Prevention, Advocacy, and the Future of Eye Health with Dr. Janet Garza
Hey, it's your eye health experts, Prevent Blindness Texas, and welcome to Eyespiring, a conversation about all things vision and life. Hello and welcome to Eyespiring with Prevent Blindness Texas. We're inspiring a brighter vision. I'm your host Heather Patrick, the CEO of Prevent Blindness Texas. Prevent Blindness Texas is focused on advocating for improved health equity, empowering children, adults, and seniors to experience life at the highest level, and improving overall health, including physical and mental health, by preventing vision loss and addressing eye health issues across the entire health spectrum.
Heather Patrick:Our work improves the health and quality of life for thousands of individuals across the state. I'm Heather Patrick and I have been doing nonprofit healthcare for over twenty years. I've been the CEO for Prevent Blindness Texas for almost eight years. And for me, this work is really a calling. It's about advocating for better access, better care, and being a voice for those that don't use their voice or can't use their voice to change the system.
Heather Patrick:Alright, so we have a fabulous guest today. I'm super excited to have Doctor. Janet Garza with us. I'm going to tell you a little bit about her. Doctor Garza earned her Doctorate of Optometry degree from the University of Houston, Gokooks College of Optometry after graduating from the University of Texas at Austin.
Heather Patrick:She further specialized with the residency in community based family practice with an emphasis on ocular disease. Following several years in private practice, Doctor. Garza joined the University of Houston College of Optometry faculty in 2017. Beyond her clinical leadership, Doctor Garza is a dedicated educator, lecturing on diverse topics and serving as a course master for the medical procedures lab.
Heather Patrick:This year, her commitment to the profession and leadership in optometry was recognized with the prestigious Molly Armstrong Leadership Award from the Texas Optometric Association. Doctor. Garza believes in treating patients, not just their eyes. Welcome optometrist, clinical associate professor at the University of Houston College of Optometry, and native Texan, Doctor Janet Garza.
Dr. Janet Garza:Well, thanks so much, Heather. I really appreciate you giving me the opportunity to be here and contribute in this space.
Heather Patrick:Oh, we're super happy to have you and can't wait to hear a little bit more about you and your perspective. So tell us a little bit, give us a little bit of background. Tell us something that no one else knows.
Dr. Janet Garza:No one else knows. I guess I can start by saying, I never ever envisioned myself, being here, like, in this space, in the role that I act, practicing the way that I practice ever, ever, ever. Like, the like, not in my wildest dreams. So it's just really interesting. It's important to follow your heart and follow what is meant for you, and even if you don't always know what that is, and I certainly did not know what that was.
Heather Patrick:So what was that like? What changed that for you to walk you down this path?
Dr. Janet Garza:Yeah, so, I would say that one of my biggest turning points was actually in optometry school. It was, I was in my last year of training, and, as part of the curriculum we have to do some externship rotations and my very last externship rotation was actually at a community clinic, here in Houston, a community clinic associated with the University of Houston College of Optometry and, it was at that clinic where I just kind of had an awakening. That's how I chose to see it I never wanted to do a residency. My plan was absolutely to go out into private practice the beginning. Most definitely I had completely other plans to move to South Texas and open a private practice and have a business background to back it up, that was absolutely my plan.
Dr. Janet Garza:And that is not what happened and that is okay. I decided to pursue a residency because the community clinic where I was at had a residency program attached to it. And when I was there, I just saw myself there. I kind of found a home. And so, yeah, I think after that semester, I decided to pursue residency.
Dr. Janet Garza:I followed through with it. And basically the decade plus that has followed has just been never what I imagined. But in the best way possible, I have been so happy.
Heather Patrick:So how did you decide, what made you decide to go into optometry? Like you finished at UT and what happened?
Dr. Janet Garza:Yeah, so the passion to pursue optometry was well before, starting undergrad even. So for me, being in elementary school, needing glasses, not knowing I needed glasses, getting glasses for the first time really changed the path for me. I was the 11 year old who needed glasses who denied it. Mom takes her to the optometrist, and I'm like a minus two for anybody who knows what that is. I wasn't seeing the board, I wasn't seeing the overhead projector very well.
Dr. Janet Garza:And so next day going to school with contact lenses because I wasn't ready for, I got the glasses but they weren't ready yet so I had contact lenses the following day. Seeing the pores in the ceiling tiles at school, that was instant, instant changing for me. So I think the interest really started then. And a lot of students have a similar story. And I do think that that's part of what influences me to partake in these like children's initiatives and like, you know, why is it important for children to get eye exams?
Dr. Janet Garza:Because I know what impact it had on me. So yeah, my plan was, you know, optometry since pretty early on. I went to undergrad, I got a business degree thinking I'm gonna open a private That's good. Yeah, and then I knew that my top school of choice was the University of Houston College of Optometry, got in. Woo hoo.
