HEALTHY AGING

to standing; and pain from bending down to pick something up. Lifestyle changes are also important. Gene Estep, athletic trainer coordinator at Bond Clinic who received a bachelor’s degree in athletic training from the University of South Florida College of Sports Medicine, encourages men to evaluate negative physical influences as a way to stay on track physically. “Reduce as many negative vices in your life as you can,” he says. “For example, (alcohol) drinking affects hydration and you can easily cramp when trying to get fit and it also slows down the healing process for injuries. Try to reduce the negative things. You don’t have to quit them 100 percent, but moderation is the key.” All three experts say proper nutrition is key to avoiding health issues later in life, as well as being able to sustain regular workout schedules. For example, in their 20s, a lot of men’s diets include takeout, processed foods and fatty protein sources such as hamburgers and chicken wings. When men are young and their metabolism is high, the physical impact of bad diets is less. However, as men age, they need to focus more on eating food loaded with key nutrients, including fruits, vegetables, whole grains and beans. “And also maintaining hydration is so key, especially if you’re active. You need to replace electrolytes. Just staying hydrated is probably one of the most important things to do,” Goddin says. Additionally, once men enter their 50s and beyond, the psychological component plays a role in motivation in developing structured, regular fitness routines. Goddin says all men need to change their mindsets on exercise as they age. “You can’t expect to do what you did at 25, but that doesn’t mean you’re limited and have to sit on the couch all day,” Goddin says, noting that she knows 60- and 70-year-old men who are still powerlifting weights. “It’s important how you approach exercise as you age. It doesn’t mean you can’t be active and enjoy the things you enjoy; you might need a little more guidance now, that’s all.” Olgee adds that doing a variety of fitness training helps with motivation by avoiding redundancy. Of course, a proper frame of mind and focus is also key to maintaining and improving physicality as men age. Estep says staying on top of regularly scheduled health screenings for men becomes more important after age 50 and getting regular exams is crucial. “I just wouldn’t be embarrassed over anything, like low testosterone or prostate issues,” he says. “A majority of men end up going through those things; they aren’t a particular problem. But with men, it’s kind of an embarrassment thing and you just need to get over that hurdle and get it done.” Goddin emphasizes the importance of staying positive and not getting discouraged if you’re slowing down. “A lot of times you try something and you hurt yourself, and you’re not able to perform the way you expect you can, and a lot times people stop whatever training they’re doing. It’s okay if you used to run 10 miles all the time and now you can just do two,” she says. “Just ease into it. Don’t be embarrassed, just work on your goals and it will get better and better. Stay active, that’s the best advice I can give. Don’t give up.” HN

‘Doc, I Was Told I Have Granulated Eyelids’

Once in a while, a patient will tell me that a previous doctor told them they had “granulated eyelids.” What does that mean? What they are describing is a medical condition called blepharitis. Most of the time, blepharitis is caused by the staphylococcus bacteria that normally live on our skin. The bacteria are there continually, and we never get rid of them no WILLIAM CORKINS, O.D. matter how many showers you take or whatever antibacterial soap you use. To prove my point, what happens if you try to use the same towel over and over again after your shower for two weeks? The smell would be horrendous even after a few days. Why does your towel smell? Whenever you dry yourself off, some of the staff bacteria is removed from your skin onto the towel. The wet towel you hang up to dry is a great medium for the staff bacteria to grow; this is what you smell. What you are essentially doing is culturing yourself!

When we wash our face, what do we do? We lather up our washcloth, slam our eyes shut, so we do not get soap in them, and wash our face. Consequently, the margins of our lids never get a good scrubbing. What happens with time is the staph bacteria count will increase at our lid margins. The margin of the lids is where we find our lashes which are embedded into the skin by its follicle. The follicle is a nice warm moist area, and the staff bacteria migrate down the base of the eyelashes and thrive in the follicles of the lashes; this occurs in both the upper and lower lid lashes. When I examine the patient with the microscope, I do not see the bacteria because they are too small to be seen with our normal examining microscope, but what I do see is flaking at the bottom of the lashes. The bacteria produce toxins or poisons that ooze from the follicle up the lash and form a circular hardened flake around the base of the lashes. We call them collarets. I see many patients with low-grade blepharitis, and most of them are not having any problems. As the infection continues to become worse, issues start to arise from the toxins produced. The lid margins become red and inflamed. The patient complains of red, itchy lids. The toxins will fall into the eye, causing inflammation of the conjunctiva and cornea, the clear window of the eye. When this happens, the patient complains of red eyes, blurry vision, foreign body sensation, light sensitivity, and pain.

To treat the infection, I use a combination of steroid/antibiotic drops or ointment. The steroid is for the inflammation, and the antibiotic is to kill the staph bacteria. The drops or ointments do a fantastic job in getting the condition under control, but it will come back with time once the patient stops the medication. The most crucial part of treating the staff blepharitis is having the patient clean and scrub the margins of both the upper and lower lids. I usually have the patient scrub both the upper and lower lids with an over-the-counter lid scrub called Ocusoft Plus every night before they go to bed. Once they work through a box of these lid scrubs, I then tell them to make sure they scrub both the upper and lower lid margins at least once a week forever; otherwise, the infection will return. This scrub is especially important in diabetic and immunocompromised patients since they tend to get more infections than a person with a healthy immune system.

Another reason to keep the infection under control is to prevent a secondary condition called trichiasis. With chronic infection and inflammation of the lid margins, the follicle becomes altered, causing the lashes to grow in different directions. Often, the lash grows in toward the eye, causing the lash to rub the conjunctiva and cornea, causing a lot of discomfort. The treatment for this to remove the lash, but after five or six weeks, the lash grows back along with the discomfort. Attempts to destroy the follicle can be taken, which may or may not cure the problem. My point here is to never get to his advanced condition.

Another less common blepharitis is seborrheic blepharitis. This patient usually has a bad problem with dandruff in the scalp area, and dandruff can present in the lid lashes as well. The treatment for this is a steroid ointment and treatment for dandruff.

Lastly, there is a type of blepharitis usually seen in the elderly that the Demodex Folliculorum Mite causes; this parasite can live on humans. I treat this with tea tree oil.

You will not have to worry about getting blepharitis if you pay attention to how you wash your face. Remember, the eyelid margins need exceptional scrubbing! If you are having issues and would like to schedule an appointment for this or a routine visit, please call us at 800-282-3937.