Please note: transcript may not be 100% accurate
00:00
Often I find that dry eye isn’t taken seriously, but it is a condition that can have such a huge impact on patients’ quality of life. We often think of dry eyes as dry hands or dry feet and put some lotion on and off you go, but unfortunately, dry eye is not that simple.
00:24
This is Dr. Meenal and welcome to Uncover Your Eyes, where we uncover reality. As a mom and eye doctor, I wanna know it all. Dry eyes seems like a simple eye disease, but not so fast. Suffering from dry eyes can lead to so many things, including decreased work productivity, lack of interest in social activities, decreased…
00:52
quantity and quality of sleep, and overall poor mental health. Numerous studies have linked depression and dry eye disease. Depression can lead to sitting for longer periods of time and staring at computer screens or TVs. That can make dry eye disease worse, which in turn can make depression worse. It becomes a vicious cycle.
01:20
With over 15 years of experience in managing complex dry eye patients and having a residency in ocular disease, today we have Dr. Mahnia Madan, who is an expert in advanced dry eye disease and glaucoma. Dr. Madan is the past president for the British Columbia Doctors of Optometry and is a fellow for the American Academy of Optometry. Welcome Dr. Madan. Thank you for being here today.
01:47
Thank you for having me. It’s such a pleasure finally meeting you and being on this podcast. Well, the pleasure is all mine. I was just saying to Dr. Madan before this, it’s like a fangirl moment because I’m a fan of hers and all the dry eye works, great dry eye work she’s done. So, you know, tell us a little bit about the dry eye mechanisms and how we deal with it as healthcare practitioners.
02:14
Absolutely. So it really is one of my favorite topics to talk about. So again, thank you for having me here to talk about dry eye. You know, I’ll kind of share a statistic that I recently read and often share on my lectures and things. The word dry eye is actually Googled three point seven billion times a day. OK, so the word. Yeah, exactly. The word dry eye is Googled three point seven billion times a day.
02:43
which actually equates to about 40,000 searches per second. So that kind of takes it to the next point that dry eye is a very common condition. And it is something that is on top of mind for a lot of people around the globe. I mean, just evident by how many times that word is actually Googled. So pretty fascinating.
03:06
And often I find that dry eye isn’t taken seriously, but it is a condition that can have such a huge impact on patients’ quality of life, which is why they’re searching for answers on the internet for this condition, right? We often think of dry eyes as dry hands or dry feet and put some lotion on and off you go, but unfortunately dry eye is not that simple. And the reason is that
03:33
I mean, if we think about our eye, it is one of the most specialized structures of our body, right? The front surface of the eye, the cornea actually contains the most amount of nerve endings of anywhere else in the body. So it’s extremely sensitive. And along with being extremely sensitive, I mean, our eye, our vision is probably our most important sense. Do you know what I mean? We’d rather lose any other sense and but not our vision.
04:02
So protecting that eye, lubricating that eye, that very specialized sensitive eye and very important to us is this tear film that is on the top of the surface of the eye, right? So if the eye is very specialized, well, guess what? The tear film is actually equally specialized because it’s got such an important job to do. So when patients develop dry eye, which is when the tear film falls apart, for whatever reason, they don’t have good quality tears,
04:31
the impact on quality of life can be really a lot. Yeah, and I know that there’s many reasons behind it. So there’s the decreased production versus this sort of inflammatory component of it. Can you touch on that a little bit? Yeah, absolutely. So there are many reasons patients can experience dry eyes.
04:53
I mean, one of the most common reasons is obviously aging. As we get older, we, you know, unfortunately just dry out, right? We don’t, our hair is more dry, our skin is more dry. Unfortunately, our eyes are no different, but there are lots of other autoimmune conditions that can also lead to dry eyes, something like show grands, even diabetes. If patients have had any injuries or surgeries on their eyes, they can be more prone to dry eyes as well, such as LASIK or PRK or cataract surgery.
05:23
certain medications, right, overuse of, you know, preserved tears can also cause dry eyes. And then I think one of the other thing that we’re really seeing as a big, big cause of dry eye is this environmental shift in all of our lives, right? We’re now such a digital age where all of us are on our computers and devices for many, many hours. We know that reduces our blinking rate.
05:48
by almost 50%. And so when we reduce our blinking rate by 50%, we’re also reducing the quality of tears that are being produced by that amount. I mean, if you think about it, any biological function that we reduce by 50% is gonna have implications, right? I always joke to my patients, I’m like, if you didn’t poop half of the time, that’s gonna be a problem. And so we’re not blinking half of the time, you know, that’s gonna be a big problem.
