The Dry Eye Capital of the World
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Here is a heads up to all dry eye patients who want to visit, or are considering moving to, Calgary, Canada. The city of Calgary is considered the "dry eye capital of the World". I have heard of Los Vegas being the “dry eye capital of the United States”, but as a dry eye expert, I would have never known to pick Calgary for the world title.
If you go by humidity alone, Albuquerque or Santa Fe, New Mexico could qualify for the world title (of course what mayor would want their city known as the dry eye capital of the World). It is actually the combination of dry air and constant windy conditions outside, and the need for heat most of the time indoors, that creates the type of environment inside and out that can give anyone a dry eye, or two. I love Canada and have enjoyed visiting during the Calgary Stampede, so I am not suggesting that you avoid going there. I do want you to be prepared so you can enjoy your visit. Take plenty of preservative free tears, protective eye wear and sleep goggles. The most dry eye friendly environment would be a near a large body of water, moderate temperature and soft breezes.
Any island in the Mediterranean would be perfect for dry eyes, but if a trip or relocation to Malta is not on your "to do" list you can create your own dry eye friendly environment at home. Keep the temperature moderate. Do not overly cool or heat. Keep the ceiling fans on low and direct the air vents away from sitting and sleeping areas. Keep the humidity moderate, about 30-60%. If you are not ready for the expense of a whole house humidifier, consider a small ultrasonic room humidifier. These room humidifiers are widely available at stores like Wal-mart or Target, and are a fraction of the cost. Not only will your eyes be more comfortable, but also your nose, throat, and skin, all are susceptible to overly dry conditions.
You may ask “Why work so hard to improve indoor air quality when it is so beautiful outside in Florida this time of year?” One reason… tree pollen. Even if you are lucky enough not to be allergic, just the irritation from so much particulate debris blowing around can be very aggravating to dry eyes. Thanks for reading my blog, and your dry eyes will thank you the next time you visit Calgary. -Dr. Hector
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posted 1/31/2012 at 11:17:09 AM
2012 Dry Eye Resolutions
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
For all of my readers, I have prepared a list of 2012 new year’s dry eye resolutions…
I will be more consistent with my warm compresses and lid massage.
I will use a safe skin moisturizer on my eye lids every day.
I will keep my lashes and eyelids free of crusty build up.
I will remain well hydrated and moderate my use of caffeine and alcohol.
I will remember to take my omega 3 supplements.
I will keep a supply of preservative-free artificial tears handy at home and when away from home.
I will try to keep my hands away from my eyes, remembering that whatever I have recently touched may be a source of infected material or a toxic irritant.
I will remember to blink more often. Good, full closure blinks that exercise my lids and help restore all three layers of my natural tear film.
I will moderate long hours spent on the computer by taking a dry eye break every half hour.
If I am using artificial tears more than four times every day, I will consider the use of Restasis and punctal plugs.
I will make use of protective eye-wear. This may include large polarized sunglasses, new Gunner computer glasses and sleep goggles.
I will modify my environment to make it more dry eye friendly. This may include less use of ceiling fans, better humidity control, reducing the exposure to smoke and chemical fumes and better lighting.
I will consider participating in clinical studies being done to develop better and safer dry eye remedies.
If you can accomplish this list, 2012 will be a much better year for your dry eyes! Whether you can do this or not, I still send my best wishes to you and your families for this New Year. Happy New Year – Dr. Hector
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posted 1/3/2012 at 10:41:26 AM
Six Degrees to Four
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
The buzz in the 90’s was “Six Degrees of Separation”; it even became a popular movie. Now due to our electronic lifestyle the news is we are down to 4 degrees, which means we are supposedly getting closer in our relationships to each other. Because of this line of thought, we are seeing the general public being treated more and more with blanket/generic terms, and with very little thought given to our individual needs.
