WDSE WDSE WDSE ♪ DR. NALIN: GOOD EVENING AND WELCOME TO "DOCTORS ON CALL."

I’M DOCTOR PETER NALIN, PROFESSOR AND HEAD OF THE DEPARTMENT OF FAMILY MEDICINE & BIOBEHAVIORAL HEALTH AT THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, DULUTH CAMPUS.

I AM YOUR HOST FOR OUR PROGRAM TONIGHT ON EYE ISSUES -- CATARACTS, GLAUCOMA AND MACULAR DEGENERATION.

THE SUCCESS OF THIS PROGRAM IS VERY DEPENDENT ON YOU, THE VIEWER, SO PLEASE CALL IN YOUR QUESTIONS TONIGHT OR SEND THEM IN AHEAD OF TIME TO OUR EMAIL ADDRESS -- ASK@PBSNORTH.ORG.

THE TELEPHONE NUMBERS CAN BE FOUND AT THE BOTTOM OF YOUR SCREEN.

OUR PANELISTS THIS EVENING INCLUDE -- DOCTOR CHARLIE AHRENS, AN OPHTHALMOLOGIST WITH ASPIRUS-SAINT LUKE’S.

DOCTOR ELISABETH APONTE, AN GLAUCOMA SPECIALIST WITH LIFEVIEW GLAUCOMA CENTER.

AND DOCTOR LISA GRAHAM, AN OPHTHALMOLOGIST WITH RELF EYECARE SPECIALISTS.

OUR MEDICAL STUDENTS ANSWERING THE PHONES TONIGHT ARE -- NATHAN JOHNSON FROM GRAND RAPIDS, MINNESOTA.

ETHAN LORSUNG FROM SARTELL, MINNESOTA.

AND DANIELLE SANTOS FROM SMITHTOWN, NEW YORK.

AND NOW ON TO TONIGHT’S PROGRAM.

EYE ISSUES -- CATARACTS, GLAUCOMA AND MACULAR DEGENERATION.

THE QUESTIONS ARE ALREADY COMING IN.

WHAT IS THE DIFFERENCE BETWEEN CATARACTS AND FLOATERS?

>> THIS IS A COMMON QUESTION WE GET ESPECIALLY IF WE ARE DEALING WITH CATARACT SURGERY.

PEOPLE ARE ALWAYS ASKING IF IT WILL GET RID OF FLOATERS.

CATARACTS IS A HARDENING OF THE LINENS.

I TELL MY PATIENTS, EVERYBODY GETS CATARACTS, IF YOU LIVE LONG ENOUGH, THE LENS OF THE I WILL GET HARDER AND HARDER AND MORE DENSE AS WE AGE.

WHEN IT GETS DENSE ENOUGH IT WILL AFFECT VISION AND THAT’S WHEN WE REMOVE THE LENS AND REPLACE IT WITH AN ARTIFICIAL ONE.

FLOATERS, AS WE AGE, THE GEL AT THE BACK OF THE I WILL START TO LIQUEFY AND CONTRACT AND SEPARATE OFF THE BACK OF THE RETINA, THE BACK OF THE EYE AND BACK OF THE RETINA, AND IT KIND OF CRINKLES UP LIKE A CLEAR STRIP OF CELLOPHANE.

THAT’S WHAT YOU PICK UP AS FLOATERS.

A DIFFERENT AREA OF THE EYE AND A DIFFERENT MECHANISM.

DR. NALIN: THANK YOU.

WHAT ARE FIRST-LINE TREATMENTS FOR GLAUCOMA?

>> WE NOW KNOW PATIENTS WHO HAVE THE SLT LASER, THE SELECTIVELY IS HER -- LASER, HAVE A LOWER RISK OF PROGRESSION FOR GLAUCOMA.

HOWEVER, BECAUSE OF PROBLEMS WITH ACCESS, FOR MANY PEOPLE THEY STILL PLACE EYEDROPS AS A PRIMARY TREATMENT.

IT IS RECOMMENDED TO DO AN SLT AS PRIMARY TREATMENT BEFORE BEING PLACED ON EYEDROPS.

DR. NALIN: THANK YOU.

WHAT ARE COMMON SYMPTOMS OF PATIENTS WITH CATARACTS?

>> A GRADUAL CHANGE IN VISION.

SOMETIMES THE PRESCRIPTION CHANGES MORE QUICKLY.

