top of page
Search

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.

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

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.

Speaker 2

So was this part of your schooling?

Speaker 2

Then this part of you know your development was this part of schooling?

Speaker 2

Or did you link back up with Minnesota Eye consultants or?

Speaker 6

So I worked for minutes and I'll consultants while I was getting my masters degree.

Speaker 1

Cool OK cool cool cool cool.

Speaker 6

So with a little bit of both I did part time work to keep paying the rent while I was going to get my masters and I was actually working with Scott at the time and so we were seeing a lot of dry eye patients coming in in their condition.

Speaker 6

You know, was.

Speaker 6

Really affecting their quality of life.

Speaker 6

And there weren't a lot of good options for them, and so at that point you know I took a step back to try to figure out, you know, what is it that these patients should be doing or what good options are there out there for them and in office.

Speaker 6

There's great options, you know there's there's effective heat that warms the glands to the right temperature to the right amount.

Speaker 6

Time, but then I looked at the inn at home.

Speaker 6

You know, treatment options, and honestly they seemed a little bit barbaric to me.

Speaker 6

They were a little unscientific in terms of, you know, some doctors are prescribing a hot washcloth on the eyes and at the same time they're recommending a lipid.

Speaker 6

Low, which has very scientific, you know basis, and so I was like there's a little bit of a disconnect going on here.

Speaker 6

So that really started me down the process of coming up with an at home device.

Speaker 6

That's going to have effective heat for those patients, and the real kind of.

Speaker 6

Action factor behind that was not only with the doctors but also with patients.

Speaker 6

So doctors want to prescribe something that's going to work every time for their patients.

Speaker 6

They don't want them guessing the temperature.

Speaker 6

Even so, that's what led me down to two.

Speaker 6

So design the heat pack for it.

Speaker 4

Let's take a real quick.

Speaker 4

You know micro detour or it could go macro.

Speaker 1

Yeah, yeah.

Speaker 4

If you want a little bit but.

Speaker 4

Let's talk a little from, you know, Artie Foss.

Speaker 4

Society member here.

Speaker 4

What first of all is MGD OK?

Speaker 6

We're gonna ask.

Speaker 2

The expert let's phone in the expert.

Speaker 5

Can I call a friend?

Speaker 5

Yeah, and.

Speaker 3

You're our sorry.




Speaker 2

What is the main differentiator with Terer store, yeah.

Speaker 5

So Ken, if you don't mind, I'll start this one off.

Speaker 5

And then turn it over to you because.

Speaker 5

You know, at the beginning of all this, before T restore actually was in existence before it.

Speaker 5

Actually, you know, was birth Ken and I had a lot of conversations about the science, you know, and about the temperature and the time and all that kind of stuff.

Speaker 5

And but one of the things that we thought was a pretty significant obstacle is really compliance, because you're asking patients.

Speaker 5

If you're doing a 10 to 15 minute warm compress, you know even just once a day, that's 10 to 15 minutes where they have to devote it to specifically that one thing they don't really get to do anything else, and so we thought if we could create something that would improve compliance, you know, allow them to continue doing other things during the day.

Speaker 5

That really would probably help that.

Speaker 2

Absolutely so something that helps with compliance, yes.

Speaker 6

Yeah, absolutely.

Speaker 6

And actually to build on that.

Speaker 6

So once we had an idea of what we wanted to do, we applied for some funding from the National Science Foundation to really vet out the idea and and really, you know, interview patients and other doctors and and figure out if we are on to something in terms of.

Speaker 6

Or is this something people want is?

Speaker 6

Is something that.

Speaker 6

That will solve you.

Speaker 6

Need on the market and so we asked a lot of patients, hundreds of patients you know what is it about your warm compress?

Speaker 6

You know what do you like?

Speaker 6

What do you not like?

Speaker 6

How about when you don't do it, which is probably a lot of the time.

Speaker 6

What are you doing instead of that?

Speaker 6

And as.

Speaker 2

Picking my nose, watching, looking at my phone.

Speaker 6

Yeah, as you probably go, yeah, it's it's checking your know it's checking your phone's, yeah.

Speaker 2

On literally nothing, you know, right?

Speaker 2

Like I want to do nothing.

Speaker 2

There's my eyes open.

Speaker 4

Yeah, yeah, definitely.

Speaker 6

You checking your phone, you're maybe making a cup of coffee in the morning, 'cause it's part of your routine.

Speaker 3

OK.

Speaker 6

But yeah, it was mundane things and it at that point we're like.

