Conditions like glaucoma and macular degeneration are very common among older Americans. They often result in impaired vision and affect quality of life severely. Are there health practices that can reduce the risk of these serious problems?

Dry eye is increasingly common and extremely uncomfortable. What can be done to ease the burning and irritation associated with dry eye? How well do these approaches work?

The eyes offer insight into overall health. What red flags can an eye doctor detect? What are the best strategies we can adopt to preserve our vision?

Guests: Randall K. Thomas, OD, MPH, FAAO, is an optometrist in clinical practice in Concord, North Carolina. He was named Glaucoma Educator of the Year by the American Academy of Optometry, and he co-authors the Clinical Guide to Ophthalmic Drugs with Dr. Ron Melton.

Ron Melton, OD, FAAO, is co-author, with Dr. Randall Thomas, of the annual Clinical Guide to Ophthalmic Drugs. The American Academy of Optometry presented him with the Glaucoma Educator of the Year award. He practices in Charlotte, NC and lectures internationally.

Their website is:

Guest disclosure: While we consult for a number of companies, we diligently strive to never let those influence our public statements. That being said, we consult for Carl Zeiss Meditech, Alcon Laborotories, Rapid Pathogen Screening, Bausch and Lomb, and Icare, USA.

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. joy


  2. Jan N.

    I have Graves disease which is affecting my eyes. The lids are swollen and eyes bulging out slightly. Have had thyroid checked, it is high and am taking medication to lower it. Doctor said that Grave’s would not necessarily be cured by lowering of thyroid. Worst of all I have double vision. I am having a hard time finding out information about this. Is Grave’s disease an auto-immune disease? What can help?

  3. Mary C.

    Thank you, Joe and Terry for a most important program and one all should hear. I had problems last year, and again this year with “dry” eye though the first Dr. said it was ocular rosacea and treated me with Oxycycline. That left me with a problem called “cough headache” which evidently there is not a cure for??
    This past month have again had problems with dry eye and have been treated by another doctor with Azasite and Systane Ultra? At last my eyes have cleared but now I am wondering if this condition is chronic? Keep up the great medical reporting which has benefited me and my family for 25 plus years.

  4. Judy Z

    I don’t feel that they answered the question “can you overdose on (dry) eyedrops. Yes they recommend lipid drops which are most likely very expensive. If one uses gel type drops several times a day, is it doing any harm?

  5. Doris C.

    I missed hearing this program, sorry to say, but I check out the information on your email each day. I have had dry eye for 30 years and find that Muro 128 Ointment used in both eyes at night gives wonderful relief. If I fail to used the ointment at bedtime, I wake up with pain in eyes during the night. Hope this is helpful.

  6. John S.

    This was a very informative show. Please plan to bring them back!

  7. sl

    I made a point of listening to this show and am glad I did. I never know which artificial tears to purchase since none seem to offer much relief. I’ll be sure to try Systane Balance and Soothe XP, the two drops that were specifically mentioned. I’ve looked at the website mentioned, and found the new LipiFlow Thermal Pulsation System is available in NC. Certainly sounds worth checking out.
    Thanks for a helpful program. ( Dr. Melton gave me excellent advice when I was facing cataract surgery: one eye set for distance, one eye for reading, close vision. This has worked well for me. I often tell others about the option as it doesn’t seem that many doctors discuss this option with patients.)

  8. mary

    I have Thyroid Eye Disease and have had orbital decompression in both eyes. My left eye has developed chronic dry eye. I have to carry steroid eye drops with me and use approx. 6-8 times a year ( one prescription lasts a year). My question is at what point are the steroids a problem and is this a condition I will have to live with from now on?

  9. Lea

    I am listening to the eye health radio program. I had a wide angle glaucoma attack a year ago & have had both of my eyes lazered to provide drainage. Can I take a sleep aid like Tylanol PM in safety with glaucoma?

  10. ser

    How about autologous eye drops? That was only ‘drug’ that worked for my friend.

  11. Mary B.

    Is there a special vitamin that will slow macular degeneration of the retina that can also be taken by those of us with family members who have macular degeneration of the retina? I was told that there is a special supplement but I don’t have the name of the product. Thank you, Mary

  12. Maxwell

    This was an informative, valuable show. It convinced me to have a dialtion along with my annual eye exam. If I understood correctly, this allows diagnosis of certain occular conditions and provides a glimpse of both brain and cardiovascular health. And after hearing the differences between conventional eye drops and lipid-based (like Systane Balance & Soothe XP), I’m pitching all my “junk” and going with Soothe! Again, good show; next step is to explore Dr. Melton’s and Dr. Thomas’s web site so I can continue to learn.

