Restoring All Tears
Disclaimer: This is an unedited version of the podcast transcript. There are speakers listed above each line, as well as some grammatical issues. To listen through the podcast, click the link above.
Welcome to try not to blink a podcast about the ups and downs Inns and outs, news, tips and tricks of those who live the optometry lifestyle.
We'd like to thank the amazing people of Valley contacts who made this podcast.
Speaker 2
Possible makers of stellar gas particle lenses and the oh so incredible custom stable scleral lens.
Speaker 2
In case you're wondering, I'm on the East Coast.
Speaker 2
My name is Doctor James DM, and I'm joined by my talented cohost Rep in the West Coast.
Speaker 2
Doctor roya.
Speaker 3
Hubby what is up Roy?
Speaker 4
I was like great in track but I.
Speaker 4
Feel like I'm running down a basketball court like.
Speaker 1
And do you?
Speaker 2
When you run, do you?
Speaker 2
Wear a mask.
Speaker 4
I don't run.
Speaker 2
When you Peloton, do you wear mask?
Speaker 4
No, I felt an inside.
Speaker 1
All right, fine well.
Speaker 4
I do everything I can out of work to not wear a.
Speaker 4
Mask because you know it.
Speaker 2
You're getting asked me, I could.
Speaker 4
Tell Israel.
Speaker 2
You got some little bit of something.
Speaker 2
Right here.
Speaker 4
It's honestly it's starting to get to a point where, like I never I, I know I'm blessed for this, but like I.
Speaker 4
Never struggled with that act.
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Me as a kid.
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Or even you know it it never.
Speaker 4
Really was a problem for me.
Speaker 2
So this is becoming a big deal. People are talking about it, but we're not saying in any way with that. We don't think you should wear masks. We definitely 100% support mask. No question about it.
Speaker 4
I was lucky.
Speaker 4
No, when you wear a yes.
Speaker 4
Actually, so there's an article, plenty of them.
Speaker 4
You can go find him New York Times, etc.
Speaker 3
Lots of articles.
Speaker 4
But the Cleveland Clinic posted the struggle with mask.
Speaker 4
Knee is very real and I.
Agree with that.
Speaker 4
That you know, I've done a couple things.
Speaker 4
To try and get rid of it myself, including like replacing my masks more regularly.
Speaker 4
'cause at first we.
Speaker 4
Were like hoarding our damn mask so you couldn't use mask or reuse masks or you needed to reuse your masks.
Speaker 4
But honestly, all of that, just like.
Speaker 4
Stale air must.
Speaker 4
Cause acne.
Speaker 2
Absolutely well, you know.
Speaker 2
The American Academy of Dermatology is actually put out a nice little piece which will link to our show notes.
Speaker 2
It says 9 things you could do to prevent face mask skin problems, #1, cleanse and moisturize your face daily.
Speaker 2
Gentle skin care can prevent skin problems when washing your face, use a mild fragrance free cleanser #2 protect your lips by applying petroleum Jelly.
Speaker 2
Avoid do it after washing your face before you put your mask on and before bed #3. Skip the makeup beneath the mask.
Speaker 2
Makeup is more likely to clog your pores #4 avoid trying new skin care products that can potentially irritate your skin. You're not sure you know how that's going to react.
Speaker 2
Act use less of certain skin care products if your face becomes irritated, things like leave on salicylic acid retinoid that you may apply to your face or even aftershave.
Speaker 2
Where the right mask you know.
Speaker 2
Obviously masks come in all different shapes and sizes, and so it's not.
Speaker 2
One you know you want, you want it to be comfortable.
Speaker 2
At least two layers of fabric, so you actually get some protection.
Speaker 2
Soft natural breathable fabric.
Speaker 2
I personally like surgical masks.
Speaker 2
They seem to work the best for.
Speaker 2
Me, you know?
Speaker 2
This life one.
Speaker 2
This one I think I found the most interesting.
Speaker 2
Take a 15 minute.
Speaker 2
Break every four hours.
Speaker 2
I was like where did that come from?
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There's no studies that show that this is, you know, like somehow science based, but it's interesting because you know this is obviously what we preach about taking breaks by looking at computer screens.
Speaker 2
Now we're hearing take breaks from wearing your mask.
Speaker 2
They're saying go outside when you can go in your car and sit alone or go home and take your mask off every four hours.
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Wash your masks, right?
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Obviously we're wearing a cloth mask.
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You don't want to be putting, you know a dirty mask on every every day.
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It's almost like re wearing underwear, obviously.
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Wouldn't want to do that and.
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And you know, if you have a dermatologist, then they have a treatment plan for you.
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You know, make sure you follow it or you know at least review with them that you're a mask wearer and need to determine if it's safe.
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All right I.
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Feel like this has been a long time coming.
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Obviously you all know that Jimmy and I are big fans of treating obviously all of the eye, but dry eye is of course one of the things that we do.
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Take pride in really paying attention to for all of our patients when they come in.
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So this guest and this group.
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Even is probably a long time coming on guests for our podcast, so very excited to introduce them today.
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So Doctor Scott Houseworth is our honorary guest of the evening.
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Brought in by T Restore and Ken Doucement a really cool guys.
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Let me give you guys a little background on both of them real quick.
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So Doctor Houseworth is an assistant professor at UC Denver School of Medicine.
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He's a director of the Dry Eye Center of Colorado.
