you sleep – the glands recharge, the pH drops, etc.

S: Do you get a lot of patients with eye-stressing occupations or lifestyles, such as truck drivers or motorcycle riders?

L: Yes…those occupations all involve intense concentration or staring and the person often forgets to blink, which causes too much moisture to evaporate from the tear film. The best way to deal with that is prevention such as goggles or helmets, or pre-treatment such as applying eye drops or eye mist before you go motorcycling.

S: What about computers?

L: Computers also involve staring and cause you to blink less. You need to take frequent breaks to  rest your eyes, make sure there isn’t a vent blowing on you, and position yourself to look slightly down on the screen.

S: And finally, tell us what to do about menopausal dry eye?

L: The same as you would for hot flashes. Exercise, drink lots of water, try to stay in a cool place and wear layered clothing so you can cool yourself off.

S: Exercise reduces stress and stimulates your system but can also be dehydrating.

L: Yes. So maybe as you get into menopause, you want to do only moderate exercise. If you’re training for a marathon – and I’ve worked with Olympic athletes – you need to be very meticulous about hydration. If you’re a swimmer, you need to watch your chlorine exposure.

S: Thank you so much, Dr. Barber. My next guest is Rebekah Jones of Lake Mead National Recreation Area in Nevada, who is going to tell us more about Lake Mead and especially about an invasive mussel shell that’s been causing no end of problems there.