THEY CAN INTERFERE WITH THE VISION IN A MULTITUDE OF WAYS, JUST PLAIN BLURRINESS, CAN INTERVIEW DASHCAM INTERVIEW WITH -- CAN INTERVIEW WITH COLOR PERCEPTION, AND GLARE.

EVEN ON A BRIGHT SUNNY DAY.

DR. NALIN: A CALLER ASKS, I’VE WOKEN UP IN THE MIDDLE OF THE NIGHT WITH THE SENSATION OF BEING POKED IN THE EYE.

WHAT MIGHT THIS BE AND IS IT CONCERNING?

>> THAT’S A GOOD QUESTION.

IT COULD BE A COUPLE OF DIFFERENT THINGS.

THE MOST COMMON THING THAT COMES TO MIND IS DRY EYES.

ESPECIALLY AT NIGHT IF YOU TEND TO SOUP WITH YOUR EYES OPEN A LITTLE BIT, IT CAN CAUSE MORE EVAPORATIVE FORCES AND COST DRY I.

ONE THING WE SHOULD THINK OF AS PROVIDERS, IF YOU WAKE UP FIRST THING IN THE MORNING, RECURRENT EROSION IS WHERE THE TOP LAYER OF THE CORNEA WILL STICK TO THE BACK SURFACE OF THE EYELID.

IF THERE’S NOT A GOOD ATTACHMENT TO THE UNDERLYING LAYERS, AS YOUR EYE IS MOVING A LITTLE BIT OR WHEN YOU WAKE UP AND OPEN YOUR EYES, IT CAN PEEL PART OF THE CORNEA OFF.

THERE ARE SUBTLE CHANGES WE CAN SEE ON OUR EXAM TO IDENTIFY THAT.

FOR THIS PERSON IF IT’S REALLY BOTHERSOME OR AFFECTING THEIR VISION, I WOULD SAY LET’S TAKE A LOOK AT IT.

DR. NALIN: HAVE THE EYES EXAMINED IN THE OFFICE.

THANK YOU.

HOW IS IT THAT THE LASER TREATS THE GLAUCOMA?

>> THE TRUTH IS, IT IS A MYSTERY.

THERE ARE DIFFERENT THOUGHTS.

ONE THOUGHT IS FOR THE MECHANICAL ACTION, THE MESHWORK, IT ALLOWS THE DRAINAGE OF THE EYE TO BE MORE FLEXIBLE OF THE EYE AND DRAIN MORE FLUID.

THERE IS ALSO A THOUGHT THAT THE LASER CAN RELEASE -- THAT CAN CAUSE THE MESHWORK TO CHANGE SHAPE AND INCREASE SPACE FOR THE DRAINAGE.

WE ALSO THINK THE LASER ITSELF CAN CREATE THE INFLAMMATION INSIDE THE EYE.

WHEN THE EYE IS INFLAMED SOMETIMES, IT CAN PRODUCE LESS FLUID AND THAT CAN ALSO CHANGE THE MESHWORK.

ALTHOUGH WE DON’T KNOW EXACTLY HOW IT WORKS, IT IS HIGHLY EFFECTIVE.

DR. NALIN: THANK YOU.

ANOTHER CALLER NOTICES FEELING TIRED WHEN WEARING CONTACTS.

WHAT MIGHT THAT BE?

>> THE MOST COMMON REASON I WOULD THINK IS DRY EYES.

DRY EYES CAN HAPPEN FOR A VARIETY OF REASONS.

EVAPORATION, WHICH IS PROMINENT ESPECIALLY IN THE WINTER MONTHS WHEN THE AIR IS DRIER.

AS WE AGE OUR EYES GET DRIER AND SOMETIMES CONTACTS ARE NOT AS TOLERABLE.

IF YOU WEAR THEM FOR A LONG DURATION THEY CAN IRRITATE THE EYES AND THE EYES BECOME DRIER.

IT’S GOOD TO GIVE YOUR EYES BREAKS WHEN YOU ARE WEARING CONTACTS.

A LOT OF ADVERTISING MAKES IT SEEMS LIKE YOU CAN WEAR THEM 24 HOURS A DAY, SEVEN DAYS A WEEK, BUT MOST OF US DO NOT RECOMMEND THAT.

IT’S GOOD TO GIVE YOUR EYES BREAKS SO THEY CAN RECOVER FROM THE DRYNESS OF WEARING CONTACTS AND THE IRRITATION OF WEARING CONTACTS.