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Did school at Coe former Co?
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I suppose you say Marshall B Ketchum now formerly?
Speaker 5
Yeah formerly.
Speaker 4
Yes, he was a resident in cornea, glaucoma and surgical management.
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And has been awarded.
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All the awards.
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Probably absolutely exactly all the awards, but exactly.
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Every old awards.
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Like many of.
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Our pets.
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Very grateful for.
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Basically everything you can think of, he's done and one of the things that I think is super super admirable slash goals if you will, is he's on the.
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Tear film, tear film and ocular surface society.
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The member, he's one of the 150 international.
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What we call Elite if.
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You will on treating dry eye true.
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You guys are very kind.
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Just say yes, yes that's me.
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I'm the one.
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Did I come here for an?
Speaker 4
There's an international yes, you did, and you.
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Ego boost. What is this?
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All about now.
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Just got.
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Don't hear it.
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That's why we're here.
Right?
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And would not get into again.
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We're just going to beat you up from the rest of the time, so I hope you're good now.
Speaker 5
OK, perfect perfect.
Speaker 3
We build you up to tear you apart.
Speaker 5
It's all about balance.
Speaker 5
It's all about balance.
Speaker 2
Yeah, yeah.
Speaker 4
Well, I think OK on top.
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Of that balance thing, I think it's important to say I don't.
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I always bring this up.
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I always look.
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At people especially, we have our guests.
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On but you have.
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All of these accolades.
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You were on the TF OS.
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Group you lecture nationally, internationally, but also you have a basically five star rating.
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From your patients, your patients love you.
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You still practice, yeah?
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And your patients have like nothing, but there's 625 reviews at your current location and basically a five out of five star review. 4.7 but I.
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And that's really.
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I mean honestly 'cause sometimes people get so I don't know.
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This happens with a lot of professionals but.
Speaker 1
You get so.
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Caught up in all of the things that you're doing, you don't have time to really let a patient understand what they're what you're talking about, and the complexity of their eye disease.
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So I think I think it's worth saying and pointing out.
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When you are well reviewed by our patients, it's important not just to.
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Smart and really you know, go above and beyond in regards to treatment patterns but also getting your patient on board and understanding.
Speaker 4
How to treat?
Speaker 5
Yeah, I that's some.
Speaker 5
Well thank you for pointing that out.
Speaker 5
I guess because really at the heart of all of this stuff really is clinical care.
Speaker 5
And really, you know all of the research, all of the lecturing.
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That's all.
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Based on what my experience has been like in the exam room.
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So you know what we need to figure out is really how to take all of that knowledge.
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And translate it into better patient care.
Speaker 5
And so it's it's good that that part of it is appreciated, because that's really kind of the core of what we do, right so?
Speaker 4
Totally yeah totally well.
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I want to get.
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Into T restore and Ken.
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But before I.
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Do that you.
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Know all of our listeners know we.
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Like to go?
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Over some of the you know, trending news and right now trending news is all about masks.
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We've talked about masks.
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We've talked about.
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All everyone has the most annoying thing related to masks.
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Going on in their office, whether it be fogging up the phoropter's or.
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Or you know all the different things or patients are complaining about when it comes.
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To masks but.
Speaker 2
Yeah, Speaking of masks, I heard that we're going to be talking about a mask tonight, right?
Speaker 2
It protects you from COVID.
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You could do your you know Facebooking and also heat up your your meibomian glands.
Speaker 2
Isn't that right?
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Maybe that's not totally true.
Speaker 4
It's giving away all the clues.
Speaker 2
We won't.
Speaker 2
We won't make those claims here tonight.
Speaker 1
It's classic.
Speaker 2
Let's maybe as a political rally that we could make those claims.
Speaker 2
I don't know.
Speaker 2
I'm just kidding.
Speaker 2
Uhm anyway, so yes, let's let's hear about some of this controversial slash.
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Just life.
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We're living dry eye discussion, Roy, a trending hashtag.
Speaker 4
News if you will OK.
Speaker 4
So there is officially a term we call made mask associated dry eye. You know this is this is 2020 now.
Speaker 4
So we've got to be on top of these terms, but there actually is an older study from 2019. Well, it says during the 2019 novel Coronavirus Outbreak, investigation of dry ice.
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Symptoms of medical staff during hospital work during the coronavirus outbreak.
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So basically what they did is they checked out doctors and nurses and they were looking at several different things, including OSDI score.
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Uhm, how much you were experiencing mild, moderate, severe dry eye.
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Time and correlated factors including protective eyewear.
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Their, et cetera related to masks, and they found that doctors and nurses were experiencing a significant increase in dry eye because of masks.
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There's even now a fancy infographic for made.
Speaker 4
So I don't know what do you have.
Speaker 5
Well, I think it's.
Speaker 4
To say about this.
Speaker 5
I think it's the real deal. I mean, you know we go from, you know, wiring under under certain conditions so you know for folks that are are operating and stuff where they've got them in the OR.
Speaker 5
But we've, you know, during an entire clinic day, now you you barely take it off unless you're just getting a drink of water or grabbing something to eat.
Speaker 5
So so it all kind of comes down to.
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To airflow and and changes in lid position and all that stuff that Max.
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And a good fitting masks actually cause so so in poor fitting masks you've got all of that air.
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That kind of comes up that accelerates a, you know vaporation and.
