Dry eye, skeet shooting, driving to Vegas

August 1, 2014

I grew up, you could say, all over the place. My dad worked for a corporation. I was born in Union City, TN. Beyond that, we lived in Tennessee, Alabama, Oklahoma, Ohio, then we moved on to Canada, Brazil, and Luxembourg. We’ve been all over the place. A lot of people wonder if I was an army brat. I was a corporation brat.

 

 

Where did you grow up?

I grew up, you could say, all over the place. My dad worked for a corporation. I was born in Union City, TN. Beyond that, we lived in Tennessee, Alabama, Oklahoma, Ohio, then we moved on to Canada, Brazil, and Luxembourg. We’ve been all over the place.  A lot of people wonder if I was an army brat. I was a corporation brat.

What do you do for down time?

There’s a lot of things I like to do; I don’t have a lot of time to do them. I’m into fitness and running, I run half-marathons. Something that people wouldn’t necessarily know about me is that I’m also a sport shooting enthusiast. Surprising, right? I shoot pistols, rifles, and I’m a trap and skeet shooter. I like to go to the range and shoot handguns typically but, being outside is really nice, too. I just don’t get as many opportunities for that.

Why did you go into dry eye?

That was definitely an evolution. I was in private practice for 10 years at a referral center. It was me and another few optometrists and an ophthalmologist. We started working in dry eye there, and that’s where my interest started. Then when I came to SCO, an opportunity presented itself to have a dry eye clinic. Naturally, I want to be a part of that, and it went from there.

How did TearWell come to be?

TearWell started before I came to SCO. I’ve been at the college for a little over a year now. Our chief of staff started developing the idea, then he started bringing on different faculty members. I was recruited to work here and so was Dr. Alan Kabat, and the pieces just started coming into place with staff.  We started acquiring the technology. Just from there, it’s really blossomed into its own entity.

How has technology improved dry eye diagnosis and treatment?

I’ve been in practice for close to 15 years now, and the technology we offer is really impressive. Years ago you’d just say, “Oh, your eyes look dry.”  You do some Schirmer strips or tear break-up time and consider Restasis or artificial tears. Now we have meibography, which lets us look at the meibomian glands by infrared photography-we get really down to the root of what’s troubling the patient. One of the things our patients say is, “I’ve been told I have dry eye, but no one tells me why. No one tells me what kind of dry eye I have.” The new technology really offers us an opportunity to educate the patients on their condition.

What was it like to use LipiView the first time?

I think I might have been my own first patient. When we went through training with LipiView (Tear Science), I knew my own eyes were dry. It was eye-opening, no pun intended, to see the results of my own testing. It is space-age technology, and it’s impressive to patients. That’s wonderful to appear to be innovative, but the actual science behind it is innovative as well. There’s really no other way to can look at the lipid layer like LipiView can. It can be a little bit of a challenge to go through it with a patient piece-by-piece so that they walk away understanding what all that means. But now, we’ve worked that through and they really understand the condition better.

 

What do you say to patients when they react to LipiFlow's price tag?

It’s not been a big issue for us. The patients who come to us are patients who have been everywhere. They’ve seen everyone and tried everything, and they’re to a point where price is not the biggest stumbling block. What’s really driving them is that their activities of daily living have been so profoundly affected by their condition that the price tag isn’t that shocking, honestly. We try to ensure to the patient that we’re going to choose only patients who we think are going to be successful. Certainly there’s no guarantee, but we try to use our diagnostic testing to find the best quality patient for the procedure. That’s served us well so far. We’ve had excellent feedback from the patients who we’ve treated.

What alternative treatments does TearWell offer?

We don’t want to offer just one thing to patients. Some people come in using just an artificial tear off the shelf; they have not put any further thought into it than that. We try to educate them in the differences among the tears. We may prescribe medications, but we’ve also found that some of our patients come in suffering from dry eye with other conditions at play. We’ve performed a lot of Sjögren’s blood testing here in office-and some of those patients didn’t know they had a chronic condition beyond the dryness.

Do you see increasing interest in ocular nutrition among your dry eye patients?

I do. Nutrition’s a funny thing in America-a lot of people are interested but don’t always want to follow through. Luckily for the dry eye patients, there’s a capsule for that. A lot of them are already taking omega 3 and using flaxseed oil. At TearWell, we really want to tap into wellness and not just be a doctor’s office. We want to participate in our patients’ overall well-being. So, part of what we’re offering to them is nutritional counseling as well.

What's something your colleagues don't know about you?

My original career aspiration was to be a broadcast journalist. I worked for an ABC affiliate in Oklahoma before going on to college. And then I realized there are a lot of people out there wanting that same job, and to rise to the level that I’d want to was going to be too big of a challenge. I still have a letter from Jane Pauley on Today Show stationery encouraging my career aspirations. I have a cousin who’s an optometrist, and he fit me in my first pair of contact lenses when I was 12 years old-I am very, very myopic-so it was a life-changer. While broadcast journalism sounded exciting, that really made a huge difference in my life. That’s how I progressed on to optometry.

If you could change anything, what would you do differently?

You know, I almost feel like I already made the change in some ways. When I graduated and I went into practice as an associate for one year, I realized I didn’t like what I was doing. I wanted more from my career. So, I went back and completed a residency. My motivation was not only to learn more, grow more, and give myself more opportunity, but I wanted to teach at SCO. That was in 2003. I didn’t come here until a year ago, so there’s a 10-year lapse. I went on to work in private practice for 10 years, and that gave me a different perspective than if I spent my entire career in an academic institution. Not better, not worse, just different. I’m really glad that I’ve come back around to working here with students. In some ways, I did make my change.

What's the craziest thing you've ever done?

I gotta tell you, I’m not really crazy. Um…this is not terribly crazy, but when I was in optometry school, a friend and I decided that we wanted to drive to Las Vegas over spring break. So, we left Memphis and drove 20 hours all the way to Las Vegas. We were there for two days, then we drove back. You know what, we had more fun on the road than we could ever have in Vegas, anyway.ODT