Guest #1 - Philip Paden, MD (Medford, OR), Ophthalmologist, owner of Paden Eye Care Center.

Guest #2 - Art Bernstein (Gold Hill, OR), writer and naturalist.

Sharon Kleyne (paraphrased): Welcome to the Sharon Kleyne Hour. Today’s special guest is my good friend, Dr. Phil Paden, an ophthalmologist with a fascinating and varied background.  Good morning, Dr. Paden. Could you tell the listeners how you became interested in the eyes?

Dr. Philip Paden (paraphrased): I guess it began in junior high, when I developed a passion for photography. I earned money at it all through high school and college and in the process, I became interested in optics and how light and images are transferred and recorded. At age 30, I was teaching chemistry full-time at Cornell University, in New York and racing motorcycles in my spare time. I didn't like teaching that much so I decided to go to medical school. I ended up doing a residency in ophthalmology and here I am.

S: Could you talk a little about eye health?

P: The importance of vision is easy to understand. Most people would rather be deaf or crippled than blind. Sight is extremely precious to us. Interestingly, our eyes are about the same as they were 100,000 years ago. However, our environment had changed drastically so that far greater demands are made on them. This change is mostly in three areas:

1. We live much longer. Instead of living to 30 or 40, we typically live to 80 or 90. That means our eyes are more likely to wear out. Problems with the cornea and retina often need to be repaired, and the delicate glands that produce the tears begin to fail.
2. We are subjected to city air, with its high ozone and particulate pollution, inversion layers, etc., which are dehydrating and irritating to the eyes.
3. Indoor air is also dehydrating and irritating. Technologically controlled environments were supposed to be the final word, but we ended up with forced-air heating and cooling, insulated walls and window, and a myriad of chemicals. There is no fresh air from the outside, dust and bacteria are re-circulated, and the humidity can get dangerously low.

S: I understand you're talking to us from Chicago at an ophthalmology convention.

P:  I am indeed. I'm presenting a paper in 45 minutes on a new laser procedure for glaucoma that I've used on 400 patients.

S: Tell us about dry eye.

P: It’s the most common medical complaint that eye doctors encounter. And by the way, I'm a big fan you your show's sponsor, Nature's Tears EyeMist, which is a remarkably easy, quick and  natural way to replenish lost moisture in dry eyes. I hand out samples to my patients all the time and have received excellent feedback.

S: Could you explain the tear film to us?

P: Unlike a camera lens, which is made of polished glass, the eye's main light transmitter, the cornea, is made up of living tissue with cells and nerves. It has no blood vessels or skin, though and is not naturally shiny. The shininess, which enables it to transmit images, comes from the microscopically thin tear film, which also provides oxygen in lieu of blood. The tear film consists of a MUCIN layer that attaches the tear to the cornea so it doesn’t bead up, the AQUEOUS layer which is mostly water, plus electrolyte, growth factors, antibodies, etc., and the LIPID layer, a single-molecule coating of oil that prevents the aqueous layer from evaporating.

S: I’ve heard that with dry eye, the lipid layer can be too thick. Is that correct?

P: In a healthy tear film, you don't see the lipid layer at all. In dry eye, the eyes sometimes look very oily and the oil can be clumpy and thick. This doesn’t prevent evaporation as effectively and doesn't transmit light as well, either.

S: I’ve been doing some research on the worst US cities for dry eye. #1 is Las Vegas, #2 is Lubbock, TX, #3 is El Paso, TX, #4 is Midland/Odessa, TX and #5 is Dallas, TX. Outside the US, the situation is often much worse. In Argentina, the air is so bad, they recommend you spend no more than three hours a day outside. That’s partly because of ozone layer thinning and an increase in UV radiation. The air is also terrible in China, Mexico and Australia. The tear film is taking a beating in these places and the main culprit is lack of air moisture, which causes increased tear film evaporation. Do you have any nutritional suggestions for maintaining a healthy tear film?

P: Dark green leafy vegetables such as kale, chard, spinach and leaf lettuce. Also flax seed oil and omega-3 fatty acids. The worst thing we can do is keep our eyes opened too long. When we're just sitting around, we blink 30 to 40 times a minute. When were engrossed in something like TV or the computer, we tend to blink only three or four times a minute. This can dry out our eyes very fast because the less you blink, the more evaporation takes place.

S: Is there a nutrition supplement for children’s vision?

P: As I said earlier, barring injury of major illness, children’s eyes are pretty resilient. The problems develop as we age.

S: What about infant eye tumors? I understand that's on the rise.

P: That’s true. However, retinal blastoma, or melanoma of the eye, used to be invariably fatal and it usually no longer is.

S: What are the symptoms of eye cancer?

P: They’re usually pretty evident and "worst case." The outside of the eye is inflamed, there may be retinal detachment or diminished peripheral vision, and so forth.

S: What about macular degeneration?

P: It usually occurs in older people but occasionally turns up in teenagers. In the elderly, it’s part of the normal aging process. The retina loses pigment and deteriorates. The good news is that studies show that the diet I suggested earlier can reduce macular degeneration by 50% or more.

S: Do you have any final words?

P:  Just the usually doctor's advice of eating nutritious foods, getting plenty of exercise and staying healthy in general.

S: And use Nature’s Tear EyeMist whenever your eyes feel dry. Thank you, Dr. Paden, for some fascinating information. My next guest is also an old friend, naturalist and writer Art Bernstein, who's going to talk about air quality in China. The world's attention is focused on China these days because of the 2008 Summer Olympics…but China also has by far the world's poorest air quality.