DR. NALIN: THANK YOU.

A COLOR HAS NOTICED AN INCREASED DIFFICULTY DRIVING AT NIGHT REGARDING VISION.

WHAT MIGHT BE EXPLAINING THAT?

>> THE TWO MOST COMMON THINGS THAT WE’VE HIT ON TWICE.

DEPENDING ON AGE AND WHAT THE EYE EXAM LOOKS LIKE, IF ANYONE IS STRUGGLING WITH GLARE OR NIGHTTIME HALOS, WE THINK ABOUT CATARACTS, ESPECIALLY AS WE AGE.

DRY EYES CAN CAUSE SIMILAR SYMPTOMS TO CATARACTS WITH GLARE AND THE HALOS OFF HEADLIGHTS.

ESPECIALLY NOW, I’M SURE YOU ARE NOTICING THIS IN YOUR CLINICS BUT WE ARE SEEING AN INFLUX OF DRY EYES THE LAST COUPLE OF MONTHS BECAUSE OF THE CHANGE IN THE WEATHER.

WE LIVE IN NORTHERN MINNESOTA, ARID CONDITIONS THOSE ARE THE TWO MOST COMMON CAUSES.

OTHER THINGS THAT CAN CHANGE THOSE ARE LESS COMMON AND YOU WOULDN’T THINK OF THOSE UNTIL YOU ARE DOING YOUR EXAM.

CHANGES IN THE CORNEA.

MUCH LESS COMMON.

THE TOP TWO ARE CATARACT AND DRY EYES.

DR. NALIN: A CALLER WANTS TO KNOW WHAT THEY MIGHT BE ABLE TO DO TO SLOW THE PROGRESSION OF THEIR GLAUCOMA.

>> OBVIOUSLY THEY HAVE TO SEE THEIR EYE DOCTOR.

AND BASED ON THE EYE PRESSURES, THEY MIGHT HAVE RECOMMENDATIONS, WHETHER IT IS LASER, EYEDROPS, SOME EYE SURGERIES.

PATIENTS OFTEN WANT TO KNOW WHAT THINGS THEY CAN DO AT HOME TO HELP TO SLOW DOWN THE PROGRESSION.

ONE THING WE DO KNOW IS JUST LIKE FOR THE BRAIN, IT’S GOOD TO EXERCISE.

IF YOU CAN TRY TO EXERCISE 20 MINUTES, FOUR DAYS A WEEK, THAT CAN SLOW DOWN THE PROGRESSION OF GLAUCOMA.

DR. NALIN: THANK YOU.

HOW DOES SCREEN TIME AFFECT ONE’S EYES?

>> IN A VARIETY OF WAYS, IT DEPENDS ON YOUR AGE.

I THINK FOR KIDS, WE KNOW PROGRESSIVE CHANGES IN VISION, ESPECIALLY NEARSIGHTEDNESS, CAN OCCUR WHEN THERE IS A LOT OF SCREEN TIME.

IT’S GOOD FOR KIDS TO BE OUTSIDE AND FOCUSING AT A DISTANCE.

SO YOUR GRANDMA’S OLD RECOMMENDATION DON’T SIT TOO CLOSE TO THE TV, GO OUTSIDE AND PLAY, IS PROBABLY TRUE.

AS WE GET OLDER, WE HAVE MENTIONED DRY EYES A NUMBER OF TIMES BUT SPRINGTIME CAUSES YOUR EYES TO DRY OUT BECAUSE YOU DON’T BLINK AS OFTEN WHEN YOU ARE STARING AT SOMETHING.

PROBABLY 30% LESS.

YOU ARE NOT COATING YOUR EYES WITH TEARS AS OFTEN AND THEY DRY OUT MORE READILY.

THERE ALSO VARIOUS REPORTS ON LIGHT EXPOSURE FROM SCREENS AFFECTING YOUR SLEEP PATTERNS AND SOME OF THOSE ARE TRUE, THEY ARE NOT OLD WIVES TALES.

DR. NALIN: THANK YOU.

A CALLER ASKED ABOUT THE NEW LENSES FOR CATARACT SURGERY AND ARE THEY WORTH THE COST?

>> THAT DEPENDS.

WE WERE JUST TALKING ABOUT THIS BACKSTAGE.

