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heath matters 081719

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by Tara Fatemi Walker HEALTH M A T T E R S EYE HEALTH 101 P eople often discuss how to stay in good general physical health (including getting enough exercise), but what about eye health? I recently spoke to three locals—two optometrists and one nutritionist—to get some information. A Mexico City native, Doctor of Optometry Maricela Salgado has been at Salud Para La Gente since 2007. She serves as Director of Optometry at Salud, a Watsonville-based nonprofit federally qualified health center. Dr. Salgado provides comprehensive family eye care services and has served as Director for the last six years. She is passionate about providing services to underserved populations, as well as connecting them to community resources that can aid in their overall well-being. She's especially interested in the prevention and treatment of eye diseases, eye care for all ages, and community access to health education. In the last two years, the bilingual Salinas resident has expanded services from a single location with a team of two, to two locations with a team of nine. Dr. Salgado has a few tips to start with. "Be aware of potential hazards in your work, home and recreational environments such as loose debris, chemical fumes/irritants, and overexposure to ultraviolet rays from the sun, to name a few hazards," she warns. "Use eye protection such as sunglasses, work protective gear, goggles… mainly when outside, at work, and during sports, to decrease the risk of trauma," she adds. Dr. Jennifer Buell, Doctor of Optometry and co-owner at Plaza Lane Optometry in downtown Santa Cruz, echoes this advice. "We live in a very active community and spend a lot of time outdoors, year-round," says Dr. Buell. "Outdoor activities are generally beneficial for physical health but not everyone is wearing the proper sun protection. Make sure that you have a pair of sunglasses that are 100 percent UV blocking. If they don't meet this standard they could be causing more harm than good (a dark lens makes your pupil dilate so now you are allowing even more UV light in). Plus, you want to protect the delicate skin around your eyes from harmful, wrinkle-inducing UV as well!" For more tips from Plaza Lane Optometry, you can check out their blog (plazalaneoptometry. com/blog) that includes posts like "Your Guide to Nutrition For Healthy Eyes" (November 2017) and "How to Protect Your Eyes from a Sunburn and Snow Blindness." Dr. Salgado encourages individuals to schedule a comprehensive eye exam annually, or "…sooner if you notice any changes with your vision, eyes, or are taking medications with potential to cause toxicity in the eyes." Also, she advises talking to your primary care provider about any concern with headaches and other symptoms that can relate to your vision. "Preventative medicine, as we now know, leads to better outcomes and lower costs," says Dr. Buell. "Visual health is no different, which is why the first eye exam with an eye doctor is recommended before the age of one. I love to see kids between six and nine months old for a full evaluation of their visual systems. It is recommended that all individuals, whether you 'see well' or not, have comprehensive eye wellness exams every one to two years throughout life," says Dr. Buell. "Your eye doctor can tell you if you should be seen more frequently," she adds. At Plaza Lane Optometry, they offer a range of services. These include "InfantSEE exams—a free exam for children between 6 and 12 months, something not all eye care providers offer," says Dr. Buell. "We have exams for kids to ensure both eyes see well AND function well as a team (binocular vision), which is essential for reading, tracking and learning." They also offer specialty contact lens fittings for individuals with corneal disease, comprehensive eye wellness exams, medical eye exams (for red eyes, infections, foreign body removal, glaucoma, dry eye, etc.), and LASIK and Cataract surgery "co- management." A Santa Cruz resident, Dr. Buell has been practicing at Plaza Lane Optometry since 2013 and bought into the practice as a partner in 2016. "I take pride in the high standard of personalized eye care that myself and my business partner, Dr. Curt Simmons, provide." She believes in a holistic approach to patient care. "Conversations about lifestyle and a person's general health (diet and exercise) play a major role in my eye exams," she explains. "So many people are unaware that your overall health directly affects your eyes and that one of the best things you can do is get regular eye wellness exams to help ensure great vision for life. One of the big topics I always discuss with people is cigarette use since smoking is one of the biggest modifiable risk factors for macular degeneration development and progression." Speaking of things that are modifiable, you can also change what you eat. Certified Nutrition Consultant Madia Jamgochian, who coaches people about nutrition with her business "My Healing Habits," encourages everyone to "eat the rainbow for eye health." More than 50 million Americans suffer from vision problems, she says, and a big part of eye health has to do with getting a variety of nutrients from many different types of whole foods, fruits and vegetables. She recently researched some details in author Michael Murray's "The Encyclopedia of Healing Foods." "The structural parts of our eyes and the eye microbiome (yes, eyes have microbiomes too!) are affected by lifestyle and diet," says Jamgochian. "Risk factors associated with macular degeneration include smoking, obesity, cardiovascular disease, chronic inflammation, poor digestion, diabetes, lack of sun, and nutritional deficiencies. In terms of micronutrients, the best way to ensure you are covering all the bases is to eat the rainbow: each color will give you V I S I O N & H E A R I N G by Tara Fatemi Walker continues on C3 Dr. Jennifer Buell photography by Kevin Painchaud Advertising Supplement Dr. Maricela Salgado SWIMMER'S & SURFER'S EAR I f you're an active resident of Santa Cruz County, swimmer's ear and surfer's ear are conditions you should be aware of. The Mayo Clinic web site defines 'Swimmer's ear' as "an infection in the outer ear canal, which runs from your eardrum to the outside of your head. It's often brought on by water that remains in your ear after swimming, creating a moist environment that aids bacterial growth." 'Surfer's ear,' on the other hand, is "… medically known as 'exostosis of the external auditory canal'…caused by repeated exposure to cold water and wind. Cooling of the ear canal stimulates bone growth that narrows the canal and blocks the eardrum. This narrowing traps water and earwax in the canal, often resulting in painful ear infections and hearing loss… Santa Cruz is distinctive as a world center for surfer's ear" (excerpted from Sutter Health Palo Alto Medical Foundation's web site). Dr. Douglas Hetzler, an ear, nose and throat specialist at the Palo Alto Medical Foundation-Santa Cruz office in Soquel, suspects that Santa Cruz County has such a high per capita rate of "surfer's ear" due to "…our cold ocean water temperature; the large number of people who spend time in the ocean here; and the duration of time people spend in the ocean over years." When surfer's ear gets bad enough, surgical removal can be necessary. With 'swimmer's ear' (infection of the skin of the ear canal often due to prolonged water contact from bathing or water sports), says Dr. Hetzler, if an individual has significant narrowing of their ear canal -- such as from advanced surfer's ear -- they have a higher likelihood of also getting a swimmer's ear infection. "There may be a higher rate of swimmer's ear in warm water (ocean, pool, hot tub or bath) if people spend longer periods of time in the water and if there are higher bacterial counts in that water," Dr. Hetzler adds. Patients have traveled across the world to see Dr. Hetzler, who treats individuals of all ages. Earlier this year, while attending a medical meeting in Australia, he checked emails sent to his California office. "I had received an email from a surfer in Sydney who was having severe problems with his ears. We arranged to meet as I was passing through the Sydney airport and I examined him and reviewed his situation and was able to show him his ear anatomy using a video camera attached to my laptop computer," says Dr. Hetzler. "He subsequently chose to fly to the U.S. to have me perform surgery on his ears. He healed very well and happily returned to surfing in Australia." If you feel like you might be developing symptoms from bone growths in the ear canal (usually water trapping or wax/debris trapping), Dr. Hetzler recommends consistent use of earplugs and/ or a neoprene hood to decrease the future growth of the bone continues on C6 Dr. Douglas Hetzler

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