Episode 1 - Meet the Hosts

Transcription:

Unknown Speaker 0:03

Welcome to the jazzy eyes podcast, taking care of your vision with expert precision. Here's your hosts, Dr. Laura Falco, and Dr. tween un.

Unknown Speaker 0:16

Hello, hello, and welcome everyone to episode number one of the jazzy eyes podcast. Yes, I am your co-host, and producer of the show, Jeremy Wolf. And I'd like to welcome to the stage.

None other than your hosts, Dr. Laura Falco, and Dr. Thuy Nguyen. Ladies, thanks so much for being here. That's what I normally say. But really, you know, you're inviting me in. So, thanks for having me. This is so exciting. Congratulations on the first episode of your very own podcast.

So, I'm excited to jump in and get started. So, I thought we would start by why don't you share with the listeners for those that don't know? Tell us about a little bit about jazzy ice.

Unknown Speaker 1:07

So jazzy ice has actually been a staple of the daily landscape for 35 years, approximately, its people who grew up in this area remember coming as kids to get their first pairs of glasses, and now they're bringing their kids for their purse, the first pair of glasses, so it actually started off without a doctor. It started off as an optical by itself, and everybody would bring outside prescriptions.

And there were appointments to get your glasses done. And it was it was a really fun place that had probably the broadest selection and the funkiest glasses. Probably in Broward maybe like the whole Broward and Dade County. I mean, it was it was it was a place that everybody who grew up here kind of went to I didn't grow up here. So, this is all information to me from other people.

But I've had plenty of patients tell me, I've been coming here since the late 80s, since Jimmy opened it who was the optician basically, who started the business. And I would say, probably five, six years into the business. Dr. Michael Kimmelman, who preceded me, but the business would work in the business, like a couple of days a week carved out a little area in the practice just to do eyeglasses. Well, you fast forward that and he eventually owned the business, bought the business from the people who had previously owned it, and did eye exams full time, and not really fast forward.

So, five years ago, I bought the business and renovated the business to have two exam lanes. And now Dr. Newman and I both have our lanes and we work side by side now two doctors are seeing patients at the same time, full time pretty much a jazzy I so it's come from having no doctor to a doctor part time, a doctor full time and now to this is the first time to my knowledge that there's two doctors working at jazzy is awesome. And I know we actually got into a little bit into your background when we did the Good Neighbor podcast and you have a strong background in education.

But I wanted to have Dr. Nuun talk a little bit about her background first and kind of what she's now bringing to the table over at jazzy eyes because I know she's this is relatively new for you guys. She just came on. I mean, how about we go Doctor new interview Come on. Two, two and a half months ago. Wow. Congratulations, by the way. Thank you.

Unknown Speaker 3:34

Yes, so I I'm local here. I've grown up here since I was one been here for 20 something years in Broward County. I went to high school on Ross was Broward high. graduated in 2015. Had no idea what I wanted to do right after I graduated high school because people want you to know exactly what you're doing when you graduate high school to get into college. But that wasn't the case for me.

So, during the summer of my 2015 After I graduated, I met Dr. Falco who had been like a longtime friend of my sisters. She knew that I had absolutely no idea what I wanted to do when I graduated. So, she was like, oh, you know, I'm a professor at NOVA. How about you come just shadow me in optometry and see how you So, like it. I ended up doing it for about three months until my summer and I was like, wow, I really like this. I like the pace of Optometry. Like how intimate it is.

I just like how having just a pair of simple glasses can just change your life forever. And I'm saying was a personal experience because I didn't get my first eye exam or I didn't even get my first pair of glasses till I was 18. And she was the person who made me made me my first pair of glasses. And my vision was horrible.

Unknown Speaker 4:48

If I had taken the driver's exam, my licensing exam for driving without glasses, I would have never passed in a million years. Like my vision was that when she gave me those first pair of glasses it change my life and so I ended up going to optometry school.

I ended up going to Nova for undergrad because I knew I wanted to go to Nova for my optometry school. They were the only optometry school in Florida. So, I went and I applied for my undergrad. And I also did a dual admissions program which means they would save me a seat for the optometric program and Nova if I had just, you know, did well at school and gotten did well on the admissions test for Optometry.

So, I did my undergrad there I majored in biology minored in psychology, and then in 2019, I graduated undergrad with distinction. And then I went on to apply for optometry school at NOVA. And then recently 2023 I had graduated with honors and now I'm at jazz. Yeah. As for Falco? Well, again, congratulations on this wonderful new opportunity.

It's always nice, isn't it Dr. Falco, to bring in some, you know, a fresh face to the business and kind of rejuvenate everything. So that sounds like you got a wonderful team working over there. And it's so funny, you said earlier about not being able to really see until you got your glasses like talk about a true eye-opening experience, right.

Unknown Speaker 6:23

I mean, it's great how you're you became so passionate about how you both knew each other before this, and you're working together now. And we're all part of unity. Really, really phenomenal. Dr. Falco, why don't you share a little bit briefly just about your background.

We talked about how you were in education. I know you've worked at NOVA for many, many years. Just share briefly a little bit about that. Yeah. So, Speaker 6:23 I grew up right outside of New York City. I grew up in Rockland County. So that's 25 minutes outside of Manhattan.

Unknown Speaker 6:49

I'm sorry to cut you off. Did you say Rockland County? I did. I grew up in Rockland County. I was born in Suffern, Good Samaritan Hospital. My brother was born in Good Sam.

How did we not recognize I think you said that on the Good Neighbor podcast. It didn't register. I think I heard something else. But yeah, I lived in New City, Spring Valley, until I was about 15. I moved down to South Florida.

Unknown Speaker 7:11

in Rockland, two years. Yeah. And Suffern. Hi. Oh, okay, Ramapo. Okay. I guess I'd say I'd say I wouldn't hold it against you. But what does it even matter? I don't remember that far back anyway.

Unknown Speaker 7:25

Yes, it does. So yeah. So, I grew up, like 20, as you know, 25 minutes outside of Manhattan. And then I went to undergrad, I was in New York State residents. So, I did all New York State School. So, I did Albany. And then I went into Manhattan for optometry school.

And then my how I ended up at NOVA was I ended up doing a residency in anterior segment, which is red eye stuff. And I wanted a different experience. And I had never left New York my entire life, and had really no I really never experienced like outside of the New York tri state area right there. So, I ended up going down to fly to see residency down in Alabama. So, University Alabama, which I literally had to get a map out to figure out exactly where I was going in Birmingham, because the New Yorker doesn't really know anything outside of New York sometimes. So, I flew down and I looked around, I said, wow, this is so different than anything I learned and the environment with which I grew up in.

So, I packed it up against my family's advice where like, no one no one could wrap their mind around New York City to Birmingham. But I did, I had a great experience. And while I was in the middle of my residency, I met one of the deans at NOVA, who loved the fact that I had cross training because I had done an external rotation in Atlanta and for the lighthouse for low vision. And then I was doing New York and Birmingham, which is atypical. So, he invited me down, they offered me a position and I taught which I thought I would only stay for two or three years. 18 years later, I taught at the university for 18 years, teaching in the theory and methods class and then seeing patients at all pretty much all of novice clinics at the time, I was there in North Miami, Broward and the Devi clinic.

Unknown Speaker 9:09

And it was it was excellent. It was a totally different every semester, you got to see things that are really really wild stuff, amazing machines that you know, most people can't afford, I got to use. So, it was a really great experience. But there was always this little part of me that wanted to be an entrepreneur and own my own business.

And it kind of went on the backburner and for many years and I enjoyed my time at NOVA, I raised my daughter and then I the opportunity presented itself with Jazzy eyes and I basically took it jumped and took after 18 years, you know, jumped out and said, this is it I'm going to do it so, so yeah, I did have a long stint there of teaching at the university but it was awesome. Ya know, that's really great. And we talked about this before how wonderful and important it is that you bring such a strong, educated educate

Unknown Speaker 10:00

Getting your educator background to the business, you know, to learn and really teach and share your knowledge with people and then take all that knowledge and take all that everything you've shared and to open up a practice to continue to help people in a different way is really, really awesome. So why don't you I know you both are incredibly busy. Obviously, we all are.

Unknown Speaker 10:20

Why don't you Why don't you share and if you can start with your doctor knew and share with the listeners, why you're doing a podcast, right? Like, what's, what's the goal? What's your mission behind doing this? So, I think there are two sides to the podcast one, the person doing the podcast. For me during the podcast, I think it's just a great way to be more personal and intimate with the community and the people that I'm reaching out with.

And it's, it's about educating, educating the community and keeping them up to date about, you know, the newest technology for glasses and stuff like that, while talking about my interest about optometry, for the people listening to the podcasts, I think it's a very now podcast is very convenient way of getting your news and, and all of your up-to-date kind of technology.

Unknown Speaker 11:04

It's more convenient than, like television or not reading because now podcast, you can listen anywhere at any time. And it's just, it's a better way of you getting even in the car on the way to work. It's just more convenient. It's a listen to. Yeah, it really is a wonderful platform. And you know, for me personally doing the good neighbor podcast, it's really transformed my own situation.

And I've met so many wonderful people and learn so many wonderful stories. So, it's really, really great to be doing this with you, ladies. So, Dr. Falco, maybe if you could share with us, what's your motivation behind doing the podcast? I'm going to echo what Dr. Noonan said that I do think it's a really, it's another medium for people to listen.

And today, I hope they listen is I can't get my background to work because I'm old. So listening would be a better way, because then it doesn't look different. But no, but in all seriousness, I've, I've always networked since I bought the business. And this is a really interesting way to Speaker 11:59 reach people different than the traditional mediums that I think when you start a business everyone pushes you into and tells you like you need to, you need to be in this wanting to be there, you need to go in this meeting and meet these people and, and that's great.

But then you know, something like COVID hits, and all of a sudden, all of these events to get your name out there to meet people to for them to get to know you personally, you know, like she's saying, when people aren't gathering in groups anymore, or it's kind of like a little bit different now post COVID I feel like this is a really interesting way to have people get to know you.

And like she said, the more you feel like you know your doctor, and if you click with that person, the more comfortable you are. And this is this is like a really nice way to do that, regardless of pandemic status. Yeah, absolutely. And I'm incredibly excited to embark on this journey with you both and I'm looking forward to future episodes where we could, where you can really share with listeners

Unknown Speaker 13:25

and educate all about what you guys do for our great community. So, did you have anything else that you wanted to add before we close?

Unknown Speaker 13:37

Not everybody all at once.

Unknown Speaker 13:41

Alright, well, I guess with that, we'll, call it and we'll look forward to seeing everyone on the next episode of The jazzy eyes podcast. Everyone have a wonderful day. Thank you. Thank you. Bye, ladies.

Unknown Speaker 13:58

Thank you for listening to the jazzy eyes podcast. For more information, visit Jazzyeyes.com or contact 954-473-0100

Episode 2 - Tips for Back to School with Dr. Falco

Speaker 1 0:03

Welcome to the jazzy eyes podcast, taking care of your vision with expert precision. Here's your host, Dr. Laura Falco.

Jeremy 0:16

Hello, hello, and welcome, everyone to episode number two of the jazzy eyes podcast. I'm your cohost and producer of the show, Jeremy Wolf. And I'm here with none other than your host, Dr. Laura. Falco. Dr. Falco, how are you today?

Unknown Speaker 0:31

I'm doing well. Thank you. Thank you. Good to see you.

