The Dry Eye Show I'm Dr. Travis Zigler and Dr. Jenna Zigler and here serving you on July 1st!
Happy July 4th everyone if you're in America celebrating Independence Day! So, we're excited to celebrate that we were at the lake all weekend which is why my face is fried. I got trapped on a boat for four hours yesterday without sunscreen. I put it on before I went on the boat but four hours out on the boat proved too much. The good news is I used the hypochlorous acid spray, Heyedrate Lid and Lash Cleanser, both last night and this morning and I feel pretty good. So, it took away the burn and I feel pretty good and no burnage left. Yes you can use it for a lot more than just your eyelids and so it worked pretty well.
So, we have a sale going on until the end of the night. It's 2020BLUE is the discount code and it's an Amazon code on Amazon only for 20% off of our blue blockers which just came back in stock. Here’s our blue blockers, there's blue ones fancy fancy, but everybody needs a pair of these. There’s the link click over to Amazon and check them out!
How belief in yourself can enhance your dry eye treatment.
So, really this goes along with the placebo effect actually and I'm sure that a lot of you will know what the placebo effect is but basically it's a phenomenon where somebody can receive a sham treatment or a sugar pill basically and as long as they have the belief that they're getting the actual medication they will actually end up getting better from that treatment.
So, it's basically getting better from a sugar pill or a sham treatment and the reason that that happens is it actually causes a neurobiological change within your body where dopamine is released and that's how it works. It's pretty amazing that belief can shape the way that your treatment works.
Past studies have suggested a really strong power to this placebo effect and you know a lot of us are unaware that it can happen but your beliefs can actually make you feel better. So, if you believe that your treatment is going to work then you're much more likely to be successful with that treatment then if you don't believe it's going to work if you go into it and you say “this is just going to be another treatment, it's not going to work,it's going to be another waste of my money” it's definitely not going to work for you because that's a bad attitude to start with. But if you go into a treatment with a good attitude you're much more likely to have a good outcome from it.
That goes along with the faith and everything too. So, have faith in medicine but also if you are Christian or Islamic or Hindu usually people that tend to have more faith also tend to heal faster because of this it could be because of this placebo effect they can also be due to your faith. If that's what you believe in as well and so it's all connected in this belief and this mindset that we always talk about. We always talk about doing meditation and just believing in something other than just what's around you can actually cause you to have a more enhanced life because you have faith in something other than just the physical goods that are in front of you.
And so, you know one of the greatest tools that we have is truthfully the belief in ourselves so without this none of the results that you want to achieve or going to occur. If you want to live a healthier life and finally find relief for your dry eyes, it might sound really crazy, but it can be the missing link in your search for health.
We see a lot of patients that say they try a treatment and they stop it because they say this just isn't working for me you know it's not doing anything and they don't continue to push forward. Those are the people that they just don't have belief in them themselves but you know if you can push forward through that continue on your treatment plan don't just jump around to different treatments all the time but really believe that you can get through it. I really believe that you can and live that little healthy lifestyle and some common misconceptions that we hear all the time with our patients is that “oh I'm big-boned I can never lose weight” and that is the biggest false misbelieve in the world. My mother is overweight so I was doomed to be overweight. My mother had diabetes so I'm doomed to have diabetes. it's not true, it's lifestyle choices and some things. Yes, they are genetic but most things like diabetes, high blood, pressure and high cholesterol are a result of your actions and your eating habits and your lack of exercise. So, believing in yourself number one and believing that you can make the changes to help your lifestyle with dry eye and to help out with diabetes and high blood pressure is just key.
So, we wanted to address this because there was just so much negativity going through the community and if you notice that we do delete some posts we do that because we don't want negativity in the community. We don't like negativity around our dry eye show because we want this whole thing to be a positive environment and will actually kick people out of our community if they're negative all the time. The reason we do that is just because we want to create a positive area that you guys can converse and talk about things and not a place to commiserate because commit misery loves company and the more people that are miserable the less likely you are to get treatment and to get treatment that works because you're not going to believe that a treatment will work for you.
