You Are What You Eat!... Getting Your Dose of Vitamin "Eye"

Hi everyone! I apologize for the delay in posting. The optimist optometrist has had a lot going on lately, but she's back and ready to talk about one of her favorite topics... nutrition and eye health! I had a patient the other day with macular degeneration who smokes and whose diet consists of potatoes and big macs... it reminded me of the importance of treating the patient as a whole and not just looking at the eyes alone.

What you put into your body certainly can affect many body systems, including those windows to your soul!

Anyone remember "Supersize Me"? I saw the movie and also read his second book, and found it quite interesting how many problems arose after a relatively short time of eating only McDonald's. We are so busy that sometimes it's hard to take the time to eat healthy foods. Hopefully we are trending toward healthier living.

So, let's talk about those eyeballs... What nutrients affect the eyes, and how do I get them? Let's talk about a few of the important ones:

Lutein & Zeaxanthin: These guys affect the health of a very important part of the eye called the macula. They are both antioxidants, and they affect something called the macular pigment optical density (MPOD). People with high MPOD levels have greater tolerance for glare, which can help night driving. They act like internal sunglasses to filter out harmful light. These nutrients can reduce the risk of macular degeneration and cataracts. Popeye probably has pretty high MPOD levels, since these nutrients are often found in spinach.

Vitamin C: As a Florida girl, I love my citrus fruits! Vitamin C is found in fruits such as oranges and grapefruits. Vitamin C affects many cells in the body, including those of the eye. Vitamin C can be especially important to reduce the risk of certain types of cataracts. Go drink some O.J.!

Vitamin E: Vitamin E is good for repairing cell membranes. Everyone wants healthy cell membranes, right? Your immune system is also affected by Vitamin E. This vitamin likes to hang out in foods such as nuts, fortified cereals, and sweet potatoes.

Essential Fatty Acids: Low levels of fatty acids are associated with dry eye syndrome. Dryness in the eyes can make your eyes feel uncomfortable, but increasing your EFAs can help deccrease the incidence of dry eyes. One way we optometrists look for signs of dryness in the eyes is by putting in a drop that lets us see dry spots on the front part of the eye (the cornea). A dry cornea has spots of dryness that look like the picture here. Essential Fatty Acids like DHA and EPA are found in fish such as salmon and tuna. Take a trip to Red Lobster or Bonefish Grille!

By the way, most of this info can be found on our national optometry association's website, http://www.aoa.org/. Not the stuff about Popeye though.

I also recently read a book about brain health, and a lot of the same nutrients that affect the eye also affect the brain. Good to know.

So, bottom line: What you put into your body affects you! I know I always feel better when I eat healthy foods. Your eyes need nutrients too, so don't forget about them! You may consider taking a dietary supplement if you are not getting adequate levels of nutrients via your diet. Also, stay positive about your health and your diet... don't get discouraged if you have a day or two when you need to eat chocolate (eat the dark kind... antioxidants!). Just remember that you are feeding all the cells of your body, and by eating nutritious foods, you can keep those cells happy.

Now go out and have some salmon with a side of spinach and a baked sweet potato, and drink some O.J.! Your eyes will love you for it.

Why the twitching?

Ever have one of your eyes start twitching for seemingly no reason? Twitching can be annoying, and most of the time twitching is associated with a high stress level. So this post is going to be about... STRESS REDUCTION! Yay!

I will share a bit of my personal experience over the weekend, and talk a bit about how running has changed my attitude and allowed me to lower my stress level. Over the weekend I ran the Grandfather Mountain Marathon in North Carolina. This was my first full marathon, and it happens to be one of the more difficult ones because of the many hills and the altitude. I trained in Florida, which is about as flat as it gets and not at all high altitude. So this made the race a bit challenging for me. However, the views during the race were splendid; I felt like I was in another country. The mountains, the trees, the fog... hard to explain. The beauty of nature definitely helped me get through the many miles of running.

Over the past few years, running has been a great stress reliever for me. There are many ways to relieve stress. If you are having eyelid twitching, try one or more of these potential stress relievers:

• Art (painting, pottery, sculpture)
  


• Music (ever play the drums? great way to get some anger out!)



• Meditation (great way to clear your mind)



• Yoga (and you get the added benefit of increased flexibility)



• Martial arts (The Ninja Turtles had the right idea)



• Gardening (for all those with a green thumb)



• Have a spa day (you deserve it!)
  