06:15
And so we’re definitely seeing a lot more dry eye being more prevalent because of our digital age, because of our lifestyle where we’re not outside as much, and perhaps even a poor diet, right? The whole shift towards a bit more of a poor diet as a culture is also having a big impact on our eyes. In fact, I read another statistic where now half of the visits to an optometry practice or an ophthalmology practice are related to dry eyes.
06:44
Yeah, so a lot of people coming in even to see us for routine eye exams, like the number one thing they mention is their dryness. And a lot of times we pass it off. But I can only imagine how many times they’re mentioning it to other health care practitioners as well, you know, that my eyes are blurry or my vision is blurry. And, you know, family physicians might just test them with the eye chart and think everything is great. But a lot of times, dryness is a big is a big culprit of the reasons they have this fluctuating blurred vision.
07:14
and then obviously affecting their wellbeing, their mental health. Like you were saying, how many times it’s Googled? I’m in shock at how many times it’s Googled. I would have never thought that. So it’s obviously affecting people, right? Their wellbeing, would you say, like their mental health? Absolutely. So dry eye again can be, moderate to severe dry eye can have a really big impact on a patient’s quality of life. In fact, another study showed that among the ophthalmic conditions,
07:41
The highest rate of depression was observed with dry eye, followed by glaucoma. As you know, glaucoma is a blinding disease, followed by macular degeneration, and then followed by cataract. So all of those super serious diseases, of course we believe that they can have an impact and cause depression and anxiety, but guess what? Dry eye was even above them in terms of the level that it can affect a patient’s mental state. And of course, having dry eye can also lead to
08:10
reduction in work productivity, right? And that can be a financial hit too for a lot of patients. And that’s a really big impact as well. And I think a lot of patients will leave it, obviously, you know, they’ll ignore it and because they can still function day to day, you know, get outside, do things there, go to their grocery stores, at least show up to work. But they’ll live with it and they won’t address it. And that’s why dry eye just tends to go from
08:40
you know, what are some basic therapies that you would recommend in terms of drops? I think most patients will just go over the counter and get those artificial tears. Any recommendations on preserved versus non-preserved? Absolutely. And you know, the other thing that is so important, what you’re saying is so true, is that patients will kind of suffer before they even come in and ask for help, right? In fact, there was another study that showed that on average patients live with dry eyes for 6.5 years.
09:09
they’re asking their friend on how to treat it, they’re asking their coworker, they’re Googling before they even show up to your clinic, because now it’s bothering them enough that they need to come in and present and talk to you. But by then, you’re absolutely right. It has maybe moved to sort of being a mild, a nuisance to maybe more of a moderate condition. And dry eye is a chronic condition. I often tell patients it’s much like having arthritis, where if we don’t have good quality
09:38
lubrication in our joints actually creates a lot of inflammation. And that inflammation can be quite damaging and can progress the condition further, right? So patients can actually lose their joint function if that arthritis is not managed. And I often say that to them with their dry eye as well, that it’s not just as simple as replacing using an artificial teardrop and replacing that, you know, your own natural tear film.
10:04
Because let’s face it, artirafilm is so, so incredible in the amount of all these growth factors, vitamins, minerals that it contains, that it just cannot simply be replaced by anything over the counter, right? So we do have to be mindful of, you know, we wanna get to the root cause of it. We wanna treat the dry eye. We wanna pick up on those symptoms earlier before the inflammation takes over and starts to kind of progress the condition.
10:30
But you’re absolutely right. So in an earlier form of dry eyes, if some of my patients come in and they’ve got mild symptoms and of course mild signs, I think starting off with a good quality artificial teardrop is absolutely the way to go, right? And in these teardrops, I often recommend patients to use something that is preservative free. We know that we need preservatives in a lot of things to extend the shelf life of our products.
10:57
and of course to combat any bacterial infections that can come through. But preservatives are also a necessary evil. Do you know what I mean? And so they can actually harm the ocular surface, especially if it’s already compromised by not having a good quality tear film to protect it. So I think my first step is often, let’s go ahead and start with a good quality preservative-free artificial tear. And I think, like I say, dentists always recommend flossing.