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Touch and then you've got some that may be so tight that they actually cause a deformation of the lid and and change blink patterns and so that changes how those meibomian glands will work and tear redistribution work, so it's it's the.
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Real deal.
Speaker 4
I recently I live on the West Coast and I flew to visit my parents on the East Coast.
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And so that's just.
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Five and a half hour flight, and you keep your mask on on for most airlines nowadays and.
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I left with an episcleritis.
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And when in the mirror I looked in.
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The mirror and I had the reddest.
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I mean, I don't.
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I have don't usually deal with dry.
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I don't wear contacts, so like when I see a red eye on my own self.
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It's kind of weird.
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And I was thinking, Oh my gosh, what did I do to myself and I realized like I was just bundling air right at my eyes?
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You could have been tier restoring the entire flight.
I could have.
Speaker 3
Been higher point you could see restoring.
Speaker 5
They should have should have that.
You could have been.
I could just.
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Watching, did you watch a movie on the inflight?
Speaker 4
Next time I will be.
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Media would you want?
Speaker 4
Oh yeah, I just.
Speaker 4
Just, uh, what did I watch?
Speaker 4
I I probably watched some TV show.
Speaker 3
You could have the restored.
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While you watch that.
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I'm just kidding.
Speaker 4
I couldn't hear sword I could have.
Speaker 2
I'm just kidding.
Speaker 4
Done a lot of things, but instead I.
Speaker 4
Just I've used in abusing my pretty eyes.
Speaker 3
Yeah well there are lots.
Speaker 2
Of Scott Point, you know there have been, you know, numerous studies that look at the size, shape, length, curvature of lashes and the associated flow of air so.
Speaker 2
You know, I I.
Speaker 2
Don't know if there's a, is it.
Speaker 2
Have you seen studies that prove?
Speaker 2
What you're talking about, royea?
Speaker 2
Or is this you know, kind of theoretical in nature?
Speaker 4
So we talk about air blowing up my eyes.
Speaker 2
Matt made yes, I know there's an infographic, so that means it's almost basically, you know.
Speaker 5
If it's on the Internet, it's.
Speaker 3
On the Internet it's.
Speaker 5
Gotta be real.
Speaker 3
And there's a really cool infographic.
Speaker 2
So I'm I'm sold.
Speaker 3
I'm good, but I'm just wondering.
Speaker 2
Did you any studies now?
Speaker 2
It makes sense.
Speaker 4
I mean that one study I just told you.
Speaker 4
About that was I'm going to link that.
Speaker 1
Is that a study?
Speaker 5
So yeah, so this is actually something that we're looking at in an informal sense now.
Speaker 4
Study, yeah, it's on Putnam.
Speaker 5
And depending on what kind of information that we get.
Speaker 5
Maybe you know who knows, maybe we'll be able to pump out a paper in in a few months or something, but because of that and then also anecdotal reports have increased.
Speaker 5
Like you know, Sties and Hardy.
Speaker 5
Ola, you know we're starting to to at least do some survey work right now with the hospital workers that we've got around University of Colorado to take a look at.
Speaker 5
Whether or not this is something that does need more investigation.
Speaker 1
Cool, well weirdly.
Speaker 4
Well, I mean, you know.
Speaker 2
We got.
Go ahead.
Speaker 4
You have to have.
Speaker 4
Air coming toward your eyes.
Speaker 4
I mean, where else if?
Speaker 4
If you're sitting by the front door and the front door keeps fogging up, why would it not be coming toward your?
Speaker 4
Eye without the.
Speaker 4
Proper there you know, like air is coming out, errors rising when you're talking, especially or heavy breathing.
Speaker 4
Where else is going?
Speaker 4
To go.
Speaker 2
Yeah, cool that.
Speaker 5
Yeah, are you guys doing anything that that is helping patients with this?
Speaker 3
Well, listen, we're going to.
Speaker 5
I mean 'cause?
Speaker 5
You both are clinicians as well.
Speaker 5
So do you have those little plastic like airflow, redirectors or anything like that?
Speaker 2
No, no, I haven't done anything, I mean.
Speaker 4
Let's see, I don't know this freedom.
Speaker 2
I think we've talked to patients about, you know you could.
Speaker 2
Tape, you know, hold it on tight or pinch it closer, you know.
Speaker 2
Really no, no, I don't have any good advice.
Speaker 2
How about you?
Speaker 5
I I don't really either if they're fogging up before after then, usually we'll apply a little bit of paper tape across the top of the mask just to redirect it, but I've seen some you know interesting, like YouTube videos and stuff of people taking like those clear, then almost like a folder?
Speaker 2
Are you talking about behind the phoropter, yeah?
Speaker 5
Yeah, yeah, exactly 4 after specifically.
Oh yes, yes.
Speaker 2
My I know this.
Speaker 2
I get darts for this but I just tell him to take the mask down while we're doing that I just say pull your nose out, you know and you know I won't look at you while you're breathing and and yeah it's it's a little controversial I guess.
Speaker 2
But you know, you know, is it better to get all that moisture on the on the lenses and you know?
Speaker 2
I don't know.
Speaker 2
You probably don't refract all that much Doctor Ashworth I.
Speaker 2
I'm not sure, but you know.
Speaker 2
It's a laborious.
Speaker 2
This part of the day to begin with, and then you know to make it that much more complicated.
Speaker 2
So for me, you know that's what we've been doing since March, and we've not had any problems.
