Ep 594: Dry Eyes in the Digital Age: Causes & Natural Relief with Dr. Pam Theriot

In this episode of the Health Fix Podcast, Dr. Jannine Krause interviews, Dr. Pam Theriot an optometrist, author, and dry eye specialist who dives into the growing dry eye epidemic, especially as screen time continues to rise in our digital world.

Dr. Theriot explains why dry eyes are becoming more common, how blinking less while using digital devices impacts tear quality, and why natural tears are far more complex than artificial drops. She also explores how detoxification, inflammation, cosmetics, medications, and underlying health conditions can all play a role in chronic eye irritation.

Drawing from both her 20+ years of clinical experience and her own personal journey with dry eye, Dr. Theriot shares practical, proactive strategies you can start using today to protect and restore your eye health.

If your eyes feel dry, irritated, red, or “just not the same,” this episode is a must-listen.

👩‍⚕️ About Dr. Pam Theriot

Dr. Pam Theriot is an optometrist, dry eye specialist, and author based in Louisiana. With over 20 years of experience, she leads the Dry Eye Relief Center at Lusk Eye Specialists, helping patients find personalized, long-term solutions to chronic dry eye symptoms.

Her own struggle with dry eye, affecting everything from contact lens wear to running and applying makeup sparked a professional mission to help others feel comfortable in their eyes again.

Dr. Theriot shares her expertise through her book Alleviate Dry Eye, online courses, a weekly blog, and her Editor’s Pick Award-Winning TEDx Talk. Her mission is to help 1 million people care for their eyes as routinely as they care for their teeth by building simple, sustainable daily habits.

🔗 Connect with Dr. Pam Theriot

🌐 Website: www.pamtheriot.com
📸 Instagram: https://www.instagram.com/pam.theriot/
📘 Facebook: https://www.facebook.com/pamtheriotpage
💼 LinkedIn: https://www.linkedin.com/in/pamtheriot

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Podcast Transcript

Chapters

00:00 Understanding Dry Eyes: A Growing Concern
02:52 The Impact of Digital Devices on Eye Health
06:08 Natural Solutions for Dry Eyes
08:36 The Connection Between Detoxing and Eye Health
11:18 Toxins in Cosmetics and Their Effects on Eyes
14:16 Identifying Underlying Conditions for Dry Eyes
17:28 Personal Experiences with Dry Eyes
20:18 Practical Tips for Eye Care
23:12 Recognizing Symptoms and Seeking Help
26:27 Maintaining Eye Health in a Digital World

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Jannine Krause (00:01.602)
Dr. Pam Theriot welcome to the Health Fix Podcast.

Pam Theriot, OD (00:05.178)
Thanks Jannine it was so good to be here.

Jannine Krause (00:07.732)
I’m excited to talk about dry eyes because it is something that I’ve noticed in myself as I’ve gotten older and I’ve noticed that a lot of my patients in that 35 to 55 inch range, they’re like, my eyes just don’t feel the same. Or we hear a lot about the sandpaper eyes and all that kind of stuff. So I’m guessing this is something you see every day in the optometry world.

Pam Theriot, OD (00:31.704)
Absolutely, every single day. It’s becoming more more prevalent and that has a lot to do with the amount of time we spend on our screens.

Jannine Krause (00:39.86)
Isn’t that something? Yeah, I, you know, I’ve heard my grandma talking about dry eye, but you know, she was in her eighties by the time I was hearing things and I’m pretty sure she never looked at a computer in her time frame, in her age. By the time she had passed, think computers were just starting to be a thing. Probably had one of those like big dinosaur gateway computers in my house back in those days. But we’re on them, you know, right? Our phones are our computers. have

Pam Theriot, OD (00:42.054)
you

Jannine Krause (01:08.938)
iPads we have, know, what we’re doing right now and sitting in front of the computer. Have you found that certain filters and things help or do you feel like it’s really just getting the time off of them?

Pam Theriot, OD (01:22.991)
Right?

Gonna back up just a little bit. It used to be 10 years ago our dry eye patients were typical middle-aged women. Women in that perimenopause area of time hitting 40 and their tear production was just slowing down because of hormonal changes. So we didn’t have very many male dry eye patients and we didn’t have them under the age of 40. And fast forward past COVID and now we can see the prevalence of our dry eye patients.

in our 15 to 30 year old range is equivalent male to female. And that’s exactly because everybody across the board is spending all that time on their digital devices. And those 30 year olds are really the generation that was born with a cell phone in their hand. They got their cell phone when they were in their strollers at the age of two, they’re hanging on a mom’s cell phone and they get their iPad.

those current 30 year olds that were having more of that digital device all the time. Whereas the older of us, we didn’t get them until we were already adults. So that’s a big change that’s happening. We are seeing more dry eye in men and the filters really, really aren’t cutting it. We can talk about different layers of light. If we’re talking about yellow light to block the blue or red light at nighttime.