Speaker 3

Is what they said they said just.

Speaker 2

Kind of basic stuff, yeah?

Speaker 6

Yeah, it's OK.

Speaker 6

'cause when you really grill them, we got to really get into it.

Speaker 6

'cause at first they come up with really you know things that that you know take a lot of stuff.

Speaker 2

Balancing my checkbook.

Speaker 6

Yeah, exactly.

Speaker 2

I don't know something very important.

Speaker 6

And then you're like, what about the next time that you skipped it and they're like, OK?

Speaker 4

Everything else, yeah.

Speaker 6

I was checking my phone and I just didn't want to do it.

Speaker 3

Yeah, let's be honest.

Speaker 6

So, so that point is like we're on to something we can give them usable visions during this time and give them back that 15 minutes of their day, which really adds up over time.

But then.

Speaker 6

I mean 15 minutes every single day for the four days a year.

Speaker 6

He just laying there blindfolded.

Speaker 2

It's cool, yeah, that's cool.

Speaker 4

I think that like real talk here.

Speaker 4

When I so I got the product I got to try it and the first thing I thought was but it's not touching my lids like is that is it still working?

Right?

Speaker 4

This is a mask for any of our users.

Speaker 4

We have a we have a link on.

Speaker 4

Our Instagram thing.

Speaker 4

You can go check it out on Facebook if you.

Speaker 2

I've I put some pictures up.

Speaker 4

Want to see what we're?

Speaker 4

Talking about this this sweet mask.

Speaker 2

We're going to put some some goofy pictures of us on there because 'cause listen it makes you kind of feel a little.

Speaker 4

Yes, well.

Speaker 3

Silly at first.

Speaker 2

Because but you know what people loved it and you know, yeah, superhero asked people like what're you like coming out of superhero, UM, when I had it on, my staff was like walking by like what do you?

Speaker 4

No, I would say super.

Speaker 4

I'd say super super Contra.

Speaker 4

Cording, it's gotta go, yeah.

Speaker 2

What is that?

Speaker 2

What is it?

Speaker 2

It definitely inspires questions.

Speaker 2

You know that.

Speaker 2

So that's really a.

Speaker 2

Cool thing about it conversation, yeah.

Speaker 1

Yeah, yeah.

Speaker 4

No, but really it's not necessary.

Speaker 4

So there's open eyes like a mask.

Yeah, it's here.

Speaker 4

And you can see.

Speaker 4

So you can sit, you know, type your charts up.

Speaker 4

You can sit and sit on your phone, but if it's not touching my eyes, does that mean it's not working?

Speaker 5

Yeah, so, and we actually thought that exact same thing like OK if we're going to do this, we need to test it.

Speaker 5

And so we we actually just a bunch of us at my work.

Speaker 5

We're just sitting around and we basically looked at lipid layer thickness before after we looked at, you know, a little bit of subjective symptoms just to see, hey, what's it doing and.

Speaker 5

We were really pretty impressed with the amount of change that was actually taking place was up to like 30%.

Speaker 5

Of an increase in lipid layer thickness just by having that and part of it is probably the heat, but the other part maybe actually that we're allowing the patient to blink or through it as well.

Speaker 5

So not only are you liquefying the my bum, but you're also using your natural mechanisms to actually move.

Speaker 5

Some of that might come out of the gland.

Speaker 5

You don't get that with.

Speaker 5

A closed I warm.

Speaker 5

Compress so right now.

Speaker 5

I mean, that's a little bit of a sort of a sneak preview, but we have larger clinical trials going on right now just to make sure, because we had a pretty small sample size with the first sort of preliminary pilot study, so we're looking at, you know, trying to do a little better job to make sure that it holds true across the population, so those those are undergoing right now.

Speaker 2

Awesome, and I think you mentioned that there was and I've seen this type of imagery with other heat devices at home or in office.

Love this.

Speaker 2

Some infrared heat imaging, you know.

Speaker 2

So do you did.

Speaker 2

You use that as sort of like a proof of concept, like an idea.

Speaker 2

In other words, that you actually saw heat.

Speaker 2

On the lids around the eye with it, did you see that or what can you tell me about that?

Speaker 6

Yeah, so that was one of the first things we wanted to evaluate because of the open eye is that upper lid you know not getting as much heat as maybe the lower lid was, but our finding with the thermal imaging that we've done is that it's pretty uniform across the lids and there's only speculation which may be why that is, but that also.