The practice of medicine gets caught up in this mind set. Insurance companies want us to expedite care and save money by mass prescribing basic treatments. No time to sit and find out the specific, individual problems each patient is having that may require a different approach. I try and fight this as best I can. I even had my business cards printed with the message that I treat one patient at a time and treat them as the individual they are. This is harder than you would think. Not only because of the demands put on us by the government and insurance companies, but patients come in with their minds made up about what they need because their spouse, neighbor and/or computer search convinced them about a particular diagnosis and treatment. Just a few years ago, patients would come in telling me what Paul Harvey had recommended. So I would have to work around his recommendations because they were going to do what Paul Harvey said and if my treatment plan did not agree with his, I was obviously out of the loop. I do welcome any and all patient input and will review their internet search print outs (you would not believe what they find, or maybe you would, ha-ha), but I have to go by what I see during my exam to decide upon an appropriate treatment. Internet and news media reports on medical treatments and products usually have a slant to the reporting. Some person or corporation is usually trying to push their product. So a grain of salt to those stories and maybe, just maybe, no treatment (medication) is needed. Maybe just an increase in daily compresses and nutrition will take care of the dry eye symptoms.
If you feel like you cannot talk with your doctor, bring your spouse or neighbor, someone to serve as your advocate. Tell them to feel free to ask questions in your behalf. It is a lot easier to go over the clinical and treatment options right there in the exam room. Many times patients will call later in the day or next day, with their questions, which is fine, but there is always a delay in responding, which means a delay in the treatment. –Dr. Hector
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posted 12/14/2011 at 4:27:41 PM
God Bless Our Veterans
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Having served in the United States Army for 13 years I have special respect for our military and its veterans. My assignments took me from the top military medical centers to isolated troop clinics all over the world and the conditions the troops had to work under created many unusual dry eye problems. From the constant blowing salt spray sailors face, to the intense reflected sun light off the ice fields of Alaska. Many are stationed in cold, dry climates where they may have had to fight for their lives, as in Korea. I have treated soldiers that literally had frozen eye balls and eye lids. This obviously severely damaged their tear producing systems which leaves their already damaged eyes even more exposed to poor healing and infection.
Then there are those working the dry sandy climates of the Middle East. The severe sand storms there are literally blinding. Many dry eye patients complain that it feels like they have sandy eyes, well, these soldiers would get sand blown into their eyes on a daily basis despite the use of protective eye wear. Frequent eye lubrication was not an option, it was mandatory to prevent the development of blinding scar tissue. The exposure to chemical warfare and lasers that were produced and used to blind our troops in battle is another occupational risk for our soldiers. Special training and protective masks had to be developed to offer them protection from these dangers.
The basic training our troops receive gives them special insight into the need to keep your equipment clean and protected so it will function properly. This is true for their weapons and their eyes and eyelids. Soldiers learn to break down and clean their weapons every day to keep them working properly, and they quickly adapt to the need to perform the compresses and massaging needed to keep their eyelids clean and working properly. They truly appreciate the use of protective eyewear.
I learned a lot serving in the Army, and would like to pay it forward to all those who also served and are presently serving. God bless you all. - Dr. Hector
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posted 12/6/2011 at 8:06:56 PM
Giving Thanks
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
It may be difficult to find something to be thankful for these days. Out of a job, out of our homes, our state and federal legislators totally out of their minds and in a total dead lock over the simplest of issues…AND out of our natural tears. The good news, it’s healthy to try and focus on the positives, is that Dry Eye Syndrome is finally being taken very seriously by the medical community. Whether you are being fitted with contact lenses, computer glasses, having LASIK surgery or being scheduled for cataract surgery, doctors are looking to see if your tear film is adequate in volume and quality.
A steady stream of new products are coming onto the market from artificial tears, to better designed eye wear and more ophthalmic medications that are dry eye friendly. The dry eye patient has finally earned the concern and respect they need and deserve. We did it without occupying Wall Street, demonstrating and burning cars or bras in front of our doctor's offices and optical shops. We did it without having the computer and airline industry place large graphic warnings on their products about how their use is a threat to dry eye patients. They have rooms in every airport for our nicotine addicted friends, but there are no rooms for dry eye patients to rehydrate their bone dry eyes after being trapped in the world's most arid environment for hours. If there is a delay that prolongs one's flight, we may get free alcohol; shouldn't they also pass out free bottles of preservative free tears? Absolutely!
