Dry Eye with Paul Jenson

*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

And Welcome back to the program everyone on this fifth Saturday of July, where we have a very special guest here, Dr Paul Jensen, who is with the northwest dry eye center in Bellevue, Washington. Dr Paul, welcome to our program. Thank you for having me here and I you know, that’s right. I said the word dry eye and I bet there’s a lot of us that have no clue about what that is. As am I right, dry eye is a really funny condition because if you don’t have it, it just seems like kind of a minimum little issue now really doesn’t really doesn’t count for much. Maybe people expect you put a drop in every now and then in your eyes and you feel a little better and you move on. But Dry I can be anything from that to a debilitating, painful, vision robbing condition that is very, very difficult to handle well, and I can imagine. I know way back when when I used to wear contact lenses, I got, you know, my eyes started really hurting. I think that’s one of the reasons why I stopped wearing them. It was just it was uncomfortable. After a while I couldn’t I could only wear them for short distances of time and I’m sure that that’s part of it, isn’t it? Or sure can be. Yeah, I mean anything, anything from the outside world, a contact lens or pollution or dry conditions are random. Almost anything can kind of lead to lead you down that mode. There are a lot of other conditions that are also part of that too. But sure, and I’m sure just this is totally naivety here, but if you live in the city and you have a lot of round a lot of exhaustion or different things like that, does that affect your eyes or not? Oh, it’s sure can. I mean of all the maybe environmental conditions, you might think hot conditions and dry conditions are really the top, the top issues that we have to deal with. In Seattle. It’s not as bad as it would be in Phoenix or Denver, but it definitely environment is definitely an issue. Why? But eastern Washington would be more so? Sure. Yeah, sure, because they have a drier climate over there. Yeah, and harsher climate. So that may effect to does hydration make a difference? Is that one of the things that you find or not? We occasionally do. There are some people who are just generally dehydrated and we can prescribe water for them? Yeah, realy the easiest, least expensive prescription they’ll ever get. That we don’t see that all that often, but it does happen, absolutely sure. So if somebody has dry eye, I mean how do they find you and how do they know that they have dry I are they are you usually have patients that are referred to you by other doctors? Or How do you guess? How does this, the whole process start? Northwester eye center is a referral practice. A lot of people find me and they’ll find me on my website or read an article that I had written, or they all sorts of ways that they might find a bit but generally it’s a referral practice from optometrous ophthamologist from the region who’ll send patients and who are having difficulties. And then and then when somebody comes to see you, what what do you do in an exam to determine that? Well, it really varies based on what we’re talking about. What the patient complains of. Dry Eye can be just a huge variety of conditions. It can be, as we said before, maybe some environmental issues. It could be people who work on computers a lot and you know, I never thought of that. Oh boy, when a lot of younger people we see who are, you know, twelve, fourteen, sixteen hours on a computer every day, they just don’t blink all that much and really can be a problem. So there’s an exposure issue for them. Other people we look at maybe medication they could be taking or just tissue changes as they get older. Maybe they are producing enough tears or maybe the tear quality isn’t as good as it should be, and those are definitely aging issues for sure. What are some symptoms? Are Indicators that cause people to think about, well, maybe I have dry eye. Well, there are a few things. One is the obvious, if they actually feel dry. A lot of people will wake up in the morning and they’re just dry for the first few minutes of the day and you have to look at maybe exposure overnight for something like that. A lot of people get dry our during the day. Other people maybe they’ve, like I said before, maybe they’ve change medications that become dry. So a lot of times it’s an I try to throw out as many adjectives as I can when I’m asking people if they’re dry it she bernie, scratchy, read, just any of those kind of issues. The other thing we see quite frequently actually is blurred vision. It’s very, very common for people in the evening, maybe after dinner, maybe the watching TV something like that, for the vision to begin to blur out. That’s also a very cold, well symptom of dry eye and they may not even feel dry but the vision just kind of goes on them. We see that all the time and and really it may be so subtle that people may not realize it. So if somebody went in, like you said, you were referral practice, would a typical automatrist or ophthimologists be able to determine that somebody has dry eye by looking at the rise? Most of the time they do determine. The doctors determine that they have dry eye. But getting to the root cause is the problem. God, it’s easy to try some drops and to try this or to try that. There’s all sorts of, you know, home remedies and prescriptions and all sorts of things that people can try and that doctors recommend to me. Really, what we do that is different is we try to get to that root cause, or in my case, probably root causes. The patients I see tend to be more advanced cases and there may be several different things kind of adding up to cause a problem for them. So for me I kind of try to separate out the different conditions that might be in in a given eye or a given person’s life and then we go from there. So the trick