Different things work for different people. One person's stress reliever might actually cause stress for another person. So try a few different things to see what works best for you. We all have stress in our lives, and it's up to you to find ways to control that stress. Stress not only affects your eyes, but can have all kinds of health consequences. Do yourself a favor and take some time to figure out what relieves your stress.

I'll leave you with a bit of inspiration from Lance Armstrong's book: You have the power and the responsibility to make this day the best day possible, and then string the days of your life together in a way that brings you happiness.

Have a wonderful Tuesday.

You got *WHAT* in your eye?

So this is a bit belated, but I said I would do an eye injury post for the 4th of July. I hope everyone had a fantastic 4th of July, and that you feel thankful to live in a country with many freedoms.

Speaking of freedoms, in America we have the freedom to do not-so-smart things to our eyes. So today we shall talk about... EYE INJURIES and what to do if you get something weird in your eye.

So let's talk first about what happens if you get metal in your eye. This is what you may think if you are grinding metal and an opossum stole your safety glasses and the metal got in your eye:

"Where did that crazy opossum come from," and "oh, it will come out by itself, I don't need to go to the eye doctor."

Don't listen to that inner voice, because metal that is stuck on the cornea can rust fairly quickly and pose danger to your ocular health. It also doesn't feel very good. When a patient comes in with metal in their eye, I check their vision and then look to see where the metal is located. If the metal is not very deeply embedded, I try to wash it out with saline first. If the metal is too deep, then we put drops in to numb the eye, and then remove the metal with some cool tools. If the metal has rusted, we may have to use a special drill to get the rust out. This is what metal embedded in the cornea looks like:

After the metal is removed, we send you home with antibiotic drops and see you back the next day to make sure you are healing properly. I've had a few patients who have had metal in their eye multiple times, but they still refuse to wear safety glasses when drilling. Please don't be that guy. Even our President wears safety glasses when needed, see?

So that's about it on the metal issue... I also wanted to talk about what to do if you get a weird liquid in your eye. Let's say you were busy cleaning your home, and you got some of the cleaner in your eye. (See, cleaning is dangerous. I hate cleaning.) What should you do? IRRIGATE! That means flush the eye out with water, and not just for 30 seconds. My hubby worked at the FL Poison Center, and they recommend the same treatment: Get in the shower and flush the eye out for 15 minutes. Yes, that's a long time. But we want to make sure all of the chemical gets out. After the eye is flushed, come over to your friendly eye doctor so we can make sure there are no chemical burns or abrasions. We can put this cool dye in your eye to look for those things. We may give you antibiotic drops if you are at risk for infection.

The moral of this post is that injuries are no fun, so try to avoid them if possible. Be aware of your surroundings, and be careful of any chemicals in the vicinity that could cause harm to your eye. PLEASE wear safety glasses if you are doing something dangerous, like grinding metal. Or playing raquetball. We like healthy eyes without injuries, so be careful! Have a safe and wonderful summer!!!

Does this outfit make my eyes look fat?

So for this post, I thought I'd talk a bit about how our weight can affect the health of our eyes. I actually have a Continuing Education test to turn in about "The Eyes and Obesity," so perfect timing!





So, being fat can be bad for your eyes? Really? ABSOLUTELY!

Here are some of the many ocular conditions associated with obesity or poor nutrition:

1. Hypertensive Retinopathy

2. Diabetic Retinopathy

3. Pseudotumor Cerebri

4. Macular Degeneration

5. Floppy Eyelid Syndrome

We all know about diabetes and high blood pressure, so I'm going to save those two big topics for another time. And macular degeneration deserves a separate topic too. Let's talk about two of the lesser known conditions found more commonly in obese individuals: Pseudotumor Cerebri and Floppy Eyelid Syndrome.

So, what the heck is pseudotumor cerebri? It's a condition often found in overweight women of childbearing age. The optic nerves become swollen, and vision can be affected. These patients come to us with complaints of headaches, blurred vision, and blackouts of vision. Here is a picture of a swollen optic nerve from pseudotumor:

The only way to know if you have pseudotumor is to see your eye doctor. Again, we're cool! If we suspect pseudotumor, we will send you for further testing to confirm. This condition is much less common in women who are not overweight, so another reason to get fit. Also, part of the treatment for this condition is weight loss, and losing weight can often make the condition go away completely. So get on that treadmill, ladies!