Speaker 6

Plate is significantly thinner on that upper lid and therefore could radiate the heat a little bit better from the brow than negative level.

Speaker 2

Cool well I have tried it.

Speaker 1

Absolutely, I think.

Speaker 2

Couple Times Now couple things that I want to say about it.

Speaker 2

Number one you have, like some super magic goop in there that does like the coolest thing.

Speaker 3

I mean, you click the button and I just like whoa, you know like you.

Speaker 3

Could see this, it's a phase.

Speaker 2

Change, that's what's occurring in there.

Speaker 2

So that's pretty cool number one like I wish that did that every single time that I could watch it, like snake through the bag and the color change and like that was the coolest part of the whole thing for me.

Speaker 3

I was just I was really impressed.

Speaker 3

Yeah I'm like my I just didn't care.

Speaker 6

Pretty sure it.

Done during my time.

Speaker 3

Just look at it.

Speaker 3

So that was number one.

Speaker 2

I really so you know, there's these little rubber, whatever plastic.

Speaker 2

Containers that have something that you're gonna explain.

Speaker 2

Scientific in there.

Speaker 2

That's something like Tronic.

Speaker 2

Some some something happens.

Speaker 2

There's a change of liquid to solid and it gets hot chemistry.

Speaker 5

It is instructionally chemistry.

Speaker 2

And it's very impressive.

Speaker 4

From room temperature to a warm compress.

Speaker 2

So for my you know, simple mind it was just impressive.

Speaker 2

And so I put it on immediately.

Speaker 2

You know, after I placed it in this holder that allows it to go onto my face and then I was able to, you know, answer emails and do XYZ.

Speaker 2

So what's going on there?

Speaker 1

Sure, yeah.

Speaker 5

So the the chemical is sodium acetate and it basically in it's in solution and essentially what happens is when you click the little tab it basically causes a crystallization like supersaturated and when it crystallizes its exothermic so it releases heat and so one of the things that.

Speaker 5

We did and the design was, you know, looking at that time.

Speaker 5

Standpoint, we knew it had a pretty reliable heat release, but we also wanted to make sure it lasted long enough to be therapeutic.

Speaker 5

So so calculated the volume of the of the the bag you know essentially and how much chemical is in there.

Speaker 5

So we knew it could last at least that 10 to 15 minutes.

Speaker 2

It definitely stayed warm.

Speaker 4

Very good.

Speaker 2

I mean, I was.

Speaker 2

I was impressed.

Speaker 2

I was really impressed.

Speaker 4

When I think about.

Speaker 4

Just general treatment recommendations and this is talks about everything across the board when it comes to medical recommendations we give, I think about how inconvenienced I am by recommendations, and I think I try and think about that for my patients.

Speaker 4

For instance, like it.

Speaker 4

Early on in my career, I felt kind of appalled to tell a patient to like make a beanbag sock at their house to do a warm compress.

Speaker 4

Even though, like that's what my professors told me, because like.

Speaker 2

Yeah, and I think you think you're doing them like a solid like because you don't have.

Speaker 2

To get them.

Speaker 4

Right like why like I'm?

Speaker 2

To buy anything you're like, guess what?

Speaker 2

Get a clean sock, one that's not dirty.

Speaker 4

Right like I'm crafty, right, right, right?

Brand number one.

Speaker 2

Put some rice in.

Speaker 4

It right like I'm not.

Speaker 4

Like less than patients like trying to do it themselves.

Speaker 4

That's their prerogative.

Speaker 4

But like no one trying to do a craft experiment to like treat themselves like coming to you for the best recommendation, not for a like project.

Speaker 4

One but #2, so you find a product that works really well is really convenient. How many times I have to tell my patients like go you take this bean bag. You warm it up in the microwave.

Speaker 4

You only do.

Speaker 4

It 10 seconds at a time, wait?

Speaker 4

Till it gets too hot.

Speaker 4

But don't do it too.

Two other.

Speaker 4

Because it'll explode, like those things also are extremely inconvenient, so like something that's going to warm up by itself.

Speaker 4

Brilliant and then number two.

Speaker 4

OK now it's warmed up.

Speaker 4

Now what do?

Speaker 4

I do OK you have.

Speaker 4

To boil this thing, to make it on on or restart to reset it.

Speaker 4

OK, well that means I.

Speaker 4

Have to go get a pot of water.

Speaker 4

My patients who travel a lot.

Speaker 4

It's really inconvenient.

Speaker 4

Like every step that makes it inconvenient as a patient, just not doing it or IE me not doing it.