Jeremy 0:34

Yeah. Likewise, I'm excited to get into this topic today. Because, as you know, I have two small children not well, not so small anymore. My daughter just went entered middle school, so nine and 11. And I'd like for you, I think it would be useful to talk a little bit about some tips now that the kids are going back to school, some things related to eye care. And talk a little bit about that. And then we'll kind of go from there.

Dr. Falco 0:59

Yeah. So, I think it's really important to understand that, although they do check vision, when you go to the pediatrician’s office, and some pediatricians actually have some devices that do an estimate of a prescription. That that's one part of, of anybody's vision is visual acuity. So, there's a statistic out that says, about 70, the screenings missed about 75% of the kids who really do need glasses for school. So, the screening is one part, it's just acuity. And if you've watched kids do it, you know, there's a stationary chart or they look into a box, and they can kind of squint and there's letter recognition. And they some kids are very smart, they read it with one eye, and they've got it memorized for the other eye. Because many times I've seen a kid need glasses really for one eye. So, you I keep changing the chart and in the pediatrician’s office, it's the same chart on the wall. Now, I'm glad they do it. It's one more thing for them to check off. But I don't want anyone to confuse like a screening of vision that you might get in a doctor's office for a full vision examination that we would do at any optometry and a lot of Ophthalmology practices as well. So, there's that first part, that's vision. So that's just your acuity is your is your child 2020? Are they 2030? Are they 2040? Are they 2200? You know, can they only see the big E, or, you know, are they 2025. And sometimes a kid doesn't have to be 2020, you can have a kid in the first couple grades where the work is in front of them, the writing on the board is quite large. And maybe they're not 2020. But that's okay. And they can still get through school and do everything that they need to do, it's different than yours adults who are driving. But there's a couple other things that we do that I wanted just to kind of go over, that you won't have done unless you're having a full eye examination. So, the first one is fine ocular vision. So, you won't refer this as eye teaming that is our eyes working together. So, there's something called Convergence where the eyes when you read, tilt down a bit and turn in a bit. Now, that's normal, some kids don't turn in enough, some kid’s eyes turn in too much. And their eyes are working way harder than they need to be. There's other tests that we can do that will check tracking. So tracking is how efficiently your child is going to move their eyes left to right. So where do you think obviously this would affect their kid, you know, even from second There are grade, first grade, second grade, spelling reading, that's huge. In third grade, your kids are really starting to work independently have homework assignments to read. So, when your child's reading a book, or they're understanding what they're reading, do they have to read the same sentence over and over? At what point? Should they not be using their finger? You know, to track left to right, and should there be efficient tracking of the eyes moving in the left to right fashion. So again, these are things that wouldn't be tested in other offices that we're going to take a lot of time and sit with the kids to check to test. There's also it's called accommodation, but it's focusing right? When you hold a chart in front of a child for small print up close, and you ask them how far down Can you read on the card and even an adult, when it takes about three seconds and they look down at the card and they read the letter. That's great. But it's very different when you want a child to attend and to read for 30 minutes, 20 minutes versus one minute. So sometimes the kid can hold their focus for one minute, but to hold their focus on the page appropriately for 30 minutes they can't write. So, what would that child start complaining of? So maybe, maybe they don't know? Oftentimes, they don't really know how to put it into words. I don't want to read. Can I watch the movie? I want to listen to it. Let's say your kid understands it audibly. They're processing it, but visually, they're not processing it. So, what if that's because it is so straining on the eyes for them to sit there and try to track left to right, they're having trouble hold their focus. So, they're getting a headache, they want to close their eyes, they just don't want to do it anymore. They don't really know why, but it hurts them, and it bothers them. And they can't explain why to you. So, I joke with the parents and the kids. And I was like, you know, if you don't come in here, having a headache, you leave my office having a headache, because I sit there and do all these different tests. And I and I'm making things double on purpose, I'm seeing how long it takes for patients to get it back to single when it breaks. And all of these little things are really, really important to let you know how your child is functioning visually, not just other 2020. Like that's a very small piece of the overall back to school, you know, like, are my kids set up for success when they start, you know, third grade, fourth grade, and that's where it starts. But, you know, my child is in college. So super aware that they're on the computers and the screens in school, right? It's not like, you can't be one of those, oh, there's not going to be any screen time when you get home kind of a thing, because your kids are going to fall behind. Right? Yep. So, they have to go on Canvas, they have to log in to get their homework, there's no textbooks, right? It's evidence-based learning. So, they have to look up the facts they're trying to get, and then they have to upload their homework. And, and it's screen time, the entire time. And it's focusing at this near point. And then what I what I always tell parents as well, is what I think is interesting is so when somebody of my age, which is not super old, but um, you know, I've been out of college for 25 years, 30 years, but when we're done on the computer, working, I think a lot of us shut the computer like we can't wait to shut the computer in, however, we're going to wind down, whether it's TV, are we going to walk the dog, what are you going to do, when these kids wind down, they minimize one window, but continue to stare at the device, just maybe they're winding down with a video game, maybe they're winding down on YouTube, maybe they're winding down on tick tock like, we're I feel like of our generation, we kind of can't wait to shut the screen off and look far away. They're still attending here. And we're, we're I'm still somebody who wants a TV to watch a movie, they'll watch a movie on their on their device, they'll watch a movie on their phone, on their iPad on their screen, which is keeping their focal point right up there. You know, like right there, they're not getting a chance to relax their focus for FAR and give their eyes a break, even though they're not concentrating. Maybe they're concentrating more who knows what like, you know, it's different the way they use their eyes. And the way we do is different. So, it's really important to check not only, you know, visual acuity, but how this kid is doing with their eyes up close after prolonged work.

Jeremy 8:18

Yeah, I mean, God, you've touched on so much, so many good points there. And it's I think it's more important now than ever, to make sure that we're getting our kids checked out regularly, like you said, with all the screen time constantly on these devices. Yeah, I got to I got to imagine that, you know, if a child is struggling, and you don't get that issue resolved or addressed quickly, you're probably going to regress quicker than it would be otherwise, if they're squinting all the time and putting additional strain.

Dr. Falco 8:47

Right. Well, yeah. And, you know, a good analogy is like, you know, they can get through the day, but maybe they're not achieving, like you think they should be, you know, and I tell patients, you know, you can get through your day, if I put a 10-pound ankle weight on each leg of yours and told you to go through your day, right? Like, you could still do it. But wouldn't your legs be so much more tired at the end of the day. So, some kids without these glasses for up close without these glasses, you know, just see, to help them doing their tasks. It's like they can do it. But they're pooping out earlier. They're more tired, they're crankier, they're shutting their eyes after they read their book in their room, and they don't want to do anything. And because it's taking 110% It shouldn't be that difficult. Now, sometimes I should say the answer is a pair of glasses. Sometimes it's not. There's plenty of times that I send out a patient to vision therapy. Because if you think about like, you know, the kid's brain is like a black box, right? So, you have input, so we have to make sure the images coming in clearly, we're getting a bit of the processing. Are they tracking properly? Are there who are their eyes teaming together properly and are they holding their focus appropriately? But then there's a whole thing and processing that goes on in the brain as well. What are they doing with that information? And then what's the output of your test question? You know, what's their answer? Like? Can they attempt to make achieve what they need to achieve that day? So, we're fortunate that you know, being that I was at NOVA two is that they have a huge binocular vision department. There's other private doctors that do that there's few, but there's a few in the area that we can make referrals to, because sometimes the answer isn't a pair of glasses. Sometimes it's something called vision therapy.

Jeremy 10:29

I was gonna ask, please

Dr. Falco 10:32

taught, the child has taught how to use their eyes more effectively, they have to wake up their focal points, they have to wake up their ability to focus, they have to learn how to convert their eyes go together diverge, to relax their eyes. And I, you know, when my child again was in third grade, I noticed that she was skipping lines. And she was using her finger. And we were rereading, we were getting frustrated. And anyone who practices No, you cannot examine your own child is a disaster. So, I could not examine it was it was futile, I couldn't examine her. So, I had this funny feeling. She at the time was smart enough to get by. So, she wasn't flagged in class. It was me noticing. And that's oftentimes the way it is. And a lot of parents are like, something's not making that I don't like the way she's reading. Something's not working. Oh, but her grades are fine. And she's where she has to be. And she's great level and like, Yeah, I'm not buying it. Yeah, something's off, right. So, she went in for an eye exam, with a really good colleague of mine at NOVA, and he came out and said, she's a hot mess. You know, like, she was all over the place with the tracking, like, here, here, here, here, here. And I said, I knew it. I knew it. I knew it. So, she did vision therapy, probably three, four months. And it hurts like just if you had physical therapy, and you sprained your arm, you hurt me. And then you had to rebuild the muscle. So, she had to learn how to track more effectively left to right, left to right. And it's So, monotonous. And it's it bothered, she complained, and there were slamming doors, and there was crying and there was fighting, and that's about right, happens. And then she gets into fourth grade. And then there was an essay about like, what was something significant that happened to you, that was good, you know, in third grade, and she wrote this entire essay how vision therapy was the best thing. And our eyes, me well, the fights and the crying and the screaming that we endured so, so it does work, some in somewhere in the recesses, they know what they're doing helps them even though sometimes when you're going through it, it's one more thing to make parents crazy, I get it, I've been there. But, you know, it was one of those things that I knew she needed. And sure enough, like, she's a voracious reader, now she reads super, super fast, it helps her stay on track, not have to reread the same passage, over and over and over, but get through the paragraph understand what she read, because she wasn't losing her place. And it was disjointed, you know, so. So, it helped it helped a lot. But so, there are things that you can do with So, your child, you know, that can help it get better, even if it's 2020. And it's not just simple glasses. But again, these are things that, unfortunately, I don't usually see until this kid is really complaining and the parent is at their wit's end. And so like, they're like starting all, we're just going to check everything. They have headaches, you know, they have headaches, what's going on? And that's one of the main things.

Jeremy 13:33

Yeah, and, you know, I'm, I'm guilty. I'll be the first to admit now that I'm glad we're having this conversation, because Jeremy of this discussion, I'm bringing my two kids over to see you to get know, it's been a while. Yeah, and yeah, everything seems good enough. But there are other devices all the time. And I don't know. So, I hope this raises awareness for other parents out there, to make sure that they're taking their children in frequently. Yeah, check these things out. Because life happens, right? Everybody's busy. And vision can be one of those things, you know, not like get your annual checkup at the doctor you could write but that go by the wayside, and really neglect that if you're not careful. So

Dr. Falco 14:10

Well, yeah. And I don't think I don't think kids put two and two together if they think they can see, they don't know that there's more to it, that that could be the reason why their head hurts, that that could be the reason why they're not they're not understanding what they're reading, and then it's a self-confidence thing. And he Yeah, it's snowballs. And the reality is, as much as everyone you know, vilifies the devices, they're endemic, and the kids have to be on them to stay competitive in life. And when they go, you know, to get when they're going to go to get jobs. They can't not be computer savvy. That's not an option. I'm not saying give a three-year-old an iPad and a restaurant. I'm not saying but when they're in high school, junior high school, they are going to be on these devices for all of their work and three-year-old it is what it is. So basically, we have to what can we best do to keep their eyes healthy to keep them comfortable once in a while and successful while they're in school. So, it's that these are definitely some things that most people don't think about. Just because your kid can see clearly there is still more to check.

Jeremy 15:18

All right, anything else you'd like to share before we wrap up here?