11:25
The two things I always say that everyone should have, even if you’re not experiencing dry eye symptoms, is a non-preserved tear and a mask of some sort. But I mean, those are the two things that people should be doing daily to maintain their good eye health, just like a dentist is saying, to floss. So I know for me, I usually recommend a non-preserved tear and a moist heat mask, like the Bruder mask. Do you have recommendations on, I know there’s this whole debate on moist heat
11:54
not moist heat. So what kind of moist heat versus dry heat? Sorry, what are your thoughts on that? The differences? Yeah, absolutely. I think I do prefer moist heat as well, especially when we’re talking about dry eye thing. It can be just a little bit more moisturizing for the patients and also not dry out the surf, you know, the delicate skin around the eyes as well. So
12:21
I think we have to be mindful of when we’re putting heat on the surface of the eye, we’re also putting heat on the skin around the eyes as well. And that skin is actually really quite delicate. And so I find that moist heat is perhaps a little bit better and gentler on the eye and the skin. And it should be just part of everyone’s daily routine, I think now, so that they’re not getting to that point of moderate or severe dry eye. You mentioned inflammation, right?
12:50
definitely think there are drops out there like immunomodulator, cyclosporin. What are your thoughts on drops, you know, and using these drops when you feel a patient has inflammatory dry eye or there’s an inflammatory, you know, component of it? Are you recommending those to your patients? Yeah, absolutely. You know, we’re practicing in such a great time right now. When we do have dry eye that is inflammatory, we have so many great treatment options.
13:20
beyond just supplementing the tear film to actually help manage the condition. So I am a big fan of when I see enough signs of dry eye, when I see enough symptoms of dry eye, starting these patients on anti-inflammatories to slow down the disease process to preserve the health of their ocular surface. I think it would be very advantageous to start some of these therapies early on.
13:45
A lot of these therapies like immunomodulators, like cyclosporine or lefetograph that are available in Canada are safe. They have a very good safety profile. We have some really great data that shows us that they work. And so starting them early on can be quite beneficial for these patients. And a lot of these drops are used twice a day. So I think it’s easy for patients to put that in their routine.
14:11
I always love going back to the dental analogy, right? I tell my patients to put their anti-inflammatory drop right next to their toothbrush. So in the morning when they brushed your teeth, go ahead and put your anti-inflammatory drop in as well. And same thing at bedtime. So it can really fit into their routine. And a lot of these anti-inflammatory drops again, help to increase tear production and also reduce inflammation within the eye.
14:36
So can I ask you like at what stage you are recommending these drops to patients? Like how do you know as an optometrist, as an eye doctor, that you want to take that step to go from the basic artificial tears and the moist heat masks, which is very minimal mild dry eyes, to prescribing the cyclosporine drops. How do you know you want to take that step? I think absolutely an evaluation by an eye doctor is so important.
15:06
because as you know, so some of the symptoms of dry eyes are, you know, itchy eyes, burning eyes, irritated eyes, foreign body sensation, watering, light sensitivity. But there are so many other eye conditions, as you and I know, that can also present in some of those symptoms, right? So we can’t just always go off of these symptoms. Things like herpes eye diseases or iridesces, which are caused by autoimmune disorders, also sound exactly like that, right?
15:33
So I think absolutely first step is if you’re experiencing any of those symptoms is to come in and get an evaluation. We have such great battery of tests that we use to evaluate the ocular surface. One of my favorite tests is to test for the osmolarity of the ocular surface. And I love actually explaining osmolarity to my patients. I tell them, you know, think of your eye bathing in, you know, in this tear film and think of your tear film as this ocean.
16:01
that has all this beautiful fish underneath. And with this osmolarity, what we’re checking is that quality of that water in that ocean, right? If there are changes in that water, if that water in that ocean is becoming toxic, we know sooner or later the fish are gonna die. And so in the same way, if the tear film isn’t healthy, we know it’s going to impact the cornea, the front surface of the eye. So by checking osmolarity, I’m really checking the health and the quality
16:29
quality of that ocean that everything is surviving and bathing in. And so they really kind of get that when I say it that way. So that would be one of my favorite tests that I like doing. And of course, we have vital dyes that we use in our clinic as well to stain the cornea, to look at how fast the tears are evaporating, how long they’re staying on the eye. And then of course, some of the newer tools like my biography, which is looking at the
16:59
to see the quality and the quantity of oil that’s being produced by our eye. I’m so glad you mentioned the oil glands because there are great treatments now, like we’re using radio frequency or intense false light to help with those oil glands. Can you touch on that and how that’s helping your patients? Yeah, so I think once we see the patient and we kind of evaluate them from dry eye, we’ve got to really start to figure out what is the root cause for this patient.