The next one, floppy eyelid syndrome kind of has a funny name, huh? This one is more common in overweight men, usually middle aged guys. These guys can usually be seen on the beach in a speedo sporting their beer belly. Gross!

So what happens if you have floppy eyelid syndrome? Nothing that makes you very attractive... your eyes become red and inflammed, and your eyelids are so loose that they rub up against your pillow at night and cause irritation. Most of these guys also have sleep apnea. Not fun!

Sometimes it is hard to separate what is good to eat and what is bad to eat. There are diet plans that cut out fat, others that cut carbs, others that focus on sugar intake... the diet industry is HUGE. So why are Americans still gaining weight? In the CE lecture on obesity, we learned some startling things... Americans are heavier than ever... Children are getting diabetes at much younger ages than before... lots of startling and upsetting facts that signal to me that we Americans need to make some lifestyle changes. With a healthy diet and exercise program, hopefully we can improve our lives and keep our eyes healthy.

A good place to start is to write down what you eat and how much you exercise, and be honest. Seeing the amount and types of food you consume written down can be very eye-opening (no pun intended... okay maybe a little pun intended). If you consume fewer calories than you burn, you will lose weight. Losing weight can come with physical health benefits as well as mental ones... don't we feel our best mentally when our bodies are healthy? So take control of your life, get active, and eat something good for you... you'll be thankful that you did!

The Power of Positive Thinking

I'm going to take a little break from the optometry stuff and write a bit about the power of positive thinking. I believe that we each have the power to control our own lives. We can choose the way we look at things... Sure, good and bad things will happen in all of our lives. But our perspective on our lives can play a big role on our levels of happiness.

For the past few years, I've read a few books about the Law of Attraction. To me, the take-home message is this: Positive thinking can bring positive things into your life. Here are a few quotes from different parts of The Secret that I found helpful:

From the book:

"Create your day in advance by thinking the way you want it to go, and you will create your life intentionally."

"Every single thing that you've been through, every single moment that you've come through, were all to prepare you for this moment right now."

"So inner happiness actually is the fuel of success."

"Let go of difficulties from your past, cultural codes, and social beliefs. You are the only one who can create the life you deserve."

"You cannot help the world by focusing on negative things. As you focus on the world's negative events, you not only add to them, but you also bring more negative things into your own life."

"Treat yourself with love and respect, and you will attract people who show you love and respect."

"Expectation is a powerful attractive force. Expect the things you want, and don't expect the things you don't want."

"Gratitude is a powerful process for shifting your energy and bringing more of what you want into your life. Be grateful for what you already have, and you will attract more good things."

"All that we are is a result of what we have thought" --Buddha

"It is impossible to feel bad and at the same time have good thoughts."

"Your current thoughts are creating your future life. What you think about the most or focus on the most will appear as your life."

Just a few quotes that I have found to be personally true. The main idea from The Secret is to take control of your life and bring positive things into your life via positive thinking.

I also recently read a book (well, audiobook, I drive a lot) called "Authentic Happiness." It was written by a psychologist, and mentioned a few studies on levels of happiness. From this book, we learn that the Beatles were right... money can't buy you love. One of the studies included information on the level of happiness for people who have won the lottery. While the lottery winners did have a temporary increase in their level of happiness, a year after winning they returned to their pre-lottery happiness level. The book goes into what can bring you true happiness, with things like family, a good social network, a career you enjoy, and a healthy lifestyle playing a major role in the happiness level. Race and income level played a surprisingly small role when determining a person's level of happiness. They also showed that physical activity caused a much higher boost in perceived happiness than watching TV. Even sitcoms, which are supposed to make you laugh, decreased the perceived happiness level of the research subjects.

So what does all this mean? Think positively and take care of yourself. You will be glad you did.

You can get freckles in your eye? Seriously?

I had a friend ask me about freckles in the eye, so my second topic for this blog is going to be (drum roll again…) Ocular Nevi. That’s just a fancy term for eye freckles. The singular form of the word is ocular nevus, in case you want to impress your friends with your wealth of eye knowledge.

Yes, you can get a freckle in or around your eye, and there are certain things we look for when we see them.