Dr. Falco 15:27

My associate is gonna we're like, we kind of divided some of these topics. So, I took these topics, she's going to talk a bit about blue light, like protection, myopia control some of the other things that may be a little sexier that you've heard in the news lately, I did kind of like the tried and true, like, you know, what other kinds of things that I, you know, but I do I explain it on a weekly basis to patients. And I think patients are always happy to understand Oh, that's why like, that makes sense. I get it, you know. And to be honest, these are not just things that happen to kids. This is just one more thing. It's back to school. But the all of these kinds of conditions I check for on many, many patients, even if they're not heading back to school.

Jeremy 16:10

Dr. Falco, always a pleasure. And you will be seeing me and my children very, very soon. Sounds great. Hold my feet to the fire if I don't show up there. This is good stuff. So. All right. So, everybody, thanks for tuning in, and we will look forward to seeing you on the next episode of The jazzy eyes podcast. Everyone have a wonderful day and take care. Take care.

Speaker 1 16:37

Thank you for listening to the jazzy eyes podcast. For more information, visit Jazzyeyes.com or contact 954-473-0100

Episode 3 - Back to School Eye Care Tips with Dr. Nguyen

Speaker 1 0:02

Welcome to the jazzy eyes podcast. Taking care of your vision with expert precision. Here's your host Dr. Thuy Nguyen

Jeremy 0:14

Hello, hello and welcome, everyone to episode number three at the jazzy eyes podcast. I'm your co host and producer of the show. Jeremy Wolf. And I'm here with none other than your host. We have Dr. Thuy Nuun. Dr. Newman, how you doing? How you doing today?

Unknown Speaker 0:30

Yeah, how are you?

Jeremy 0:32

I am doing very, very well. It's Monday, it is back to school officially back to school. Kids are out of the house back in school, out of school. Now there's a lot of out of school traffic now.

Jeremy 0:46

What? Yeah, just shock to the system, right, total change in schedules. And I know, I was just talking to Dr. Falco about this whole issue of back to school. And she offered some really valuable insights that made me realize like, Wait, I gotta come in and see you guys very soon, because it's been too long since my kids have had an eye exam. And we were just talking about how it seems that everything's okay. But oftentimes, that's not the case. And it's important to get checked out. So, I was hoping that maybe you could share your perspective on our kids going back to school, maybe share some tips and things that they can do to ensure they're making the most out of their vision and that they're the most productive that they can be in school.

Dr. Nguyen 1:24

Right, right. So now kids are going back to school. And it's a you know, they're spending all hours of their days in school reading textbooks, and they're coming home and they're doing their homework up close. And back then it was, oh, after you do your homework, you can go outside and play with your friends and everything outdoors, right. But now with because of technology, social media, and in gaming, everyone is on their phones more looking at a device more after they done their homework. And so back then there wasn't a lot of studies showing, oh, you know, if you're on the computer a lot that's going to increase, you know, nearsightedness and kids, because that's what shows, you know, kids are born a little bit more farsighted. And when they go back to school, when they go to school, and they're looking at near work, they become a little bit more nearsighted, you know, year by year. But ever since, you know, tablets and phones have become a thing. It's been shown that, you know, there's more evidence supporting that it could increase nearsighted in kids now, not because of specifically the device that that they're on, but more because they're not outdoors as much.

Jeremy 2:36

He said, it could increase neuroscience, I mean, goodness, that I can speak from experience. When I'm on my phone too much. My eyes start straining. And I can only imagine for kids, especially if they're already having if they're younger kids, and they're already having some issues that with their vision that aren't known, right, maybe they're not getting help, they don't have glasses, and they're in school all day, and then they come home and now they're right on their devices straining and looking. I can only imagine that that could you know, that problem could get spiraled out of proportion real quickly.

Dr. Nguyen 3:06

And so, everyone can have eyestrain kids, adults, everyone that's a short-term effect of like everything being like 30 inches, or 30 centimeters away from you. That's just the short-term effects. But long term now it's people are becoming nearer and more and more nearsighted. I don't know what it is about the outdoors or the day lights. But being outside actually slows the progression of being nearsighted. And because kids are on their device more often. They're not outside as often and so they're getting more near side. And that's what seems to be the trend going long term now.

Jeremy 3:40

I mean, my son was nine, thankfully, we live in a neighborhood where he can go outside and play with all the kids and get lost out there for hours upon end playing sports. My daughter, unfortunately, she is the one that's typically on it. Like when she's playing with her friends, it's on her devices. They're on a chat group, and they're playing games off that there's and there's some value to her always be on the devices. She's getting good with graphic design and certain useful functions. But at the same time, it's pretty freaky, to see them on their devices for as long as they are not knowing long term effects of this type of stuff. And I know I just mentioned before we hopped on my son just got the VR headset, the virtual reality which is incredibly cool. But also incredibly concerning that if he has that on too often, like what are going to be what are the long effect long term effects of that for him? I'm interested to hear your perspective.

Dr. Nguyen 4:42

How often are they on the cusp? Like how many hours would you say they would be on a device you know, all day?

Jeremy 4:48

Oh my God, my Well, my daughter. It's many hours on the day so far too much. I'll be the first to admit and I do whatever I can to pull in. I'm hoping that With school now she'll have more time to draw away from that. But at the same time, if she's in school all day looking at books and looking at the teacher in the front of the room, and then she comes home and she's on the device, how much too much is, is it right? Or how much too much is too much if I could speak properly, right.

Dr. Nguyen 5:17

So being on the computer, whether it's like gaming, or like, you know, all of the graphic designs that your your daughter is doing, all of it contributes to this, this name that they coined computer vision syndrome, which is not only eye strain, you know, you're gonna have eyestrain, you're gonna have a big one is dry eyes, you're gonna have issues focusing, which is why you might see a little bit blurry sometimes. But other than eyes, you would also have neck stiffness, headache, just your posture, some people hunched over a little bit more when they're on the computer. So it's your whole body, including your eyes is part of this computer vision syndrome. And so, interestingly enough, when you're on the computer relating to dry eyes, when you're on the computer, you're not blinking as much as you should. So I think the average blink rate is you're supposed to be blinking 15 to 20 blinks per minute.

Jeremy 6:14

You got a lot now, I'm like conscious of like, How many times am I blinking?

Dr. Nguyen 6:18

Thankfully, our body does it for us. But when you're on a computer, and you're more focused, you're actually blinking much, much less than 1520 blinks, the minute, you're actually blinking like five or seven times a minute. And that's a very generous five to seven blinks. So if you were to talk about, you know, someone working for eight hours a day, right, normally, they would blink 7000 blinks. If they weren't on a computer just in that eight hours of a workday. If you're working at a computer, or you're a student who's online, and they're eight hours of school, you're actually blinking about 2000 to 3000 blinks within that eight hours, that's a, that's like a, you're missing out on 4000 blinks that you should be blinking like you're not. And so that country that makes the dry eye symptoms even worse, and everyone has dry eyes, they just don't feel the symptoms. But when you're on a computer screen more gaming or on or doing work or stuff like that, it can exacerbate dry symptoms.

Jeremy 7:24

Well, I can say, from my own personal from where I sit my own personal experience, I could use a break from the screen time because we're here on this recording. And as we're talking, I'm feeling the dry eyes and I'm feeling a little bit of head pressure. And I don't know, I need to get speaking of my kids, I need to go get my eyes checked out. Because we might need glasses. What had LASIK surgery done years ago, and it was phenomenal. And I haven't really done anything since and I know it's not it's not optimal, right now I know I need to get reevaluated. So, I'm coming in with the kids. That's it.

Dr. Nguyen 8:00

Everyone who had least expect and they get a good 1015 years out of it. But after a certain age, you're gonna start realizing that you need glasses for up close work or for computer or else you're going to be sitting at your computer at an awkward position hunched over looking in a little bit because you're in near sight. Your your near vision isn't as good as it used to be when you're younger.

Jeremy 8:21

Yeah, and everyone. And um, I think people are just stubborn, right? When it comes to my wife, my wife told me yesterday, she finally she increased the size on her phone of the text. And she goes, let me do it for you. Let me do it for you. I said no, no, no, no, no, no, I'm good. I don't want to go there yet. There's a resistance to doing that. Well, in many cases, that's probably a function of I probably do need a tune up or a new LASIK surgery or glasses. And I just don't want to go there. And then now I'm resisting, increasing the size of my phone and all these things are probably just making my situation worse quicker. I'd imagine. It's actually people who haven't worn glasses in a while that people have LASIK. And now they have the convenience of not having to wear glasses. Or to convince them or wear glasses when they finally need it again, stubborn, stubborn breed, right. I'm interested to see I imagine that I might very well be a good candidate. I mean, obviously depends on a lot of factors. But for LASIK again, right? They do second rounds of LASIK surgery all the time. I'd imagine they do but it puts you up for a lot of other complications such as corneas or tissue can thin because now they're lasering more tissue than they did the first time and dry eyes is a very common symptom of actually having it done again.

Unknown Speaker 9:49

All right, well, I'm filling a pair a new pair of Gucci shoes in my future. I think we got you for that.

Jeremy 10:00

Dr. Neumann Is there anything else that you'd like to share with us or touch upon any other tips you'd like to give before we wrap it up?

Dr. Nguyen 10:09

So, we talked about like the screen times the confusion, the computer vision syndrome, and the dry eyes, all of those are kind of interconnected. And so there are things that we can do that can alleviate those symptoms, like taking breaks more often is what you talked about. I don't know if you've ever heard of what it's called the 2020 20 rule. It's like, Sure, every 20 minutes, you're supposed to take a break and look away in the distance 20 feet away for 20 seconds. And that's what I tell my patients to do. However, like when you are working, and you're so into your work, 20 minutes goes by super quick. And it's So, counterproductive for you to step away from your computer every 30 minutes, because you're not getting things as quick done quickly as you want. So even if patients can't meet that 2020 20 requirement, I tell them that it doesn't have to be 20 minutes, they can just every hour, every two hours, they can just stare away, stare at a window Daydream for about one to two minutes and then come back to whatever they're doing.

Jeremy 11:11

I thought you were gonna say I'm sitting here like, 2020 20 I'm like, Okay, so 20 minutes worth of work. 20 minutes worth of looking away and 20 minutes for naptime. Yeah, like, my optimal recipe for success or lack of productivity, right?

Dr. Nguyen 11:24

That's probably what I should start telling you do. Write a write a script to their work, she has to take a 20 minute nap every single day.

Unknown Speaker 11:33

absolute necessity for optimal peak performance. Don't you know?

Dr. Nguyen 11:37

Doctor's orders? Awesome. Awesome. Well, hey, taking those breaks, you know, artificial tears even when you're not feeling the symptoms of dry ice could help because once you're starting feels dry. Sometimes it's already too late. You're already having you know, the cycle of dry eyes and then rubbing your eyes and then I'm strain and everything.

Jeremy 11:58 Yeah, I think I think the optimal mix is just to not do any or the optimal mix. And the best thing is just not to do any one thing. Too often. Like for me, if I'm having a hard time, if my eyes are straining, I'll just go. Maybe take five minutes and meditate. Just close my eyes and listen to a meditation app and just kind of do that or sometimes just go for a run like you said get out getting outside. Outdoor time. That's different perspective. Sunlight, all these different things obviously. up so the afternoon Always a pleasure. Always a pleasure. I lost my train of thought there for a second. It's been a long Monday with the kids back has been and people are still getting out of school. My nephew's getting picked up right now on the lines at least an hour long.

Jeremy 12:46 Chaos casts Awesome. Well, I will look forward to seeing you on the next episode. And thanks always to our listeners for tuning in. And we'll see you later. Everyone. Have a wonderful day and take care.

Speaker 1 13:05

Thank you for listening to the jazzy eyes podcast. For more information, visit Jazzy eyes.com or contact 954-473-0100

Episode 4 - Soft Contact Lenses

Announcement 00:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr. Laura Falco.