Dr. Janet Garza:And you know what, I guess I kind of never left. So yeah, after graduation I did a residency program, like I said, was affiliated with UHCO and then I stayed as an adjunct professor all the while working private practice. I absolutely love private practice as well. That certainly is one of the things that I just love about optometry is that you can practice in so many different ways, And I have, I've just loved my journey so far.
Heather Patrick:That is awesome. All right, so you talked about it had an impact on you as a young child. So why now is eye health so important to you? You've spent time in the industry, you've seen the good, the bad, and the ugly, right? Why are you so committed to it?
Heather Patrick:What, you know, it's a passion, so what do you see in not only kind of the past when you look back and you can see, okay, this drove that, this drove that, but going forward to, you know, why is it so important to you and what do you want to do going forward with that passion?
Dr. Janet Garza:Yeah, definitely. I believe that for me it's vision, like our ability to see things, That's often where it starts, but that really is only the first layer. And so that is what I would love to communicate to the public, to my patients every day, day in and day out. That is what I communicate to my students that I teach. It is kind of this belief that it's not just vision care, it's not just eye care, it's we are treating whole people, it's getting to the point that eye health is healthcare, it all tied together.
Heather Patrick:So talk a little bit about, you you do spend a lot of time wrapped around children's vision, right? So talk about what you see and what's important there and if you could give, you know, advice, what would you tell parents or, nurses or, you know health administrators in the district? What advice would you give?
Dr. Janet Garza:The importance of, not just screening but actually following through with any results from a vision screening like recommendations to go in and have a child's vision assessed, a full eye exam, if you will. There's so much more than just how well do we see, but it can impact so much within a child. It's learning behavior, it's behavior in general. Mean, I've just seen incredible changes in children from the first time that I meet them to, let's say I bring them back for a follow-up visit and after they've received glass, there's been studies done that say that truancy improves with glasses wear and children who need it aside from just behavior changes, but self esteem improves. There's so many things that can ensue from just having an eye exam.
Heather Patrick:But it's not just an eye exam.
Dr. Janet Garza:It's not just an eye exam.
Heather Patrick:So what inspires you on those days that, and we all have them, you know, it's been, you've had a hard day with a patient who you couldn't help as much as you wanted to, right? What's your why? What inspires you?
Dr. Janet Garza:Every day, if I can move the needle even just a little bit, I have to always remind myself, right, that I I'm I'm not gonna change deep rooted systems, you know, one day to the next. But if I can just move the needle a little bit every day, that that is my motivation to keep going. Yeah. I have been also just really blessed, frankly, to have really good people around me. My parents have always been there, I was an only child for a while, that might be something that a lot of people know about.
Dr. Janet Garza:So I was an only child for about nine years before my first two siblings came along, But I spent a lot of time with my parents, did become my friends and there's a lot of qualities in each one, they're very different. But my parents truly have been role models to me in different capacities. My peers, I definitely have a circle of friends that I adore, that I actually, people don't believe me about this either, but I have the same group of friends that I went to pre K with.
Heather Patrick:Oh, wow. Really?
Dr. Janet Garza:Yep. We went to pre K, elementary school, middle school, high school together, and we still keep in touch to this day. Some that I went to college with, some that didn't go to college, all in different professions, different fields, some that stay home, whatever it is, we still keep in touch, I've just been surrounded by really amazing people and mentors that have really just helped me get to where I am today.
Heather Patrick:That's amazing. So part of that, so going back to you have amazing people, you've built this great circle, which I think is definitely the difference moving forward and finding success and finding that happiness and contentment is really having that circle of support, right, from friendship to mentor to who you work with. The end of the day is there someone in particular, especially like right now, that inspires you or that you want to learn from or keep learning? They're doing something that you want to learn how to do.
Dr. Janet Garza:Yes, and I'm call out my mom on this one. My mom does not work in health care. In fact, my mom was a homemaker. She is a homemaker still. So I spent a lot of time with my mom.
Dr. Janet Garza:But my mom is one of those people that just really inspires me. When I say that, I'll give you an example. My next door neighbor, her next door neighbor, we kind of stopped seeing them for a while and she was worried, and so she decided after about a couple of weeks of that, to call up the neighbor, it's an elderly couple, the neighbor's daughter, and it turns out that neighbor had had a stroke. So, turned out the elderly couple had moved, at least temporarily, to move with their adult kids to, just kind of get through the difficult time with the recovery. It turned out, you know, they needed a wheelchair and they needed a walker and they needed all these things and they didn't really have access to those things, and my mom is the kind of person who will make things move.
Dr. Janet Garza:So she heard that and immediately she's like, oh, I think I might know somebody who has a walker and I think I might know somebody else who has a wheelchair. Things just start to move. And so my mom is, she is like the glue. She will bring people together, she will make things happen, and, that is kind of what inspires me. That is something, someone, that inspires me to do the work that I do in a better and a different way, to bring groups together, think outside the box, be more creative, find other solutions, and at the end of the day just be good humans and help each other out.
Heather Patrick:Do you think that influenced your approach to the way you treat your patients?