17:28
are they just not making enough tears or are they just not producing enough oils? And once we kind of determine the cause of their dry eye, I think coming up with a treatment plan that really suits what the root cause is can be quite helpful. So if a patient has what we call myobomian gland dysfunction where their myobomian glands are not producing enough oil, and that is one of the major causes of their dry eye,
17:54
then absolutely, I think there’s a multifactorial approach in how we can kind of approach that in helping their oil glands produce better oils. And some of the newer technologies now are these in-office therapies that are so powerful in helping these oil glands not only reduce inflammation around them, but up-regulate their oil production and reduce the burden of perhaps the microbiome that’s upset on the lid margin as well.
18:24
So some of these tools along with obviously some of the in-home therapies, right? Maintaining that with a good lit hygiene and a clean diet. Some of those pillars of wellness that are so, so important as well because our eyes are not just on a stick, right? They’re part of the body. So taking care of the whole body and taking care of your eyes with some of these therapies can be quite beneficial.
18:49
Yeah, and it’s not just, I mean, if patients are coming in for radio frequency or IPL treatments to your office, it’s not just, you know, these are the treatments done. There’s a lot of home remedies and there’s a home component to long-term maintaining those oil glands, you know, otherwise we start back at square one again a few years later. So that’s so important to maintain the tear film with, you know, your diet, your hydration, your moist heat masks, your non-preserved tears, like there’s that whole…
19:18
lid hygiene component to it, right? Like we brush every day, twice a day, hopefully, and we don’t do that with our eyes, so that’s so important. I feel like every patient needs to be walking out of our office with this at-home remedy kit to be doing once or twice a day, and it’s just so undervalued and not done as much as we should be.
19:43
Yeah, and of course, and now we’re paying attention to it so much more because of the rise in dry eye, because of our lifestyle changes with being on a digital world. So I think we do have to adapt. We do have to be more mindful of now looking for dry eye and proactively treating it before it gets worse. And, you know, it really is a and I think setting patient expectations around dry eye is so important in their success in having some relief and managing this condition. Right.
20:12
again, have to get away from the fact that dry eye is a simple, you know, put some lotion on and off you go type of a condition that it is a multifactorial chronic condition that does need a multifactorial approach, right? The patient and yourself really has to be partners in managing this condition and that it is a chronic thing. But what we’re really looking for is more good days than bad days, right?
20:39
We want to manage it so it does not impact your quality of life and that you enjoy good, clear vision. That yes, like in any chronic condition, there may be some flare ups, but we really hope that there are more good days than bad days. Yeah. You know, and as you said, like these non-preserved tears and things like lotion, you know, these are band-aid solutions. I think, you know, I saw some articles written by you on, you know, biologics, you know, which are probably more…
21:08
you know, not band-aid solutions, but more long-term solutions that are actually helping to improve the actual tear film quality. You know, can you discuss a little bit about the types of biologics? Yeah, absolutely. You know, and I mean, again, every form of dry eye needs a lubricant, right? So artificial tears have their place, especially in the mild dry eye.
21:29
But as things get more advanced and the osmolarity of the tear film really starts to change, so that ocean is not great, and now we’re seeing damage on the ocular surface, that might be a good time to turn to something like biologics. And really why the biologics are so, so helpful, we really have to go back to, well, what does our tear film contain, right? So our tear film actually contains close to 2,000 different molecules that we know of.
21:56
And these are growth factors, vitamins, minerals, antibodies, anti-inflammatories, electrolytes, and they’re all working really hard and they’re on a really tight balance to help then support, lubricate and heal that ocular surface. And so, you know, even the best teardrop on the market is not going to contain those 2000 molecules, right? Best teardrop on the market maybe contains four. So when we’re looking to substitute the tear film, what we have found is that
22:24
our plasma within our own body and our platelets contain many of the same molecules that are found in our tear film. In fact, all those 2000 molecules that are found in our tear film are also found in our platelets. They have growth factors, vitamins, minerals, antibodies that can be very, very healing to the surface of the eye. So it’s incredible to now see some studies where, you know, we can take the patient’s blood and draw the patient’s blood and spin it down and then dispense them something called platelet rich plasma.
22:54
or autologous serum, which is basically, you know, components of plasma and platelets. And that’s something that they can then use as a lubricant on the surface of the eye. And these biologics can be very healing, you know, and correct osmolarity and correct the inflammation on the surface of the eye. So are these drops that you’re prescribing or are patients like how do these drops work? Like are there certain companies that are making these drops?