Speaker 5
OK, I suppose it's too much to ask him to hold their breath the whole time that you're attracting, even with the even with the exponent you know.
Speaker 4
I mean what I?
Speaker 1
You know?
Speaker 3
It was a little hard to.
Speaker 3
Just pick people up off.
Speaker 2
The floor all the time, you know, so it's just.
Speaker 4
A couple couple learned lessons.
Speaker 2
Yeah, what do you?
Speaker 2
Do Roy I think we've talked about this, but I forget what you do.
Speaker 4
No, actually.
Speaker 4
So most of the time I'm not doing the primary refraction, but if anything I come in at the end, so my tech typically does put a little piece of tape across their nose.
Speaker 4
Yeah, but I mean it does suck, and especially if a patient has like keratoconus.
Speaker 4
Or a higher.
Speaker 4
Prescription you know they need to be closer anyway.
Speaker 4
If they're like a - 2, they can float away a little bit and it's.
Speaker 4
Fine, but have a.
Speaker 4
Higher amount of prescription it's going to definitely affect their prescription so.
Speaker 4
I do my best to say if you pinch your nose it is less likely to go up toward the eyes so, but it's frustrating to patients too.
Speaker 3
Don't pay.
Speaker 4
So like sometimes if it's like some of my older patients, they.
Speaker 4
Just take their mask down.
Speaker 4
And I'm like whatever, I'm.
Speaker 2
I got mine on your good.
Speaker 4
Staying out of your way.
Speaker 4
Let's get this.
Speaker 4
Done quick you.
Speaker 2
You know we'll clean it.
Speaker 4
Chose this one.
Speaker 4
Yeah you you chose this, I didn't tell you to do this that's.
Speaker 1
Yeah, yeah fine.
Speaker 4
Why you chose this?
Speaker 2
Anyway, so listen.
Speaker 2
We are like you said, we talked a lot about dry eye.
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We've talked a lot about, you know, new technologies with dry eye.
Speaker 2
We saw you know a picture online the other day with a dude and I thought he was in the Blue Man Group.
Speaker 2
He was wearing this thing on his face.
Speaker 2
I'm like yo this new treatment for dry eye involves being part of the Blue Man.
Speaker 2
And so it's a newfangled, you know, thermal based treatment for meibomian gland dysfunction is is basically what we got, and so we got the co-founder of tear restore here on the line today I'm.
Speaker 4
Your bangled
Speaker 2
I'm sure he's won, won lots of awards.
Speaker 2
Also in his own right, but he is here with Doctor Houseworth to speak to us tonight.
Speaker 2
His name is Ken Dow Schmidt.
Speaker 2
He's an avid soccer player.
Speaker 2
Actually, that's all you really need to know about him.
Speaker 2
I'm just kidding.
Speaker 2
There's much more that you should know.
Speaker 2
About him, but you know what I want to know about him is how in the world did you get mixed up with dry eye?
Speaker 2
You're not an eye doctor.
Speaker 2
You know who forced this upon you and and why didn't you run the opposite direction?
Speaker 6
Maybe I shouldn't.
Speaker 1
I don't know.
Speaker 4
It's not too.
Speaker 4
Late or maybe it is.
Speaker 6
Yeah, well, my background was originally pre Med.
Speaker 3
OK, well there you go alright?
Speaker 6
And then I started working at at Minnesota Consultants and so they scared me away from being a doctor right away, but.
Speaker 1
OK.
Speaker 6
They also introduced me to dry, so I answered like I had a bit of that.
Speaker 6
You know, baseline to I epiphany if you will or someone tells you that it's not a lack of tears and then.
Speaker 6
You're like, wait?
Speaker 6
It's not.
Speaker 6
Disclaimer: This is an unedited version of the podcast transcript. There are speakers listed above each line, as well as some grammatical issues. To listen through the podcast, click the link above.
Welcome to try not to blink a podcast about the ups and downs Inns and outs, news, tips and tricks of those who live the optometry lifestyle.
We'd like to thank the amazing people of Valley contacts who made this podcast.
Speaker 2
Possible makers of stellar gas particle lenses and the oh so incredible custom stable scleral lens.
Speaker 2
In case you're wondering, I'm on the East Coast.
Speaker 2
My name is Doctor James DM, and I'm joined by my talented cohost Rep in the West Coast.
Speaker 2
Doctor roya.
Speaker 3
Hubby what is up Roy?
Speaker 4
I was like great in track but I.
Speaker 4
Feel like I'm running down a basketball court like.
Speaker 1
And do you?
Speaker 2
When you run, do you?
Speaker 2
Wear a mask.
Speaker 4
I don't run.
Speaker 2
When you Peloton, do you wear mask?
Speaker 4
No, I felt an inside.
Speaker 1
All right, fine well.
Speaker 4
I do everything I can out of work to not wear a.
Speaker 4
Mask because you know it.
Speaker 2
You're getting asked me, I could.
Speaker 4
Tell Israel.
Speaker 2
You got some little bit of something.
Speaker 2
Right here.
Speaker 4
It's honestly it's starting to get to a point where, like I never I, I know I'm blessed for this, but like I.
Speaker 4
Never struggled with that act.
Speaker 4
Me as a kid.
Speaker 4
Or even you know it it never.
Speaker 4
Really was a problem for me.