Speaker 4

If something is exceed 2 steps more than I feel like it needs to.

Speaker 4

Be I would just rather not do it.

Speaker 4

And so I'll just deal with the problem, and I think that's the thing that we need to think about for.

Speaker 4

Our patients, especially not to like stereotype myself.

Speaker 4

But our millennials, who are looking for like kind of a quick fix, that's going to work the way it's supposed.

Speaker 4

To when it's supposed to.

Speaker 2

So and so you've taken the guesswork out of the reheat 2, which is nice because you have the heat option 'cause it can be reheated.

Jury out.

Speaker 2

You said 60 times, I'm gonna say.

Speaker 6

69 Yep yeah.

Speaker 2

9060 to 90 so you know three months.

Speaker 2

That's two months worth if you're doing it twice a day.

Speaker 2

So what about the the reheating process?

Speaker 2

It doesn't need to be boiled, so how did not microwaved?

Speaker 2

So what you send me this nifty kettle and I'm like I'm not using this freaking thing, But then I'm like you.

Speaker 2

Know what it actually worked really good.

Speaker 2

I was totally shocked.

Speaker 2

It was easy.

Speaker 2

I was able to just plug it in right at my desk and it was super duper easy.

Speaker 2

So tell me a little bit about the genesis of the tier restore electric kettle.

Speaker 6

Yeah, absolutely.

Speaker 6

I mean, I think Doctor Habibi, you know, touched on it right there.

Speaker 6

We we want to make it as easy as possible for the patient to to be compliant with the treatment.

Speaker 6

You know we're trying to maximize and or at least minimize the hindrance of of.

Speaker 6

You know, doing a treatment like this, and so we made.

Speaker 6

This boiler that's collapsible and only holds 1/2 liter, so it's pretty small.

Speaker 6

And it one click, you fill it up with water one click.

Speaker 6

It turns off when it's boiling and then you just have to.

Speaker 6

It's gotta keep warm setting on it as well, but you.

Speaker 6

Just have to go back.

Speaker 6

And and basically pour out the.

Speaker 6

Water and it's ready to use the next time.

Speaker 2

I was texting and I'm like how do I get it out without burning my hands?

Speaker 2

I was like go look.

Speaker 3

At the video, you idiot, he actually.

Speaker 2

He was thinking that but he didn't text it to me.

Speaker 2

But then I went to.

Speaker 2

The video

Speaker 2

And I'm like, oh God, yeah, just pour it out.

Speaker 2

So anyway, there's a cool video we'll show.

Speaker 2

You on the show notes of you know exactly how to do it.

Speaker 2

'cause I was like, you know you need to tell me how to do it.

Speaker 2

You know, I wanted to make sure because I'm also trying to think about like what my patients are going to do.

Speaker 2

Like if I'm not intuitively doing it, then I know that I need to into.

Speaker 2

You know, I need to spell it out for my patients also, so I appreciate the.

Speaker 2

The video on the website 'cause that that helped fill in some gaps for me, so I appreciate that, UM.

Speaker 2

So you know I'm gonna hold your feet to the fire a little bit, right?

Speaker 2

Because you know we are, uh, I'm a business owner and Roy is in practice and so you know, one of the things that people you know we talk a lot about in practice and doctor Hauswirth, I'm sure you deal with this quite a bit.

Speaker 2

Also in a university.

Speaker 2

Setting there may be a little bit of division of church and state.

Speaker 2

I'm not sure I'm assuming there is, but you know, this is something that patients are going by, right?

Speaker 2

And so they.

Speaker 2

Nice that you will have various options, but I like to be able to show my patients these things in the office and stand behind them and tell them about it and we like to sell them in the office so we like that opportunity.

Speaker 2

I know that there are other options from what you said, so I.

Speaker 2

Want to hear?

Speaker 2

A little bit about your thought in.

Speaker 2

Uhm, how you're going to offer this to patients.

Speaker 2

And you know what role does the doctor play in that?

Speaker 2

And then also cost, you know, I think that's an important discussion and something that I'm sure you had to really think long and hard about.

Speaker 2

'cause you're obviously in business and you know you need to be able to make it work for you too.

Speaker 2

So and I totally respect that.

Speaker 2

That so tell us a little bit about that 'cause our listeners are gonna be like.

Speaker 2

OK this is fantastic.

Speaker 2

But what does it cost? Is it $1,000,000? Is it unaccessible to my patients because of that? So let's hear a little bit about that.