Jeremy Co-host 00:16

Hello, hello everyone, and welcome to episode number four of the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolfe, and I'm here with none other than your host, Dr. Laura Falco. Dr Falco, how are you doing on this glorious Monday morning?

Dr. FalcoHost00:32

I'm doing great, thank you. How are you doing?

JeremyCo-host00:35

I am great, feel really relieved now that I finally got in to see you. It has been I don't know how many years since I saw an eye doctor and thankfully, I have a good report. I'm not in need of anything severe, but you hear that listeners out there don't wait four years, like I did, to go see an eye doctor. You should go see at least every year to get your vision checked and make sure you are up to speed. Interesting topic of conversation today, something a little bit not foreign to me but it's distant the idea of contact lenses. I used to wear contacts before I had lasik surgery 15 years ago. I have a little bit of a recollection of what that was like, but I was hoping maybe today you could share a little bit about contact lenses, soft contact lenses.

01:21

Yeah, I'm going to listen to those on that topic.

Dr. FalcoHost01:24

Yes, absolutely. Soft contact lenses are exploding as far as the amount of different contacts there are. So today I'll talk a little bit about soft contact lens wear. There's a couple of different modalities.

01:40

Most people that I end up examining I end up putting in a daily, a one day lens. It's a one wear lens. The advantages of the one-day lens is that you do not have an opportunity for everything that's in the air to build up on the lens. Lenses stick to dust pollen, everything that's in the air. So, when you re-wear a lens over and over and over, that's when patients start to have an intolerance to contact lens and their eyes feel irritated. They can't wait to get the lenses out because everything that is in your eyes and the gunk in the corner like everything is accumulating on that contact lens.

02:20

So really, truly the healthiest way to go in a soft contact lens is to use a one day lens, and I even tell patients like it's a one wear, you put it into place sports for a few hours, you take it out, you throw it right in the garbage. The advantages are you don't have to buy any solutions. You don't have to worry about oh my God, how long was this contact lens in this case, for Is the case clean? Did the fluid evaporate in the case and now the lens is funky, so you're not ever going to. People sometimes have put tap water in their cases and then that's a whole other issue where you can get a really serious pseudomonas infection.

JeremyCo-host02:57

So, it takes back. Hold on back up a second there. So, if you get tap water in the solution, well, some patients store their lenses. Oh, just water.

Dr. FalcoHost03:07

Filter tap water, thinking it's clean and it has bacteria in it and then they put their lens in their eye and you can get it. It's called a pseudomonas infection, where you could literally go blind. I mean, it's really taps bad.

03:21

That's no good. So, the one-day lens is a really nice modality because you don't have to buy a solution. You go on vacation, you bring a bunch of lenses for the right eye, a bunch of lenses for the left eye, one rips, no big deal. You've got plenty of backups. So that's probably the most common way I prescribe contact lenses for patients. There's a two-week lens that is out there. There's really just one two-week lens that I would say most patients end up over wearing for a month. I don't know if they think it's a month, but there's a two-week lens out there and then there are a few monthly contact lenses. So, with the monthly contact lenses and the two-week lenses, now you're looking at buying solution.

04:05

Now you want to clean the lenses and I'm a proponent of even though these newer solutions have said no rub like you could just put the, it'll clean the contact. You should always put it in your palm and use some friction with your index finger to clean the contact, because there are things that deposit on the lenses and you do want to clean that lens before you put it in the case. There's another solution out there that's called clear care. It's a hydrogen peroxide solution. It is different in that you cannot just rinse hydrogen peroxide on your lens and put your lens in your eye. You will burn your eye?

JeremyCo-host04:42

I suspect not. Yeah, hydrogen peroxide does not sound like something you want to put directly in your eye. For sure, absolutely not.

Dr. FalcoHost04:47

However, you're going to have your lens sit overnight and it really is a fantastic cleaner. It really gives like think of it like a deep clean. So, I really do like that solution, but you have to make sure that you know how to use it properly.

JeremyCo-host05:01

Yeah, I imagine after you let it soak overnight before you put it in your eye, you need to then take some saline or something and wash it off before you put it in right.

Dr. FalcoHost05:11

So yeah, so there's those for the multi-use. You know like you're using the contact for more than one time and they can also be utilized because sometimes they have parameters that are beyond the parameters, prescription wise, of the daily lenses. So sometimes we have to go with a monthly lens. But there are other issues in also, in addition to just having the different modalities, and that's how long you put the contact lens in your eye for. So, you could be wearing a one-day lens, but if you wake up first thing in the morning and the first thing you do when you get up and go to the bathroom is put your contacts in, because your eyes have been closed all night, and then the last thing you do before you go to sleep is take out your contacts. And I've even had parents tell me there's dried up contact lenses on their no offense suns nightstand. They literally don't even wash their hands. We take their contacts out literally right before they're passing out and they like flick them on their nightstand, which is not what we recommend.

JeremyCo-host06:21

Boys will be boys.

Dr. FalcoHost06:24

So, when we talk about wearing a contact lens during the day, it's still very important to understand as breathable as these contact lenses are, it's still foreign material you're putting in your eye, like think about, you're putting a little saran wrap in your eye all day, and yes, it's breeds more than that.

06:45

But the reality is your cornea needs oxygen. So, as we mature, what we could get away with at 25 is not what we can get away with at 45. And people don't make that jump to that being an eye issue. They're like oh, I can't go out at 10 o'clock and go to bed at two and function the next day, and I used to be able to run five miles and I used to be able to squat this much and I used to use to used to. Well, it's the same thing for the eye. So, you could kind of get away with maybe a little more contact lens abuse at 25. But then at 45, it's like the rubber meets the road, so hold on.

JeremyCo-host07:26

Speak for yourself. I'm like a fine wine. Okay, I get better.

Dr. FalcoHost07:30

Yes, yes, we are Right, and women we are. We are aging like jalapenos, so we're getting hotter to get older. So, as we, as we get older, the cornea needs oxygen. So, I tell my patients you know you can't not have a pair of glasses. Contacts are always like your extra. So, in the morning it's better to put your glasses on and open your eyes and let your So, cornea get actual oxygen. And then at night I never recommend waiting right before you go to bed to take out your contacts because you're closing your eyes, your eyes roll up, your lids come down and then you're in the same situation and your cornea is not getting oxygen. So over time, when you do that and you don't put glasses on to watch TV in bed and you don't give your eyes a couple hours per day of air, the structure starts to send the cornea an emergency signal to the brain that says I'm not getting what I need, I'm not getting oxygen. And the brain says don't worry, I gotcha, what I'm gonna do is grow in Blood supply to your cornea and what we call that is neo new Vascularization.

08:40

These are new blood vessels that don't belong in the cornea. It's a clear structure and the body grows in blood vessels because Hemoglobin in the red blood cells carries oxygen. So, if you're not going to give your cornea oxygen, your body is going to find a workaround and the workaround is growing in an abnormal blood supply to a clear structure. So, this is not a good idea. And as we mature, that's what I see in my patient. So, what, oh? But I used to always wear it. Yeah, okay, I used to do a lot of things, but as you get older, your cornea needs that air. So, when I see a patient that has that and I educate them about the situation like this is bad. This can reduce your vision permanently.

09:26

You want to decrease your wear time, wear your glasses more, and the reality is those blood vessels will never go away. They're called ghost vessels. The blood will recede from the vessel so they won't be actively. You know blood going in, but the vessel will remain and it's called a ghost vessel and depending upon how much that vessel grows into the cornea if it grows into your central cornea, you will always be looking through a hazy ghost vessel for the rest of your life.

09:57

So, this is why we want to start having good contact lens hygiene. We want to take our contacts out. We want to, you know, use the proper cleaners. We want to make sure that the body and this is why Patients have to come in once a year if they're contact lens wearer Because I have to make sure and look at that cornea with my microscope that they haven't done damage to the eye that makes them, you know, a bad candidate. I have to make sure that we're not setting ourselves up for potential vision loss in the future. So, patients like I don't know I have to come in once a year, yeah, because I have to check, I have to make sure that your cornea is still healthy enough to put that contact lens on for now.

JeremyCo-host10:39

Yeah, and I think this is important to talk about this kind of stuff because it all goes back to Building strong daily habits and routines. Personal high chair preventative same thing with, like brushing your teeth. Now, when you're dealing with contact lenses, it's important to have everything on a on a routine and get into the habits of doing that so you don't have these you know downstream issues later on for sure.

Dr. FalcoHost11:02

Right, right, and I and I'm totally, you know, I'm told I, when patients have success with contact lenses, I'm super happy for them. You know, again, as we mature to it's different when you in a in a multi focal, progressive pair of glasses. It doesn't translate exactly, you know, to contacts and as we, as we mature, our eyes become drier and so there are newer materials that hold the moisture better. But you know that I would say the most popular reason for contact lens fallout as we mature is So, that you just can't get the same multi focal Lens as you can in glasses. And then you know the material your eyes do feel. You feel it by the end of the day, but sometimes for weekends, for dressing up, whatever, you know, we can absolutely do that and there's no reason why I have patients in their 70s who can put contact lenses and it's fine as long as you're doing it the right way. So, it doesn't mean you can't have them. You just have to keep a little bit of a closer watch on patients’ ocular health as they mature.

JeremyCo-host12:03

All right, very good. So, I'm interested now to hear dr Nguyen’s perspective. I'm gonna talk a little bit about more specialty types of situations. Have anything else that you wanted to add before we hop on with her?

Dr. FalcoHost12:17

You know, not really. I think we kind of cut, you know, like everything else would Has launch us into like another 15-minute conversation. So, I think we're good, the little tidbits here and there is perfect, but yeah.

JeremyCo-host12:30

Perfect, all right, well, sounds good. Dr Falco is always a pleasure. I've actually had the pleasure of seeing you twice and so, just a couple days, so looking forward to our So, next discussion together and to our listeners. Thanks, as always for tuning in and we will see you on the next episode, jesse, as podcast. Everyone, have a great day.

Announcement12:52

Thank you for listening to the jazzy eyes podcast. For more information, visit jazzyeyes.com or contact 954 473 0100.

Episode 5 - Speciality Contact Lenses

Transcription

Announcement00:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr. Thuy Nguyen.

JeremyCo-host00:14

Hello, hello everyone, and welcome to episode number five of the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolf, and I'm joined with none other than your host, Dr. Thuy Nguyen. Dr Nguyen.

Dr. NguyenHost00:28

Hello.

JeremyCo-host00:29

I'm doing well. Happy Monday to you.

Dr. NguyenHost00:32

Happy Monday, yes.

JeremyCo-host00:34

Yeah, we just saw you this weekend with the family. I was telling Dr Falco I'm glad that I came in to finally get my eyes checked.

Dr. NguyenHost00:40

Yeah.

JeremyCo-host00:41

Yeah, if there's a long, long overdue, you got a chance to meet the family so I know you had your hands full in your office with my two kids. Oh, they were great, they were great.

Dr. NguyenHost00:52

Yeah, they were kind of trying to outcompete each other to see who had better vision, and then there would be little giggles here and there when someone would read a letter wrong and be like oh no, I have so much better vision than you.

JeremyCo-host01:03

They were great, too funny, too funny, good deal. So, I just spoke with Dr Falco and she was talking a little bit about soft contact lenses, some tips, some background about that. So, I was hoping maybe you could share a little bit about more specialty types of cases or specialty lenses for our listeners.