Speaker 2
So this is becoming a big deal. People are talking about it, but we're not saying in any way with that. We don't think you should wear masks. We definitely 100% support mask. No question about it.
Speaker 4
I was lucky.
Speaker 4
No, when you wear a yes.
Speaker 4
Actually, so there's an article, plenty of them.
Speaker 4
You can go find him New York Times, etc.
Speaker 3
Lots of articles.
Speaker 4
But the Cleveland Clinic posted the struggle with mask.
Speaker 4
Knee is very real and I.
Agree with that.
Speaker 4
That you know, I've done a couple things.
Speaker 4
To try and get rid of it myself, including like replacing my masks more regularly.
Speaker 4
'cause at first we.
Speaker 4
Were like hoarding our damn mask so you couldn't use mask or reuse masks or you needed to reuse your masks.
Speaker 4
But honestly, all of that, just like.
Speaker 4
Stale air must.
Speaker 4
Cause acne.
Speaker 2
Absolutely well, you know.
Speaker 2
The American Academy of Dermatology is actually put out a nice little piece which will link to our show notes.
Speaker 2
It says 9 things you could do to prevent face mask skin problems, #1, cleanse and moisturize your face daily.
Speaker 2
Gentle skin care can prevent skin problems when washing your face, use a mild fragrance free cleanser #2 protect your lips by applying petroleum Jelly.
Speaker 2
Avoid do it after washing your face before you put your mask on and before bed #3. Skip the makeup beneath the mask.
Speaker 2
Makeup is more likely to clog your pores #4 avoid trying new skin care products that can potentially irritate your skin. You're not sure you know how that's going to react.
Speaker 2
Act use less of certain skin care products if your face becomes irritated, things like leave on salicylic acid retinoid that you may apply to your face or even aftershave.
Speaker 2
Where the right mask you know.
Speaker 2
Obviously masks come in all different shapes and sizes, and so it's not.
Speaker 2
One you know you want, you want it to be comfortable.
Speaker 2
At least two layers of fabric, so you actually get some protection.
Speaker 2
Soft natural breathable fabric.
Speaker 2
I personally like surgical masks.
Speaker 2
They seem to work the best for.
Speaker 2
Me, you know?
Speaker 2
This life one.
Speaker 2
This one I think I found the most interesting.
Speaker 2
Take a 15 minute.
Speaker 2
Break every four hours.
Speaker 2
I was like where did that come from?
Speaker 2
There's no studies that show that this is, you know, like somehow science based, but it's interesting because you know this is obviously what we preach about taking breaks by looking at computer screens.
Speaker 2
Now we're hearing take breaks from wearing your mask.
Speaker 2
They're saying go outside when you can go in your car and sit alone or go home and take your mask off every four hours.
Speaker 2
Wash your masks, right?
Speaker 2
Obviously we're wearing a cloth mask.
Speaker 2
You don't want to be putting, you know a dirty mask on every every day.
Speaker 2
It's almost like re wearing underwear, obviously.
Speaker 2
Wouldn't want to do that and.
Speaker 2
And you know, if you have a dermatologist, then they have a treatment plan for you.
Speaker 2
You know, make sure you follow it or you know at least review with them that you're a mask wearer and need to determine if it's safe.
Speaker 4
All right I.
Speaker 4
Feel like this has been a long time coming.
Speaker 4
Obviously you all know that Jimmy and I are big fans of treating obviously all of the eye, but dry eye is of course one of the things that we do.
Speaker 4
Take pride in really paying attention to for all of our patients when they come in.
Speaker 4
So this guest and this group.
Speaker 4
Even is probably a long time coming on guests for our podcast, so very excited to introduce them today.
Speaker 4
So Doctor Scott Houseworth is our honorary guest of the evening.
Speaker 4
Brought in by T Restore and Ken Doucement a really cool guys.
Speaker 4
Let me give you guys a little background on both of them real quick.
Speaker 4
So Doctor Houseworth is an assistant professor at UC Denver School of Medicine.
Speaker 4
He's a director of the Dry Eye Center of Colorado.
Speaker 4
Did school at Coe former Co?
Speaker 4
I suppose you say Marshall B Ketchum now formerly?
Speaker 5
Yeah formerly.
Speaker 4
Yes, he was a resident in cornea, glaucoma and surgical management.
Speaker 4
And has been awarded.
Speaker 3
All the awards.
Speaker 4
Probably absolutely exactly all the awards, but exactly.
Speaker 3
Every old awards.
Speaker 3
Like many of.
Speaker 2
Our pets.
Speaker 2
Very grateful for.
Speaker 4
Basically everything you can think of, he's done and one of the things that I think is super super admirable slash goals if you will, is he's on the.
Speaker 4
Tear film, tear film and ocular surface society.
Speaker 4
The member, he's one of the 150 international.
Speaker 4
What we call Elite if.
Speaker 4
You will on treating dry eye true.
Speaker 5
You guys are very kind.
Speaker 2
Just say yes, yes that's me.
Speaker 2
I'm the one.
Speaker 5
Did I come here for an?
Speaker 4
There's an international yes, you did, and you.
Speaker 5
Ego boost. What is this?
Speaker 3
All about now.
Speaker 2
Just got.
Speaker 3
Don't hear it.
Speaker 3
That's why we're here.
Right?
Speaker 2
And would not get into again.
Speaker 2
We're just going to beat you up from the rest of the time, so I hope you're good now.
