Listen as Dr. Latkany explains dry eye, the symptoms, causes and treatment from questions asked by women on EmpowHer.
Todd:
Hi, and thank you for joining us, and lots of women have been coming to EmpowHer, the home of women’s health online, to learn more about dry eye. And that’s why we are joined by Dr. Robert Latkany from the Dry Center at Physician Eye Care of New York. Doctor, thank you so much for joining us here at EmpowHer.
Dr. Robert Latkany:
Thank you for having me.
Todd:
Now I know your book The Dry Eye Remedy is available on Amazon, but what exactly is dry eye, and is it singular or plural?
Dr. Robert Latkany:
Good question, no one has ever asked that before, but it is plural and dry eyes basically is not having enough moisture to cover the surface of your eye, and that’s because you either not make enough tears or you have poor quality tears, or it could be combination of the two. More often than not, it has to do with the poor quality of your tears.
Todd:
So some tears have a higher quality, I guess is what you are saying.
Dr. Robert Latkany:
Oh, definitely. It’s not just water that covers your eyes. It’s a mixture of mucin or mucus material, water, and oils or lipids. A lot of people are deficient in lipids, and the tears that cover their eyes, they break up very quickly, especially when they are staring at a computer and their eyes will get that feeling of dryness.
Todd:
Well let’s talk about the symptoms. I think that’s always a good place to start. What are the symptoms of dry eyes? I mean, I notice that I am in front of the computer all of the time working here at EmpowHer. Sometimes I feel a stinginess in my eye. Would that be one of the common symptoms, and what are the others?
Dr. Robert Latkany:
Sure, there’s tons of different symptoms, and some people can present with all of them or just one of them. Probably the most common is this intermittent blurry vision where you are looking at something and it’s clear one second and it’s not so clear the next. The feeling of dryness, the feeling of red eyes, tired eyes, even itchy eyes, feeling like there’s something inside your eye. You can also have swelling, and in severe cases you can certainly have almost a painful stinging, prick-like sensation.
Todd:
Doctor, when I announced on EmpowHer site that you are going to be joining us, I got a flood of e-mails and also women posting on the site. Would you be okay with me running through some of the questions that have been contributed by anonymous women on the site?
Dr. Robert Latkany:
Of course.
Todd:
Okay, cool. So doctor, can dry eyes be associated with a hormonal imbalance or a testosterone deficiency?
Dr. Robert Latkany:
Sure, this is currently being researched, but I would say the majority of my patients are over 40 and female, and so there is clearly some sort of hormonal relationship. The belief right now on the surface is that there’s a drop in androgen levels as we age, and this drop in androgen somehow is impacting the quality and quantity of tears on the surface of our eyes.
Todd:
All right now, I work at EmpowHer where no question is a silly question, and which is a beautiful place for me to work, so androgen levels--what are androgen levels?
Dr. Robert Latkany:
It’s basically the testosterone and/or the derivatives of testosterone.
Todd:
Doctor, one woman e-mails into me saying, “Todd, make sure you ask Dr. Latkany this question: one friend suffered with dry eyes, and the doctor never checked her hormone levels. Why is it that doctors don’t check women’s hormone levels and the association that they might have with dry eyes?” Do you have any insight on that?
Dr. Robert Latkany:
Yeah, I mean it’s a good question. In general, I rarely check hormone levels. I’ll just assume that something is, you know, there’s some contribution there, but since we don’t really know what to make of it, it’s not a routine test. We don’t know if it has any impact on estrogen levels, progesterone levels, androgen levels, so we really wouldn’t be able to make any sense of the result.
But sometimes I’ll refer a puzzling patient to an endocrinologist to get hormone levels checked, more for just information rather than any sort of help in how I would manage this patient.
Todd:
Right, another woman e-mailed in and said, “I have got dry eyes and I’ve been to countless doctors, and they can’t figure out what’s wrong with me. Doctor, how do I advocate for myself?”
Dr. Robert Latkany:
That’s another great question, and I would say the typical patient that comes to see me in New York City is one in which has seen somewhere between 8 to 10 doctors before they make it to me.
Todd:
Wow, really?
Dr. Robert Latkany:
And they are rather frustrated, and some fly from around the world, you know Australia, Africa, you name it. And these are patients that are screaming out for help, and even though dry eyes remains to be the most common reason why someone would present to see an eye doctor, it’s not a very exciting disease, and it’s non-surgical, and there’s really no cure for it.
So sometimes the doctors often mismanage it or neglect these patients and because it’s not a simple thing like an infection: you take an antibiotic and you’re all better. It requires a lot of handholding, a lot of detective work, and frequent visits to the office, and often you’ll encounter frequent failures in treatments, but there are so many options and there are so many ways to manage the condition.