Dr. NguyenHost01:27

So, Dr Falco talked about the traditional soft contact lenses which most people are familiar with. What most people are not familiar with is that there are specialty contact lenses which we call them rigid gas permeable lenses, but that's not what they were traditionally called.

JeremyCo-host01:45

They rigid gas permeable lenses.

Dr. NguyenHost01:47

Yeah, it doesn't roll off the tongue.

JeremyCo-host01:50

I guess those would be the hard lenses as opposed to the soft lenses.

Dr. NguyenHost01:55

People now used to call them hard contact lenses. We don't call them that anymore just because when we tell patients, oh, we're going to move on to a hard contact lens, usually they have some hesitation, like oh, I'm going to be putting something hard in my eyes, kind of thing. So, we now call them rigid gas permeable, you can call them RGPs. Correct, they're called RGPs.

JeremyCo-host02:15

They are called, though, because that's the variation.

Dr. NguyenHost02:16

That's exactly what they're called, yeah, instead of hard contact lenses, just to ease them into it a little bit more. But they are still made out of the silicone materials that traditional soft contact lenses are made out of. They're just a little bit more rigid and they hold their shape a little bit more. So, the soft contact lenses, when you put it onto your eyes it conforms to the shape of whatever your cornea is. For the RGPs they're a little bit more hard and so they hold their shape a little bit more.

02:46

And why that's important is because some people, because of genetics or disease or whatever the pathology might be, their cornea might be irregularly shaped and so when we put a soft contact lens on it and it kind of collapses onto that irregular cornea, it doesn't really do much for them. Their vision is not. They can't get the most optimal vision. But when you put a hard contact lens in and it kind of it holds its shape more and it's not distorted by the shape of your cornea, it actually allows light to focus better and so you get more optimal vision out of it.

JeremyCo-host03:23

Interesting. I remember going back to many, many, many years ago when I had contact lenses. I remember I think I'm pretty sure I had the soft disposable ones. I remember my stepfather. He always had the hard RGPs.

03:36

Yes, the RGPs and I remember I'd asked him, if I recall correctly, why he has those. I'm not a candidate for the other lenses. He had very, very horrible vision. I'd imagine that folks that have more severe cases are probably not really candidates for the soft lenses. The more it warped your cornea I don't know how to express the science behind it, but I'd imagine the worst the case you have, the more you need to have an RGP. Is that right?

Dr. NguyenHost04:05

Yes. So RGBs are great for people who have very thin corneas. So, when you have an area of thinning on the cornea, the fluid behind the thin cornea kind of presses on that thinness and the cornea protrudes forward, which is now. It creates an irregular cornea. It's not spherical anymore, it's kind of cone shaped or it's not as regular. Those are people who had lefic or any other surgery to the corners before that could cause the thinning and cause the irregular shape. People who have genetic diseases such as keratoconus that also causes irregular corneas. People who have very dry, severe dry eyes. They can also find therapeutic uses. Out of an RGP Are those with super high prescriptions that traditional soft contact lenses can't give them the best vision. Those are all good candidates of RGPs.

JeremyCo-host05:06

Very interesting. The human body never ceases to amaze me, how we've talked and what we are, especially the eye. It's so fascinating how it works. Are there a lot of people or these more fringe cases that just don't qualify at all for any kind of contact lenses, whether they are soft or RGPs, and just have to wear glasses? I'd imagine that in extreme cases, that's the default. Right is open-leaf glasses.

Dr. NguyenHost05:39

For people who so, let's say, you go into an eye exam and you're able to be corrected to 2020. We usually would give you contacts or glasses. For cases that glasses or soft contact lenses cannot give you 2020 or the best ultimate vision, we actually move on to a hard contact lenses. In some cases the hard contact lenses is better than glasses. We always recommend people to have a back-up pair of glasses, just in case you're trying to put your hard contact lens on, you drop it and you accidentally hear a crunching sound because you stuffed on it. It's happened to a lot of people. That's why you have back-up pair of glasses, but usually for people who have been placed in RGPs, glasses don't usually give them the best, a better vision than the RGPs.

JeremyCo-host06:31

Interesting. So, glasses, soft contact lenses, RGPs, and you have Lasik surgery, which has been around now for quite some time. Are there any new cutting-edge technologies beyond Lasik surgery that are being used to treat certain eye conditions? Is there anything on the horizon Do you share with?

Dr. NguyenHost06:52

us as of right now. All I know is the techniques for Lasik has evolved over the years. They're not cutting as much tissue as they used to or they're not shaving off as much tissue. The concept is still the same, where they reshape the cornea a little bit or they shave off a little bit of the cornea to correct your vision, but in terms of Lasik it's still Lasik. They're just improving the techniques of Lasik, so you're not shaving as much tissue off and you're not having as much of these complications such as corneal thinning.

JeremyCo-host07:28

So, they're not 3D printing new eyeballs anytime soon for folks.

Dr. NguyenHost07:32

No, but it's funny that you mentioned 3D printing because the RGPs one of the RGPs is called scleras and they're actually bigger than traditional soft contact lenses and they're so customizable that you know that alginate molds that dentists would use to form a mold for the teeth.

JeremyCo-host07:53

I remember it and I had a conversation with a dentist recently about that, how he doesn't use that anymore because it's kind of outdated. Yeah, or it turns out they use like 3D imaging for this instead of the molds, the thing that always, when you were a kid, they put it in. You gagged on it.

Dr. NguyenHost08:11

So, for scleras and RGPs, they actually do that. Now for the mold, they use an alternate mode as well and they mold your eyes. They take a mold of your eyes and they send it to a lab so that they can create a customized, personalized contact lens that fits to your eye shape and only your eye shape. Another thing is, instead of doing the molds, they do have other technologies that lets you scan the surface of your eyes and map it out 3D. We can customize your contact lens that way, your RGPs that way, and that's what makes RGPs right now A great thing for people who can't fit in soft contact lenses. It's a great tool to use right now.

JeremyCo-host08:55

Very, very interesting Anything else that you'd like to share with our listeners about RGBs or anything related to the subject of contact lenses?

Dr. NguyenHost09:05

Yes, so Halloween is coming up, and so a lot of people are trying to get fit into these Halloween contacts right now.

JeremyCo-host09:16

Oh, scary eyes, yes, Spooky eyes.

Dr. NguyenHost09:21

Usually October is the month that people or healthcare professionals raise awareness of contact lens hygiene, but because Halloween is at the end of October, we want to do it in the middle of September so that we can give people the time to educate themselves on how to wear contact lens, how to use contact lens and when to start ordering the Halloween contact lenses when it comes, because people think you can just walk in and get your Halloween contact lenses the same day, but usually, because they're special contact lenses, you have to come in about three at least three weeks before Halloween to get your order in and to get it on time for Halloween. So, if anyone's hoping to get some Halloween, scary Halloween contacts, I would recommend coming at least three weeks before actual Halloween to get evaluated for them.

JeremyCo-host10:15

Don't tell my kids about it. They might want that an add on for their costumes to get this fancy contact lens.

Dr. NguyenHost10:19

Oh my gosh, they've never worn contacts before, right.

JeremyCo-host10:22

No, never. No glasses.

Dr. NguyenHost10:24

It's going to be a task teaching them to put it on Goodness All right, cool.

JeremyCo-host10:30

Unless there's anything else, we'll wrap this one up. That was very insightful and informative as always. So, it's always a pleasure getting a chance to talk to you and have you share your expertise. So, until next time, thank you, listeners, for tuning in, and we'll see you on the next episode of the Jazzy Eyes podcast. Everyone, have a wonderful day.

Speaker 1Announcement10:55

Thank you for listening to the Jazzy Eyes podcast. For more information, visit jazzyeyes.com or contact 954-473-0100.

Episode 7 - Understanding and Managing Dry Eyes

Transcription

Speaker 1Announcement00:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr. Thuy Nguyen.

JeremyCo-host00:14

Hello, hello and welcome everyone to the Jazzy Eyes podcast. I'm your host, I'm your co-host, I'm sorry, I'm co-host Jeremy Wolf and I'm joined by your host, Dr. Thuy Nguyen. Yeah, Dr. Nguyen, always a pleasure.

Dr. NguyenHost00:28

Yeah.

JeremyCo-host00:30

I'm so used to doing my own podcast. I'm just like hey, I'm your host right why? Not, why not, why not, why not? I even have my background up here for the Good Neighbor podcast, but that's okay.

00:41

So, we hope you've been well since the last time we spoke and thanks to our listeners for tuning in. I just finished a segment with Dr Falco where she talked a little bit about blepharitis and I know you were going to talk a little bit about dry eyes on a broader side, so please share with us your thoughts on that subject.

Dr. NguyenHost01:04

Yeah, so dry eyes. Everyone has dry eyes, Everyone in their mothers has dry eyes. So, what is dry eyes? Dry eyes is basically like an inflammation cycle. So, what happens at first is the layer of fluid covering our eyes. When you have dry eyes it becomes unstable and it's not. It doesn't wet the whole surface of the eyes as it should. There are spots of dryness and so over time those dryness can actually end up damaging the cells on our cornea, that front part of our eyes, and when those cells get damaged and they die, then that starts the whole inflammation process. When that inflammation process happens, then that leads back to the unstable tear film and it goes as a cycle, as you have unstable tear film, then you have cell death and then you have inflammation. So, it's a cycle.

JeremyCo-host01:56

You said unstable tear film.

Dr. NguyenHost01:59

Tear film Tear film Okay. Yes, so the tears, our tears, are made out of liquid oils and actually a little bit of mucus, and all of those work together to form our tear film.

JeremyCo-host02:12

Interesting.

Dr. NguyenHost02:13

Yes, and so that's why some people with unstable tear film or dry eyes experience any burning, redness, itching or any gritty or sandy feeling of the eyes. Only enough people who complain that, oh, their eyes are always tearing is also a sign of dry eyes. Just because we're producing those tears that are. Our eyes are so dry that our glands are producing more and more tears to compensate for that dryness, and so people get teary eyes.

JeremyCo-host02:42

So, if you're suffering from just the general dry eyes, I'd imagine there are over the counter eye drops you could use for that, but then also you wouldn't want to use them too much. You probably want to go get that checked out. What would you recommend for someone that is looking for, you know, maybe to have some dry eyes and they just want to get something to kind of help the issue? What would you recommend they get you know over the counter anyway.

Dr. NguyenHost03:06

So, when you go into the over the counter, you're like bombarded with all these eye drops and you don't know which one to get. I usually tell people to get either a refresh or sustain. Those are what I've used, that I like them, so I recommend it to my patients. I tell my patients not to use Visine because a lot of people who use Visine they tend to have irritation and even more redness from before they started Visine. And so, I tell them just to be safe over the counter, like refresh or sustain.

JeremyCo-host03:39

See, it's interesting. Why is it that Visine, or what's the primary difference between something like Visine and refresh and these other brands that are less, I guess, less damaging to the eyes?

Dr. NguyenHost03:52

So Visine? Sometimes they have a little preservative that people are not, that they find irritating on their eyes, and the main mechanism of Visine to make your eyes look brighter and wider, they constrict the blood vessels or the arteries on your eyes. But when our arteries bring oxygen and blood to the eye, so when you constrict it, you're cutting off the oxygen supplies to go to the eyes. So, when Visine wears off, your arteries actually double in size and so they look even redder than before you started using Visine.

JeremyCo-host04:25

See, that's interesting, because Visine obviously has done such a phenomenal job branding their company as when people think of eye drops, they think immediately of Visine, right? It's synonymous with that, right? So, I tell them not to use Visine.