Like our Heyedrate Lid and Lash Cleanser it's a fantastic spray and 90% of the people that order it ordered again and unfortunately the 10% liked to talk a lot. The people that it didn't work for and it's probably because they didn't believe in it, they didn't use it long enough or they might have a sensitivity to one of the chemicals. It's the same with any treatment out there.
So, actually we want to talk about a new treatment tonight as well. We're also going to be going over the NuSight Medical NuLids System. So, this actually came out at the American Optometric Association meeting very recently and it is a brand new treatment. It's the NuLids System and how it works is basically in 60 seconds per day they say morning and evening that you can find relief from your dry eyes. Now this is a device that's mostly meant for those with meibomian gland dysfunction. What I can gather I haven't seen the device or anything like that but what I can gather is basically it takes the caps off of your meibomian glands. So, if you've got caps on your meibomian glands that are blocking those glands from releasing oil it will remove those caps and it also does a little bit of massage at the same time. So, it increases good blood flow to your lids and helps your meibomian glands produce the oil that they should be producing. So far they've done some studies and no adverse effects have been noted something to note with these studies is and these are done by the company.
You are using this really close to your eyeball but studies have been good from the company now it's a 65% improvement to your breakup time and an 81% improvement in ongoing gland oil secretions and 95% of those surveyed post-treatment were satisfied with their treatment. So, that’s the way that I see this working.
They say that it will be available at Doctors offices soon. It's very new so it's very possible that your doctor will have absolutely no idea what you're talking about but you know bring them the information and bring them the website and I'm sure they will be happy to contact the company for you. All they have to do is contact the company and say that they want to be a distributor for the product and they should have no problem getting it for you. It's something that will be done probably in office or demonstrated in the office and then you'll be able to take it home.
This is about $320 or a thirty day supply of the tips plus the actual new lead device. And then you do have to buy disposable tips I guess for it but it's shown a lot of promise. So, we're always hopeful that something is going to work. It's significantly less expensive than having lipiflow and things like that done. It is something that you add to your routine every day and this is something that's very similar to our product Heyedrate Lid and lash Cleanser.
A lot of people ask why we aren't in all Doctors offices because you have to convince doctors to bring your product in and it takes a lot of manpower and we have somebody dedicated full-time to doing that. If you want your doctor office carry either our Heyedrate Lid and Lash Cleanser or the Nulids System you just have to ask them. Tell them bring a card of ours in, bring an empty bottle of ours in and say it's working for you really well and you want them to carry it so they can buy it from and you can buy from their office instead of buying online either one works.
We have actually on-boarded about five doctors as a result of you all taking it to your Doctors so it's been great and we're very thankful for that. So,just ask your doctor about the NuLids System and see if he'll look into it and we're looking into it for you as well. So, if we can become a distributor you may be able to buy it on our website real soon.
Alright so again if you're just joining us welcome to the Dry Eye Show I'm Dr. Travis Zigler and Dr. Jenna Zigler. We posted a sale that we have going on until the end of the night it's 20% off of our blue blockers that we just had re-released. We were out of stock for about two months. Pink and blue and black and then none of those we don't have stocks of them anymore. No orange. 20% off tonight only ends at midnight and there's a link also you can click over to our website to find them on the website and then they'll take you over to Amazon on the page.
Have you heard anyone having success with testosterone cream for dry eye?
This has been posted a lot in the community and it's not talked about much in the optometry world. I've never had a patient that was on it so I can't speak to it because it's not something that we ever really talked about in school.
I haven't read any studies on it or anything and it's not something that's talked about very often at all. I mean we can definitely look some stuff up for you but I don't know if there's going to be a lot of information out there truthfully. I would look if you have any studies that you found or any information where you've heard of this from. Be feel free to post it as a reply to what you already said and then we can look into it a little bit more.
Peggy going along with our belief says acceptance is key as well I battled dry eye for 20-plus years and have never given up hope for more comfortable eyes. I love your show and products and willing to try anything recommended by you. Thank you for all your help. Peggy, we appreciate you being a customer and thanks for those kind words.
What is NuSight's website?
So, I'm going to actually post our blog post that we wrote about NuSight medical in the comments below. So, I'll put that in there for you and the blog post does contain information about the NuSight . It will have the website everything that's why I'm putting it in there.
