When will things get back to normal?

The title of this post is a great question. As an optometrist I did not think I would ever work from home but here I am listening to webinars, doing blog posts, and research from home. Ultimately we need to get back to seeing patients and delivering top quality eyecare.

The answer to the question in the title is never. Our reality has been fundamentally changed and this was from a virus which although deadly, has a relatively low mortality rate. Imagine a virus such as H5N1 (avian flu) that has a mortality rate of 60%. Remember that one, it is still out there.....

We can't live our lives in fear, we can only control what we can control. Hopefully we learn from this and we are better prepared down the road if something more dangerous or something similar comes along.

To relate this back to eyecare and our office, I don't think you will ever see a kids play area or magazine rack again. Honestly, I would hope you do not see those in any office waiting room. We have removed ours, and guests can use the complimentary Wifi while waiting. We will also have shields installed in key areas of the office to help protect staff and patients once we are back to work. The number of people in the office at one time will be limited and we will look to use technology even more than we do now to minimize trips or touch points in the office.

Optometry will be one of the first back to work in my opinion. It is important for people to see and we are offices that do not have sick people coming to visit. We generally see healthy people and other than talking, we have people keep their mouths closed. There is always risk, so we will do the best we can to minimize it. I mentioned all this in my last post.

Since my last post this video came out on the Today show talking about the very point I was making.

Today Show - who goes back to work?

Stay well, and look forward to seeing you soon!

Dr. Jason

COVID-19 and the eye

Well, it seems like eons ago when I did this previous blog post. In re-reading that who would have thought we would end up where we are now.

A couple quick things to comment on. In a recent study it was shown that the virus is not transmitted in tears. This study was only 17 people but was very well done. None of the 17 had traces of the virus in their tears. Now to be clear you can still inoculate yourself through the mucus membranes of the eye but new tears do not seem to shed virus as far as we know currently.

The second thing to comment on is signs of conjuctivitis or "pink eye" associated with the virus remain very low, at about 1%.

In the office we have installed breath shields on our microscopes and changed how we interact with patients to minimize chance of contamination. We are fortunate that our office is not a place where sick people go and we do not have the aerosol issues that our dental colleagues have to deal with. There is always risk, and we will do the best we can to minimize and control those risks once we get back in the flow of taking care of our patients.


Dr. Jason

Lets Quit Changing the Clocks!

Well, its Sunday morning and we lost an hour. I am sure more people missed church today than almost any other Sunday or a few people showed up at the wrong time (guilty of both of these myself in the past).

There is no debate that we are hard wired to wake up with the sun and go to bed at night. Every cell in our body has a circadian clock. Morning sunlight in your eyes shortly after waking up is a great way to set your clock and tell your body it is time to get moving. It also helps with sleep in the evening as your clock has now "been set".

Despite all the hype around blue blocking glasses in the last couple years morning sunlight is going to have a high level of blue light which is beneficial to your sleep/wake cycle. That is why blue light in the evening can disrupt things.

What can we expect this week by messing around with the clocks:

1. Car accidents will increase on the Monday following the spring forward.

2. There will be more workplace injuries tomorrow and of higher severity than normal.

3. The risk of having a heart attack goes up in the 3 days following the spring clock change. It goes down in the fall when we move the clocks back.....

There are more, but you get the idea. The correct way to do this is split the difference on the half hour between standard time and DST and never change the clocks again. Everyone wins!

A few tips to help avoid the above problems are get some morning sunlight and go for a walk or get some early morning outdoor activity followed by a light breakfast. Those 3 things will send a powerful signal to your body to help set your clock.

Go to bed a little earlier this week. Ideally that would have been a good idea for the week leading up to this but since I am writing this on Sunday that advice is a little late.

Have a great week and enjoy the later sunset. Also as a side note, please do not say the days are longer. The days are still 24 hours and the amount of daylight is exactly the same as before we changed the clocks. All we are doing is moving it from before work to after work.

Dr. Jason

Are generic medications safe?

I just finished reading the book "Bottle of Lies" by Katherine Eban. It is an inside look at the generic drug industry. To answer the question I put in the title of this blog post - maybe or maybe not.....

I won't give the complete rundown of the book but would encourage you to read it if you are at all concerned about the medications you or your family take. One of the things that jumped out at me was that U.S. drug manufacturing plants can be inspected any time any place with a surprise inspection from the FDA. Foreign plants in India and China, which is where many generics come from, get six weeks notice before an inspection. SIX WEEKS!!!!!! I can't help but thinking of how my house looks if I know I have company coming over vs someone just pops in unannounced.