Dr. NguyenHost04:43

I tell my patients to throw the Visine right away, right in my office. And then I tell them that there are prescription medications that can help the dry eyes. And these prescription medications they work at different levels of the dry eyes. To treat the dry eyes, for example, there is a prescription medication called Zidra, and what that does is it prevents inflammation by blocking inflammatory markers called cytokines, and so that kind of stops the dry eye cycle from the beginning. There are other drops they're called sequel and restasis which not only prevents the or minimizes the inflammation, it also produces it makes our tear gland produce more tears. And then there's a new medication that recently came out called mybo, and the nature of the drop itself not only it gives you an even wedding, the drops evenly wet the surface of your eyes, it also prevents the tears from evaporating as quick. So, there are other, not over the counter medications but prescription medications for those with more moderate or severe dry eyes. Were over the counters won't do them justice.

JeremyCo-host05:50

Putting medication aside for a moment. Yeah, are there any tips or recommendations you could make For just natural things that you could? We're also tuned in on our screens all day, every day and our eyes are Constantly stressed. Are there any suggestions that you can make for just again going out like what I'm thinking is taking a break Every once in a while? Just go outside, be in nature, just take your eyes off the screens. Any thoughts on that?

Dr. NguyenHost06:18

Yeah, so when people are on their computer, they blink less. So, if you're on a screen, I recommend having an artificial tear draw tears right next to you Just to use when your eyes are feeling a little dry and to take more frequent breaks. Also, when you're sleeping some people sleep with a fan on, and so people, when they sleep, most people don't close their eyes fully all the way, and so when the fan is on, it's drying out the bottom of your So, your eyes as well. As when you're in the car, some people have their acs blasting right into their face, and that also makes dry eyes a little bit worse. So, it's a little, it's little stuff like this that you can change in your daily routines to help manage your dry eye symptoms.

JeremyCo-host06:57

Very cool and, of course, as always, is something I just learned. Just learn it, but Make sure you get your eyes checked routinely, obviously like any other anything else in life, preventative, being diligent on prevent, on the preventative side, is usually what will ultimately help you long Tour, long term.

Dr. NguyenHost07:16

Yeah and you can come in to get your eyes exam Examined. There are some office procedures that we can do to help Manage the dry eyes, like Punto plugs, where we put little collagen plugs in the and the tear ducts to prevent the drip, the tears, from draining as quickly so our eyes are more moisturized throughout the day. Or maybe even like heat therapy, where some people put Heat pads onto their eyes to help the, the, the oil glands, liquify and so there's more oils on the eyes to prevent the tears from evaporating as quickly.

JeremyCo-host07:49

All right, very good, dr Neuwen, always a pleasure. Thank you for sharing those little dry nuggets of insight and wisdom and I'll, you know, look forward to getting into another segment soon. And thanks to our listeners for tuning in and we will see you on the next episode. Everyone, take care.

Speaker 1Announcement08:10

Thank you for listening to the jazzy eyes podcast. For more information, visit jazzyeyes.com or contact 954 473 0100.

Episode 9 -

Speaker 1Announcement00:03

Welcome to the Jazzy Eyes Podcast. Taking care of your vision with expert precision. Here's your host, Dr Laura Falco. 

JeremyCo-host00:16

Hello everyone and welcome to the Jazzy Eyes Podcast. I'm your co-host, Jeremy Wolf, and I'm here with the host, Dr Laura Falco. Dr Falco, we were just talking about diabetes. It is upcoming Diabetes Awareness Month and we're talking a little bit about the illness and as it pertains to your eyesight. But something I didn't ask on the last segment that I think we should clarify right now for listeners can you just give a basic definition for those that maybe don't know as to what diabetes is in the first place? 

Dr. FalcoHost00:47

So diabetes is diagnosed by your blood sugar level, right? So patients will typically have blood work done fasting in the morning and there are certain readings. If you're over, say, 120 in the morning, you're going to be diagnosed fasting, you know, as a diabetic, because you could should be 100 or less, right? There are other tests and I'm actually glad you asked this I was going to talk about this. It's called a hemoglobin A1C, so it's a percentage. Now hemoglobin A1C is basically giving you an idea of, over the course of the life cycle of a red blood cell, which is about 90 days, how high and low your blood sugar fluctuates because diabetics tend to peak high and then come down. So they're these huge swings in their blood sugar level and that can also go along with like frequent urination, frequent thirst, like their symptoms that patients can have or sometimes they really don't know they have any symptoms. So the higher the highs, the lower the lows, the bigger, like the peak to the trough you know like is up and down, the larger the number will be the percent. So if somebody has a number that's say 8, 9, 10%, they're definitely a diabetic. You know you're looking to have a number under 6%. Some people want it under 5.5%. So this is basically telling you over the span of 90 days if your blood sugar, if your body's regulating in a tight zone or if your body's having trouble and it's going up, down, up down. And these peaks and valleys are quite far from one another. The further they're apart, the higher their percentage the number will be. So that kind of like ties into the newest research is showing that the HbA1c everyone thought was like the, the, the answer is kind of not the best prognostic indicator for us to see what you know, how much damage we might see in the back of the eye. We used to think if we heard an A1c level was like 12 or 13%, we were going to see a disaster in the back of the eye, all these bleeds and stuff. And now we're So, kind of not and So, they're tying it in eye signs at least, and microvascular blood vessels to more of. 

03:20

Is the patient on insulin or not versus A1c? Because typically the harder the diabetes gets to control they end up on insulin and that seems to correlate more with changes in the back of the eye. But just to name a couple of symptoms a patient might have. Who's diabetic eye wise? There is a. Your prescription can change quite a bit and you're not sure why. So your glasses that worked all of a sudden don't work. These can actually change your glasses prescription because it changes the physiology of the lens in the eye and that changes the prescription Fascinating. Yeah, so sometimes we actually won't prescribe glasses until somebody's stabilized, because what I see one day isn't going to work three months later. If they're A1C, or if everything gets vastly changed, you can have patients with more dry eye than typically, because diabetes and dry eye are linked together. Can you back up? 

JeremyCo-host04:28

a second there. What's the A1C again? 

Dr. FalcoHost04:31

It's the hemoglobin A1C. That's that percentage test. That gives you an idea because it follows the life of that red blood cell. The hemoglobin on the red blood cell is a 90-day life. Whether or not the patient is again the peaks and valleys, if they are far apart or if they are close together, that will affect the result. So your percentage will be high or low and you really want a lower number for that. You don't want big peaks and valleys. 

JeremyCo-host04:57

Thanks for clarifying. It's Monday and I'm slow processing things. I need to hear things twice sometimes. 

Dr. FalcoHost05:03

Yeah, no, the other big. You know there's cataracts that also can come earlier with diabetics than non-diabetics, and all of those are pretty treatable. The one that is that you really have to look out for is called diabetic retinopathy. So the eyes are amazing. It's like one of the few places you dilate the pupils, you look at the back and you're looking at the microvascular. You're able to visualize arteries and veins in basic in their natural habitat without being very invasive. And whatever you're seeing in the back of the eye you have to understand is what the rest of the body is looking like. You just can't see it. But we get a window in, literally through the pupil and we examine the back of the eye and patients who have uncontrolled diabetes and have diabetic retinopathy have a lot of changes back there. And then we sometimes that's how they're diagnosed because they don't even know they have it. But it's very important because that's where you can really have permanent vision loss. That's not correctable anymore. So you know, just to like kind of summarize, diabetes management for the patients is definitely a team approach. It's not just me, it's not just an ophthalmologist, it's not just an endocrinologist, it's co managing these patients with the primary, if that's, you know, to keep them abreast the endocrinologist, a nutritionist, for a lot of patients because the root cause is being obese, and then the ophthalmologist, when it's getting to a point where they need treatment because of what we're seeing in the back of the eye for the diabetes, and it is, it's basically communication. The patient has to understand. The patient has to come in, you know, and co-managing realize that this is there's a group of us who can manage, you know. There's wound care also, to be honest, podiatry and wound care, because they can have, they can have um sores, you know, and co-managing neuropathy. So it's a big issue. It's affecting a ton of people. 

07:10

There are newer technologies that patients are using to keep it under control, because if your diabetes is under control, then all these other side effects, you know, all these other sequela they don't happen as frequent or as severe. 

07:28

So there's something called continuous glucose monitoring. So a lot of people are now wearing glucose monitors, which is a huge improvement, and on their smartphone there's an app, so they're not guessing. If their blood sugar is in range, they know, and they can keep it in range and take their medication when needed, or if their blood sugar is going too low. That can actually be more dangerous than blood sugar going too high for a lot of patients. And they can make. They can have a little orange juice, they can have a little candy just to make sure their sugar is staying in the right zone. So there's a ton of um. There's a ton of things patients you know can do, but they have to come in, be seen, be monitored and everybody has to have open communication to all the doctors who are managing these patients for these patients to have the best outcome. 

JeremyCo-host08:23

Absolutely, and I think the one message I'd like to give everybody out there is take care of yourself right. Exercise, eat well, get seen frequently, monitor your condition, because it's so much easier to address a lot of these issues before they become major issues. 

Dr. FalcoHost08:42

Exactly. I mean, like you said, the best thing you could do is move. The best thing you could do is watch what you eat and move your body. I know that these new medications that a lot of patients are using that's going to be approved for obesity in addition to diabetes are work for some patients and they're helping people lose the weight. But the reality is you have to change your lifestyle, because when you're no longer on those medications, how are you going to prevent that from happening again? And so it's hard. We've been conditioned to take a pill and just continue to do what we want to do, but the reality is, with this condition, that's not a great plan. It's a lifestyle and it's changing eating habits and it's moving physically. 

JeremyCo-host09:31

Yeah, for sure. 

Dr. FalcoHost09:32

Yeah. 

JeremyCo-host09:34

Right, very interesting stuff. We could probably talk for hours upon end about this topic, but we'll get into a little bit more with Dr Nguyen, 100%. 

Dr. FalcoHost09:44

Right Dr. 

JeremyCo-host09:45

Falco always a pleasure. 

Dr. FalcoHost09:47

Good to see you. 

JeremyCo-host09:49

All right. Likewise, and thanks to our listeners for tuning in and we will catch you on the next episode of the Jazzy Eyes Podcast. Everyone, have a great day. 

Speaker 1Announcement10:00

Thank you for listening to the Jazzy Eyes Podcast. For more information, visit jazzyeyes.com or contact 954-473-0100. 

Episode 11 -

Speaker 1Announcement00:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr Thuy Nguyen. 

JeremyCo-host00:14

Hello everyone, welcome back to the Jazzy Eyes podcast. I'm your host, Jeremy Wolf, joined by Dr Nguyen. Dr Nguyen, we are on a roller coaster ride of Diabetes. It is upcoming Diabetes Awareness Month and we were talking all about diabetes and how it pertains to your vision. I know in previous segments we covered some various subjects and I know you wanted to get into a little bit more about some of the ailments that can come to the eyes as a result of diabetes. Please share with us. 

Dr. NguyenHost00:45

So we just talked about diabetic retinopathy and how it affects the retina, but diabetes can affect other parts of the eyes, such as the lens. You've probably heard of someone in the family having cataracts before. Basically, you're going to say oh, it's my grandmother, my grandpa, Some grandparents has cataracts. Cataracts is just your natural lens becoming cloudy over time. It's usually most cataracts for age-related. But there's another form of cataracts, especially in diabetic patients, where their lens becomes cloudy prematurely due to how much sugar is in their blood. 

JeremyCo-host01:25

Fascinating. 