Speaker 5
OK, perfect perfect.
Speaker 3
We build you up to tear you apart.
Speaker 5
It's all about balance.
Speaker 5
It's all about balance.
Speaker 2
Yeah, yeah.
Speaker 4
Well, I think OK on top.
Speaker 4
Of that balance thing, I think it's important to say I don't.
Speaker 4
I always bring this up.
Speaker 4
I always look.
Speaker 4
At people especially, we have our guests.
Speaker 4
On but you have.
Speaker 4
All of these accolades.
Speaker 4
You were on the TF OS.
Speaker 4
Group you lecture nationally, internationally, but also you have a basically five star rating.
Speaker 4
From your patients, your patients love you.
Speaker 4
You still practice, yeah?
Speaker 4
And your patients have like nothing, but there's 625 reviews at your current location and basically a five out of five star review. 4.7 but I.
Speaker 4
And that's really.
Speaker 4
I mean honestly 'cause sometimes people get so I don't know.
Speaker 4
This happens with a lot of professionals but.
Speaker 1
You get so.
Speaker 4
Caught up in all of the things that you're doing, you don't have time to really let a patient understand what they're what you're talking about, and the complexity of their eye disease.
Speaker 4
So I think I think it's worth saying and pointing out.
Speaker 4
When you are well reviewed by our patients, it's important not just to.
Speaker 4
Smart and really you know, go above and beyond in regards to treatment patterns but also getting your patient on board and understanding.
Speaker 4
How to treat?
Speaker 5
Yeah, I that's some.
Speaker 5
Well thank you for pointing that out.
Speaker 5
I guess because really at the heart of all of this stuff really is clinical care.
Speaker 5
And really, you know all of the research, all of the lecturing.
Speaker 5
That's all.
Speaker 5
Based on what my experience has been like in the exam room.
Speaker 5
So you know what we need to figure out is really how to take all of that knowledge.
Speaker 5
And translate it into better patient care.
Speaker 5
And so it's it's good that that part of it is appreciated, because that's really kind of the core of what we do, right so?
Speaker 4
Totally yeah totally well.
Speaker 4
I want to get.
Speaker 4
Into T restore and Ken.
Speaker 4
But before I.
Speaker 4
Do that you.
Speaker 4
Know all of our listeners know we.
Speaker 4
Like to go?
Speaker 4
Over some of the you know, trending news and right now trending news is all about masks.
Speaker 4
We've talked about masks.
Speaker 4
We've talked about.
Speaker 4
All everyone has the most annoying thing related to masks.
Speaker 4
Going on in their office, whether it be fogging up the phoropter's or.
Speaker 4
Or you know all the different things or patients are complaining about when it comes.
Speaker 4
To masks but.
Speaker 2
Yeah, Speaking of masks, I heard that we're going to be talking about a mask tonight, right?
Speaker 2
It protects you from COVID.
Speaker 2
You could do your you know Facebooking and also heat up your your meibomian glands.
Speaker 2
Isn't that right?
Speaker 2
Maybe that's not totally true.
Speaker 4
It's giving away all the clues.
Speaker 2
We won't.
Speaker 2
We won't make those claims here tonight.
Speaker 1
It's classic.
Speaker 2
Let's maybe as a political rally that we could make those claims.
Speaker 2
I don't know.
Speaker 2
I'm just kidding.
Speaker 2
Uhm anyway, so yes, let's let's hear about some of this controversial slash.
Speaker 2
Just life.
Speaker 2
We're living dry eye discussion, Roy, a trending hashtag.
Speaker 4
News if you will OK.
Speaker 4
So there is officially a term we call made mask associated dry eye. You know this is this is 2020 now.
Speaker 4
So we've got to be on top of these terms, but there actually is an older study from 2019. Well, it says during the 2019 novel Coronavirus Outbreak, investigation of dry ice.
Speaker 4
Symptoms of medical staff during hospital work during the coronavirus outbreak.
Speaker 4
So basically what they did is they checked out doctors and nurses and they were looking at several different things, including OSDI score.
Speaker 4
Uhm, how much you were experiencing mild, moderate, severe dry eye.
Speaker 4
Time and correlated factors including protective eyewear.
Speaker 4
Their, et cetera related to masks, and they found that doctors and nurses were experiencing a significant increase in dry eye because of masks.
Speaker 4
There's even now a fancy infographic for made.
Speaker 4
So I don't know what do you have.
Speaker 5
Well, I think it's.
Speaker 4
To say about this.
Speaker 5
I think it's the real deal. I mean, you know we go from, you know, wiring under under certain conditions so you know for folks that are are operating and stuff where they've got them in the OR.
Speaker 5
But we've, you know, during an entire clinic day, now you you barely take it off unless you're just getting a drink of water or grabbing something to eat.
Speaker 5
So so it all kind of comes down to.
Speaker 5
To airflow and and changes in lid position and all that stuff that Max.
Speaker 5
And a good fitting masks actually cause so so in poor fitting masks you've got all of that air.
Speaker 5
That kind of comes up that accelerates a, you know vaporation and.
Speaker 5
Touch and then you've got some that may be so tight that they actually cause a deformation of the lid and and change blink patterns and so that changes how those meibomian glands will work and tear redistribution work, so it's it's the.
Speaker 5
Real deal.
Speaker 4
I recently I live on the West Coast and I flew to visit my parents on the East Coast.