Even using these filters, it’s not affecting the dryness of our eyes. And that’s specifically because we need to blink our eyes while we are moving throughout our day. And if you and I were sitting across the table from each other, sipping a cup of tea, drinking some water, and having a conversation, we would blink about 20 times a minute. In this screen world that we’re living in, you know,

Pam Theriot, OD (03:23.792)
curious to see how you’re reacting to me and so I’m staring at you in the screen and we blink about a third as much so about seven times a minute on a screen. That also happens if you were reading a book you’d blink a little bit less but if you were if you were reading a paper book you’d blink more than you would if you’re reading on a Kindle or on a screen. So the screen specifically really reduces the amount of time we’re blinking.

Jannine Krause (03:52.982)
I had no idea about that. I had no idea, like the blinking thing, I mean, it makes sense. It makes perfect sense. And I know like days that I’ve been on the computer longer, my eyes feel worse by the end of the day. But you know, a lot of us and myself included, I was like, is it eye strain? Maybe, but I didn’t think about the blinking.

Pam Theriot, OD (03:53.154)
Yeah.

Pam Theriot, OD (03:59.622)
it

Pam Theriot, OD (04:10.926)
Right, so some of it could be eye strain because our eyes really weren’t meant to focus up close all day long. We were designed to be hunters and gatherers and be outdoors in the fields. And so our vision, the least resistance of being able to see is looking far away. That’s how our eyes focus the easiest, the best, the least amount of energy and input is seeing far away. When we see, when we focus up close, our eyes have to come together to point

the same thing at the same time and they have to focus the lens inside of our eye changes so that we can see up close. So two things have to happen energetically and then as I said we just tend to blink less often which is coating the front surface of our eyes with lubricants, our lubricating tears to keep that mucous membrane moist and ready to see.

Jannine Krause (05:06.626)
Hmm. So of course you got something kind of turning in my head about the lubricating component going on and the tears. You know, I think a lot of people, they will think, okay, I’ve dry eyes, I just put the artificial tears in, I’m good to go. You know, sometimes as I mentioned, like fatty acids, we’ll think, okay, we need to increase that.

Is there like an exercise we can do too of say we do have to be on the computer for work that we can like blink in between or we can help like with the production naturally so we don’t have to supplement in?

Pam Theriot, OD (05:38.02)
Right, although…

artificial tears have that moniker that it’s a tear. There’s really only like four components in a good artificial tear, right? It lubricates and just kind of adds some moisture to the eye, but our natural tears have 2000 components. So they have anti-inflammatories, growth factors, things that are going to help fight infection. So our natural tears have no comparison to the artificial ones that we’re dumping in. So that’s number one.

can add some lubricating drops to your eyes to give yourself that moisture. They may help, they usually don’t last as long as we’d like them to, even the ones that have oil in the artificial tear. So the better idea then is to either support our bodies to make healthy tears, number one, and number two, to blink our eyes on purpose with regularity to lubricate the front of our eye.

is going to close the eye right and then our tears spread out from our eyelids across the front surface of our eye, but some oil expresses from our eyelids as we as they come together just a little bit of oil comes out spreads across the front surface of our eye and protects our tears from dehydrating into the air and so doing some timed blinking or on a schedule okay I’m gonna finish this one document and then I’m gonna close my eyes for a few seconds I’m gonna squeeze them

them hard, get those oils to come out, do three or four of those in a row, and then I’m going to get back to work again. really being mindful of taking those breaks. And there’s some apps that you could add to your computer or your cell phone that could be a reminder. saying to yourself, OK, I’m going to finish this one thing, and then I’m going to blink, or I’m going to read this paragraph, and I’m going to blink three times, I’m going to go back and read the next paragraph. Things like that.

Pam Theriot, OD (07:39.704)
really make a better difference than just hydrating with artificial tears.

Jannine Krause (07:48.598)
I love it. I love it when it’s free, of course, right? Love it when we can use our own natural resources. So now, of course, I’m like, I’m gonna blink and I’m keep myself looking. I wonder if it’s also why I’ve noticed when folks who have really dry eyes, it’s like their body’s trying to blink more. Is that a phenomenon I really see or am I imagining that someone might be trying to blink more in those cases?

Jannine Krause (08:35.5)
No! We froze!

Pam Theriot, OD (08:36.582)
I’m back, right? I think we froze there for a little chunk.

Jannine Krause (08:42.124)
I’m looking outside. Yeah, I guess the weather has got us a little bit, but that’s okay. We can edit that out and see if it keeps going okay for us, because I am on our house.

Pam Theriot, OD (08:54.99)
landline land to right okay

Jannine Krause (08:55.618)
I don’t even know what you call it. Network. Network. Yeah. Yeah. Yeah. So it’s gotta be.

Pam Theriot, OD (09:02.052)
Now I hear you fine, but your face is frozen.

Jannine Krause (09:07.138)
my goodness. Okay. Well, now I’m working again. Okay. Did you hear my last question by any chance?

Pam Theriot, OD (09:08.55)
now you’re working.

Pam Theriot, OD (09:18.966)
No, I didn’t hear your question. Maybe if you repeat it.