Dr. Janet Garza:Absolutely, absolutely. Whenever I see patients, I have to think of them like family, right? And I think that's the only way to treat patients is if you are my family member, what kind of care would I be giving you? Or what kind of care would I want you to be getting?
Heather Patrick:Yep, yep, that's a huge difference than kind of I think the general practice in healthcare. And so how does that impact you when you take that approach? Because sometimes, right, doctors take it, they're going to keep that barrier because you do have so many patients that you can only help so much and sometimes that's especially on the vision side, right? But then you always have those patients that you change their life with your care, but how do you kind of maintain that emotional capacity because you are so vested in your patients?
Dr. Janet Garza:It is not easy. Like I said, there's a If I can move the needle even a little bit, I'm feeling good, but it is easy to get burnt out. It is important at the end of the day, have to remind myself like why I'm doing this work. And so communication with patients, patient education is everything for me. I let them know what my limits are, what I'm able to do, and then beyond that, if I have to connect them to care to get them to the next resource, then that's what I do.
Heather Patrick:Yeah, you're an amazing doctor. So why does it matter so much to you to be in the community, right? So you never pictured yourself in a community setting, it was private practice, you have this experience and it changes you, right? Why does it matter so much to be in the community and serve the community?
Dr. Janet Garza:I've asked myself that a lot, and I think the better question for me is why not? Like why wouldn't it matter? When I or anyone for that matter kind of finds themselves with a skill set or a talent and it's needed, like why wouldn't we help, right? That's how I ultimately found myself in that community home.
Heather Patrick:Yeah, yeah. When I graduated and I went to school and I got a business degree, I envisioned myself running actually a fashion company to be quite honest. I never thought about nonprofit. I didn't even know what nonprofit was really. I mean I had volunteered but it never dawned on me that this was a whole industry.
Heather Patrick:And then I was in fashion and I had several direct reports, and one of them was a breast cancer survivor, and she actually was my bridge into the nonprofit world, and I made that move and never looked back but it was the same thing. You get this, I think it's just this taste of wow this is really powerful and I can use my talent to do good and it matters, it makes a difference. And so yeah, I never look back, I've been in it twenty plus years.
Dr. Janet Garza:I love it, I love it.
Heather Patrick:All right, what is the first thing that comes to your mind when you talk about eye health, but then also what are some of the things you hear, the common myths about eye health or vision that you're like, no, I have to correct you on this.
Dr. Janet Garza:And there's a lot of them, but I think the first one that I come across is we were talking earlier about children and making sure that they were getting eye care and glasses if they're necessary. The myth that wearing glasses is going to make us dependent on glasses or is going to weaken our eyes. So I will debunk that right away. Certainly not the case, but yeah, it is a common misconception out in the public and a lot of parents are concerned that once their children start wearing glasses, it's going to keep worsening their eyesight. Not the case, the only thing that happens when we don't wear glasses, if they're necessary, is we struggle.
Dr. Janet Garza:It causes more eye strain, children will end up getting headaches a lot of the time, more complaints. In fact, not wearing glasses can be what actually makes the vision worse. So I did wanna throw that out there as a very common misconception.
Heather Patrick:Okay, so now I have a question. Contacts, wearing contacts in a pool or taking a shower or good, bad, what should be done?
Dr. Janet Garza:Please know. Please know. So one of the things that, first time contact lens wearers especially, but in case it was never told, to a contact lens wearer, one of the things that I always bring up is absolutely no water activities. Really does not matter, if it's fresh water, salt water, chlorinated water, water even, like there's lots of microorganisms in the water that can stick onto your contacts and give you some pretty nasty infection. So please know water activities while wearing the contacts.
Dr. Janet Garza:I do teach a medical procedures lab where one of the things that we do is see what kinds of bacteria grow in different places on the eye and on contacts and in old contact lens cases and things like that. You'd be amazed what we find.
Heather Patrick:I will admit, it wasn't until I think maybe one lunch with Doctor. Sego when we were talking about contact lenses case, and that you should be changing it basically. I change out my contacts every month, and she's like, well you should be changing your contact case every, and I was like, really? She's like, yes. Yes.
Dr. Janet Garza:Yes.
Heather Patrick:So now I do. Now I go to Amazon and buy, you know, a month a twelve month supply, but yes, I never that was never shared or if it was not something that I picked And up so I do think there are these little things that are important to reiterate to patients so that they learn because again, even with your eyes, just like any, I think any other health thing, right, you only hear a couple of things. So it's important that, I mean as providers, right, we share those messages over and over again so that patients hear the whole story.
Dr. Janet Garza:That's right, that's So
Heather Patrick:what advice would you give someone about their eye health, just in general?
Dr. Janet Garza:To take it seriously. I do think that eye health is one of those things where, well, if it doesn't hurt, why do I have to get it checked? Like, why do I have to go and be seen? Eye health is something that we often take for granted. And I think a big part of my own personal mission has been to educate the lay public, not just my patients, but find other avenues to educate like this, Heather.