  13. Carrie C.

    Good morning everyone,
    In the last couple of years (few years, maybe,) I’ve noticed when I’m in bed at night and move my eyes sharply to left or right, up or down, (with my eyes closed,) I see circles of light that seem to be double circles with breaks in them. Have you heard or this, and if so, what might it be?
    Thanks for your response.

  14. Johnny

    I had a growth that was removed several years ago, I was told it was due to being in the sun without eye protection. I was told I have dry eyes, but they water a lot, is there something I can do?

  15. Danny

    How successful is the use of pixels in the eye for retina damage? How well can people see with the pixels? How far advanced is the treatment?

  16. Lesley from Durham

    I have a question about vision therapy for children who have trouble reading including reading slowly, losing their place, skipping lines, etc. My son was referred to a vision therapist by our eye doctor. His examination revealed poor tracking skills, focusing ability, eye teaming difficulties, and visual perceptual training. She recommended vision therapy.
    I have looked in the medical literature and found review papers concluding that vision therapy is not effective for improving reading skills/dyslexia. On the other hand, my mom just told me about a coworker whose son had poor tracking skills and vision therapy did help.
    Do your guests have any opinion on this matter? Thank you.
    Lesley from Durham

  17. Beth Friedland, M.D.

    Joe and Terry: I am listening to your show with optometrists Drs Melton and Thomas, and I need to add a comment about the discussion of Aspirin use and Macular Degeneration. Dr. De Jong and collegues, from the Netherlands clearly state that this finding is merely an association and bears further study. When you look critically at their data, it implies connections, but in no way suggests that there is any causality.
    “The authors advise caution in interpreting the results of the study. “This was a cross-sectional study, and the possibility that people with AMD took aspirin after experiencing visual problems cannot be excluded,” they note. Another limitation is that “it is possible that participants incorrectly reported their [cardiovascular disease] history, leading to residual confounding and measurement error.”
    However, the authors say, “the protocol attempted to minimize misreporting by asking about serious events such as heart attack and stroke and also recorded the date of the event.”
    Keep in mind that patients self reported their cardiovascular disease, that aspirin use is very widespread, and that the doses differed among the 4700 participants.
    A prudent course, that I am advising to my own patients is to weigh the potential risks and consider reducing aspirin use to 81 mg every other day, with the collaboration of the patient’s cardiologist or internist. Obviously we all agree that patients with severe cardiac disease need to reduce their risk of stroke by taking Aspirin.
    There are also several articles showing a strong correlation with ischemic heart disease and both wet and dry macular degeneration, further complicating the story. More research is needed before we send out a blanket message to stop aspirin for patients.
    Thank you for your thoughtful and encouraging note about the association between aspirin and macular degeneration. We think you have pretty much summed up the research nicely and we concur. The risks (if there are any) seem fairly small at this time compared to the potential benefits of aspirin for those at risk for things like cardiovascular disease or colorectal cancer.

  18. DIK

    I am 85 years of age and been hypothyroid since 1975 when I had my extreme hyperthyroid condition change with the ‘radiation cocktail’. I have taken many kind of thyroid meds since then, including armour. I was recently told by my eye Doctor that I had signs of macular degeneration. He told me to go to a website that Bausch and Lomb sponsor and start taking that medication. I have done so. Have not had problems, yet and hope I don’t.

  19. Pam

    I have very dry eyes; according to the ophthalmologist or optometrist (I apologize for not knowing the difference) I’m seeing, this will need to be resolved before we start working on changing prescription for my eyeglasses. I am near the end of my first three months of using Restasis twice daily. I understand that I might be using it for the rest of my life. My physician’s assistant thought my thyroid might be a contributing factor (I am hypothyroid–used Levothyroxine for maybe three years; switched to Armour about three months ago), but he did a thyroid panel and said it shows “normal.” Vision is essential to my professional life (I’m a writer/editor) and my personal well-being. Do the doctors have any suggestions?

  20. DW Parker

    I hope your guest will also discuss detached retinas. I am 70 years old and I am near sighted and have worn glasses all of my adult life. I have consistently had annual eye checkups, yet I cannot remember ever being advised about detached retinas with my various eye doctors.
    Approximately five years ago while on a business trip to Central Asia I experienced a detachment of my left eye’s retina. If it had not been for a very astute Physician Assistant at the American Embassy (I was a Foreign Service Officer) who after determined my condition and facilitated my medical evacuation to Germany, I would have lost the use of my left eye.
    Like I said about, not one of eye doctors that I had visited made me aware of the early signs of a detached retina nor told me the seriousness of this condition. Needless to say, I feel the Ophthalmology “industry” is doing its clients a disservice by not making them aware of the early signs on a detach retina and steps that should be taken.

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