Dr. NguyenHost01:30

So the excess sugar in the blood, glucose, gets converted to a substance called sorbitol, which just sits and accumulates in the lens and causes chemical changes, breaks down protein prematurely and causes cataracts. 

JeremyCo-host01:44

Sorbitol sounds like an artificial sweetener. 

Dr. NguyenHost01:47

Yes, doesn't it? Yes, yes, it certainly does. Sorbitol causes cataracts in a diabetic patient and it can actually lead to the swelling of the lens inside the eyes and causes a prescription change, which is why, if you know a diabetic, they would say oh, sometimes my vision is fluctuating Some days it's blurry, Some days it's not and it's directly correlated to the fluctuation in their blood sugar. 

JeremyCo-host02:16

It's interesting, as you're saying, that I'm thinking back to all the times that my vision has kind of fluctuated a little bit. 

Speaker 1Announcement02:23

I'm thinking in my head like do I have? 

JeremyCo-host02:25

diabetes. I need to get checked out Is that normal though that sometimes I do see fuzzy, sometimes I don't. I don't know if I'm just getting older. 

Dr. NguyenHost02:34

What's going on? A lot of things can cause fluctuation of vision. Diabetes and the cataracts is one, dry eyes is actually another one, and when you wake up in the morning your eyes are just very tired from waking up. Normal for your eyes to fluctuate and vision first thing in the morning, but diabetes it can cause fluctuation randomly throughout the day. 

JeremyCo-host02:55

I'm thinking the figures are high. When I wake up in the morning and I'm a little dazed and confused, I just dunk my head in a bucket of ice water and that wakes me up really good. 

Dr. NguyenHost03:02

The ice bucket challenge. 

JeremyCo-host03:07

I'm a firm advocate of ice baths, though, on the side, yes, it's very good for your muscle recovery and everything, yeah. 

Dr. NguyenHost03:14

But yes, the swelling in the lens due to glucose and diabetes causes a prescription shift and most commonly it makes you more near sighted as opposed to far sighted. So your prescription when your cataracts gets, when your diabetes gets worse, you come back for your, your annual exam. We check the lens and see if there's any changes in the cataracts or your diabetes. And you might say that, oh, I'm not seeing as well as I used to. I have to come closer to my computer to see. And my diabetes has been out of the control. Most likely it's the, the, the cataracts becoming worse from the diabetes. If you're already a pre-diabetic, if you're already a diabetic and it hasn't been controlled and you know that your, your sugar levels are off the roof, then it's not great. 

JeremyCo-host04:02

So I'll get leave on this note and I say this often if you get anything from these discussions, take care of yourself out there, watch your diet, exercise, address these issues before they become issues and obviously get routine checkups, not just with your eyes but also at your doctor and everything else, because this stuff is a lot easier to manage when you deal with it preemptively and before it becomes a big issue. 

Dr. NguyenHost04:30

Yeah, speaking of management too management, too. A common surgery to get rid of cataracts is cataract surgery, where they take out that cloudy lens and put in a clear lens so that people can see clear. But the thing with cataract surgery and diabetics is you have to take precautions because that person is a diabetic. When you're a diabetic, you're open to much more risk after the surgery, such as increased macular swelling or bleeding, and most ophthalmologists won't perform the cataract surgery on you If they know that you're a diabetic and your diabetes is uncontrolled. They want you to take care of the underlying issues, such as any diabetic retinopathy, before they even touch your lens. So very important that you take care of yourself. 

JeremyCo-host05:12

You said they just removed the lens and put a new one in. 

Dr. NguyenHost05:15

Yeah, simple like that, right? They just take it out, Just take it out pop up. Easy peasy? No, not that simple. 

JeremyCo-host05:23

Dr Nguyen, anything else you'd like to share before we wrap up? 

Dr. NguyenHost05:29

Yes, take care of yourself, control your diet, exercise and exercise and diet are huge things, not just for diabetes, but just for your general well-being 100%, Dr Nguyen, always a pleasure. 

JeremyCo-host05:47

We'll look forward to catching you on a future episode. So you have a wonderful day. And to our listeners take care, stay safe, stay healthy, and we'll catch you next time. 

Speaker 1Announcement06:04

Thank you for listening to the Jazzy Eyes podcast. For more information, visit jazzyeyes.com or contact 954-473-0100. 

Episode 6 - Demodex Blepharitis

Speaker 1Announcement00:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr. Laura Falco.

JeremyCo-host00:15

Hello everyone and welcome to another episode of the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolfe, and I'm joined by your host, Dr Laura Falco. Dr Falco, always a pleasure to see you.

Dr. FalcoHost00:29

Nice to see you.

JeremyCo-host00:30

Yeah, of course, and thanks to our listeners, of course, for tuning in. So why don't we get into the topic today? I'm going to have you talk a little bit about and I'm hoping to pronounce this correctly Demodex blepharitis.

Dr. FalcoHost00:45

Yes.

JeremyCo-host00:46

All right. So please, I'm not familiar, I may or may not have this myself, because I know when I met you, you gave me some. What were they? Topical, what do you call it?

Dr. FalcoHost00:59

So, we're in, so lid wipes probably Little lid wipes for something that might be Demodex blepharitis.

JeremyCo-host01:04

So please enlighten us, tell us a little bit about what that is.

Dr. FalcoHost01:08

So, the first thing I want to just talk about is blepharitis and basically the suffix itis, which is basically an inflammation of anything, so like appendicitis, any cellulitis. Any time you have an itis, it means you have an inflammation of the tissue. When you have blepharitis it's quite a general term it's an inflammation of the eyelid margin on the top and the bottom, specifically, think where your eyelashes connect into the eyelid. I tend to see a little bit more inflammation in men than women, and part of the reason I think that is So, because women wear makeup. So, when we remove our makeup and we wash our face at the end of the night, we pay special attention to make sure our mascara is off, our eyeliner is off. So, we're using cleaning products that are specific for the eyelids on the eyelid margin.

02:04

Every day Men no offense sometimes wash their face and kind of ignore the eyelids. So, they'll wash around their face, their cheeks, their forehead, their eyebrows, but maybe not the lids per se. And the job of your eyelashes is, as you're blinking during the day, to catch everything that's in the air. Dust, pollen, bacteria likes to live right on that lid margin and all day, as you're blinking, your eyelashes are supposed to catch everything in the air from preventive, from going in your eyes, but as you blink throughout the day. If you have an accumulation of whatever is in the air and bacteria and dead skin cells on your eyelid margin as you blink throughout the day, that material will fall into the eye throughout the day. Things that you might experience are irritation, grittiness, red eye, even itching, depending upon what it is that's falling into the eye at the end of the day. So over time that can develop an inflammation of the margin and then we have blepharitis.

03:09

Now what we've found is demodex, which is basically I'm sure we've had it for a while, but we're really just using electron microscopy to look now at exactly what's living in the eyelashes and, as you know, like all over your skin. If you looked with a microscope, you would see organisms and you have natural flora. So, I don't want people to freak out, but there is something called a demodex mite which under like gross magnification it almost looks like a little worm, but not a word. But it's very, very. It's a mic. It's a very little organism and it can live. It loves to live and feed on all the gunk that lives right on our eyelash margin.

03:53

Sometimes people think this is dandruff, if they have, if they look in a magma and see they have flaking along the lid margin, the demodex is really diagnosed by your doctor because you do need to look with a microscope because it leaves a slightly different kind of residue on the eyelash margin. Now for everyone you know panics and freaks out I have my. It's pretty common. I think it's been there for quite a while. We're just looking at a tissue now and gross magnification and the good news is it's super treatable. So, you'll see a lot of products say demodex now and the thing that really gets them is tea tree oil, which I don't want anyone to get out and get tea tree oil and use it right on their eyelash margin because they would find tea tree oil.

04:38

So that's an essential oil but, if you see, it is now part of a lot of eye cleaners wipes, because it really it cleans the gunk, it kills the mites, it cleans everything in it and it works For patients that have really, really severe cases. I have an in-house treatment that we do, where I numb the eyes and I really scrub with a special tea tree scrub that you can't use at home. I have to do it, or a doctor has to do it, and it gets rid of it all. And there is a new medication out by a company called Tarsus. The medication it doesn't roll off the tongue, it's called X-dem-V.

05:20

Anyway, that is the first medication of its kind. That is an eye drop that you would really put on your eyes but like really concentrate in the eyelid margin, and it's one drop twice a day for about six weeks. That is the first FDA approved eye drop for this particular type of blepharitis. So, there are all different ways you can have an inflammation in the eyelid margin called blepharitis, but we were just specifically today, going over this one, which is the Demodex mite, which is super responsive to the tea tree-based oils, and then this one new medication for those cases that are pretty severe. So, again, this is why you go in once a year for an eye exam. We check to make sure the eyelashes look clean. I would also caution women who are getting extensions in their eyelashes, which is super popular to really make sure that they get those inspected, because those are just breeding ground for more gunk to live on. So, it's really important that you clean those properly as well.

JeremyCo-host06:21

Interesting. So, if I understand this whole segment correctly on the blepharitis right, the way I'm seeing it in my mind is kind of like the eyelids or the windshield washers on a car and they constantly are cleaning all the gunk off and they're pulling it down to the, I guess, the base of the windshield where it kind of builds up there. And that would be like the base of the eyelids that are getting kind of gunk built up from all the blinking throughout the day, right, and the eyelashes pick up the dirt and whatnot, and then it deposits on the.

06:50

Is that a good analogy?

Dr. FalcoHost06:52

So, yeah, the eyelashes. The point of the eyelashes and the reason just like you have cilia in your nasal passages as you're breathing is to catch all the dust, pollen, everything in the air that you don't want to get into your eye per se. The eyelashes job is to catch that, to be like a pre-filter and a HEPA filter, if you will, to catch some of the stuff before it lands in your eyes, and it's important to clean it and clean those. So I think that's where a lot of people fall short is that when they wash their face they don't really pay special attention to the eyelashes and over time you can have all the stuff that's in the air and those of us who have pets if you snuggle your dogs and your cats and then obviously gunk lives on their hair and now it can live in your eyelashes like it's just, you know, every night, every morning, to get into the routine to clean the eyelash margin.

JeremyCo-host07:45

All right, very good, and that was definitely helpful for me anyway, right, because you gave me those little pads to wipe my eyes, and I'll be the first to admit, I haven't been doing it daily.

Dr. FalcoHost07:55

So, any friendly reminder to continue, that is definitely helpful so you're there with that, I love the pre-moist and towelettes too, because if you travel one less liquid that you have to worry about getting through TSA because you can literally just take a pack of. They're good eye makeup removers. They're good end of day like they refresh the whole eye area, clean off all the gunk and they're easy to travel with. So, I love those.

JeremyCo-host08:19

All right, very good, Dr Falco, always a pleasure.

Dr. FalcoHost08:22

Thank you.

JeremyCo-host08:23

Looking forward to our next segment. Everyone thanks for tuning in and we will catch you next time. Everyone take care.

Episode 8 -

Speaker 1Announcement00:02

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr Laura Falco. 

JeremyCo-host00:15

Hello everyone and welcome to the Jazzy Eyes podcast. I'm your cohost, Jeremy Wolf, and I'm joined by your host, Dr Laura Falco. Dr Falco, always a pleasure. 

Dr. FalcoHost00:25

Good morning. 

JeremyCo-host00:27

How are you today? 

Dr. FalcoHost00:28

I'm good. How about yourself? 