Dr. Janet Garza:Thank you for just helping spread that message that it is so easy to take for granted, but it is something that is so important and, prevention is easy and it's just a matter of knowing what to do.
Heather Patrick:Yep. So talk a little bit more about those connections. So we've talked with the importance of understanding that connection between children and learning and development, but also talk about then kind of as you go through the life cycle, right, what other pieces of health are tied to your vision or as an eye doctor or somebody comes into your clinic and what can you tell about their health through their eyes?
Dr. Janet Garza:So a lot to unpack here. So it's quite a bit. So when children, I talked about a few of the things, even some things that I didn't mention that I think I'd like to bring up here is things like focusing issues. Like just because we're able to see something doesn't mean we see it well or doesn't mean our visual system has an easy time seeing it or it's necessarily comfortable vision. So focusing is a big issue.
Dr. Janet Garza:Color vision anomalies are another thing that often come up and they are detected at comprehensive eye exam. Just by testing color vision, a lot of children get misdiagnosed as having learning deficiencies. And it's not actually that, they're not able to discern colors very well. In adults, a lot of things can manifest. So we bring up a lot of, questions.
Dr. Janet Garza:Even now I get patients who are like, why do I have to fill out this big questionnaire and you're asking me about what medications am I taking and what medical conditions and why does it matter if I have hypertension and this, that, the other thing. I'm always happy to, I mean I welcome any opportunity to help people understand a little bit better that it is all interconnected and we can actually tell if there's something not very well controlled in the body by simply looking at the eyes at times.
Heather Patrick:So I went to go see my eye doctor and I go in the summer but I had been on a trip in November and my eye would not stop watering. And so, and I had a bump so I thought I had a sty. So I went in and they fit me in and it turns out, well, I have clogged oil glands, but I also have dry eye which happens as we age, right, it can be a result of different things including hormone changes, right, so even things like that, as the aging process happens, what happens to our eyes?
Dr. Janet Garza:Every single piece of the eye anatomy is changed. It's affected in some kind of way as we age, from the eyelids to the eyelashes to the conjunctiva, which is like the outer covering of the eye, we can end up developing cataracts. Most people will, by the way, and it's a very natural thing to develop cataracts over time. Our retinas, the inside of the eyes can change. We may become more predisposed to certain eye diseases.
Dr. Janet Garza:As we age, we know these things to be true. Aging is inevitable, but we hope to help everyone do it gracefully. If maybe we just know what to watch out for sometimes, right?
Heather Patrick:Yeah, when I turned 40, literally that year, I had to get readers. Readers. And now every year it's just gotten, now I wear progressives. But it really is interesting, just kind of like clockwork on some things, how your eyes just really do begin to change, So back to some of those aging eye diseases, what are they and what are some of the signs or symptoms?
Dr. Janet Garza:Sure. So a lot of the signs and symptoms can be silent, especially early on, and that is always one of the fear factors with some of the eye diseases and why we always, I'll just say it here and I'll say it later, but why we always encourage preventative eye care. Which translates to what? Which translates to making sure that we are having our eyes examined, in my opinion, at a minimum on a yearly basis. Once a year.
Dr. Janet Garza:Comprehensive eye exam to take a look, detect any, early conditions. Because a lot of these things, like I said, don't have signs associated with them, not many symptoms, or things that are easy to brush off. Your eyes won't hurt a lot of the times. Certainly if something's causing vision loss, it's not always quite obvious. Some vision changes, like let's say in glaucoma, they happen very, very slowly to the tune that you don't notice It's like watching hair grow, right?
Dr. Janet Garza:If you're looking at the hair every single day, you don't realize it's growing, but certainly if you compare from now to six months from now, grown, right? Yeah.
Heather Patrick:So glaucoma, what else? What other?
Dr. Janet Garza:So cataracts are another big one, very natural change. So cataracts happen when we have a natural clouding of the lens that sits inside the eyeball. So a lot of patients or the public will confuse cataracts with maybe pterygium. So this is another common condition. A pterygium is a small growth on the whites of the eye that can start to grow.
Dr. Janet Garza:Sometimes it does start to crawl over the colored part of the eye. But both of these conditions, while not the same, can be aggravated by extended UV exposure. Even if we don't spend a lot of time out in the sun or, with UV now, let's say we did in our, like, like, early adulthood or even in our childhood, that can still be affecting us now. So I would say cataracts are a big one, pterygium is one that I like to educate on just because I get a lot of questions about that too. Dryness is so common.
Dr. Janet Garza:So thank you for sharing your own story. Interesting thing about dryness that I don't think a lot of people understand or have heard about is that there's actually different kinds of dryness. So to your point, Heather, you actually said you were complaining about eye watering. And so patients will often say, what do you mean my eyes are dry? I just told you they're watering.
Dr. Janet Garza:But that is actually how the mechanism goes whenever we have problems with those oil glands. If the oil glands are not producing oil like they're supposed to, tears have a hard time staying on the eyes and will often just kind of roll over onto our cheeks and drip down.