Jannine Krause (09:21.57)
Okay. Okay. I was saying sometimes I’ll notice. Is it working now?

Pam Theriot, OD (09:27.621)
Yes.

Jannine Krause (09:29.484)
Okay, I was saying sometimes when I see patients, good, blinking their eyes a lot with the dry eyes. Is the body naturally prone to try to overcome the dry eye by blink, like triggering a blinking reflex?

Pam Theriot, OD (09:47.335)
Absolutely. So when our eyes dry out, our vision will get fuzzy and so automatically you’ll blink the eyes to try to refresh the tear film, get a new coating over the front surface of the eyes. It’s also irritating so you might feel that stinging and burning starting to set in and you’ll start to blink to try and clear that. You know, and sometimes it works. Sometimes you do it too many times and there’s just not enough reservoir reserve there to clear the vision and

coat the front surface of the eyes.

Jannine Krause (10:22.83)
Oh my goodness. Yeah, it’s, you know, it’s, one of those things that it’s been a phenomenon in my office where, you know, we’ll try a supplement that has the fatty acids, we’ll have something with antioxidants, you know, we’ll try those kinds of things, but I never knew that you could just blink more and hold the eyes and do that to help promote the, you know, the lubricate. Like 2000, I’m like still blown away that there’s over 2000 things in your eye drop, you know, like your actual eye.

Pam Theriot, OD (10:51.62)
your natural tears. Yeah, your natural tears, are perfectly balanced to keep our eyes healthy. So they bring all those anti-inflammatories to the front surface, they fight infection, they hydrate and heal. So our natural tears are really the way to go. And by giving your body the building blocks of those healthy tears, like using an omega-3 fatty acid supplement, can support those healthy tear production, keeping our patients

Jannine Krause (10:52.888)
Yeah!

Pam Theriot, OD (11:21.564)
hydrated. I know you talk a lot about hydration and getting enough water into our bodies. If we don’t have any water, we can’t make tears. Because even with those 2,000 components, tears are still 70 to 80 percent liquid. So we really need to make sure we’re well hydrated enough. And the Omega-3s will support that oily layer that’ll coat the tears and keep it from dehydrating into the air.

Jannine Krause (11:51.758)
Makes sense, it makes sense to do. Now of course my next question, because you brought it up that you would listen to my podcast on detoxing, of course this is coming out just after that one. How does detoxing tie into eye health? I’m super curious and I’m sure a lot of people will be like, huh. And know, of course Chinese medicine, eyes are the window to your detox.

Pam Theriot, OD (12:12.772)
Right? So I was thinking about the detox and what…

Pam Theriot, OD (12:19.088)
Can you repeat the question?

Jannine Krause (12:22.702)
No, yeah, sure. No, my question’s more like how do we tie in detoxing to eye health and what should folks look for different things they could be checking out because eye being connected to Chinese medicine, liver, I’m like, makes perfect sense to me.

Pam Theriot, OD (12:41.282)
Absolutely, so the main

driver of dry eye disease is inflammation. so as you’re detoxing, you’re decreasing levels of inflammation in the body, which could really improve not only the amount of tears that you’re creating, but the quality of those tears. Our tears have both pro and anti-inflammatory cytokines in them, and I heard you talk about cytokines in your detox episode. So having more of those anti-inflammatory

in our tear film will bring down the levels of inflammation on the front surface of our eyes and could significantly make the tear film healthier to us, more supportive to our eye health and our vision. But in general, I was also thinking about the idea of detox in the things that we’re putting in on and around our eyes themselves. So if we take this time in January to kind of go through the things that we’re using

Jannine Krause (13:37.614)
Thanks, guys.

Pam Theriot, OD (13:43.097)
on our faces and in our eyes, we can remove toxins from those products. So the first thing that I can think of would be artificial tears. So we were just talking about that. You’re sitting in front of your digital device and you want to add some moisture to it. What about our artificial tears? Are you using one that’s in a bottle and is preserved? Then you’re putting a toxin in your eye every time you add the artificial tear.

Right?

Jannine Krause (14:14.924)
Yeah, that makes sense. So what do you have like a favorite artificial tear? Is there one that’s not toxic?

Pam Theriot, OD (14:22.608)
So there’s a ton of them that are preservative free these days. When you go to the artificial tier aisle at the pharmacy or the grocery store, just make sure you’re looking for the words preservative free. It used to be that they came in little individual vials, you broke the top off and used the tier and the vial, but now they’ve gotten a little bit more fancy with their packaging and you can get a bottle of preservative free and a new multiple dispense bottle, but it’s still no preservatives in it. So just make sure you’re checking the label.

you

Jannine Krause (14:54.542)
Okay, now you had mentioned other things that go around the eyes, like makeup and those kind of things. How would those cause dry eyes? And you explained, because I think a lot of people might be thinking, I know that I personally use different types of eyeliners that just flared up my eyes. And same thing with some of the mascaras too.