23:22
Yeah, I mean, so availability of biologics is really still quite limited. We do see biologics in so many other areas of medicine. If you’ve kind of heard of patients getting injections into their joints, right, with platelet-rich plasma or dentists actually use platelet-rich fibrin, where they draw the patient’s blood and they put that right around their tooth to help the implant that they’re putting in heal better. So these are very healing kind of areas.
23:51
materials that we can use, but unfortunately you’re right, the availability in eye care isn’t that common. So it is best to talk to your eye doctor. There are some labs in many areas that the doctors can work with that will help draw the patient’s blood and process them to make eye drops for patients to use. That’s amazing. That’s great to know because, you know, a lot of times
24:16
You know, there are so many therapies like you’re talking about, whether they’re the biologics, whether it’s, you know, IPLs, there’s so many therapies. But sometimes, you know, we box the patient into one little cookie cutter box and we say, this is what you need. And we don’t introduce other therapies that might be helping them. You know, I back to kind of the lid hygiene we were discussing. I mean, a big culprit is, you know, makeup and you know,
24:42
not cleaning your makeup, obviously there’s a hygiene component to it using makeup that have a lot of preservatives and chemicals. So talk to me a little bit about like lashes, you know, there’s this big fad about fake lashes or eyelash extensions, you know, is that, are you seeing that in your practice contributing to a lot of the myobomian gland dysfunction? You know, you have a practice that’s heavily focused on dry eye disease. So are you getting a lot of those patients come in and do you feel a lot of it is from
25:12
from lashes? Yeah, I mean, absolutely. Cosmetics are really interesting. And of course, we do want to look beautiful, and we do want to wear makeup. And that’s such a part of so many of our self-identity. I enjoy wearing makeup. And I never want to tell a patient, hey, don’t wear makeup because you have dry eyes. Because let’s face it, that has an impact on their quality of life, and that’s not really fun to live with either, right?
25:40
But it’s interesting to note that, you know, makeup does, can contain so many toxic things that can harm the ocular surface. In fact, the last time, you know, the makeup cosmetic FDA industry was kind of updated was 1938, right? So lots has changed, we’ve learned so much. And so that industry really isn’t held up to those standards where they have to disclose the side effects of all of these makeups can have on the surface of the eye. So.
26:09
As I care practitioners, I do share some tips with my patients. I tell them, don’t put makeup on your water line and don’t use waterproof stuff. Don’t do a lot of heavy makeup, right? Everything in moderation. Of course, we understand for a wedding or whatnot, but on a daily basis, really try to keep the water line clean. Don’t wear waterproof makeup. And then so important to take makeup off at night so that our eyes have time to.
26:37
breathe and rest and not be covered in makeup when they’re going to bed. And of course, eyelash extensions. I mean, who doesn’t love the look of those things. So I don’t fault my patients for wanting to have eyelash extensions because let’s face it, they do look beautiful and who doesn’t want to look beautiful, right? Um, but again, yeah, one of the biggest tips I share with them is, is everything in moderation. Um, you want to go to a skilled technician, uh, that, uh, has a lot of experience.
27:07
You want to maybe test some of those glues that are used for eyelash extensions on your body before to see if there’s an allergic reaction, because that’s one of the most common things I see with them. And then really, let’s decrease the chronic use. I mean, if we ate McDonald’s every single day, it’s not it’s not going to be great. It’s not going to be great. And I mean, eyelash extensions is that, you know, reduce the chronic use. Yes, it’s okay to do it once in a while.
27:35
And then of course, taking care of them. You know, and I think as eye care practitioners, we don’t wanna have our wall up and judge our patients for some of these decisions that we make, right? Cause then I think we can really alienate them rather than be in care with them, where we can encourage healthy habits and clean, you know, eyelash extension habits. So super important to have those open discussions and, you know, some of these personal decisions
28:04
We just have to have a lot of empathy, right? Why our patients are doing these things and really be their partner in these areas. Right? I recently, it was funny you mentioned that, like, not alienating them because, I had a 13 year old patient the other day and there’s a whole Sephora trend with the teenagers and whatnot. And she’s mom and her telling me, and I can see the eyelash extensions and obviously I’m cringing, right?