is a diagnosis to really down to exactly why the eyes are doing what they’re doing. Wow, and we are talking to Dr Paul Jensen of the northwest dry eye center and Bellevue, Washington. And Paul, before we continue forward, tell me a little bit about how where you’re located in Belleview and you know how. I know you’re primarily a referral practice, but can people actually call you directly? They could call direct absolutely, but it is, like you said, refel like this weird north about a half mile north of over Lake Medical Center in one and sixteen along there in Bellevue. HMM, okay, that’s great. And do you have a website? We do. It is in w dry eye CENTERCOM. That’s wonderful. So if if I have dry eye, maybe I feel like I might have a little bit of something and you know, going on. What are some things that maybe I could do to first of all, see if I could help myself there. They’re like special types of drops. Are Do over the counter drops really work? Well, they sure can. What I tell people is if they need up to two over the counter drops per day and that seems to keep them happy, they’re they’re comfortable their visions, Claire, then I don’t consider that something that we really need to ramp up and do a full diagnostic workup on. If they’re doing those drops and they’re just not getting there, either they’re continuing to get worse than not getting better, or there are other issues that come up. Their eyes stay read, then this when we would really slip it into a workup and really try to get to that root cause. And if you’re if you’re having some system symptoms like you were saying it she. What are the symptoms like it? She’s scratchy. I would imagine your eyes would be more scratchy. Yeah, I mean almost anything that you can imagine. I have patients who tell me, well, my my eyes are very sandy but not gravelly feeling, and so I’ve kind of come to the point where I feel like I just want to let them explain to me what they feel, because I can throw it all sorts of different words. People are very specific about how they feel and and I want to let make sure they get that out and tell me their story. Yeah, and I hope that they’re telling their general optometrist drop demologist these things, because that helps them, I’m sure. But can optimologists or optometrist actually see that an eye is dry when you’re doing in that’s exam? Oh yeah, yeah, okay, so the microscopes from for and rebel a sorts and eyes yellow and green blue dyes, and that’s what causes it. Yeah, they play the die on the eye right. Certain tissues will respond to those eyes and so with the microscopes we can really see what the tissues are doing. Got It. So it’s really amazing, you know, and and somebody like you, I’ve never heard of a practice like yours. So you’re really specific, which is amazing. Well, my northwest dry center is the first standalone dry eye center in the United States. That is a thing. There are a few that have sprung up in vary cities around now, but but we’ve been there for four and a half years now and it was a new concept back four years ago. So tell me about dry eyes and seniors. Obviously the we’re a program that focuses on seniors. Tell me a little bit about that. Well, with seniors we definitely see issues with the ILID. In fact, a lot of times I tell my patients that I spend more time on the eyelid than I do the eye. Laxity of lids or lids that may kind of Sag just a little bit right don’t really wipe very well. So blinking really doesn’t help those patients because their lids aren’t doing the job. God, we see that all the time. The number one cause of dry eye with anybody, seniors or anybody else, is oil gland production. That drops down on the oil glands on the LIDS can get clogged up. Oil is a vital portion of the tear film. It flows over the top to prevent evaporation of the tears and without that of the glands are working properly, the tears just evaporate immediately. So they stay dry and the blinking doesn’t help and things really cure downhill. So obviously with that piece and if a senior is dealing with maybe another condition on top of it, that could be, you know, dry eye could almost be a sub condition from that. Well, sure and we work with other coorial specialists and and I live specialists and all sorts of people to make sure it’s kind of a team approach when we have to do it that way. It’s very, very common. The you know, that is interesting because because you know, when you think about, for example, cataracts, obviously you know. Just makes me wonder, are they both related? I’m not sure that it was. Would be one thing or the one relationship is that people who take anti inflammatory drops tend to have dry eyes and that can lead to cataract. Other than that, we kind of look at them, but remember the cataract. Totally different there. They tend to be different because cateracts inside it. Can Medications affected? Oh absolutely, yeah. There are a variety of blood pressure medications that are dehydrating. Beta blockers very common. Blood pressure and heart rhythm me a medication can cause dry eyes. There’s also some of the antidepressents can cost dry eyes. It’s good to know. Yeah, I’m one of those. Are the case. Usually we can figure that out pretty quickly and get right to it. So, Paul, how do we reach you? Well, probably the easiest way to reach me would be through the website the NW dry eyescom. Phone call is fine too, but the website is by far the uses. And on the website my email is listed there and I love getting emails from patients, even if they live thousands of miles away. They don’t have any plans to come to me, but they have questions and I have relationships with people all over the world just by email and I’m happy to Champe and it’s just a real nice way to get home. And what is your website again? It’s N W dry eyecom. You know, this is so important information and I’m so glad you were here on the program today. Thank you for having me