Pam Theriot, OD (15:16.364)
Absolutely. the toxins that are in our makeup are just astronomical. If we lived in Europe, the European Union bans like 1300 different ingredients from their personal care items. But here in the U.S., the

The laws are not as strict. about three years ago, only had 13, one, three ingredients that were banned from our personal care products. And in 2024, they came out with a modernization of Cosmetics Reform Act, MOKRA. It was presented in 2024. And so they’re starting to tighten down on the ingredients that can be included in our makeup.

makeup, especially as women. We’ve been wearing eye makeup probably since we were teenagers. We’re putting it on maybe first thing in the morning before we get to the office. We’re taking it off the last of the day as we’re getting into the shower or into bed. So you’re wearing that makeup for 14-16 hours a day for five, seven days a week for decades upon decades. So having toxic ingredients in our cosmetics doesn’t make a difference

between what you wore on New Year’s Eve and the next morning. But it’s this year after year after year of putting this same old mascara on that is filled with parabens or phthalates or a toxic preservative and leaving it on your eyes for 14 to 16 hours a day. I have prepared for your audience a makeup remover list and at the bottom of the makeup

I have a whole list of my favorite cosmetic products, mascaras, eyeliners, and eyeshadows that are toxin free and safe to use for sensitive eyes. So we’ll link that in the show notes so that everyone can download that guide. I give it out to all of my patients to make sure, number one, if we’re putting makeup on our faces, we’ve got to remove it before we go to bed. So many reasons for that. But as well as nice brands that

Pam Theriot, OD (17:34.384)
are going to help our eyes feel more comfortable throughout the day and not give you that stinging and burning.

Jannine Krause (17:41.294)
Yeah, it’s so wild to think, you know, I look at it and I’ve heard from some of my patients, but also I notice it in myself that even just certain like makeup remover wipes or even certain scents, like if they’re synthetic, like say there’s a diffuser by me or something like that, I will also notice that even that seems to affect my eye. Does that go along with the dry eye component too?

Pam Theriot, OD (18:06.51)
triggering to sting and burn.

Absolutely. The problem with makeup remover wipes in general, when they’re packaged in those plastic, like a baby wipe, multiple in the same container, those are preserved with alcohol. Alcohol! And now you’re about rubbing alcohol right on the front surface of your eye. It’s horrible. So, in my makeup remover list, I have some that are individually packaged and they don’t contain alcohol. So if you love having those makeup remover wipes on the go,

Jannine Krause (18:40.078)
That makes sense.

Pam Theriot, OD (18:41.192)
I do have one in there, but scents and fragrances are also very toxic to the ocular surface Even if it’s a natural scent even you know putting some lavender in there could be irritating to the eyes depending on how how sensitive patients are or what the percentage of that scent is in the in the packaging, but in general fragrances can be irritating

Jannine Krause (19:11.21)
my goodness. I absolutely have found that myself and I love talking about it on the podcast. I think a lot of folks wear some strong scents or they have like Febreze in their home. They still have the Glade plugins and all those different things and I just can’t help but think that the eyes having mucosal tissue. I mean, it’s just that’s sensitive. It’s really sensitive.

Pam Theriot, OD (19:31.106)
sensitive. Yes, you’re exactly right. And everyone’s obsessed these days with not only us smelling good, but our home smelling good and smelling clean, and so everywhere you go, there’s someone’s burning a candle or having one of those plugins, and so everything is scented.

Jannine Krause (19:52.064)
my goodness. Now, beyond dry eyes looking at like, okay, we have just dry eyes from screens. What other conditions are there? Like say autoimmune kind of conditions, thyroid conditions, things of that nature that you can kind of help folks like say they’re blinking more, they’re trying to work on things, they’re taking a fatty acid antioxidant formula and things aren’t changing.

What should they be looking into? What should they be telling their eye doctors, their optometrists, their, you know, what should they be saying? So try to get a little bit more investigation.

Pam Theriot, OD (20:26.47)
Absolutely Jannine, you hit the nail on the head. So patients who have an autoimmune disease, thyroid disease, diabetes, they are all going to be pre-sensitized to having dry eye disease. So definitely a risk factor. You add on to that being female, being over the age of 40, and you have a hot mess expressed towards dry eye, unfortunately. And then we’re spending our day in front of our computer. So when you look at dry eye, we can look at so many

things that we can change to help our environments. We can add a humidifier at our desk and we can blink more. We can use some artificial tears, support with some omega-3 fatty acids. But if that is not working and you have one of these additional risk factors like a health problem, autoimmune disease, diabetes, thyroid disease, those are also, even someone with allergies, taking an oral antihistamine on a regular basis will decrease your tear production very quickly.

So if that is you, please see your eye care provider see your local eye care provider and let them know Hey, I have these symptoms my eyes sting and burn they they’re red they’re sensitive to scents and makeups and things that are around my eyes and I have to use a digital device to do my job, you know And so that the doctor can prescribe number one a prescription medication. We have immunomodulators that can help reduce the

inflammation in the eyes. I find that these are very key with my autoimmune patients having a prescription drug on board because they have a systemic disease that needs more support.