What is the product?
It is called NuSight Medical NuLids System. So, just remember
NuLids systems and it's N-U-L-I-D-S, I just posted in the comments a website that can take you to our blog post and then you can find their website on there.
My doctor loves your spray.
That's pretty awesome he probably has it because of you and Monica's going to take it to her doctor in Maui “wish do have a doctor that is in Maui that does have it.” Yes, Dr. Sakamoto, so he's using it right now. So, if you are near him I think it's Dr. Randall Sakamoto, so you can check him out and he uses our product.
She hopes we become distributors of the NuSight Medical we hope you do too. Cynthia loves her blue blockers awesome stuff. We got a lot of people joining us so thank you for joining us here.
I've struggled inflammation for the past year and was recently diagnosed with episcleritis fluorescent lighting is particularly difficult for me to see certain stores are worse than others for example I just left TJ Maxx and while in the store my eyes always get red really red and irritated do you know why this would happen?
Yes so it's actually pretty common to have that happen in places like Walmart and TJ Maxx it's because it's just circulated air over and over and over again and it's fairly highly processed there so it's always got fans and vents blowing at all times. So, there's a constant motion of the air to keep it at a cooler environment and just to help with air flow in general.
So, with that air flow may be subtle enough that you don't notice it on your skin or anything but your eyes are going to notice it and so just that dry air and even fluorescent lights can cause problems in some people. Some people just are more bothersome because if you I don't know if I want to say this but fluorescent lights actually flicker and you don't really notice it because it's such a fine flicker but it can bother some people in kind of a subconscious way. So, that could be what's causing your problems. Episcleritis is just inflammation of a certain area of your eye that gets inflamed due to a certain reason.
I was recently diagnosed with dry eyes but that surprised me because the problem I had for decades is watering eyes.
So, basically the question is what causes watering eyes and what can you do about it? The good thing is we actually just wrote a blog post about what causes watery eyes. There are a couple different things that can cause it one of them is definitely dry eye. So, if you are diagnosed with dry eye then meibomian gland dysfunction, blepharitis and dry eye and they can all contribute to watering eyes because we have three layers of our tears and when each of those layers aren't doing their job or if one layer isn't doing its job then tears can actually fall off of your eye. And instead of sticking to the front of your eye like they should to lubricate your eye so that is why you have it's usually from meibomian gland dysfunction.
The things to do for meibomian gland dysfunction, absolutely dry eyes in general, drink more water and you need to really pay attention to your diet get rid of processed foods and things like that. We're talking about omega-3s, you did say you're taking in omega-3 which is awesome, make sure it's triglyceride base which is great. I posted the article too so if you want to read up even more about it and everything that we go over with watery eyes.
It's just like she said to treat your meibomian gland dysfunction which is most likely causing your watery eyes. I mean having a good lid hygiene regimen is really key so read that blog post and let us know if you have any further questions.
Does massaging your eyelids to express your glands after using a mask cause damage to your cornea?
This is something that gets very thrown around in the community and it's funny because things like things get thrown around in communities all the time and they just kind of blow up and this is kind of one of those things like that. There's somebody going around saying that warm compress has caused corneal damage and what the actual study showed was that if you keep your cornea heated up above like 142 degrees over like a 15 minute period that it can cause some corneal damage but it didn't really cause that much corneal damage. So, it's very very hard to heat your cornea up enough to cause corneal damage.
We do LASIK on the cornea and LASIK is a high-powered high heat laser being applied to the cornea and yes it does cause damage because that's what LASIK does. That should give you an example of things that we do to the cornea that you're warm compress at home is not going to cause damage to your cornea.
I'm going to post how to do meibomian gland expression safely. It's not hard to do, you should not press hard, it's more of just kind of a finesse of rolling the oil along your glands. I just posted that video that Dr. Jenna did so well.
Any suggestions or words of advice? The inside corner of my eye has all of a sudden become really red and irritated tender and hurting near my plugs?
So, if you have plugs and it's really tender in that area that could be a sign of an early infection and so it's very common for your puncta to get infected and it's not common but it does happen. If you've got plugs in there and they can become even more effected so I would get that checked out just because it could be an early sign of an infection.