Disclaimer time: An eye freckle is often something that does not need treatment… HOWEVER, there are some freckles that need to be monitored by a specialist, or even removed. Your eye doctor will let you know what you should do. SO GO TO YOUR EYE DOCTOR, I promise again that we are nice!

I’m not going to go into freckles on your eyelids or around your eyes; let’s save that for another time. I do want to talk about freckles on the white part of your eye as well as retinal freckles.

So let’s talk about the freckles you can see yourself… those on the white part of the eye (conjunctival nevus) or the colored part of the eye (iris nevus). Here are some pictures of freckles that you can see yourself in the mirror:

You can also get freckles that you won’t see in the mirror. A choroidal nevus is one that you cannot see yourself in the mirror because it is behind the iris. We can get pictures with a retinal camera so you can see your freckle though, and they look like this:

So which freckles are no big deal, and which ones do we worry more about? We use this ABCDE thing to decide if a freckle worries us more or less:

A is for Asymmetry: You know how they say the more symmetric your facial features are, the more beautiful you are? We feel the same way about eye freckles. If the right is the same shape and size as the left, and the top is the same shape and size as the bottom, then we have a more safe (and beautiful) freckle.

B is for Borders: I don’t mean the bookstore, although I do have a gift card to use there… any good book recommendations? We like the edges of the freckle to have distinctly defined borders. Uneven, irregular borders make us worry more.

C is for Color: If you have a green freckle, you might be from outer space. Just kidding. We like freckles to have a color that is the same (uniform) throughout, rather than a bunch of different shades of colors throughout.

D is for Dimensions: Bodybuilders might tell you that bigger is better, but that’s not the case when we’re talking about freckles. Your eye doctor will measure your freckle and compare it from visit to visit.

E is for Elevation: We like freckles to be nice and flat instead of raised. Your eye doctor will watch your freckle to determine if it is flat or elevated.

So, now what?

When I see a patient with a freckle, and it is a symmetric, even-colored, small, flat freckle with defined borders, then I do the following:

• Take a picture of the freckle. (Say, “Cheese”!)


• Measure the freckle


• If the patient was here before, compare it to last visit


• See the patient back (usually in 6 months) to take pictures again and look for any changes
  

If the freckle worries me in any way, or if I see changes in a freckle from a previous visit, then I will send the patient to a specialist for further evaluation. The specialist may do a scan of the eye or sometimes a biopsy.

Healthy living time! Regular screenings with your eye doctor can assure that your eyes stay healthy. If we see a freckle, we will document everything we see so that we can make future comparisons. Knowing exactly what a freckle looks like at a certain point in time can make it much easier to properly diagnose your condition.

By the way, I just had a patient with a choroidal nevus. His wife was in the exam room, and since the nevus was in the left eye, she named the freckle “Lefty.” An appropriate name, I suppose.

Hope everyone found this helpful... my next topic I think will be something on either sports or sun protection... Have a BEAUTIFUL week!

My eyes won't stop itching... what gives?

I decided that my debut patient education topic will be (drum roll, please)... Ocular Allergies! Allergies have certainly been on the minds of many of my patients lately. Springtime in Jacksonville brings quite a bit of pollen to the air, leading to itchy, watery eyes.

So, what causes allergies? And what the heck can you do to make them go away?

An allergic reaction is your body's way of telling you it doesn't like that allergen. When you encounter the item you are allergic to, your body tries to fight it off via an inflammatory response. In the eye world, this response often involves:

• Redness
• Itching
• Watering
• Discomfort
• Eyelid swelling
  

In this post, we will discuss just allergic conjunctivitis, and will leave other types of allergic eye responses (such as eyelid swelling from contact with a new soap or eye product) for another time.

This is the part when I put in the disclaimer: Redness of the eyes can be caused by a number of different things, and some of them can be a little scary. You need to visit your eye doctor (we're nice, I promise!) to properly diagnose your condition.

So back to the allergies... We optometrists use our cool tools to look for a few different things when we suspect allergies. First, we'll check your vision to make sure it has not been affected. Then, we will use a cool microscope to look for signs of allergy in each eye. Some things we look for include:

Papillae: Ever flip your top eyelid up to freak out your younger sibling? We optometrists flip up eyelids quite frequently, but not to freak you out. We do it to look for little bumps called papillae that are often a sign of ocular allergy. These bumps rub up against your eye every time you blink, causing the itching you might experience with allergies. Some allergy eye drops are made specifically to shrink the papillae and stop that annoying itching.