Ok, back to Thanksgiving. Be thankful for the new research that is being done to improve the treatment of dry eye syndrome. And be really thankful that we live in a free society where we can express our views and hopefully find a political candidate or two that loves America more than the American dollar. God bless you on our national day of thanks. – Dr. Hector
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posted 11/22/2011 at 9:31:46 PM
NEW Dry Eye Friendly Airplane
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Dry eye air travelers stand up and rejoice!!! The new 787 from Boeing has numerous improvements in fuel efficiency and greater head room, and also has a MORE HUMID CABIN! If you have not connected the dots by now, whenever you travel by air those with dry eyes tend to suffer terribly. The recycled air in these cabins creates extremely low humidity, 9% to 28%. Humidity less than 40% indicates an arid environment! Is it any wonder we suffer on these flights, no matter how short they are?
In addition to improved humidity levels, the air in the new Boeing 787 will be bettered filtered for viruses and the internal air pressure will be higher. So hopefully that will mean fewer post travel respiratory and ear infections. Unfortunately, the first flights on these new planes are headed for Japan and New Zealand. Until then, keep your artificial tear gels and ointments handy, bring along a pair of Tranquil Eyes dry eye goggles, be well hydrated before and during your flight and come in and get "plugged", punctal plugs that is. Alcohol will dehydrate you, as will caffeine, so be selective in your pre-flight visits to the airport lounges and Starbucks. As always, my best wishes for a safe trip. – Dr. Hector
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posted 11/8/2011 at 11:16:54 AM
Music That Brings a Tear to Your Eye
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
If you have been to the office recently, you may have seen and/or heard some of our new videos being played in the waiting areas. Andre Bocelli, Stevie Wonder, Ray Charles…are you seeing a pattern? They are all great performers that lost their vision at a very early age.
Stevie Wonder was born 6 weeks premature, he was place in an incubator with high levels of oxygen to keep him alive, but unfortunately Oxygen is "toxic" to premature eyeballs. He lost his sight soon after birth from retinopathy of prematurity. Stevie, one of 6 children being raised by a single mother, was discovered at age 13 for his multiple talents of singing, playing the piano, harmonica, drums and base guitar.
Ray Charles started to lose his sight at age 5 and was completely blind by age 7 from glaucoma. He attended the school for the blind in St Augustine, FL and was taught classical music until age 15, when he was left an orphan by the death of his mother (his father had died 5 years earlier). To support himself he played with bands in Orlando and Tampa until 1947, when he moved to Seattle and started his recording career at the ripe old age of 17.
Andre Bocelli had a congenital form of glaucoma and always had poor vision but suffered a head injury at age twelve while playing soccer that left him completely blind at age 12. Bocelli was discovered when he was 22 years of age singing at a party to earn money for law school.
Blindness, and many other obstacles, couldn’t stand in the way of obstacle these remarkable men. The good news is that, in this day and age, all the conditions that caused these men to lose their sight are more successfully treated. All the more reason to marvel and enjoy their success. – R. Hector
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posted 10/25/2011 at 3:10:21 PM
Allergies and Dry Eyes
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Dry eye patients are much more prone to allergies. Their lack of tears means that allergens, like dust and pollen, do not get washed away as they would by those with normal tear volume. Also, the dry eye is already inflamed and this means that when an allergen does irritate the eye and eyelid, it creates a greater reaction. So the frequency, and the severity, of the allergy attacks are greater in dry eye patients.
The safest treatment is plain COLD compresses. I know what you are going to say, “Dr. Hector, you have always recommended warm compresses for my dry eyes.” When you need relieve from an allergic response, during the day, just do the cold compresses. Then at night do your regular warm compress, followed by a cold compress. Plain, preservative free artificial tears will also help relieve some of the allergic reaction. One little trick is to refrigerate the drops and use them cold. When you can’t refrigerate your drops (in the car or at the beach), there are medicated drops that help relieve itching. Some are over the counter, others by prescription. You can use them up to twice a day and most of them are safe for prolonged use.
When an allergic reaction is severe, we will prescribe steroids/cortisone, either topically (drops and /or ointment) or by mouth (Benadryl, also over the counter in pill or liquid form). I do not recommend Benadryl ointment around the eyes.