THERE ARE NEWER TECHNOLOGIES COMING OUT ALL THE TIME AND IT IS KIND OF FUN TO BE IN THIS OCCUPATION BECAUSE RIGHT NOW, ALL THESE COMPANIES ARE COMPETING AGAINST EVERYBODY COMING UP WITH NEW ADVANCEMENTS.

IT’S FUN BEING ABLE TO OFFER THESE TO PATIENTS.

IT DEPENDS ON THE INDIVIDUAL AND WHAT THEY EXPECT AFTER CATARACT SURGERY.

FOR SOME PEOPLE, IF THEY HAVE ALREADY SIGNIFICANT MEDICAL ISSUES WITH THEIR EYES, THEY MIGHT BE A FIT FOR OUR STANDARD LENSES.

THE MAJORITY OF SPECIALTY LENSES WE USE OUR GEAR TOWARD GETTING RID OF GLASSES AND BECOMING A SPECTACLE -- AS SPECTACLE INDEPENDENT AS WE CAN, WHICH IS CORRECTING FOR ASTIGMATISM, BIFOCAL LENSES, IT RUNS THE GAMUT.

IT’S UP TO THE INDIVIDUAL PATIENTS.

THESE ARE THE CONVERSATION I HAVE.

IS IT WORTH IT TO THEM TO BE GLASSES FREE AND WHAT THEIR ACTIVITIES ARE IN REGARDS TO THAT?

DR. NALIN: WOULD YOU PLEASE DESCRIBE THE RECOVERY AND ADVICE TO PATIENTS AFTER LASER SURGERY?

>> FOR THE LAW, ONE’S, THEY CAN GO BACK TO REGULAR ACTIVITIES ON THE SAME DAY.

THE PROCEDURE ITSELF TAKES ABOUT FIVE MINUTES.

WE ASK PATIENTS TO WAIT IN THE OFFICE FOR 30 MINUTES SO WE CAN CHECK EYE PRESSURES.

THEN THEY CAN PRETTY MUCH GO BACK TO REGULAR LIFE ON THE SAME DAY, SO NO RESTRICTIONS.

DR. NALIN: THANK YOU.

HOW ABOUT FOR CATARACT SURGERY?

THE RECOVERY AND YOUR ADVICE TO PATIENTS AFTER THAT SURGERY.

>> THEY HAVE BEEN SEDATED THAT DAY SO IT’S PROBABLY GOOD TO GO HOME AND RELAX THAT DAY.

I’VE HAD PEOPLE GO BACK TO WORK ON THE SAME DAY.

WE DON’T RECOMMEND IT WHAT IT IS POSSIBLE.

THEY MAY BE A LITTLE BLURRY ON THE DAY OF SURGERY IN THE OPERATIVE EYE.

THEY WILL BE DILATED FOR MOST OF THE DAY AND INTO THE NEXT DAY AND THAT CAN GET IN THE WAY OF YOUR VISION A BIT.

THERE ARE MINOR ACTIVITY RESURGENCE, WE TELL THEM NOTHING STRENUOUS AND NO HEAVY LIFTING FOR A WEEK AFTER SURGERY.

MOST PEOPLE CAN STILL DO NORMAL ACTIVITIES.

THEY ARE ON EYEDROPS FOR THE MOST PART, ESPECIALLY THE FIRST WEEK AFTER SURGERY ARE MOST FREQUENTLY THE FIRST WEEK AFTER SURGERY, TAPERING THE FOLLOWING WEEKS.

THERE ARE NOT A LOT OF RESTRICTIONS.

MOST PEOPLE ARE SEEING WELL AND FUNCTIONING WELL THE NEXT DAY.

DR. NALIN: WHAT IS THE DISTINCTION BETWEEN DRY MACULAR DEGENERATION AND WET MACULAR DEGENERATION?

>> A GOOD QUESTION THAT WE GET EVERY DAY IN THE CLINIC.

DRY MACULAR DEGENERATION IS ABOUT 90% OF THE PEOPLE AND ABOUT 10% OF THE PROBLEMS, WET MACULAR DEGENERATION IS ABOUT 10% OF THE PEOPLE AND 90% OF THE PROBLEMS.

YOU GET AN ATROPHY OR THINNING OUT OF THE RETINAL CELLS THAT SINCE LIGHT IN THE UNDERLYING LAYER THAT PROVIDES NUTRITION FOR IT.

IT’S A SLOW, GRADUAL PROGRESSION FOR DRY.