And letting the doctor know, you know, I have an autoimmune disease, I take an antihistamine on a regular basis, I drink 20 cups of coffee a day, and I am dehydrated. You just have to be honest with your healthcare practitioners, right? If you know that you’re not drinking enough water, let them know. You know, there’s tons of things that we can suggest and advise, but if you don’t tell us what you’re really doing behind the scenes, it’s harder to know.

Jannine Krause (22:38.052)
it’s so true. It’s so true. I mean, we just have to. And yeah, that’s why I’m here. I’m hoping to make, you know, Madison a little more approachable when it comes to looking at what’s going on with our bodies. Now, of course, you have a TEDx talk. You talk all about your personal experience. And I would love for you to share a little bit with folks because you mentioned about red eyes.

Dry red eyes a lot of folks will come into my office and they see it as two separate things and I would love for you to kind of bring that full circle for folks because Unfortunately, I have sometimes a hard time convincing folks that your dry your red eyes are actually a dry eye situation And and in many cases, I mean sure there’s some some caveats and I’m gonna let you explain since this is your specialty not mine

But please tell us a little bit more about your journey and how you had the red eyes, you know, dry eyes, the whole thing and kind of help us folks to really see like, wait, maybe my red eyes are dry eyes.

Pam Theriot, OD (23:44.295)
All right, so let’s start with something super simple. Let’s say I took my thumb right here and I smashed it with a hammer

My thumb would then be red, right? So my thumb would be inflamed. So redness equals inflammation. If we think about any other part of our body, if our elbow was inflamed, it would be red and puffy, right? If our cheek, we had a dental procedure and our cheek were inflamed, it would be red and puffy. So it’s the same thing with our eyes. It’s just that we’re thinking that the redness is something different other than inflammation.

because we’re not correlating that quite as readily, maybe because the symptoms don’t line up. But redness equals inflammation. We can just kind of lay that as the groundwork. So my own personal story kind of happened when I was a lot younger, in my 20s, and I was a contact lens wearer. I wore makeup every day to work because I was a newly minted optometrist.

and I was in my first job and I moved to New Mexico because my husband, my now husband, he wasn’t my husband then, but he was my boyfriend and I followed him to New Mexico and he was in the military. So we lived a lot of places throughout the US, but our first station was in Albuquerque, New Mexico, which if you have never been there, it is the high desert. So it’s elevation of about a mile high and it’s very dry.

So when I when I moved there it was just the perfect storm of New environment new job where my eyes were doing new things spending more time on the computer Spending more time behind the microscope which might even we may blink even less when we’re behind the microscope that we do on a on a digital device but and then the environment of all of that so I was in my late 20s and really struggled so much to where my contact lenses

Jannine Krause (25:44.204)
Yes.

Pam Theriot, OD (25:53.881)
lenses first. So I wasn’t able to wear my contact lenses throughout the day like I had been when I was a student. And then my eye makeup didn’t want to stay on my face because my eyes were red and watery and irritated.

I would start to cry my makeup off. So I went down the whole rabbit hole of let me try 15 different eye makeup removers and seven different mascaras and all the different eyeshadows and nothing felt better on my eyes, right? Because truly it was that my eyes themselves were inflamed and dry and needed to do a whole reboot. So it was really, it was at the beginning of my career and I just, I felt so hopeless that, you know, here I was finally made it through all of the school.

and I’m really, a real doctor now, but I felt like I couldn’t fix myself. Luckily, research has become a long way since then and the way that we treat dry eyes is so much more thorough. understand the causes a lot better and there’s so many more things that we can do. So over the past 20 years, really I’ve been in practice now 25 years, gathering all of that information, all that experience, all of the thousands and thousands and thousands of patients

that I’ve seen, but the impetus was trying to help myself so that I could see my own patients and not have tears running down my face and my vision blurring throughout the day. Isn’t that so common for us doctors? Like we get really interested in something because either ourselves or a loved one, it hits home for us and then we end up diving deep.

Jannine Krause (27:24.482)
goodness. You know, it’s…

Jannine Krause (27:37.55)
100%. 100%. I’m definitely here because of multiple things, know, mom, and then, you know, now here because of my own health and the whole perimenopause thing. And just, yeah, it’s incredible. you know, looking, I wonder if there’s something in the universe, right, where it’s meant to happen because that’s like what we’re here for, right? Like that’s our journey. my goodness.

Pam Theriot, OD (28:03.846)
Exactly. A calling. It hits us first and then we’ve got to figure it out and then spread the word so that everyone else can have an easier time at it. Because dry eye, it really is happening to so many patients around us. You know, you can talk to your girlfriends or your loved ones and they will have these symptoms. Unfortunately, we play them off and say, you know, my eyes are just bothering me today because, I had that report I had to get done yesterday. I was on the computer nonstop. was, that’s

That’s why they’re bothering me, not knowing that it’s really this snowball of, note your eyes didn’t make enough tears yesterday, they’re causing inflammation on the front surface of your eye, and if we don’t step in and stop that inflammatory cycle, they get more dry, and they get more dry, and then it starts happening more and more often. So realizing, recognizing those symptoms as a problem instead of a,

It’s just because I did this one thing is the point.