Ocular hyperemia: That's just eyespeak for dilated blood vessels on the white part of your eye. The vessels surrounding your iris become much more red and noticeable if you have ocular allergies. However, redness of the eyes can be from a number of different causes, including infections or abrasions. Redness does not necessarily mean allergy.

Mucous Discharge: You lucked out, I decided not to put any pictures of mucous discharge on here. But yes, often with allergies you can have stringy, watery stuff coming out of your eyes.

Also, usually allergies tend to affect both eyes fairly equally. Other causes of red eye are usually just in one eye or start in one eye and pass to the other.

So I have ocular allergy. Now what?

I'm supposed to tell you to avoid the allergen that is causing the allergy. However, this is often very difficult to do, since usually eye allergies are caused by something in the environment. Living in a bubble would be a great way to get rid of your allergies, but who wants to do that? Also, pet allergies are very common and can cause allergic reactions, but please don't get rid of Fido, he needs a good home like many of the other dogs and cats in this world. Did I mention I'm a bigtime animal lover? We actually have hypo-allergenic dogs that don't shed because the dude I married suffers from pet allergies.

So, if you can't avoid the allergen, I like to start with a few easy things to help your allergy symptoms. Cool compresses (cold towel or one of those fancy gel pack things) are great for swollen eyelids and ocular irritation. I also like to use artificial tears to flush out whatever allergen is causing the reaction. If you put the artificial tears in the refrigerator, they feel nice and cool when you put them in, also helping with discomfort.

If cool compresses and artificial tears aren't enough, there are some great prescription eye drops that can help with itching and allergy symptoms. If the allergy is severe, sometimes we will prescribe a mild steroid (not THAT kind of steroid, you won't grow huge muscles and get all angry) to help with the redness and swelling.

Oh, and I almost forgot, but have had a lot of patients ask me this lately... suffering from allergies does not necessarily mean you cannot wear contact lenses. I usually fit my allergy patients in a daily disposable lens that is used only once and then thrown away. While this might seem a bit wasteful, it is worth it for allergy patients to have a clean contact lens on every day.

I think I mentioned before that I want to try to incorporate optimism and healthy living whenever I can in this blog. Allergies in the eyes can be annoying, but they almost never threaten your sight or life like other health conditions. Living a healthy lifestyle and keeping a positive attitude certainly can't hurt!

Hope everyone has a wonderful, allergy-free day!

The Beginning

So, what is the point of this blog? I wanted to create a place where optometry and optimism meet. Let me explain.

I am an optometrist. Every day, (well, four days per week right now) I perform eye exams, fit patients for contact lenses, treat wacky eye infections, and try to solve any eye problems my patients may have.

I am also an optimist, and I try to look on the bright side of things. I have been doing that more lately... being happy and thankful for the good things and people in my life... I am glad to be healthy, employed, and a member of a very caring family.

So why the blog? I googled "optometry blog" and found way too much negativity. All kinds of information about how optometry as a career is going downhill fast because of places like Wal-Mart. I do not work at Wal-Mart, and probably never will... but I do know some excellent, capable, intelligent doctors who happen to practice there. I am hopeful that hard work will pay off regardless of a doctor's mode of practice.

I believe that a positive attitude can greatly improve your quality of life. I think if more people looked on the bright side, then the world would be a better place. I believe in the Law of Attraction and The Secret... that each person has the power to make their life better.

So, being both an optimist and an optometrist, I started this blog with the following purposes in mind:

• To talk about the good things happening in optometry, and look for solutions to the challenges facing our profession



• To discuss new treatments and practice ideas



• As a patient care tool

The last part, the patient care stuff... Not sure exactly how this is going to work, but was thinking of doing like one topic per week of the most common questions I get from patients. I always ask my patients at the end of the exam if they have any questions; I plan on writing down these questions for the next 2 weeks and then doing a new topic every week... And they could be based on whatever is going on in the world right now... summertime will talk about the consequeces of sun damage to the eyes... Fourth of July could be eye injury topic week.... you get the idea. I definitely want to cover sports and nutrition because those things interest me personally...

So there you have it, my first optimist optometrist blog. More to come later!