WITH WET, WE GET ABNORMAL BLOOD VESSEL GROWTH AND THE LEAKING OF BLOOD VESSELS THROUGH THE LAYER BELOW THE RETINA, WHICH CAN CAUSE LEAKING AND SCARRING IN THE RETINA.

THAT CAN LEAD TO MORE ABRUPT AND SIGNIFICANT VISION LOSS WHEN THAT HAPPENS.

DR. NALIN: THIS QUESTION IS ABOUT LIGHT THERAPY AND THE CALLER WANTS TO KNOW WHAT IS THE EFFECTIVENESS OF USING RED LIGHT THERAPY FOR DRY AMD?

>> I AM NOT SURE ABOUT THE EFFECTIVENESS OF THAT.

BUT WE DO HAVE TREATMENTS THAT ARE PROVEN.

FOR THESE PATIENTS, YOU CAN DO INJECTIONS.

THEY ARE HIGHLY EFFECTIVE TO TREAT THE WET MACULAR DEGENERATION.

DR. NALIN: WHAT MIGHT HAPPEN IF CATARACTS -- CATARACT SURGERY FAILS AND WHAT ARE THE PATIENT’S OPTIONS?

>> IT’S QUITE RARE FOR CADILLAC SURGERY TO FAIL.

THERE CAN BE PERHAPS COMPLICATIONS THAT MIGHT PREVENT US FROM FULLY COMPLETING THE CATARACT SURGERY.

PERHAPS IF SOMETHING GOES WRONG WE MIGHT NOT IMPLANT THE LENS.

WE MIGHT HOLD OFF AND DO IT LATER.

OTHERWISE CATARACT SURGERY IS REALLY SUCCESSFUL.

EVEN WHEN THERE ARE COMPLICATIONS, WE TEND TO BE ABLE TO REHABILITATE THE EYE LATER.

DR. NALIN: A 65-YEAR-OLD CALLER SAYS HER EYES ARE WATERING ALL THE TIME.

ISN’T THIS THE OPPOSITE OF DRY EYES?

WHAT MIGHT BE GOING ON?

>> PARADOXICALLY, YES.

WE HAVE A REFLEX LOOP THAT IS DESIGNED TO PROTECT OUR EYES.

IF OUR EYES GET REALLY DRIED OUT, IT WILL INFLEXIBLY TEAR TO FLOOD THE EYE AND PROTECT IT.

WHEN WE GET REALLY DRIED OUT, WE REFLEXIVELY TEAR, BUT THEY ARE NOT THE NORMAL TEAR SECRETION.

IT IS MEANT TO FLOOD THE EYE, CLEAR OUT WHATEVER MIGHT BE IN THEIR IRRITATING IT.

THERE ARE OTHER MECHANISMS FOR TEARING AS WELL.

IF YOUR EYE LIGHT -- EYELID IS NOT APPROXIMATED TO YOUR EYE CORRECTLY, IT MIGHT NOT DRAIN EFFECTIVELY SO OCCASIONALLY WE HAVE TO DO EYELID SURGERY TO TIGHTEN THE EYELID AND GET IT BACK TO OPERATING THE WAY IT SHOULD BE.

YOU CAN ALSO HAVE BLOCKAGES IN THE DRAINING SYSTEM, OUR FACE IS ONE GIANT TUBE SYSTEM AND IF THERE IS A BLOCKAGE IN THE DRAINING SYSTEM WE MIGHT HAVE TO OPEN THAT UP TO ALLEVIATE SOME PROBLEMS AS WELL.

WHEN WE EVALUATE PATIENTS IT IS FINDING OUT WHICH OF THOSE MECHANISMS IS AT PLAY IN PROVIDING TREATMENT.

DR. NALIN: A CALLER FROM DULUTH ASKS, AFTER BEING TOLD BY THEIR DOCTOR THAT THEY HAVE CATARACTS BUT WE DON’T NEED TO FIX IT RIGHT AWAY, WHAT MIGHT BE GOING ON?

>> I USUALLY EXPLAIN THAT FOR THE CATARACTS, THEY ARE A BIRTHDAY GIFT.

WE WILL ALL GET THEM IF WE GET OLDER.

JUST LIKE FOR THE WRINKLES, JUST BECAUSE IT IS THERE DOESN’T MEAN IT NEEDS TO BE REMOVED.

FOR THE CATARACTS, IT’S PART OF THE NATIONAL -- NATURAL PROCESS OF AGING.