Speaker 6

That he so you did a lot of research when we were just, you know, interviewing patients and figuring out what they wanted in a product.

Speaker 6

We were also determining what kind of price point we could get.

Speaker 6

Yeah, and so you know, while $40 for the Michael mask sounds nice and that's something we can't do ourselves, but we wanted to be well below $100 for patients to try out the product.

Speaker 6

And, you know, get basically three months of treatment. So our retail price is 7999 for patients.

Speaker 6

And then we do have that extra bundle option for them with the easy to use kettle, and that's 129.

Speaker 5

OK.

Speaker 6

In terms of how doctors can get that to their patients, we have several options available and one of those is, you know, we want them to be profitable along with us, and so we have very generous kind of wholesale prices if they want to sell.

Speaker 6

You know, stock and dispense with in clinic.

Speaker 6

We also are partnering with several distribution arms such as you know, my I store slightly and giresse key, and so they'll have all.

Speaker 6

Of our products available as.

Speaker 2

So you could recommend a patient go to that source and get it.

Speaker 2

Right prescribe it if you will.

Speaker 2

You can send them to the online resource or you can sell it out of your office through wholesale pricing.

Speaker 2

So how would they determine that wholesale pricing?

Speaker 2

Not not what it is, but like how do they?

Speaker 2

How do?

Speaker 2

How does somebody listening to this get that from you?

Speaker 2

What do they need to do?

Speaker 6

Yes, so we have a clinician portal that's easily accessible on our website, so all you need to do is sign in with your.

Speaker 6

With your email.

Speaker 6

We'll approve you within a few minutes and then you have all of the wholesale pricing set out for you there, and we'll process your credit card and take it from there, OK?

Speaker 1

OK.

Speaker 2

And is there so when you talk about wholesale pricing, obviously it's not the you know the 7999 like you just said. It's obviously less than that.

Speaker 2

But what about, you know, if you wanted to buy, you know 5 or 10 or 20, or you know, like what if you get a bulk rate you know is there a bulk rate in addition to wholesale pricing?

Speaker 2

Or how does that work?

Speaker 6

So we wanted it to be as low as we could, so we had 10.

Speaker 6

As the minimum order for the wholesale pricing, we do actually have a starter pack that we're offering that has eight products in it, and so that's a good way to, you know.

Speaker 2

OK, got it so.

Speaker 6

Test patient feedback.

Speaker 6

Also gently through your office and really.

Speaker 6

Test out the.

Speaker 6

Product before you make too much of a commitment.

Speaker 2

Yeah, that's what I did.

Speaker 2

I stuck my pinky toe in so I'm I'm giving it a go I I don't see any problem you know we see a ton of dry patients.

Speaker 2

We've sold a ton of different types of warm copper.

Speaker 2

It's definitely, you know we'll go through those in in a couple of days, I'm sure.

Speaker 3

What about?

Speaker 4

I think a fun thing to sorry Jimmy, but I think a thing that I like to do when I'm practicing.

Speaker 4

I think that a lot of people.

Speaker 4

I don't know.

It's always this funny.

Speaker 4

Line when it comes to treating dry eye because you really have to understand the retail aspect of treatment options because insurance doesn't cover these options unless you perhaps have some sort of flex spending account.

Speaker 4

So you have to be comfortable in talking about the different.

Speaker 4

Products, because unfortunately if you don't give a recommendation of a brand per Southeast, patient is going to go get a.

Speaker 4

Washcloth, you know.

Speaker 4

Patient is going to do whatever creative thing that they can think of to do what you're saying to them and.

Speaker 2

You gotta give them, uh, so like, uh, why you know, you gotta say this one.

Speaker 2

Is better and This is why.

Speaker 4

You've got to give them a why exactly exactly, and I think having your it what I like to do in my office is.

Speaker 2

You know so.

Speaker 4

I have, you know I have tearist or maybe I have, you know, another basic option for them.

Speaker 4

If they perhaps that's out of their price point a little bit.

Speaker 4

Maybe it is the Bruder mask, right?

Speaker 4

So I say these are here for convenience.

Speaker 4

These are what I think are the best quality.

Speaker 4

They're going to work the best.

Speaker 4

They're doing what I'm prescribing for you.

Speaker 4

If you happen to go out.

Speaker 4

And search around online and find another option.

Speaker 4

You can do that.

Speaker 4

I'm not, you know this is not bound to this, but you're not going to necessarily get what I'm expecting this treatment to do for you.

Speaker 4

And so showing like I stand behind these products for you.

Speaker 4