I have Thygeson's and I showed my doctor your spray he said ingredients are good stuff. I also have your blue blockers.
It's good to hear thanks! Thygeson's is unfortunately a hard condition to manage and it's very inflammatory so hopefully he's got you on a good steroid to help get rid of that.
Do dry eye and meibomian gland dysfunction and blepharitis always go together?
It's kind of like one leads to another which leads to another which leads to another type of thing. A lot of people are surprised when we tell them that we're going to treat their eyelids when we're dealing with dry eyes it's because your eyelids is where it all starts. Your eyelids are responsible for releasing oil in your meibomian glands in your eyelids and that's what MGD is. So, your eyelids which is where blepharitis occurs because that's inflammation of the front of the eyelid. MGD is usually inflammation of the back of the eyelid.
So, if we clean up those eyelids and get them functioning better by reducing the bacteria which will reduce the inflammation and then it will clear up your meibomian glands which will then in turn release more oil and that oil is responsible for keeping the tears on your eye which will decrease your dry eye and so blepharitis can cause meibomian gland dysfunction which then causes dry eye but it can also go the other way around dry eye inflammation on the surface of the eye can cause MGD which can cause blepharitis.
So, yes they always go together for the most part but you can't have them independent but treatment options are kind of all the same and so we want to clean up the eyelids first. Look at our diet, look at our hydration and look at our exercise schedule.
How do you know if it is triglyceride based?
You just buy ours! Well, look at the price and so price is a huge indicator of triglyceride based but not all the time. If it's higher than $25.00 it's usually going to be triglyceride based if it's lower than $25.00 it's usually going to be ester based. The reason that it is because triglyceride base is a more pure form and it's a higher quality where ester based they can actually make it smaller and pack it into more and pack more into each individual pill so they can make it a lot less expensive.
So, ours is triglyceride based and it has other good stuff too. There are a couple different brands that you can get that we know are triglyceride based besides ours, that's silly though, don't do that whatever. Don't go to Walmart and buy your fish oil basically that's all I have to say about that. So yes some other good ones I'm going to post here are the very popular choice or wrong positions they've been a really great job marketing to positions and getting in their office. Nordic Naturals is usually triglyceride based I don't think they have any ester based and then that's the only one I really know. I don't know about the other like Hydro Eye is not fish oil base it's black currant seed oil base but it has fish oil in it so I don't know what their fish oil is. We'll just leave it at Heyedrate, PRN, Nordic Naturals yeah and Heyedrate Omega 3 for dry eye.
Can MGD cause coding to occur on contacts?
Yes that is very common. So, when we see a lot of oil and lipid deposits fat deposits on your contact lenses we're going to switch you to either a daily disposable lens or switch to a hydrogen peroxide based solution like Clear Care.
Read the instructions carefully and we're going to really try to solve your MGD. So, I see this very commonly with what are called silicone hydrogel lenses which are mostly the new ones so we may take you back to an older contact lens if that's the case as well but we want to address the MGD first.
Which is better as a permanent fix for keeping tears in eyes plugs or cauterization?
Fixing your diet! If you want a permanent fix for keeping tears on your eyes really look at your diet and your hydration. I would really caution you against cauterization just because it is irreversible and I just don't like that plugs are still reversible so it's not bad to get them and you want to if you want to try something like cauterization they will most likely do plugs first to make sure it works for you but addressing the actual cause of what's causing your bad oils and dry eye is a lot better better solution for this than doing something like cauterization.
How does the new device work?
We don't know much about it. So, the NuLids System is what I am assuming you're talking about. Basically it's done twice a day you run it along your eyelid margin and it helps to remove the oil caps on your meibomian glands so that's kind of the gist of it.
Is blepharitis and meibomain gland disease is the same thing?
So, meibomian gland dysfunction is a form of blepharitis. There is a anterior blepharitis and a posterior blepharitis. Anterior blepharitis is what we think of blepharitis with crusty eyelashes and things like that your eyelid stuck together in the morning that's anterior blepharitis. Posterior blepharitis is meibomian gland dysfunction.