SURGERY HAS RISK SO WE ONLY WANT TO REMOVE THE CATARACTS IF THEY START TO CAUSE SYMPTOMS, WHICH INCLUDES SOME GLARE WHEN PATIENTS DRIVE AT NIGHT, BLURRY VISION, TROUBLE TO READ.

IF SHE STARTS HAVING THOSE PROBLEMS, AT THAT TIME IT IS WORTH THE RISK OF SURGERY.

DR. NALIN: AN INTERESTING QUESTION, WHAT IS A LIGHT ADJUSTABLE LENS?

>> THAT’S ONE OF THOSE NEWER ELECTIVE LENS IMPLANTS.

IT’S VERY INTERESTING.

THE BENEFIT IS WE CAN IMPLANT IT LIKE ANY OTHER LINENS DURING CATARACT SURGERY BUT WE HAVE AN OPPORTUNITY TO FIND TUNE THE POWER OF THE LENS AFTER SURGERY.

ONCE THE EYE HAS HEALED AND YOUR PRESCRIPTION HAS STABILIZED, WE CAN DO LIGHT TREATMENTS, WHICH IS WHY IT IS CALLED THE LIGHT ADJUSTABLE LENS, TO CHANGE THE SHAPE OF THE LENS IMPLANT WITHIN THE EYE, AND CHANGE THE PRESCRIPTION THE PATIENT HAS TO MINIMIZE THEIR GLASSES PRESCRIPTION.

IT IS AN ELECTIVE LENS IMPLANT THAT I THINK WE CAN GET AS CLOSE TO ZERO PRESCRIPTION AS HUMANLY POSSIBLE AFTER CATARACT SURGERY.

DR. NALIN: A COLOR HAS A FOLLOW-UP QUESTION.

IS THERE ANY TREATMENT FOR FLOATERS?

>> THERE IS BUT WHAT I TELL PATIENTS IS THE VAST MAJORITY OF FLOATERS, PATIENTS WILL GET USED TO.

ALL OF OUR PROCEDURES HAVE A LITTLE RISK, NOT A HIGH RISK BUT IT IS NOT ZERO.

THE TWO PROCEDURES I DISCUSSED -- I DISCUSSED WITH PATIENTS TO GET RID OF FLOATERS, ONE IS A LASER, A DIFFERENT LASER TO THE GLAUCOMA STUFF.

WE BASICALLY WILL TRY TO BREAK UP THE FLOATERS, POTENTIALLY VAPORIZING SOME OF THE STRUCTURES AND RELIEVING SOME OF THE SYMPTOMS.

IF THAT DOESN’T WORK OR PATIENTS ARE STILL SYMPTOMATIC, YOU CAN DO A SURGERY WHERE WE REMOVE THE VITREOUS CAUSING THE FLOATERS.

AGAIN, I WOULD USUALLY CANCEL PATIENTS THAT IF YOU JUST STARTED GETTING FLOATERS, WAIT AT LEAST SIX MONTHS AND SEE HOW YOU DO.

THE LARGE MAJORITY, PATIENTS GET USED TO THEM.

DR. NALIN: I THINK THIS COLOR IS ASKING A QUESTION ABOUT THE PHYSICAL EXAM, AND THEY WERE TOLD THE PUFF OF AIR IS RELATED TO A HIGH-PRESSURE.

WHAT IS GOING ON?

>> THERE ARE DIFFERENT WAYS TO CHECK EYE PRESSURE.

SOMETIMES FOR THE CLINICS, THEY CAN USE FOR THE PUFF OF AIR.

MOST PLACES DO NOT USE THAT NOWADAYS.

THEY CAN USE SOMETHING ELSE TO CHECK THE EYE PRESSURE.

IT’S JUST A WAY TO CHECK THE EYE PRESSURE.

IT’S A GOOD WAY TO SCREEN AND IT DOESN’T INVOLVE THE USE OF EYEDROPS, WHICH IS NICE FOR THE PATIENTS WHO ARE GOING TO GET SOME EYE EXAMS FOR EYEGLASSES.

DR. NALIN: A CALLER WAS RECENTLY DIAGNOSED WITH DIABETES.

HOW DOES DIABETES AFFECT ONE’S EYES AND HOW?

>> DIABETES CAN AFFECT THE EYES IN A LOT OF WAYS.