Jannine Krause (29:09.262)
And what you’re saying makes perfect sense because you know, the long-term results of dry eye that’s not mitigated, now I’m hearing folks getting plugs and different types of procedures done to try to counter the dry eyes. And so at what point do we kind of gauge between like, okay, maybe this has gone beyond?

what I can do for myself. And of course in this podcast, I want everybody to try to do what you can, you know, for yourself. But I do want to maybe put in a little bit of fear. I don’t know, I don’t like the word fear, but like little bit of like warning that you could do the free things. And if the free things, you know, time out or you’re not doing them enough, then we end up with worst case.

Pam Theriot, OD (29:58.501)
Right? So, so one thing that I did in my Ted talk, and if anyone wants to listen to the, to the Ted talk, I fully support that. Please, please go and listen to it. But the, the test that I did during my Ted talk is something that anyone can do at any time. And this will give you a really kind of quick and dirty, am I in trouble or not with my dry eyes? So, Jannine, why don’t, why don’t we walk through it? It’s, it’s a quick, it’s a 10 second test. And so what I like people to do is just kind

get your eyes ready, of blink a couple of times, and then what I’m gonna do is count to 10 for 10 seconds, we’ll count to 10, and you’re gonna try not to blink. You’re gonna hold your eyes open and we’ll see how many seconds you can get before you have to blink and then I’ll tell you the grading scale, okay? So everyone’s gonna blink, blink, blink, and then hold your eyes open. One, two, three, four, five, six, seven,

Jannine Krause (30:37.816)
Okay.

Pam Theriot, OD (30:58.406)
8, 9, 10. All right, what number did you make it to, Jannine?

Jannine Krause (31:03.854)
I made it I think I made it to nine and a half maybe

Pam Theriot, OD (31:10.362)
Right? Did you start burning? At what number were you like stinging and burning?

Jannine Krause (31:18.06)
You know, instead of more of like a sting and burn, I felt like a twitch. I felt like my eyes wanted to twitch underneath.

Pam Theriot, OD (31:22.95)
Gotcha. Yeah, I started feeling around six to seven seconds mine were really stinging and burning and by eight seconds I had to give up so I had to blink. Now I would say that if you made it to eight seconds or more before you were stinging and burning you’re probably really mild but

Five to eight, it’s moderate and below five seconds, really there’s something going on and you really need to make an appointment to see your eye care practitioner. If you’re not able to hold your eyes open without blinking for five seconds, your tear film is breaking up, it’s dehydrating very quickly and it’s time to step in and see a medical provider. that’s a quick and dirty kind of easy test to do. Takes only 10 seconds. It’ll just give you a gauge.

Jannine Krause (31:52.654)
Mm.

Pam Theriot, OD (32:13.084)
fun thing would be to like do it at the beginning of the day before you’ve started working on the computer and do it right before you take a lunch break and see you know just that four hours on the computer did that significantly make a difference in the quality of the tears on on the front surface of my eyes so

Jannine Krause (32:31.49)
like that, I like the before and after check too. I like that a lot. Now, what I kind of thought of, you know, because eye twitching can be another thing that a lot of folks will sometimes attribute to dry eye, but also I’ve seen like I’m fatigued, my eyes are dry because I’m tired, kind of comments go hand in hand too. So I am super curious on the eye twitch component.

Pam Theriot, OD (32:37.702)
You

Pam Theriot, OD (32:51.782)
Mm-hmm.

Jannine Krause (32:57.12)
Is it a deficiency of a mineral or is it more an eye strain thing? Like what’s your take on?

Pam Theriot, OD (33:04.326)
So an eye twitch is like any other muscle twitch. And when a patient comes in and is complaining of an eye twitch, and it’s not related to stress or lack of sleep, that can also cause it. But in general, the treatment that I give my patients just first off is to increase electrolytes. So magnesium, potassium, I’ll have them eat some bananas, drink some Gatorade, get some more electrolytes into their system.

and if that doesn’t cure it. The funny thing about that blepharospasm is that it can be related to anemia. So if it continues and it doesn’t go away, seeing a doctor about looking into anemia and then the crazy thing is that it is curable with Botox injections. So if you have a spasm and I’ve definitely seen it in the 25 years of practice, I’ve had probably two patients that just constantly spasm.

no matter what they did all day long, their eyes just blinking and blinking. Those poor patients, need some Botox so that they can function more regularly. I think what’s more common is though that we get run down and we’ll get a twitch just for a shorter period of time and increasing your electrolytes is an easy way to cure that.

Jannine Krause (34:04.398)
Yeah.

Jannine Krause (34:31.694)
Sounds good, sounds good. Yeah, that’s one that I think maybe, you when I look at my, how I was doing things, I was opening them really wide. I’m like, was I trying to counter balance there by opening my eyes too wide? Can you cheat on this test? Did I try to cheat? That was what was happening here.