Is IPL good add to a routine care?
Yeah it definitely is. So, you probably every six months or so depending on what your doctor wants to do.
My eyes feel drier after using my lubrication drops have you heard of this complaint by others? My eyes just don't seem to like anything.
So, yes you probably haven't been following us very long and we actually do not promote the use of eye drops because eyedrops are just a way of covering up a problem that you have. We recommend addressing the underlying problem which is usually a blepharitis, meibomian gland dysfunction or other forms of inflammation in your body. Once we get in all those are forms of inflammation, blepharitis meaning inflammation of the eyelid, meibomian gland dysfunction meaning inflammation of the back of the eyelid and then dry eye is inflammation of the surface of the eye. So, those are all inflammatory components and so we want to figure out what's causing your inflammation first which most likely the cause is your diet and so really adjusting your diet to be more of a plant-based diet, healthy organic, staying away from pesticides and drinking a lot more water.
We actually have a dry eye boot camp that we will be opening up here very shortly. We just finished up our beta run with 50 members and we're kind of gathering the data right now. We're improving it and then it will be released again here in a little bit. We'll probably let another 50 to 100 members in. We're actually pretty excited about it it'll be fun. We had fun it and it was cool, it was challenging for us too and we'll probably add the second round we'll add some stuff to it to make it even better and so look for that to come and that is pretty much helping you figure out how to change your lifestyle to decrease your inflammation which then addresses your dry eye problems.
You do not have to rely on drops a good place to start though is dryeyecommunity.com dryeyecommunity.com is where you can get a free book from Dr. Jenna and then you can get more information on our products and everything. So, we don't recommend prescriptions we actually are very against big pharmaceutical companies and we don't like prescription drops so we try and weed over the counters because they don't really do much. So, we try to do everything to avoid that stuff.
Nordic Naturals are triglyceride based they should try ours. Ours come with the satisfaction guarantee which no other product does so if you don't like them we'll give you a full refund.
Do you think the new device will be available in Europe?
We have no idea. You'd have to contact the company for that but you can order our spray and have it shipped to the UK and Germany from our website.
We both have our Eye Love shirts and if you want an Eye Love shirt you can let us know. We'll make them available and we'll put them on Amazon here soon. I just haven't got around to it and we made these like three years ago so they're pretty old but we'll definitely do it.
Sometimes my eyelids get red and itchy but they're not usually crusty. I always thought it was allergies but maybe it's blepharitis?
It could be. If you're not already doing a great eyelid hygiene regimen at night with a hypochlorous acid cleanser like our Heyedrate Cleanser. I absolutely recommend you start doing a morning and evening eyelid cleansing routine because that can absolutely help your eyelids. Red and itchy is the tell-tale signs of inflammation and the definition of blepharitis is an inflammation of the blephra and the blephra are your eyelids.
I have an allergy app how about a dry eye app?
Let us know what you'd like in your dry eye app and let us know what allergy app it is. I'd be interested to like see what it's all about. It's pretty cool~
Deborah says “Very grateful to have been in this group. It not only helps my dry eye but my life as a whole. Thank you so much!”
You're welcome, Deborah, that's what we do this for. So keep the compliments coming because we love to see them and that's what keeps us going every single day.
I have tried every eye drop out there. Still no relief and I can't even watch TV, please help.
Start at dryeyecommunity.com and learn and learn and learn and so on our website we've written lots of blogs. I would recommend starting at Dry Eye Community we then send you a series of emails that has education on what you can do to really help your dry eye naturally. Eye drops cover the problem they don't fix it and so just always remember that fix the problem don't just cover it up
Are gland expressor forceps and/or a mastrota paddles safe and effective? If so, how can they be sanitized?
This is a good question but I've never really known anyone to use them outside of their doctor's office. I don't know if you do but normally mastrota paddles are used by your optometrist to express your eyelids but it's not something they would send you home and it's not something we really recommend you do at home. I would rather you do a more gentle meibomian gland expression which is in an article or video that Travis posted a little earlier in the show. So, take a look at that.