28:30
13 year old wearing eyelash extensions. And I want to say the mom blood in me wants to say something so badly. But you know, again, like you said, you know, you’ve got to have that empathy as well. We have to wear that hat as well and be realistic, right? I mean, even if we tell them to not, they’re not going to listen to us completely, right? So me and…
28:48
me and her just had a discussion about when she wears them, you know, just cottage weekends and, you know, sparingly. And we said, yeah, just have those good healthy breaks. Make sure you’re cleaning the base as per your aesthetician, cleaning the base of your lashes, you know, based on the glue recommendations and keeping your lids healthy when you’re on the off periods, right? Hygiene wise. So, you know, you’re right. But
29:11
I also see the flip side where we’re very upset inside that we want it. And recently I saw eyeliner tattoos really coming back. I don’t know if it’s coming back. I don’t know if they were ever in, but I see so many eyeliner tattoos these days. So that also makes me cringe, but especially when they’re very close to the water line, right? Exactly, I mean, that fad needs to go. No one needs to tattoo their eyes or have any tattoo around their.
29:40
eyelids or lash margins. I mean, come on, come on people. Yeah, that’s exactly right. But again, like you said, we have to wear that empathy hat. But it’s funny, the tattoo patient, I mean, I’ve seen a few recently. There’s one specifically that came last week. And she had a, you know, a stye as we commonly call it, which is a blocked my bohmean gland. And she was like, I just don’t understand how I how this
30:09
I just don’t understand, you know, and obviously I’m explaining it, but you know, bacteria is going in there, things are happening, but you know, a lot of times patients are oblivious to what’s happening. They’re just oblivious to it. They think this is a healthy practice and nothing can happen to their eyes, like their eyes are immune to all these things because I feel they haven’t been taking care of their eyes all these years, right? There’s no, like when you get a cavity…
30:34
you kind of appreciate the cavity because you’re like, I’ve been brushing every single day and flossing and oh my God, now I have a cavity, right? But when a sty happens to your eyes, you’re like, how did this happen? How did this happen? I don’t understand because you haven’t taken care of your eyes all these years. Right? So I find that lid hygiene and that taking care of your eyes aspect is just gone out the window. And, and I want to stress all healthcare practitioners, including optometrists to really bring it back like yourself, you know, educating others.
31:04
educating your patients, other healthcare providers about the impact that dry eyes have on lives. Absolutely, absolutely. And I think this is why this podcast like this are so important that spreading that awareness. You’re so right. Eyes are, and eye health is often taken for granted, right? We don’t usually do a lot of maintenance around our eye health like we do with our teeth until things go wrong. And then it’s very hard and frustrating for patients to understand.
31:33
How did this happen? How did this suddenly come about? And so again, I think getting your eyes checked regularly, I mean, eye exams don’t only pick up for glasses and contacts, they really are looking for so many silent eye conditions, including dry eye, right? A lot of time dry eye doesn’t have to have symptoms unless it’s really progressed. And I often tell my patient, it’s kind of like having high blood pressure. You may feel totally fine, but does that mean we should not treat it?
32:01
Does that mean we should not treat it and wait until you just develop a heart disease or a heart attack before we manage it? So yeah, really important to have some of these conversations. And I’m glad that we talked about makeup because you’re right. So many patients don’t know that makeup can be harmful. Tattoo eyeliners and eyelash extensions, tints, perm, all of those can be harmful. And it’s so important for them to talk to their eye practitioner about safe habits.
32:26
you know, before they embark on those journeys or be in partner with us, right, when they are doing those things that are so close to their eyes. Thank you so much. You know, I think you taught a lot of our listeners and viewers about so many options, right? They’re not just, you know, you started from the artificial tears and brought it up to all the different, you know, aspects and treatments. So I think that’s so important for us to be more aware of all the options, even if we as healthcare practitioners are not offering those options, but at least referring out to other
32:55
optometrists who are is so important, collaborative healthcare, I always say. But let us know, can you tell our listeners and viewers where they can find you? Absolutely, well, just like you, I’m a big fan of social media, only because we’ve got to give those TikTokers a run when they’re putting out all this false information. So we’ve got to be on there, spreading the love of eye care, spreading the love of dry eyes.
33:22
So you can find me on Instagram. It’s dr.mania.medan on all of those platforms and LinkedIn. And I love interacting with people. So please reach out if you have questions, if you are looking for dry eye treatment or have questions about it, or if you’re a fellow colleague and you wanna collaborate on a case, I would love to speak with you. You can also find me on my website, which is www.
33:51
Amazing. Thank you so, so much Dr. Madan for your time today. Really appreciate it. It’s a pleasure. Thank you so much. Thank you listeners and viewers for tuning in. If you want to catch more episodes of Uncover Your Eyes, make sure to follow or subscribe on your favorite podcast platform and on YouTube. To learn more about me, follow me on Instagram @Dr.MeenalAgarwal Until next time, keep those eyes uncovered!