The very hard part for dry eye patients with allergies is keeping their fingers away from their eyelids. Fingers that just touched the handle of a grocery cart, or a computer mouse, will transfer un-wanted infective material to your eyelids. Make use of those antibacterial wipes that are widely available, and of course, wash your hands frequently. – Dr. Hector
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posted 10/10/2011 at 10:07:04 PM
Being Eyecare Conscious
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
A recent flare up of severe eyelid infections has brought emphasis to taking advantage of all those hand wipes that are available in public places. Transmission from direct contact with soiled surfaces is still most common way to get infections. An example of “soiled” may mean the previous user’s hands touching the shopping cart after covering a cough or sneeze.
Cruise ships discovered this after several major outbreaks of viral infections among their passengers, and now you are greeted with hand wipes at almost every public place. Even around the house, if someone has a “cold”, the rest of the family members should be careful about sharing a computer, phone, dishes, etc. Our eyes get tired from using a computer, so rubbing or wiping our eyes after doing some computer work is not unusual and the computer mouse has been found to carry the highest number of infectious viruses and bacteria. So, take advantage of antibacterial hand wipes and be careful out there.
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posted 9/16/2011 at 2:42:27 PM
Fuel Efficient Dry Eyes
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
With all the new mechanical innovations, cars are getting better and better gas mileage. Recently my patients are telling me that they do not have to stop as often on trips because their new car is a very fuel efficient hybrid. Great for your bank balance, bad for your dry eyes. With better gas mileage you do not have to stop and re-fuel as frequently, your eyes do not get a rest from staring at the road and traffic as often.
On long trips I tell my dry eye patients to take a break every two hours. It literally gives your eyes a rest and gives you a chance to put in artificial tears. Being on the road for hours without a break is not good for your eyes and minor effects on your eyes can be bad enough to temporally blur your vision and make your eyes uncomfortable. So even though you do not need gas, stop at the convenience store for a bottle of water and a tuna fish sandwich (tuna = omega 3 = thicker tear film!).
Of course, I really get heartburn when my dry eye patients tell me they are taking a motorcycle road trip across the United States. Luckily they have outfitted themselves with state of the art goggles and helmets with face shields, which reassures me they are taking all the necessary precautions to protect their eyes while enjoying the amazing scenery from their motorcycles. Bring lots of pictures back to share with us. – Dr. Hector
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posted 8/16/2011 at 10:19:06 AM
Dry Eyes on the 9 to 5
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Is your work place dry eye “friendly”? In a recent medical journal they found that even moderate dry eyes could result in an 18% reduction in productivity. Workers with severe dry eyes suffered a 35% reduction in productivity. What can be done?
Ceiling fans need to be monitored so they do not blow down over those of us trying to read and use our computers.
Glare from large windows and artificial lights needs to be addressed.
The amount of air conditioning and the relative humidity are also very important. Central humidifiers are expensive, but a room humidifier or even a small table top fountain can be used to get moisture back into the room so your eyes do not dry out as fast.
Clean and adequate air filters are important in reducing the amount of mold and dust that gets circulated by the air conditioning systems and ceiling fans.
A smoke free environment is important for many reasons and is almost essential for dry eye sufferers. Heavy perfumes, air fresheners, chemical fumes, paint and glues can be equally annoying.
Being able to wash your hands on a regular schedule helps reduce the risk of inadvertently irritating your eyes after handling “toxic” chemicals, such as house hold cleaners or mop pads.
We need to start a campaign to create Dry Eye Friendly Zones in our public places and work environments. Until then we have to create our own dry eye friendly environment by wearing protective eye wear. There are several products available (Gunnar glasses, Panoptx goggle/glasses, Onion Glasses), both over the counter and by prescription, that provide excellent protection for your dry eyes. Continue to stay well hydrated, limit your intake of caffeinated fluids and take your Omega 3 supplements, and you should do just fine. If not, you know where to find me. –Richard Hector, MD, FACS
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posted 7/20/2011 at 11:47:16 AM
On The Road Again
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
It is the time of year that a lot of us are traveling to far away places. Be prepared for both the travel and the new location. Air travel is very stressful for dry eyes and extra lubrication is needed and even the dry eye goggles, Tranquil Eyes, are a great idea for those long flights. Panoptx is a company familiar to motorcycle owners because they make protective motorcycle helmets and shields. They also have a large collection of dry eye glasses that will accept your prescription and they are becoming very popular with my severe dry eye patients.