Heather Patrick:Yeah, so talk a little bit about, because not only can it be hormones or age, but also can be medication you're taking that can cause that, right? So talk a little bit about that too because I think that is one thing we don't talk a lot about enough about, but I also think it's something that, you know, providers, general providers don't talk a lot about either when they're prescribing medication of, you have the side effects, but they don't always talk about the impact it could have on your vision too. So talk a little bit about that interaction.
Dr. Janet Garza:Sure, and there's quite a few medications that come to mind. If we're talking about dryness specifically, there are certain, like let's take antihistamines for example. A lot of us, I live in Houston, right, I call it Houston it is, I'm allergic to, I don't even know what anymore. But a lot of us take antihistamines daily, on the daily. One of the main side effects of antihistamines are to dry us up.
Dr. Janet Garza:They'll dry up our mucous membranes, like our nose and our mouth, and guess what? Our eyes are included too. So antihistamines are a big one. Some of us take diuretics. Maybe we have hypertension and we take, my mom calls it a water pill.
Dr. Janet Garza:The water pill makes my eyes dry. It's true. So there's medications that are intended to dehydrate us, to take fluid out of our body and tears are not exempt from that, right? Yeah, yeah. What else?
Dr. Janet Garza:I can think of other things, for example, steroids. So some of us will take steroids and we may not even realize that we're on chronic steroid use. Some inhalers have steroids, like how many of us don't know somebody else with asthma, right? Yeah, steroids can have ocular side effects as well. They can actually raise eye pressure in some patients, not everyone, and we don't know why some people are what we call steroid responders and not others, but they can raise eye pressure, they can actually cause fluctuations in vision, because they can actually alter blood sugar as well.
Dr. Janet Garza:Wow. And so, blood sugar changes, so anyone with diabetes, maybe got started on a new medication or something and you know their blood sugar is still stabilizing, they will more than likely experience some kind of fluctuations in their vision. Wow.
Heather Patrick:Alright, so let's talk. So you mentioned diabetes, let's talk about that for just one, I know it's one of your passions. Yes, So it really believe deeply in educating about it. So talk about that connection and how important it is, even if you're a pre diabetic, right, to really understand that connection between vision and that disease.
Dr. Janet Garza:Absolutely, I'm happy to talk about that. So with diabetes, we understand this to be an elevated blood sugar, right? But those sugars can cause changes in the natural lens of the eye, which affect the way we see, okay? So there is fluctuations, there is that relationship between blood sugar and the way we perceive the world. Are we having a hard time seeing far away?
Dr. Janet Garza:This is the reason why many patients will experience shifts in let's say when they just started treatment or they've had a change in their treatment, things like that. Now here's the thing. The eyes are very special, but if you've talked to me, I've already told you that. There's very fine blood vessels inside the eye. Blood sugar, elevated blood sugar, can cause damage to those blood vessels, and result in bleeding, inside the eye.
Dr. Janet Garza:It can also cause swelling, we call this edema, inside the eye.
Heather Patrick:Is that why they check for pressure when you go get an eye exam?
Dr. Janet Garza:So not quite, but eye pressure is very important in detection of other things like glaucoma, and we can talk about that. With diabetes, the swelling is more an accumulation of fluid because our eye is trying to deal with this condition. There's damage that's happening, there's leakage that's happening. And that can actually alter not just the way we see but the integrity of the retina of the eye and that can become a little bit more challenging to tackle. And so once again, how can we prevent that?
Dr. Janet Garza:I think it's, you know, the earlier we can detect things, the sooner we can start turning things around.
Heather Patrick:Yep, prevention is key. So if you have diabetes, your risk for eye disease goes up tremendously, right? So talk about that a little bit. What does that mean? Where are the
Dr. Janet Garza:risks? Sure, so the longer we have diabetes, the higher the risk is going to be, especially if it was uncontrolled for a long period of time. The longer we remain uncontrolled, the higher likelihood there is for some of the blood vessels to become damaged, and in turn lead to, it's diabetic retinopathy whenever we have the bleeding, and potentially also the swelling inside the eyes, and that becomes, like I said, a lot trickier to control. Length of time that we've been diagnosed, if we've been uncontrolled for a period of that time, if we're also kind of involved in other things, like maybe we're smoking, our risks of all of these comorbidities and other effects starts to go up.
Heather Patrick:So changes your risk, increases your risk for glaucoma as well, right, and cataracts too. So it's kind of a domino effect, right, it's not just one thing. So understanding that connection if you have diabetes is really important.
Dr. Janet Garza:That's right, that's right.
Heather Patrick:All right, How would someone know if they're at higher risk for eye disease?
Dr. Janet Garza:Certainly if we're actually noticing things. Remember when I said, some of the signs and symptoms are kinda silent for a while, but if we are noticing things, that should be our first kind of signal that, hey, this is probably something that we should get checked out. But family history, is certainly a consideration if we have a family history of glaucoma, of diabetes, with retinopathy, any kind of blinding eye condition, anything like that I feel like should always kind of put us more in that proactive state of getting things out.