I have seen this first hand in our office. Latanoprost is a medication to lower pressure in the eye. There are currently at least 19 different manufacturers of this medication. I have many patients taking the generic form and most do well. I have seem some not do well where their eye pressure is right back to where it was before we started, almost like they were not taking the drug at all. I put them back on a branded product and boom - good to go.

A few things that you can do to protect yourself since the FDA has very little power or controls over these foreign plants are:

1. Take a branded U.S. manufactured drug if you can afford it.
2. If you do take a generic try and get one made in the U.S., Israel, or the EU.
3. If you are on an Indian or Chinese generic it may be fine, but if things are not going well don't assume the medication is ok. Your doctor or pharmacist have no way to check that the drug that was prescribed is manufactured correctly and the FDA certainly does not inspect all the medicine that comes in. 

None of these things guarantee that you would never have a problem with your medication but I think it would improve your odds. Better yet would be making lifestyle changes to get off of medications, if you can.

That is all for this week - I encourage anyone interested to read the book and feel free to post any comments.

Dr. Jason

Coronavirus, Influenza B, and the eye

Happy Friday once again. I have had kids home with snow days the last 2 Friday's so it seems especially quiet this morning. I am reading headlines about the 2020 novel coronavirus outbreak so it seemed fitting to discuss this a bit along with how it relates to your eyes. This also applies to the influenza B outbreak going through Knoxville schools right now as well.

We have all had a coronavirus infection at some point. It is a common virus and your symptoms would be like any mild viral infection and presented as a mild to moderate cold. The difference with this one is that it is new or "novel" and our immune systems are poorly equipped to fight it. This is similar to SARS, MERS, or even the Spanish flu where common viruses change and become much more potent.

Two years ago I did some traveling in Japan and in Asian countries post SARS it is common to see surgical masks on people just walking around in public. Culturally this is done more as a courtesy if someone is sick so they don't spread their germs rather than a way to prevent getting infected from someone else. Most of these surgical masks do not work well and will not stop a virus from getting through the mask. In order to prevent infection with a mask you need a N95 rated respirator and also training on the proper way to wear it.

Where the eyes come in play is the moist mucus membranes of the eye.  It is interesting to me to see all these people wearing respirators and masks but yet no protection for the eyes. The mucus membrane of the eye can easily be a transmission point for a virus such as the novel coronavirus, or our local influenza B. So to wear a mask but leave the eyes unprotected makes no sense. One of the best ways of preventing colds, flu, etc is to not touch your eyes, nose, or mouth during cold and flu season. Humans like to touch their own faces and rub their eyes so this can be hard to do. Remember to wash your hands frequently and don't touch your face, especially your eyes, nose, or mouth.

Have a great weekend and lets all try and stay healthy.



Dr. Jason

How in the heck do I avoid getting Alzheimer's?

Greetings all. Its another snowy day and schools are closed so hopefully if you are home with your kids they are outside playing in the snow.

To follow up on the last couple blog post on diet and detecting Alzheimer's disease through retinal scanning I have had a few questions on what do you do to prevent it? It is a great question and unfortunately we are far from having all the answers. However, there are things we can do to lessen the risk.  I look at these things like investing money. If you do a little early it can pay big dividends later in life when it counts. If you have a family history of dementia, like I do, you become interested in not going down that path if you can make choices to avoid it.

1. Get enough sleep. I can't take credit for the quote and it escapes me whose it is. I saw it in Dr. Matthew Walkers book on sleep which I highly recommend. "The amount of people that can get by on less than 7 hours of sleep rounded to the nearest percent and expressed as a whole number is zero." We all need 7-9 hours of sleep a night. A couple famous short sleepers are Ronald Reagan and Margaret Thatcher who both ended up with dementia later in life. That certainly is not proof, but being able to get by on less sleep in nothing to brag to about.

2. Keep your blood glucose and insulin levels in check. This goes back to the good diet advice from a few weeks ago. Elevated insulin levels increase the risk of dementia. https://www.ncbi.nlm.nih.gov/pubmed/28255864

We have long known about diabetes and the increased risks for dementia as well. I remember as a 4th year optometry student hearing about Type 3 diabetes which some were using as a term to describe dementia because of the strong association.