Pam Theriot, OD (34:47.174)
I think, I think if you, you’re realistic about, are they stinging and burning when you’re holding them open? Yeah, do we need to like hold them open like deer in a headlights? Probably not, because that’s not how you’re looking at the computer, with your eyes wide open, you’re just looking. So, but noticing that stinging and burning is, is really better even than, than waiting for you not to blink, so.

Jannine Krause (35:14.57)
sense that makes sense you know it’s funny now my eyes feel like they are actually stinky

Pam Theriot, OD (35:20.431)
You stressed him out!

Jannine Krause (35:23.064)
I’m highly suggestible apparently. So funny, so funny. Yeah, I’m like feeling it now at the bottom. I’m like, maybe I tried to cheat too hard on the test. goodness, you guys, if you cheated and you open your eyes too big, try it again. I like the before and after though. I like the before and after test though for the work day because that seems like a real good assessment. okay, say you’ve gotta be on the computer because that’s your job.

and you were talking about the blinking. What’s your opinion? Like if you get up and you, is it better to get up and walk away from the computer and do some of the blinking? Is it better to like, I used to always hear trace the outline of the room. What other suggestions do you have for folks that maybe they need to get up from their desk and do something else?

Pam Theriot, OD (36:13.764)
Right.

So again, I’ll put in a little plug. I do have a downloadable PDF that’s going to walk you through like how to set up your workstation. So how close should your computer monitor be from you? Should you be able to touch it? Should you be right up on it? That where should it be placed on the desk? What font sizes? What colors? What brightness settings should we be using? So all of those things are in the downloadable PDF. So getting yourself set up. The next would be adding a humidifier.

If you guys in Wisconsin, you’ve probably got the heater blaring because it’s freezing cold outside. It is actually 75 degrees here in Louisiana, so we don’t have the heater on. Welcome to January in the South. So the humidifier, depending on your environment and depending on the time of year, it may be real important. And then, so if you download the handout, you can get yourself all set up, but…

Jannine Krause (37:00.3)
So does.

Pam Theriot, OD (37:12.164)
What do we do when we take a break from work?

Well, we pull out our phones, right? We grab our phones and then we go and we sit and we read our phone instead of being on our computer. So absolutely, I would like step away. You’re going to take a break from work. You’re going to just take a break for your eyes. So, you know, get up from your desk, do a lap around the office, you know, drink a whole glass of water, close your eyes. You could even, you know, walk into the break room and warm up a microwave.

your eyes. for five minutes while you’re having a break. So there’s a ton of things that you could do to really rest the eyes, relax them, know, pop in your earbuds and just listen to an audiobook or a meditation for a few minutes and just detox from the work environment, right? Have that calming, meditate, close your eyes, those kinds of things. So I think there’s a ton of things you could do.

to take a break even when that is your job eight hours a day.

Jannine Krause (38:23.304)
Mmm. So good. So good. I was hoping you were gonna say the phone thing. I was waiting for it. I was like, she’s gonna say it. She’s gonna say, get off your computer and then you go right to your phone.

Pam Theriot, OD (38:32.55)
Exactly!

Jannine Krause (38:35.654)
my gosh. I think your resource for the digital devices is a really great option for folks, especially for educating kiddos on how far to be away from these things. And the brightness is something that I think maybe folks might not think about. Will you give us a little bit more detail as to why the brightness matters for the eyes?

Pam Theriot, OD (38:57.284)
Right? So one thing that we want to do for our eyes is create contrast. So that’s why we have a white piece of paper with black letters so that the contrast, it makes it easier for our eyes to read. But if we start turning up the brightness on that white paper, it actually decreases the contrast and then it’s going to just shrink your pupil down, irritate your eyes. That brightness coming off the screen can cause more glare from the items around you. And so you’re having

to negotiate what’s on the screen versus what’s reflected from the screen and so really ferreting out the best contrast for you and the best lighting in the room so that your eyes feel relaxed instead of stressed.

Jannine Krause (39:47.486)
Awesome. Now, of course, that being said about brightness, we’ve talked about, course, dry eyes. I would love to know, like, what are your go-to things? Of course, we’re going to be blinking, doing our blinking exercises. Sounds like probably some hydration with maybe electrolytes here. And then what other things would you be recommending if someone wants to keep their eyes as healthy as possible for as long as possible?

Pam Theriot, OD (40:14.232)
So I recommend doing four simple steps throughout the day to keep your eyes healthy. And the first would be hydrating with an artificial tear. The second is something that we haven’t touched on yet, a lid and lash cleanser. So we have special cleansers that we use for our hair, our faces, our teeth. You should have a special cleanser for your eyelids. So for us women, once we remove our eye makeup at night, we remove the makeup,

Then we’re going to follow it with a cleanse. So, eyelid and lash cleansers come in many different varieties. There’s a spray that’s made of hypochlorous acid, which is naturally antiseptic. It’s keeping the bacteria that live around our lids and lashes, keeping that bacteria level down. So that’s the most simple. The next would be a lid and lash wipe, just like the makeup remover wipes. There’s cleansing wipes. And then the third type is a foam

foaming cleanser and that’s similar to like a foaming hand soap but specifically designed to keep the oils of the eyes on board not to strip those oils but to cleanse the lids and getting rid of dirt dust debris and pollen and not get rid of all the oils so it’s really an eye specific cleanser is my second go-to comment for keeping your eyes healthy the third is that warm compress so when we use

a warm compress over our eyes, it helps to melt the oils that are inside the oil glands of our lids. And earlier when we were talking about blinking, I said that when we blink, a little bit of oil is expressed and it spreads across the front surface of our eye. When we don’t blink throughout the day, because we’re on our digital devices and our blinking rate has gone to a third of what it should be, the oils in those oil glands harden from them not being used as regularly. So when we heat up the oil,

in those oil glands with a warm compress. It helps to melt them so that they can come out across the front surface of our eye better. And then the fourth step.