As far as sanitation and stuff it's not something that you'll have to worry about because I don't think that you would be using one and those are stainless steel products so you can usually just use like a alcohol's pad and that usually works pretty well.
What vitamin D level do you recommend?
So, the recommended vitamin D level is usually between 40 and 60 and that's really what we recommend truthfully for dry eyes. It doesn't really need to be higher than that unless you're pregnant and you know absolutely. If it's lower than 40 then yes I believe you should probably do supplementation to get it up.
Some people have a harder time increasing their vitamin D levels and sometimes the sun just doesn't do it. You still can live I lived in South Carolina and have low vitamin D levels when I was tested so I was on a supplement for a while for it so absolutely forty to sixty is kind of what we're looking at and that goes along the lines of something that we recommend doing every day to help you sleep better actually. Go outside before 11:00 a.m. and just get at least ten minutes of sunshine so sitting outside eating ten minutes of sunshine like she said that could still not be enough even we lived in South Carolina and we were outside every day. We went for walks and everything and she's still have low vitamin D. So, just making sure you get some sunshine and supplement and that should help out.
What about eye moisture goggles?
We don't actually have a lot of experience with eye moisture goggles. They work and they're really great. I would actually post that question on the community because there's a lot of members that use them and they have lots of good recommendations but we don't have one and we've never researched them and I've never really sold them in any of my offices, in my dry eye clinic.
Another thing you can do if you go to the Dry Eye Syndrome Support Community you can use the little search bar on the left side and you can search goggles and it will bring up a bunch of different threads of where people talked about their moisture chamber goggles and sleeping you know masks and things like that. So, you'll find a lot of really great information there.
Looks like we've answered all 40 questions and you guys are very active tonight. It was great! We love that we love feeling like we matter.
So, if you guys missed the beginning of the show we have our blue blockers 20% off for tonight only ends at midnight tonight on Amazon the code is 2020BLUE all capital letters. So, we're pretty excited to have them back in stock after a month and a half long long time of being out of stock. It was already that long and it seems so much longer. It seemed like a long time.
So, we're pretty excited about that and we have some big things coming with our blue blockers, we do have some big things coming with our Heyedrate lid and lash cleanser. It's in R&D phase right no.
We also are looking into some making some greens powder that is specific for dry eyes. So, this would be a powder that a lot of people have trouble taking vitamins and pills or specific for eye health. And so, it's going to have 500 milligrams I think of omega-3, 6 and 9 per serving. It's going to have pycnogenol which is healthy for the optic nerve of your eye, it's going to have lutein which is good for your macula and then it's going to have a ton of just broccoli and wild mushrooms and a bunch of organic ingredients that just help with overall inflammation. What we wanted to make was a greens powder that decreases inflammation and helps with just overall eye health.
So, we're pretty excited about it, we're actually testing some flavors right now a chocolate, strawberry and Kiwi and they both are very tasty. We wanted something that everybody would enjoy as well and we did take what was asked by our community. We asked you guys a couple weeks ago what you would and would not want and we did take a lot of those comments into consideration in making our formulations. So, we really appreciate you guys always giving us input on our new products.
Pam says “Where's the baby?” the baby is sleeping, thank God, he's had a rough couple days. We're at the lake and we're in a friend's lake and he slept well during the day but then did decided not to sleep last night which means mom and dad did not sleep last night. I was up all night.
So, we do have a promotion going on on our website for a limited time that I will post in the links below. If you have not tried our Heyedrate Lid and Lash Cleanser I highly encourage you to do so. We're so confident that it is going to work for you that we will buy your first bottle all you have to do is pay five dollars shipping and handling. So, I'm going to post the link for the free Heyedrate bottle on us it's a one month supply and this is only if you've never ordered it before. So, if you've already ordered it it will not work.
Free Heyedrate Lid and Lash Cleanser just pay shipping which is $5. So, that's how confident we are with our product is that it will work for you and if you find that it didn't work for you will even reimburse your five dollars for shipping.
All right well thanks for joining everybody and we look forward to talking to you next Sunday. If you guys have any topics that you would like us to discuss at the beginning of the show let us know and we can do a little write-up on it and then we'll talk about it first thing in the show.