Heather Patrick:So does that include macular degeneration?
Dr. Janet Garza:It does. It does. And so some of these things will come with age as well. So, age is going to be one of our big risk factors as well. We talked about aging, but age is gonna be a big risk factor.
Heather Patrick:Alright. Awesome. Okay. So can you share with us some examples of, when you've seen vision issues or even progress into vision loss and that impact it's had on your patients mentally, what does that look like? What have you seen over the years?
Dr. Janet Garza:Yeah, this is a part of taking care of the whole patient, right? And I firmly believe that it's really hard to navigate sometimes. Vision loss or even if it hasn't progressed to any kind of vision loss, hearing something like a diagnosis for the first time can be really scary for people.
Dr. Janet Garza:And so we do have to, I consider it part of my job, right, managing the patient, their anxiety, they have needs that need to be met. And so I have seen unfortunately patients who have had vision loss and I've seen their self esteem kind of start to tank, I've seen their independence sometimes just degrade entirely, becoming dependent on other people.
Dr. Janet Garza:I've seen where this can even start to impact family members, extended family members, friends. It's what I've definitely come to find about, the eyes, vision, and eye disease is that it's often not something that's lived alone. It's something that's lived with others.
Heather Patrick:Yeah. So what can we do to help improve that part of it? Do we work with mental health providers? How do we help close that gap?
Dr. Janet Garza:Yeah, I think that closing the loop is going to look different for it's going to depend on the patient at the end of the day, but it does include working with a team of people. It includes family support, educating the family as well as the patient. It includes, keeping the primary care provider in the loop. Oftentimes there's additional specialists like occupational therapy that may come into play. Social workers may come into play.
Dr. Janet Garza:Every patient's gonna have different needs depending on their own unique situation and how it's affecting them. So
Heather Patrick:any key tips on preventing blindness and maintaining your eye health? And specifically, this is another one, do carrots really help?
Dr. Janet Garza:I love that question. Carrots are always good for us, but carrots are especially helpful in Do you know what it's like, Heather, to whenever you are in a bright setting and then you go into a dark room and then it's that dark adaptation? Like, how long does it take you for that? And the same thing is the opposite, right? When you have been in the dark for a while and then maybe you're in your bedroom and it's you've got your blackout curtains and you just woke up from a nice sleep and then you open the the curtains and you have to get used to all the light again and how long that takes you.
Dr. Janet Garza:Carrots help with that process. Yeah, the speed of light and dark adaptation is what carrots actually help with.
Heather Patrick:So the myth is true, it does So are there other things that we've talked about, obviously, getting an annual eye exam, paying attention to things that change, understanding your family history, but are there other things we can, does exercise and what we eat matter?
Dr. Janet Garza:Always. So, I believe in a very holistic approach to, all of health care. I think that everything that's available to us is good, like it obviously exists for a reason, right? But a lot of the things that we actually can do on our own that don't involve going out to purchase things necessarily can also be some of the most helpful, like exercising, like watching what we eat, making sure that we are getting the right nutrients in our bodies to feed our eyes as well.
Dr. Janet Garza:Supplements are great, and I often recommend supplements for the eyes depending on certain eye conditions, eye diseases if they're present, but I also remember that a lot of these nutrients we do get from food.
Heather Patrick:So when we go outside, we have to remember to wear our sunglasses to protect our eyes, right? But on the flip side, one of the things they're talking about with myopia, right, is being outside, right, for children. So talk a little bit about kind of both those, right, we want to be outside but we still need to protect our eyes, but talk about the importance of that or kind of the impact of being outside, how important it is for eyes, especially younger children, and then the importance of protecting your eyes out in the sun.
Dr. Janet Garza:Sure. The studies have been very clear that in preventing myopia
Heather Patrick:Well first of what's myopia?
Dr. Janet Garza:Oh, that's great question. We can start there. So myopia is, what we define as nearsightedness, but what that really means is, we have a harder time seeing far away and an easier time to see up close. So when things are blurry far away, then that is myopia.
Heather Patrick:And severe myopia could lead to what? It increased your risk for what if it's not addressed?
Dr. Janet Garza:If myopia continues to progress, it actually just puts us at a much higher risk of retinal, so the inside of the eye can become compromised because what happens when we become more and more nearsighted or more and more myopic is the eye starts to stretch on the inside. And, with that, we can develop little holes and tears in the retina. This can lead to retinal detachments. It can lead to lots of other things that hopefully are preventable. And so to speak to what have the studies actually shown, they've been very clear that people who spend two hours plus, and I know like in Texas heat sometimes that's hard, especially in the summer, right?
Dr. Janet Garza:But in children who spend two hours plus per day outdoors, their rates of progression into myopia have been significantly reduced compared to children who didn't spend any time outside.
Heather Patrick:So being outside is important.
Dr. Janet Garza:Being outside is important.