Speaker 4
And so that's just.
Speaker 4
Five and a half hour flight, and you keep your mask on on for most airlines nowadays and.
Speaker 4
I left with an episcleritis.
Speaker 4
And when in the mirror I looked in.
Speaker 4
The mirror and I had the reddest.
Speaker 4
I mean, I don't.
Speaker 4
I have don't usually deal with dry.
Speaker 4
I don't wear contacts, so like when I see a red eye on my own self.
Speaker 4
It's kind of weird.
Speaker 4
And I was thinking, Oh my gosh, what did I do to myself and I realized like I was just bundling air right at my eyes?
Speaker 2
You could have been tier restoring the entire flight.
I could have.
Speaker 3
Been higher point you could see restoring.
Speaker 5
They should have should have that.
You could have been.
I could just.
Speaker 2
Watching, did you watch a movie on the inflight?
Speaker 4
Next time I will be.
Speaker 2
Media would you want?
Speaker 4
Oh yeah, I just.
Speaker 4
Just, uh, what did I watch?
Speaker 4
I I probably watched some TV show.
Speaker 3
You could have the restored.
Speaker 2
While you watch that.
Speaker 2
I'm just kidding.
Speaker 4
I couldn't hear sword I could have.
Speaker 2
I'm just kidding.
Speaker 4
Done a lot of things, but instead I.
Speaker 4
Just I've used in abusing my pretty eyes.
Speaker 3
Yeah well there are lots.
Speaker 2
Of Scott Point, you know there have been, you know, numerous studies that look at the size, shape, length, curvature of lashes and the associated flow of air so.
Speaker 2
You know, I I.
Speaker 2
Don't know if there's a, is it.
Speaker 2
Have you seen studies that prove?
Speaker 2
What you're talking about, royea?
Speaker 2
Or is this you know, kind of theoretical in nature?
Speaker 4
So we talk about air blowing up my eyes.
Speaker 2
Matt made yes, I know there's an infographic, so that means it's almost basically, you know.
Speaker 5
If it's on the Internet, it's.
Speaker 3
On the Internet it's.
Speaker 5
Gotta be real.
Speaker 3
And there's a really cool infographic.
Speaker 2
So I'm I'm sold.
Speaker 3
I'm good, but I'm just wondering.
Speaker 2
Did you any studies now?
Speaker 2
It makes sense.
Speaker 4
I mean that one study I just told you.
Speaker 4
About that was I'm going to link that.
Speaker 1
Is that a study?
Speaker 5
So yeah, so this is actually something that we're looking at in an informal sense now.
Speaker 4
Study, yeah, it's on Putnam.
Speaker 5
And depending on what kind of information that we get.
Speaker 5
Maybe you know who knows, maybe we'll be able to pump out a paper in in a few months or something, but because of that and then also anecdotal reports have increased.
Speaker 5
Like you know, Sties and Hardy.
Speaker 5
Ola, you know we're starting to to at least do some survey work right now with the hospital workers that we've got around University of Colorado to take a look at.
Speaker 5
Whether or not this is something that does need more investigation.
Speaker 1
Cool, well weirdly.
Speaker 4
Well, I mean, you know.
Speaker 2
We got.
Go ahead.
Speaker 4
You have to have.
Speaker 4
Air coming toward your eyes.
Speaker 4
I mean, where else if?
Speaker 4
If you're sitting by the front door and the front door keeps fogging up, why would it not be coming toward your?
Speaker 4
Eye without the.
Speaker 4
Proper there you know, like air is coming out, errors rising when you're talking, especially or heavy breathing.
Speaker 4
Where else is going?
Speaker 4
To go.
Speaker 2
Yeah, cool that.
Speaker 5
Yeah, are you guys doing anything that that is helping patients with this?
Speaker 3
Well, listen, we're going to.
Speaker 5
I mean 'cause?
Speaker 5
You both are clinicians as well.
Speaker 5
So do you have those little plastic like airflow, redirectors or anything like that?
Speaker 2
No, no, I haven't done anything, I mean.
Speaker 4
Let's see, I don't know this freedom.
Speaker 2
I think we've talked to patients about, you know you could.
Speaker 2
Tape, you know, hold it on tight or pinch it closer, you know.
Speaker 2
Really no, no, I don't have any good advice.
Speaker 2
How about you?
Speaker 5
I I don't really either if they're fogging up before after then, usually we'll apply a little bit of paper tape across the top of the mask just to redirect it, but I've seen some you know interesting, like YouTube videos and stuff of people taking like those clear, then almost like a folder?
Speaker 2
Are you talking about behind the phoropter, yeah?
Speaker 5
Yeah, yeah, exactly 4 after specifically.
Oh yes, yes.
Speaker 2
My I know this.
Speaker 2
I get darts for this but I just tell him to take the mask down while we're doing that I just say pull your nose out, you know and you know I won't look at you while you're breathing and and yeah it's it's a little controversial I guess.
Speaker 2
But you know, you know, is it better to get all that moisture on the on the lenses and you know?
Speaker 2
I don't know.
Speaker 2
You probably don't refract all that much Doctor Ashworth I.
Speaker 2
I'm not sure, but you know.
Speaker 2
It's a laborious.
Speaker 2
This part of the day to begin with, and then you know to make it that much more complicated.
Speaker 2
So for me, you know that's what we've been doing since March, and we've not had any problems.