Even traveling in your car requires extra lubrication to keep your eyes from drying out. Keep the air vents from blowing in your face and when you reach your location, your eyes may face reactions to the local vegetation and/or change in humidity. There are good over the counter allergy drops such as Zaditor that provide some relieve for the itching. Though many times a good cold compress and some Benadryl by mouth will give you equal relief.
I often provide a vacation “tune-up” for my dry eye patients. We start a month before their trip. Placing punctal plugs (placed in the little drainage canals in your eye lids), either temporary or permanent, is great for those of you facing prolonged air travel and/or trips to a hot and dry climate. Increasing the frequency of your artificial tears and using Restasis also helps prepare your eyes for the added stress. Hopefully this will help you better enjoy your travels. Best wishes for a safe trip – Dr. Hector
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posted 7/12/2011 at 10:27:58 AM
Tears In My Eyes
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
There were a lot of tears in my eyes yesterday, and I am going to take a break from dry eyes to tell you why. A patient I have known for a long time was moving away and wanted a hug before she left my office for the last time.
As she left, she thanked me for saving her life. She reminded me that the first time I saw her was as an end of the day emergency due to the fact she had recently lost vision in her right eye. I found an obstructed artery to the vision nerve in her eye and learned her blood pressure was dangerously high. I arranged for her to see an internist right away. The internist admitted her straight to the hospital where she had a heart attack the next day. Although she survived her heart attack, she never did get the vision back in her right eye, but she is grateful for still being alive 10 years later. She felt she had been put in the right place at the right time and that eye exam saved her life.
So yes, eye doctors can save lives. Our view inside the eye reveals the health of one’s blood vessels, and nerve tissue which is directly connected to the brain. Diabetes, high cholesterol, brain tumors and hyperthyroidism are but a few of the many medical conditions we can readily diagnose from an eye exam. So when you come in for your eye exam, we are also checking on your general health.
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posted 6/30/2011 at 10:52:29 PM
Summer Lovin’ For Dry Eyes
By Richard Hector, MD, FACS
Board Certified Ophthalmologist
Fellowship Trained in Cornea and External Disease
Dry Eye Specialist
Summer weather has arrived in full force and it is a good time to review the basics of dry eye protection. The increased humidity actually makes our dry eyes more comfortable. But how much time do you spend outside and how much time to you spend in air conditioned comfort under a ceiling fan? The colder the air conditioned space the dryer the air and the more affected you eyes will be. So, what are our options?
1. Blink more often, exercise those eyelid muscles and stimulate tear production.
2. Increase the humidity of your environment. This can be as simple as a glass of water or as expensive as a humidifier for your central air conditioning unit. There are also smaller humidifiers that provide a nice cool mist. These are portable and can be placed in which ever room you are occupying. Turn off your ceiling fans, or at place them on a “winter”/reverse rotation so they blow the air up instead of down on your dry eyes.
3. Keep a handy supply of artificial tears within reach. You may have to use a thicker solution during the summer. And because you will be using them more, use solutions with no preservatives.
4. Intensify your lid hygiene. Good warm to hot compresses over your close eyelids and a little massage will work out the thicker oily tears that can plug up your tear glands. Follow with a quick, cold rinse to help reduce swelling and itching.
5. Moisturize your eyelid skin at night. Use a very bland moisturizer like Vaseline petroleum jelly (and don’t forget to moisturize your lower eyelids too).
6. Increase your Omega-3 in take. Consider 3,000 to 4,000 units a day.
7. Wear protective eye wear. Good polarized sunglasses that wrap around you face. Even in doors, there is protective eyewear for computer vision correction and reading that are dry eye friendly. By dry eye friendly I mean that they wrap around your eyes forming a moisture chamber and have a nice light tint to reduce the glare.
8. Consider dry eye goggles to wear at night or any time you want to really rest your dry eyes. All these products are available over the counter, most of them in The Optical Gallery at The Eye Associates locations.
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posted 6/15/2011 at 10:03:52 PM