As a side note you can have normal blood glucose and elevated insulin levels. This is a precursor to type 2 diabetes. If you are at risk ask your doctor to check not only your blood glucose but your fasting insulin as well.

3. Stay active. This does not mean doing a cross word puzzle once in awhile. This means staying physically and mental engaged. Stay socially active with your friends and family. Join a service club and get involved. Take a class for adults and learn new skills.

Ultimately we don't have all the answers for prevention and treatment. I think at this point we would be better focusing on prevention of these disease vs trying to cure it once it has happened. That's all for this week.

Dr. Jason

Alzheimer's disease and eye exams

Happy Friday everyone! It is currently cold and freezing rain, so a far cry from the 60 degree temps we enjoyed on Thursday. Such is life in the mid-west.

I have been aware of this for the last couple of years but an article hit USA Today on January 6th so I thought it would be good to discuss it briefly. First, just a little basic anatomy.  The retina is a direct extension of your brain. It is not an exaggeration to say we are looking at your brain when we look into your eye at the back of the eye where the retina is. It is obviously much easier and less expensive to look into the eye than look at your brain via an MRI or PET scan which can cost thousands of dollars.

Research is being done with a retinal scanning device called an OCT that would be able to pick up early changes in the retina consistent with the plaques that form in the brain with Alzheimer's disease. Imagine being able to run a simple, inexpensive (a couple hundred dollars) scan and determine if there is disease.

My personal opinion on this is that we will see this technology available in the years to come. We have a state of the art OCT at the office already and I would imagine it would be a software upgrade to the unit to run these scans. Time will tell of course, but I continue to be amazed at what we are able to see by looking into our patients eyes.


Dr. Jason

Diet and Age Related Macular Degeneration

Happy New Year! It is the start of a new year and people are making their resolutions and reflecting on the past year. One of the common resolutions I hear is to be healthier by exercising more and eating better. The British Journal of Ophthalmology published a study on dietary choices and the development of eye disease. The study was published in December 2019.  The eye disease studied was age related macular degeneration, AMD for short. In my world we have known that diet is a risk factor for years, and talk to patients daily about it. The study showed that the standard american diet, SAD for short, was linked to increase risk in development of AMD.

I think we all understand that better lifestyle choices can help prevent cardiovascular disease and protect your heart. This study shows that we should also be eating well to protect our vision as we age and prevent blindness.

Dr. Jason

LeLa

Everyone... meet Lela

Lela began working with us in August 2019.  She is part of our front desk team.  She will be there to greet you with a smile while you   check in or out.  

Lela has provided us with a little bit of info to help us get to know her on her 

:Employee Spotlight Blog:

Enjoy the info, followed by some random 'This or That' questions

About me:

Although we moved around a lot before I was in first grade, I have called Knoxville my home for over 44 years.  I attended North Star Elementary in 1st grade, East in 3rd and the rest of my education was at Knoxville Regular Baptist School.  

I enjoy baking (which is apparent), reading and watching movies.  My favorite time is Countdown to Christmas on the Hallmark channel. 

My husband and I have been married for 23 years (although, we both jokingly say that it feels like it has been 75-100).  Both of our immediate families live in the area or close by which is very helpful for holidays and get together's.  I love our annual Girls' Day that I spend with my sisters, sister-in-law, mother and nieces.  There just seems to never be enough time in that day for us to do or talk about everything that we want. 

I began working here at the end of August and am in the area of Patient Care, so I will either see you when you check in or as you check out.  Bear with me as I try to put names with faces.  I look forward to assisting you when you come in or if you happen to call the office.  

                                                    *THIS OR THAT*

                                    sweet or salty : I have a terrible sweet tooth!

                              horror or comedy: Comedy

                              beach or mountains: Mountains (not much for                                                                                              warmth)

                              ninja or pirate: Pirate

                              spring or fall: Fall

                              tacos or burger: Burger

                              cat or dog: Dogs (puppies, especially)

                              truth or dare: Truth

                              vintage or modern: Vintage

Eye Drops

Dr. Jason giving a few tips and tricks of how to properly insert eye drops.

7/18 ECO

Deanna giving us a little bit of info on our new frame line .ECO. 

🌳🌳🌳🌳🌳🌳🌳

5.25.18

Dr. Jason discussing cornea ulcers.  Have a happy, safe, long weekend all!

2.16.2018

Dr. Jason with his video blog--> contact lens online clubs.  Please contact our office if you have any questions!