JeremyCo-host00:30

Doing well. It is Monday yes, very excited for a productive week, and I think we have a fitting topic today, with Halloween shortly to be in the rearview mirror. You're going to talk a little bit about November. Is Diabetes Awareness Month, correct? So this is a topic that I know very little about. I certainly know even less what it pertains to the actual eyes, so please share with us, let us know, what's on your mind. 

Dr. FalcoHost01:02

So, yeah, diabetes is the leading cause of blindness in the United States for working age Americans. I think that's really important to understand. Like, we're talking about people who you know, the country loses GDP productivity because this is happening younger and younger. This is affecting people who are of working age not, you know, 85, like younger people who then cannot work, and that is a trickle down right that affects everything. So I think it's important to understand. Right now, as we know it, there's probably there are a little over 37 million patients diagnosed with diabetes. However, there's an additional 8 million patients who are currently undiagnosed diabetics 37 million, not in the US alone, right? 

JeremyCo-host02:04

You're talking about 37 million in the United States alone, out of a population 8 million yeah, 8 million undiagnosed right today in this country. 

Dr. FalcoHost02:14

So we're talking about 45 million Americans. 

JeremyCo-host02:18

That's like 10%, more than 10% of the population. More than 10%? I would have never thought. 

Dr. FalcoHost02:24

Yeah, we're, we are. If you look at the graphs we are itching our way towards. 14% of our population is diabetic and the pandemic made it worse. I think they're still figuring out whether or not COVID had a predilection for kidneys and possibly pancreas, affecting increasing the rate of diabetes. But I think what the pandemic did also was made people more sedentary and they're not commuting and they're not walking from the parking lot to their office and they're not walking from their office to the bathroom and they're sitting at home. 

03:07

So I think I mean I know the main three driving factors of diabetes in this diabetes in this country. You've got obesity we are more obese due to physical inactivity, which working from home doesn't help right. And the food. It's sad that we, if you want to eat healthy, that you're gonna spend ten times more. It's sad that you know you can get these really going to cheap things to eat For money. You know like that are not good for you, but then if you want to go in and actually try to get the healthier foods, it's going to cost you a lot more. 

JeremyCo-host03:45

So the isn't it another problem? So to cut you off that a lot of times in our country in this day and age, you might think you're eating something that's healthy, but the way it's produced and manufactured with, yeah, it's just really not. So it's harder and harder to actually determine if something is even healthy for you when you think it might be. 

Dr. FalcoHost04:07

Yeah, no, it's really. It's really hard to determine. You know, and even if you're following the news, you know. It's something just as simple as oh my god, don't eat any egg yolks cholesterol than okay, no, egg yolks are good. 

JeremyCo-host04:19

You have the cholesterol I mean it's good, Great, we need the cholesterol. 

Dr. FalcoHost04:23

Now they're seeing increased rates of dementia and Alzheimer's and patients who are on statin drugs because Turns out, we need cholesterol in our brain. So eat the egg. So, even if you're, you'll make yourself crazy, you know Like it's, it's very hard and it's a it's a full-time job to really try to eat clean. You can only do the best that you can do and I and I get it. But unfortunately, you know, diabetes is an soaring and there's not enough endocrinologists in the area. You know I have most of my patient I don't even know it's half and half. Half of them are managed by their primary care doctor, half of them are probably managed by an endocrinologist and Some are managed by a cardiologist, like it's crazy. So the patients sometimes really don't have the most up-to-date Medications because they're being managed on outdated medications, because really there's not enough endocrinologists, because the population is exploding with diabetes and that's is the doctor who's really specialized, you know, to manage that and it's, and we're seeing it in our office more and more and more and we're seeing complications in the back of the eye from diabetes more and more and more. So I think it's a really important topic, you know, knowing Halloween is coming, you know, because we really do want to make sure people understand that it is. 

05:47

It does affect the eyes. It affects the eyes in a couple of different ways and, like every condition that affects the eyes, early detection of Any changes in the back of the eye is key to managing the changes we can see from diabetes and preventing Sometimes permanent loss of vision due to Diabetes. So it's super important that patients who are diabetic have an at least an annual eye exam, including a dilated procedure, every year, because the entire retina in the back of the eye is at risk and we need to monitor Every year every patient that is a diabetic, sometimes more frequently than once a year, but at a minimum once a year. And In our office we have a diabetic summary report that we will send to Whoever's managing the diabetes to keep everybody on the same page so they know that how the patient is doing in the back of the eye. 

JeremyCo-host06:54

All right, let's end here, because this is a very broad topic and we want to get to the sink, then we'll pick it up on another segment. All right, thanks everyone for tuning in and we'll see you next time. Take care. 

Speaker 1Announcement07:10

Thank you for listening to the jazzy eyes podcast. For more information, visit jazzyeyes.com or contact 954 473 0100. 

Episode 10 -

Speaker 1Announcement00:02

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, Dr Thuy Nguyen. 

JeremyCo-host00:14

Hello everyone and welcome to the Jazzy Eyes podcast. I'm your co-host, Jeremy Wolf, and I'm joined by your host, Dr Nguyen. Dr Nguyen, always a pleasure. 

Dr. NguyenHost00:24

Nice to see you again. 

JeremyCo-host00:25

Yes, yes. So we just finished up a couple of segments with Dr Falco, and I love doing podcasts with you guys because I get two different perspectives usually back to back. We were talking about Off the Heels of Halloween, which is actually tomorrow. November is Diabetes Month and we were talking a little bit about diabetes generically and also a little bit about as it pertains to the eyes and the vision. I wanted to see if you could get into a little bit more about specifically how diabetes has an effect on people's vision. 

Dr. NguyenHost01:00

Right. So yes, November is Diabetic Awareness Month, and it's an important thing to talk about because it's a growing epidemic, pandemic, diabetes, and we really don't know how it affects the eyes until it happens all of a sudden, suddenly. And a lot of people are pre-diabetic, so they don't really get their eyes examined every year until something happens and boom, they have pre-diabetes and now it's in the eye. Diabetes is a microvascular disease, meaning it affects small blood vessels, and one of the places that we have a lot of small blood vessels is in the eyes, and so it's actually diabetic. Retinopathy is one of the leading causes of blindness in working-aged adults, and so the symptoms that could be seen in diabetic retinopathy is blurred or distorted vision, flashes of lights and floaters and sudden vision loss, which is a very scary thing, especially when you think you're perfectly healthy and boom, all of a sudden, you've lost your vision for a couple seconds. 

JeremyCo-host02:03

Interesting. So for me, I would never think I was at risk of getting diabetes. I don't know just so far. I think, probably with most people and Dr Falco mentioned, that there's 40, 30, 40 million people that currently have diabetes in the country and then another 8 million undiagnosed and I think that a lot of people are just like me. They just think, oh, that's something that would never even happen. What are some signs to look for or things that might lead you to believe that it's time to get checked for that? Or is that something that gets checked during regular physical checkups and things like that? 

Dr. NguyenHost02:37

Yeah, so it is checked every year. We ask you if you're diabetic and if you had any sudden loss of vision, any blurred vision. You go to your PCP every year. Your sugars are normal and all of that stuff. We dilate you. It's really important. That's why we dilate you every single year to make sure that there's no bleeding in the back of the eye, because most people they don't feel that their eyes are bleeding until you dilate them and say, oh, you have some blood there. Are you a pre-diabetic or do you know anyone in the family? Because it could be hereditary too. 

JeremyCo-host03:10

But like you said, though, from the vision, from an optometry standpoint, you won't really from an examination standpoint, you won't know that this is an issue. Until it's already an issue, there's nothing you can look at. 

Dr. NguyenHost03:22

You can see it. There's nothing you can look in. You can see it in the back of your eyes. 

JeremyCo-host03:25

I think you might be that's something that people need to go to their general checkups at their primary doctor and get checked for their blood sugar levels and all that regularly to make sure there's no issues. 

Dr. NguyenHost03:35

For diabetic retinopathy. When you have too much sugar in the blood, the glucose actually damages the small blood vessels, making them leaky in the back of the eyes. The more sugar that you have in the blood also means the less oxygen you have. So your body tries to compensate by producing or growing new blood vessels in the eye. But these blood vessels are unstable, they're fragile, they're prone to leaking and breaking, all of which, when the eye fails, the blood can lose to loss of vision. 

JeremyCo-host04:07

Interesting. So I wanted to ask and maybe we can do this in another segment I wanted to ask once you do determine there is an issue with diabetes that's affecting the eyesight, what are some things? What can someone expect changes to make to treat that condition? Do you want to pick that up in another segment? 

Dr. NguyenHost04:27

So I can explain it right now. The next one we'll talk about some other issues about diabetes, and so strict control over the blood sugar is a very important thing to do, especially when you have diabetes. Having your blood checked A1C your blood sugar with the PCP annually, usually A1C. We want it to be below 5% in diabetics. Also, eating a good diet of low sugars, carbs and all of that very important, as well as exercise. 

JeremyCo-host05:01

And just for listeners that didn't hear the previous segments with Dr Falco, she explained this. Could you briefly recap what the A1C is? 

Dr. NguyenHost05:09

A1C is. It measures how much sugar is in the blood stream within a three month span. So every three months they take an average of your blood sugar, the sugar within your blood, and then they calculate a percentage called the A1C. 

JeremyCo-host05:27

Okay, very good, very good. But in terms of aside from lifestyle and diet and all that, when somebody comes in and they start having their vision affected by diabetes, is there anything that needs to be done medically? Is it just more frequent checkups at the eye doctor, or what can they expect to have to do moving forward? 

Dr. NguyenHost05:49

Yes, frequent checkups for the eye doctor, absolutely, if it's mild. If your diabetic retinopathy is mild, we see them use six months to a year. If it's a little bit more moderate to advance, we see you more frequently within three to six months and if it gets to the point where it needs further treatment, all of the current treatments we will send you out to an ophthalmologist to do either surgery or injections. All of the current treatments aim to either stop or slow the new blood vessel growth, as well as reduce any fluids in the eyes or any swelling, and it can be done in an ophthalmologist's office, either via injections directly into the eye releasing medication. 

JeremyCo-host06:27

Yeah, very no, thank you. Injections in the eye. 

Dr. NguyenHost06:34

Laser, which also is. It doesn't sound as great Is that? 

JeremyCo-host06:38

is it like? Do you have to when you do an injection in the eye? Are you like numbing it up? Is there pain? 

Dr. NguyenHost06:43

there. 

JeremyCo-host06:43

I could only imagine what that would feel like. 

Dr. NguyenHost06:46

Yeah, they numb the eye with tetracane until you're super, super numb and then yeah they look down and they inject the top of the eye. 

JeremyCo-host06:54

I think I would need a valium or something before that. Just yeah, even being numb just the idea of looking at a needle coming into the eye. 

Dr. NguyenHost07:04

Right and they tell you try your best not to move, don't move your eyes. Laser doesn't sound as appealing either. The other option would be laser, where they try to zap the small blood vessels that are leaking so that it doesn't leak anymore. 

JeremyCo-host07:18

But you know, I remember when I got my Lasik surgery done that was. I think they did give me a valium before to relax. That was very it wasn't painful, but it was wildly uncomfortable in that first they kind of lock your eye down and then everything goes black and you see colors and everything, and then I swear I smelled my eyeball smoking. 

Dr. NguyenHost07:37

Oh my God, when they were doing the laser. 

JeremyCo-host07:38

I was like this can't be good. 

Dr. NguyenHost07:39

Yeah, yeah, it's very anxiety-intensive. 

JeremyCo-host07:44

Okay, well, let's end there and we'll get into some other issues of the eye as it pertains to diabetes. Okay, All right. Thanks everyone for tuning in and we will catch you next time. Take care.