Heather Patrick:But the flip side is make sure your eyes are protected. Absolutely.
Dr. Janet Garza:Absolutely. Yep.
Heather Patrick:Yep. Alright. Awesome. Okay, so now we're gonna move into patients. So, and you've seen many, and you obviously have a very dedicated approach, so talk to us about what have been some of the best patients, like what stands out to you?
Heather Patrick:And then on the flip side, what have been some of the most challenging?
Dr. Janet Garza:Yep, best patients are the patients who follow our recommendation and do what they're asked to do, And you know what, that said.
Heather Patrick:I'm not a best patient then.
Dr. Janet Garza:So yeah, when we recommend to see you back in a year and the patient, like clockwork, that always makes me feel really good, sometimes patients can be asked to come back sooner than the year for whatever reason and keeping those appointments even though we feel like we're fine, that matters. Best patients are also just the ones that are honest with us. If the patient is unable to comply, then please be honest about that, because if there's a reason that's keeping you from being a compliant patient, we need to know that in order to help you.
Heather Patrick:Yeah.
Dr. Janet Garza:Right?
Heather Patrick:Is there a story that stands out to you of even one of the children you've helped or a parent or just a patient that came in with a really big issue and you solved it.
Dr. Janet Garza:Yeah, I feel like this is every day, so it's gonna be hard to pick out just one. But we often see the videos and the stories of the babies who get glasses for the first time. These are real things. Babies who are seeing their parents for the first time clearly, these are real things. Now I really am heavily involved in children's initiatives.
Dr. Janet Garza:I'm not a heavy pediatrics optometrist per se, but I can tell you from experience and with my colleagues that I work with that, that is kind of one of the most joyous moments.
Heather Patrick:Okay, so on the flip side, have you, well I know you have, had those patients that even if they would have came in six months earlier, it could have changed the course for them.
Heather Patrick:So what's one of the hardest ones you've seen or you know those the ones you walk away at night and you feel like it's a loss because you just know some of this is so preventable and it could have been different. Talk a little bit about that.
Dr. Janet Garza:This is our reality too, right? So I can recall a patient that I saw at the end of last year, or sorry, it was at the beginning of this year, but I wondered what it would have been like if I had just seen him a few months before, like at the end of last year. So this was a patient that, young patient, like mid-40s, male coming in, knew that he had diabetes, had not been the best controlled because everybody has issues. In his case, he was having some financial difficulties and was having a hard time keeping things under control, but had started noticing that he had been having vision changes in one of his eyes, pretty drastic ones at that, and they had been going on for about six months.
Heather Patrick:Wow.
Dr. Janet Garza:And it's just so easy sometimes to brush it under the rug, it's gonna go away, it's gonna get better, let me just wait a few more days. And I think that's exactly what happened is we waited a bit too long. So whenever I saw him, he had experienced a retinal detachment secondary to diabetes complications actually. And so, yeah, I still, I think about him, I was able to tie him to some resources, we're doing the best that we can, but I know that the visual outcome could have been better had we just seen him a few months earlier.
Heather Patrick:Yep. So time does make a big difference when it comes to vision. Alright. If you could change one thing about the industry right now, what would it be? Well, me back up.
Heather Patrick:What do you love about the vision space and industry right now? As an industry, what do you think we're doing right? And then what's the one thing you'd change?
Dr. Janet Garza:So I think that technology, our access to information is better than it's ever been. Right, we have the tools, we have the power. I think where we have the biggest opportunity is in spreading it, is how do we make it more accessible? How can we share this with other people so that it truly carries that power and that weight?
Heather Patrick:So the data says that going blind is one of the biggest fears that individuals have behind having a heart attack, cancer, and then going blind. And yet a majority of the people aren't urgent about taking care of their eyes.
Heather Patrick:So how do we close that gap, right? How do we help people take that action because there is that fear there for most everybody, right? So kind of back to your, even though he knew he had issues, he still didn't take action.
Heather Patrick:How do we change that? How do we help people take action to take care of their eyes?
Dr. Janet Garza:Well I think that what we're doing here today is a big step towards to helping mitigate those kinds of outcomes, Being preventive, educating the public on why we need to do these things, but spreading the education, everybody plays their place. So I think that, it's not something that we can carry the burden on our own as eye care providers, but we can lead the way and we can team up with other groups, other organizations, other healthcare providers so that we can all do this work together.
Heather Patrick:And that's one of the reasons I love this space. I've worked in cancer, I've worked in other chronic diseases, and this space, if we do more now, we actually can change the path. It's still solvable. And that to me is exciting. It's inspiring because it really, when I say if you go get an eye exam, right, it really can change it.
Heather Patrick:It really does matter. And to me that's the exciting part of what we're doing is if we can do a little bit more of it and a little bit faster, we can really change the outcome. That's right. Where do you see vision care and health care in the next five years?
Dr. Janet Garza:I think that vision care can be a lot more integrated.
Heather Patrick:What do you mean by that?