Speaker 5
OK, I suppose it's too much to ask him to hold their breath the whole time that you're attracting, even with the even with the exponent you know.
Speaker 4
I mean what I?
Speaker 1
You know?
Speaker 3
It was a little hard to.
Speaker 3
Just pick people up off.
Speaker 2
The floor all the time, you know, so it's just.
Speaker 4
A couple couple learned lessons.
Speaker 2
Yeah, what do you?
Speaker 2
Do Roy I think we've talked about this, but I forget what you do.
Speaker 4
No, actually.
Speaker 4
So most of the time I'm not doing the primary refraction, but if anything I come in at the end, so my tech typically does put a little piece of tape across their nose.
Speaker 4
Yeah, but I mean it does suck, and especially if a patient has like keratoconus.
Speaker 4
Or a higher.
Speaker 4
Prescription you know they need to be closer anyway.
Speaker 4
If they're like a - 2, they can float away a little bit and it's.
Speaker 4
Fine, but have a.
Speaker 4
Higher amount of prescription it's going to definitely affect their prescription so.
Speaker 4
I do my best to say if you pinch your nose it is less likely to go up toward the eyes so, but it's frustrating to patients too.
Speaker 3
Don't pay.
Speaker 4
So like sometimes if it's like some of my older patients, they.
Speaker 4
Just take their mask down.
Speaker 4
And I'm like whatever, I'm.
Speaker 2
I got mine on your good.
Speaker 4
Staying out of your way.
Speaker 4
Let's get this.
Speaker 4
Done quick you.
Speaker 2
You know we'll clean it.
Speaker 4
Chose this one.
Speaker 4
Yeah you you chose this, I didn't tell you to do this that's.
Speaker 1
Yeah, yeah fine.
Speaker 4
Why you chose this?
Speaker 2
Anyway, so listen.
Speaker 2
We are like you said, we talked a lot about dry eye.
Speaker 2
We've talked a lot about, you know, new technologies with dry eye.
Speaker 2
We saw you know a picture online the other day with a dude and I thought he was in the Blue Man Group.
Speaker 2
He was wearing this thing on his face.
Speaker 2
I'm like yo this new treatment for dry eye involves being part of the Blue Man.
Speaker 2
And so it's a newfangled, you know, thermal based treatment for meibomian gland dysfunction is is basically what we got, and so we got the co-founder of tear restore here on the line today I'm.
Speaker 4
Your bangled
Speaker 2
I'm sure he's won, won lots of awards.
Speaker 2
Also in his own right, but he is here with Doctor Houseworth to speak to us tonight.
Speaker 2
His name is Ken Dow Schmidt.
Speaker 2
He's an avid soccer player.
Speaker 2
Actually, that's all you really need to know about him.
Speaker 2
I'm just kidding.
Speaker 2
There's much more that you should know.
Speaker 2
About him, but you know what I want to know about him is how in the world did you get mixed up with dry eye?
Speaker 2
You're not an eye doctor.
Speaker 2
You know who forced this upon you and and why didn't you run the opposite direction?
Speaker 6
Maybe I shouldn't.
Speaker 1
I don't know.
Speaker 4
It's not too.
Speaker 4
Late or maybe it is.
Speaker 6
Yeah, well, my background was originally pre Med.
Speaker 3
OK, well there you go alright?
Speaker 6
And then I started working at at Minnesota Consultants and so they scared me away from being a doctor right away, but.
Speaker 1
OK.
Speaker 6
They also introduced me to dry, so I answered like I had a bit of that.
Speaker 6
You know, baseline to I epiphany if you will or someone tells you that it's not a lack of tears and then.
Speaker 6
You're like, wait?
Speaker 6
It's not.
Speaker 6 Speaker 6
What kind of treatments are out there for people?
Speaker 6
So that's really what that.
Speaker 6
Got me started.
Speaker 2
Wow, when was that?
Speaker 2
Was that recently was that?
Speaker 2
20 years ago.
Speaker 2
10 years ago.
Speaker 2
Five years ago.
Speaker 6
Four to five years ago.
Speaker 2
Two years ago.
Speaker 6
OK, so that was when I was first introduced to it, and then I went back to school and got a masters in biomedical engineering.
Speaker 6
And so I kind of put those two together and found the needs within the market for dry eye and came up with this.
Speaker 2
I love it.
Speaker 2
I mean I just got tingles as you're telling me that like I mean, it's just 'cause this is what we need.
Speaker 2
We need people that like give a.
Speaker 2
Damn, you know.
Speaker 2
And go out and make stuff happen, like because you know.
Speaker 2
I mean, we're all doing it every day and like you know, over a cocktail at a meeting we might be shooting around, you know, chit chat and chewing the fat about you know things we could do and.
Speaker 2
And change the world, but.
Speaker 2
You know you get these ideas and put it to paper is one thing, then making it happens another and investing it in this whole other thing.
Speaker 2
So I mean you, you got this idea, you got this, you know passion if you will.
Speaker 2
And then you went to school so take take us through the idea to development side.
Speaker 6
Yeah, absolutely.
Speaker 6
I mean originally like I said, was was just identifying dry eye patients, you know?
Speaker 6
Seeing them in clinic.
Speaker 6
Uh, they're you know, frustrated by by the treatment options that are out there.
Speaker 6
For them, they're frustrated.