Pam Theriot, OD (42:22.872)
is taking a nutraceutical to support your healthy tear production. And we mentioned a couple of times, omega-3 fatty acids are really great nutritional support for our eyes. Another one that’s newly on the market from Bausch & Lomb is called Nutritier. That support system has vitamin D, lutein and zeaxanthin as an antioxidant, and it also has curcumin as an anti-inflammatory.

And so that’s another nutraceutical that patients could take to help bring down the inflammation in their eyes and support healthy tear production.

Jannine Krause (43:02.702)
I mean, not a hard plan. mean, easy things we can do. you know, eyes are so important. We need them. And it does seem like everybody’s kind of saying, like, my eyes are declining as we get older. And I’m like, gosh, the more we can do to preserve them.

Pam Theriot, OD (43:21.218)
Right.

Jannine Krause (43:21.486)
So I have one weird question for you. And I’ve always wanted to know about this. And now that you kind of mentioned that there’s cytokines in the 2000, you know, things that are in your tears, I’m like, huh, when you wake up in the morning and you have the eye crusties, and sometimes you have more eye crusties than not, was that your body de-inflaming itself overnight when you have more eye crusties?

Pam Theriot, OD (43:24.538)
Yes.

Pam Theriot, OD (43:49.591)
I missed a little bit of that question. What about when you have more crusties?

Jannine Krause (43:56.0)
So it’s okay. I’ve noticed just in general that when I’ve had more eye crusties, when I wake up in the morning, it might be like after a night where I’ve had like pizza or something. And so I’m questioning now, like, is that the more cytokines? Is that more an inflammation response? And I’m seeing it in my eyes.

Pam Theriot, OD (44:13.892)
So I think absolutely what’s happening is that your tears are drying out and it’s leaving behind the hard particulates that are in our tears. So could it be that there’s more cytokines? Perhaps. I think there’s also during allergy season when there’s more inflammatory cytokines, patients will complain more about that crustiness in the corners. It’s not necessarily a sign of infection. Infection would be more sticky and you’re getting

kind of a mucous residue there in the corner. But that dried up residue really is what’s left over of your tears when that 80 % of water dehydrates what’s left there. And inflammation is probably a big factor. I don’t know precisely every component of that crust, but absolutely when there’s more inflammation on your eyes, you get more crusties in the morning.

Jannine Krause (45:14.712)
Thank you for answering my very strange question. I always have to throw one or two in on folks. And that one’s been one I’ve wondered my entire life. Like, I wonder if I’m getting more eye crusties because of what I ate or something. So nevertheless, Dr. Pam Tereo.

I’ve enjoyed our conversation. I know we’ve had a little bit of tech difficulties here, but I think folks are gonna like this one, because I’ve never talked about dry eyes before. I’ve never had anybody come on and give us a scoop like you. So we gotta tell folks where they can find you, how they can get a hold of the PDFs. I know we’ll have them here in our podcast notes here at drjcrowlstind.com. And then if they wanna connect with you, Instagram, Facebook, LinkedIn, give us a scoop on how they can find you.

Pam Theriot, OD (45:58.758)
Absolutely. Well, thanks so much. My website is my name Pam Theriot, which is spelled Pam the riot.com From there you can download the two PDFs. The first one would be at Pam the riot.com forward slash Remover and the second one is for digital devices is Pam Theriot.com forward slash Ted X and those are the the two PDFs that we’ve been talking about As far as socials, I’m on all of the socials. It’s

either Pam.Terrio or PamTerrio on LinkedIn, TikTok, Facebook, Instagram, all the places you can find me there. I put out tips every single day, so there’s always something new to talk about in eye care. It’s an ever evolving field. And so I try to keep my listeners on par with what’s going on in the eye world. I hope to catch you all on social media.

Jannine Krause (46:59.874)
Good deal. Well, I definitely have checked you out. Definitely gonna have folks make sure they follow you. I help this important. It’s something that we do tend to overlook until there’s a problem, until there’s a real problem. And dry eyes is definitely something that will get a lot of good attention for folks. Once again, thank you so much for coming on and guys, everything’s gonna be in the podcast notes at doctorjkrausend.com

Pam Theriot, OD (47:27.984)
Jannine, thanks so much for having me. It was a pleasure to be here.

Jannine Krause (47:32.994)
My pleasure as well.