THE THING WE FEAR THE MOST IS THE EFFECTS IT CAN HAVE ON THE CIRCULATION IN THE EYES.

IT CAN WEAKEN BLOOD VESSELS, CAUSE THEM TO BE LEAKING, AND I’M TALKING MAINLY ABOUT THE RETINAL VESSELS IN THE BACK OF THE EYE.

IT CAN INFLUENCE THE VISION.

EVEN HIGH OR LOW SUGAR CAN AFFECT YOUR VISION.

IT CAN CHANGE YOUR GLASSES PRESCRIPTION.

DIABETICS SHOULD BE AWARE THAT IF THERE SUGAR IS HIGH OR LOW, IF THEIR VISION IS CHANGING THEY SHOULD CHECK THE SUGAR, AND THEY SHOULD HAVE A GOOD EYE EXAM EVERY YEAR, DILATED EYE EXAM TO LOOK FOR CHANGES IN THE RETINA.

DR. NALIN: THIS CALLER WANTS TO KNOW ABOUT BLUE LIGHT GLASSES AND DO THEY WORK?

>> THAT’S A REALLY POPULAR QUESTION.

THERE IS SOME EVIDENCE AND DEPENDING ON WHO YOU TALK TO AND WHAT STUDIES YOU LOOK AT, THAT BLUE LIGHT, ESPECIALLY WITH OUR DEVICES WE HAVE RIGHT NOW, MAY AFFECT THE RETINA, SPECIFICALLY THE RETINA CELLS, COULD BE INCREASING THE RISK OF MACULAR DEGENERATION.

I THINK THE 100% DECISION ON THAT IS STILL OUT.

I HAVE TALKED TO SOME RETINA SPECIALISTS WHO USE BLUE LIGHT GLASSES AND I TALK TO OTHERS WHO SAY THEY DON’T BELIEVE IN IT.

I DON’T THINK WE WILL KNOW UNTIL FARTHER DOWN THE ROAD WHEN ALL OF US USING THE DEVICES FOR A LONG TIME WILL KNOW.

I DON’T THINK IT HURTS USING THE BLUE LIGHT GLASSES.

YOU PROBABLY HAVE A LITTLE REDUCTION IN COLOR QUALITY AND CLARITY BUT IT WILL NOT HURT YOU TO USE THOSE GLASSES.

DR. NALIN: IS THERE ANY TRUTH TO THE SPECULATION THAT GLASSES MAKE VISION WORSE?

>> FOR KIDS, IF THEY HAVE THE WRONG POWER FOR THEIR EYEGLASSES, IT CAN MAKE THEIR VISION WORSE BECAUSE THE BRAIN IS STILL BEING FORMED.

FOR OLDER PEOPLE, OUR BRAIN IS FOR THE MOST PART FORMED AND SO IT DOESN’T REALLY MAKE A DIFFERENCE.

DR. NALIN: OK, THANK YOU.

ARE THERE THINGS PEOPLE CAN DO TO PROTECT THEIR VISION ON A DAILY BASIS?

>> SURE.

A GOOD, HEALTHY LIFESTYLE.

GOOD NUTRITION, A HEART HEALTHY DIET HIGH IN ANTIOXIDANTS AND A VARIETY OF FRUITS AND VEGETABLES THAT HAVE THE NUTRIENTS YOUR WHOLE BODY REALLY NEEDS IS A GOOD PLAN.

REGULAR EXERCISE AS WAS SAID, IS GOOD FOR YOUR HEART, YOUR CIRCULATION, WHICH IN TURN IS GOOD FOR YOUR EYES.

I THINK THAT’S THE BASICS.

DR. NALIN: THANK YOU VERY MUCH.

I WANT TO THANK OUR PANELISTS -- DOCTOR CHARLIE AHRENS, DOCTOR ELISABETH APONTE, AND DOCTOR LISA GRAHAM, AND OUR MEDICAL STUDENT VOLUNTEERS NATHAN JOHNSON, ETHAN LORSUNG, AND DANIELLE SANTOS.

NEXT WEEK PLEASE JOIN DOCTOR MARY OWEN FOR A PROGRAM ON CANCER PREVENTION, DIAGNOSIS AND TREATMENT, WHEN HER PANELISTS WILL BE DR. MATTHEW BRAITHWAITE, DR. ROBERTO FERNANDEZ AND DR. JONATHAN SANDE.

THANK YOU FOR WATCHING, GOOD NIGHT.

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