Dr. Janet Garza:I think we need to be at the forefront with other providers. We need to be a part of that conversation. We need to be at their table, because if we can spread our message, they can help perpetuate the same on their end. Yeah. So not everybody will come get an eye exam, but hopefully at some point they're going in and they're seeing their medical doctor, or maybe they're going and they're seeing their dentist, and there's relationships there too.
Heather Patrick:Yeah, I think even a couple of weeks ago we were at the public health committee meeting talking about you know for women that they may not have a primary care provider but they're going to see their OBGYN, right, so I think working with all, with the whole circle of healthcare and really just some key points, some key messaging, helping the patients wherever they are understand that connection. Okay, so let's talk a little bit about PBT, you and PBT. So how did you get here?
Dr. Janet Garza:Oh, this, okay, you're taking me way back. So I actually started doing vision screenings with PBT when I was an undergrad. Before I made this decision to go to optometry school, like, I mean, you better be really sure this is what you want to do, right? So they encourage shadowing, which I did, shadowing different modes of practice, volunteering. And so PBT was the way that I chose to get involved, by volunteering pretty early on.
Dr. Janet Garza:So, this was in Austin, Texas when I was doing my undergraduate. When I, moved back to Houston, because I'm a Houston native, when I moved back to Houston and was doing optometry school, Prevent Blind was also very much in the picture. And so lots of volunteering events, lots of vision screening, but especially when I was at that community clinic, my mentor and the clinical director at that time, Doctor. Pat Segu, was also very involved with Prevent Blindness Texas, and so she just kind of has always taken me under her wing and she showed me a different side to PBT that I wasn't familiar with. Not the volunteer side, but now what I do on this end.
Dr. Janet Garza:And so now I'm here, I'm part of the board, I help with a lot of the events, planning of the events, spreading the messages, this is what I'm passionate about.
Heather Patrick:And you're on the national side of things too, so talk a little bit about that experience.
Dr. Janet Garza:Sure, so more recently, in the last year and a half or so, I was invited by Prevent Blindness National to do some of their work, with them, alongside them, and, part of that included being the lead facilitatorcontent expert, for one of the initiatives that they're doing which is incorporating vision care, eye care knowledge into their primary care doctors' education system. So I have loved it. I have just loved getting to do that. I have loved getting to see their advocacy efforts and the way they choose to go about things, and it's been so, so good.
Heather Patrick:And hopefully some of that will then begin to translate down for us at state level too. So what impact have you seen prevent blindness make in the community?
Dr. Janet Garza:That is a small question with a big answer. So what I have seen, Heather, is, first and foremost, with such a small team, I mean, it's incredible what we've accomplished. But, with your leadership, of course, like, think we've come a long way with our strategic plan. Mhmm. I think we have more clarity in in our direction where we're going, how how we're going to accomplish things.
Dr. Janet Garza:Mhmm. I'm always amazed whenever we we meet as a board and we review all of the accomplishments that we've had. Just even in in a quarter, it's incredible. Like, I often don't know what to say. But mission moments are are one of my favorite things, and and that's when we have one of our staff members, Monica, and she'll read out an excerpt, something that we've received, like a written piece of feedback that we've received from a patient, someone that we've really touched out in the community, and they describe to us how exactly we've impacted their life and I love that.
Dr. Janet Garza:So that speaks volumes.
Heather Patrick:Yeah, it is. We often talk about that's our why, right? Those, and we call them our success stories. Honestly we get them every month, which I just think is cool that people take the time to let us know the impact, you know, that the services have made, but I think it always brings us back to our why, right? Why we do the work that we do.
Heather Patrick:So why should people get involved with us?
Dr. Janet Garza:Because we have a lot of work to do and there is absolutely opportunities to help. And back to what I said earlier, know, lot of us have talents, lot of us have skill sets, and there's clearly a need, there's opportunities to help, and I think, a better question is why not? Why not get involved?
Heather Patrick:Right. So there are all different ways to get involved with us. You can be on one of our board committees, you can be on one of our event committees, you can get trained and certified and go out into the field and help with screenings, you can be an educational speaker for us, so get trained on that. You can potentially serve on our board, you can come into the office and volunteer. There are all different ways to connect and engage.
Heather Patrick:You can be a social media ambassador for us and help influence others to be a part of this. So there are all different ways to connect and get involved, and of course you can always donate. So we look forward to hearing from all of you. You can always send us a note if you have questions, and we are always looking for volunteers. Okay, and I think that's it.
Heather Patrick:Any last thoughts or anything, key takeaways for the audience?
Dr. Janet Garza:No, I think I would just commend everyone for listening to this podcast and for wanting to be involved, hopefully. And just know that there is lots of ways to do that.
Heather Patrick:Yeah, well thank you so much for being here and for sharing your story and your insight, we appreciate you, and thank you to all of you for listening, And of course, we always like to remind you to subscribe to I Spiring with Prevent Blindness Texas. And of course, let us know what your vision is.