In my practice, it’s very, very high success rate in getting patients functioning, comfortable, and happy.
Todd:
Well I’ve got this other question that came in, and it’s a little long, so bear with me.
Dr. Robert Latkany:
Sure.
Todd:
The woman says, “Hi, I am asking for a friend of mine who has a mild case of dry eyes. She wants to get those contacts that you only wear at night that somehow make your eyes not need glasses during the day, but her doctor said that her eyes are somewhat dry so she is having a hard time getting a proper fit for the contacts. Would you ask Dr. Latkany if there are any natural approaches to dealing with dry eyes, for example, if any vitamins or minerals or supplements or even maybe some drops which I just added on my own, maybe a change in diet? Would drinking more water help? Thanks so much, Doctor, for being available to answer this question.”
Dr. Robert Latkany:
Sure, in my book The Dry Eye Remedy, I would say the bulk of the book is kind of a natural approach in managing dry eyes. In there, I discuss that I prefer omega-3 fatty acids, specifically salmon oil, wild salmon oil, various tips you can do at your house or in your job that will make the environment more suitable for your eyes: adding a humidifier, maybe an air purifier, tilting your computer screen that you look down on it rather than looking at a level area. This will make your surface area not as great; buying an antiglare computer screen.
Just in general, omega-3 fatty acids on the diet part of things and you can get that through nuts and a variety of dark, oily fish that you consume, but the supplements are a very nice way of getting excess quantity of omega-3 fatty acids. So yes, there are endless approaches of dealing with dry eyes in the natural category and that usually is fairly successful, but patients have to be somewhat patient because it doesn’t work overnight.
Todd:
You’re listening to Dr. Robert Latkany from the Dry Center at Physician Eye Care of New York. He is the author of the book Dry Eye Remedy which you can get on Amazon. You can visit him on the Web at dryeyedoctor.com.
Doctor, what is it about omega-3s and the fatty acids found in the salmon oil, you just alluded to it, but how does it help women with their dry eyes?
Dr. Robert Latkany:
Well, most of dry eyes has to do with inflammation. So inflammation of some source, and we’ll go over some potential etiologies of dry eyes in the future, but omega-3 fatty acids are anti-inflammatory so they bring down the inflammation. I don’t want to get people to realize that, you know, it’s you’re not going to take a few salmon oil supplements and be cured of your dry eyes, but omega-3 fatty acid is certainly a wonderful product to take for a number of ailments in the body, and it certainly helps out dry eyes, but I think that by itself won’t make you comfortable, but it will certainly be a nice additive approach to making you comfortable.
Todd:
That’s so interesting that you bring up the inflammation approach. So many doctors have been talking with me, and it could be a heart doctor, it could be a doctor that is a dentist, it could be a doctor that deals with dry eye like you and I are doing right now, but inflammation seems to be such a powerful force that goes on inside of our body. It’s so fascinating that it can just be found in all different parts of the body to create problems.
Dr. Robert Latkany:
I agree, and it certainly plays a big role in dry eyes.
Todd:
Okay, so another woman says, “Dr. Latkany, what is the spectrum of condition known as dry eye? As I am sure there is a mild to severe symptom, some diagnosable or chronic, and others perhaps more seasonable or acute. Can you elaborate on this?”
Dr. Robert Latkany:
Sure, that’s a tough question.
Todd:
It’s a big question.
Dr. Robert Latkany:
I think I can talk about it for hours, but in general I can kind of answer it by answering who gets dry eyes and how do they present, and as I alluded to before, that most common patient I see is someone over 40 and female. But I think there’s certainly another subset of groups that also present with dry eyes, and one of them would be someone in that post-surgical group, you know, LASIK eye surgery, the surgery you get to remove eye glasses or eliminate contact lenses.
That group of patients very often, you know, somewhere maybe 75 to 80% of them suffer from dry eyes afterwards and about 5 to 10% suffer chronically from dry eyes afterwards, and I talk about recent effects, professional athletes, you know, Tiger Woods had laser eye surgery and he attributes lots of his successes to his great vision.
But then again, there are a number of athletes that have suffered, and I write about it in my website medpie.com. One of them was a recent baseball player Brian McCann of the Atlanta Braves. He talks about how he can’t see the ball coming in to when it’s pitched and the quality of the vision, and he thinks it’s all because of dry eyes.
So I see tons of patients in my practice post-LASIK eye surgery that deal with dryness. There’s another group of patients – the contact lens group. Very often contact lenses exacerbate dry eyes, and that can be quite debilitating to the patients, enough so that they can’t even wear contacts anymore.
So a LASIK crowd, a contact lens-wearing crowd, and another big group of patients are people with autoimmune diseases such as diabetes, thyroid abnormalities, rheumatoid arthritis, Sjögren’s syndrome. You have very common ailments that can affect other parts of the body and result in dry eyes.
So depending upon how you present, you could have a severe case of say rheumatoid arthritis and you might have severe dry eye symptoms, and it depends on how long you’ve had the condition and what you’ve done to that point.
Todd:
Well, the rheumatoid arthritis being another inflammation issue.
Dr. Robert Latkany:
You bet, a lot of those autoimmune things are all basically inflammation, and I would say the bulk of all autoimmune patients have dry eyes.
Todd:
That is so cool that we are able to put two and two together. Often two and two go unnoticed, and people end up just living in suffering. A woman e-mailed in to ask you a question, she says, “Dr. Latkany, my mother, now 80, had dry eye. Is there a condition connection in any way to macular degeneration?”
Dr. Robert Latkany:
Well, I think that first part of the question, mother and 80 years old, that’s the giveaway right there. I doubt you’ll find any 80-year-old females that don’t at least have mild dry eyes, and then any connection to macular degeneration – in general no, because macular degeneration is caused typically some sort of genetic cause and influenced by being around second-hand smoke or smoking yourself and sunlight.
So those things tend not to cause dry eyes although smoking can exacerbate the symptoms of dry eyes, but one interesting connection is omega-3 fatty acids that we talked about earlier have shown to be helpful in treating macular degeneration, and as we already mentioned, very helpful for dry eyes.
Todd:
When I was on your website, I noticed this ”did you know” section, and one thing I found really interesting was ”persons with dry eyes often report excessive tearing. If the body senses that your eyes are too dry, it will make more tears to compensate for the dryness.” Talk to us about that. I mean, it’s often, it’s common that I see someone that is like that woman who e-mailed the question, and like her mom, 80 years old and has a Kleenex next to the side of her eye, is that a warning sign to you?
Dr. Robert Latkany:
No, not a warning sign, but certainly I might left that out in the symptoms question you asked earlier. I think it’s certainly one of the top presenting symptoms with dry eyes is tearing or excessive tearing, and very often the patient says, “How can I have dry eyes if I am tearing all the time?” And those are reflex tears. Those are tears, for example, if you are cutting an onion, your eyes tear or emotional tearing when you are crying; those are different than your baseline tears.
So if your eyes are irritated, stinging, burning, tired, what have you, as a reflex, your body and your eye causes tearing, but those aren’t tears that stick to your eyes as well as the other ones, and it could be a chronic problem. So once you’re dry and you cause an irritated surface, you’ll tear and it will fool sometimes a doctor and certainly the patient in not thinking that the patient has dry eye.
Todd:
Dr. Latkany, for those women who are listening right now that have a dry eye problem, you are the author of The Dry Eye Remedy. Tell them about your book.
Dr. Robert Latkany:
Sure, as I said, it’s the most common reason why someone presents to an eye doctor and very often, don’t get discouraged if your eye doctor does not address this or manage this properly. There are doctors that do treat dry eyes and welcome your presence in their office, and it’s a serious condition. It can cause serious unpleasant days for you, and my book goes over really basic understanding of the condition, how to manage it, and most of it is all conservative management. And it’ll give you a nice understanding of what you have, what you can do about it, who you need to see for it, and it really has been, it’s actually on Amazon.com and I think it remains to be one of the top books sold about eye-related disorders over the past two years.
Todd:
Dr. Latkany, so even though when I go to the eye doctor and I go through that checklist and I check if I have dry eye or I don’t, even if I check I have dry eye, the doctor may not specialize in and may not even know how to get me out of the symptoms that I am experiencing?
Dr. Robert Latkany:
I would say sadly enough, most often that’s the case and as I say, it’s very common that the patient that comes to see me had seen 8 to 10 doctors before they had come to my office.
Todd: Well, that really says something, doesn’t it?
Dr. Robert Latkany:
Yeah.
Todd:
He is Dr. Robert Latkany from the Dry Center at Physician Eye Care of New York. His website is dryeyedoctor.com, his book The Dry Eye Remedy available at Amazon. Dr. Latkany, thank you so much for helping us empower women.
Dr. Robert Latkany:
Thank you for having me.
About Dr. Latkany
Dr. Robert Latkany is the first New York Eye Doctor to devote a significant portion of his practice to the treatment of dry eyes and blepharitis. He founded and is the director of the Dry Eye Clinic at the New York Eye & Ear Infirmary, the first Dry Eye Clinic in the tri-state area.
Dr. Latkany is actively involved in Dry Eye research and lectures nationally and internationally. He has published several professional papers and has filed two patents. In addition, Dr. Latkany's book, The Dry Eye Remedy, the first book ever written about dry eyes to the general public has sold almost 20,000 copies in the first year.
Visit Dr. Latkany at his website
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The Dry Eye Remedy