Your Eye Health by Dr. David LaRue, D.O. The eye is a complex instrument with many parts, and in the urgent care setting, we have to know the intricacies of them all. But in short, the front part — lens and cornea — capture images and bend light energy (so-called photons) onto the back wall — the retina. Amazingly, the retina has 120 million rods and 6 million cones — these photoreceptors convert light into electrochemical signals that pass to the brain via the optic nerve (1/3 of our cerebral cortex is dedicated to vision!) A plethora of eye conditions present to our urgent care, but the most common is a red, irritated eye. Patients often complain that they have “pink eye.” This is certainly common, but a dizzying array of possibilities exist…blepharitis, conjunctivitis, styes, sicca, keratitis, scleritis, and the tongue twister…endophthalmitis! My fan favorite is keratitis or cornea inflammatory afflictions. The cornea deserves a shout-out. This modest, clear, dome-shaped goggle protects our eyes from environmental insults and provides 2/3 of the eyeballs focusing power. The lens, which gets all the credit, does only 1/3. Seemingly so simple, you’d mistake it for your contact lens if you were to place it on your finger…but it’s a wonder of complexity. Five tissue layers of epithelium, Bowman’s membrane, Descemet’s membrane, etc. All encapsulated into a 1/2 millimeter thin space. Cornea scratches, foreign bodies, and infections also present with a red, irritated eye — and are often very painful. We are well equipped to diagnose and treat most eye cases. We are trained to use a high-grade instrument called a slit lamp allowing 40 times magnification of the eye anatomy. Therefore, we can SEE much more than the proverbial “naked eye.” So if you have eye symptoms, don’t hesitate, come on in. We look forward to SEEING you:)

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Workstation Ergonomics By Doreen Hall, PT The COVID 19 pandemic has changed the way we work, maybe for the long run! Across the nation people are working from the “comfort” of home, students are learning remotely, and physical therapists are seeing more and more patients who are suffering pain because of poorly set up workstations. Unfortunately, most of us do not have an ergonomically sound space to spend many hours a day working. Over the years, the laptop computer, designed to be used in the lap, turned into a household staple and the desktop computer is more rarely found in the home anymore. This has impacted how people work and their postures very negatively. If you are working from a laptop it is essential that you use an external keyboard and mouse so that you can raise your monitor, or in this case laptop computer, to a height that you can see while maintaining neutral postures as demonstrated below. When the work from home emergency started, we had millions of employees and students spending many hours in poor postures and suffering back and neck pain because of it. At SDSM Physical Therapy we are treating many patients, both young and old for repercussions of poor ergonomics at their home workstations. One of the misconceptions about posture is that we are supposed to be staying in this static upright posture all the time. This is far from the optimal situation! Our bodies are meant to be moving, and therefore if we have a sedentary job we must make time to change positions often, even if it is a small adjustment. choose several different ergonomically sound positions and rotate through them throughout the day.

• Top of the monitor at or just below eye level
• Head and neck balanced and in-line with the torso
• Shoulders relaxed
• Elbows close to the body and well supported
• Lower back supported
• Wrists and hands in line with forearms
• Adequate room for keyboard and mouse
• Feet flat on the floor

Regardless of how good your working posture is, working in the same posture or sitting still for prolonged periods is not healthy. You should change your working position frequently throughout the day in the following ways:

• Make small adjustments to your chair or backrest.
• Stretch your fingers, hands, arms, and torso.
• Stand up and walk around for a few minutes periodically.
• Perform some of your tasks in standing: computing, reading, phone, meetings.

Reference https://www.osha.gov/etools/computer-workstations

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Understanding Dietary Fat By Linda Illingworth, RDN Dietary fat is one of the most misunderstood macronutrients. For example, you’ve probably seen conflicting advice about saturated fat as healthy, referred to as poison, and everything in between. In truth, we need fat in our diets for energy, as metabolic messengers, and as structural components of our bodies. Fats are broken into three main categories according to their biochemical structure:

• Saturated fat (no double bonds)
• Polyunsaturated fat (multiple double bonds)
• Monounsaturated fat (one double bond)

Neither is more important than the other, but monounsaturated fats generally require more effort to include in our diet than saturated or polyunsaturated fats. Saturated fats are found in animal products and are solid at room temperature–think of butter or the fat around a piece of meat. They may contribute to less healthy cholesterol levels, and can cause an insulin response which can play a role in obesity and inflammation. Polyunsaturated fats are derived from plants and seeds. They have been found to be heart-healthy, but many of these fats also help the immune system mount an inflammatory response. When large amounts of polyunsaturated fats are consumed they can contribute to systemic inflammation due to their Omega 6 content. Monounsaturated fats, on the other hand, support an anti-inflammatory response in the body. They are found in seeds and fatty fish and protect the telomeres or endcaps on DNA strands. Monounsaturated fats are also important for nerve and brain health and contain anti-inflammatory Omega 3. A healthy amount of fat in the diet is about 30-40% of your total calories. A 2000 calorie diet with 30% fat, would have about 65 g of fat each day. The general recommendation to balance the different types of fat is to limit saturated fat to 10% or less of total calories, while the American Lipid Association recommends 7% or less come from saturated fat. Intake of monounsaturated fat should be about 10% of your calories. This means saturated fat should represent about one-third of that 30%, polyunsaturated fat about one-third, and monounsaturated fat the remaining third. While saturated fats are fairly easy to identify coming from animal products, polyunsaturated fats are used extensively in prepared, off-the-shelf packaged foods, and restaurant food. They are the primary fats used in crackers, cereals, and baked goods. To control your intake of Omega 6 inflammatory oils, you’ll need to edit your cooking oils at home, limit the number of meals eaten away from home, and choose snacks with healthy oils or fat-free snacks that you can pair with avocado, nuts, seeds, or fish. Here are some general rules to help you better balance your fat intake. Fats to Avoid:

• Margarine and vegetable shortening
• Sunflower and safflower oils
• Corn oil, cottonseed oil, and mixed vegetable oils.
• Products made with refined soybean oil
• All products made with any partially hydrogenated oils
• LIMIT coconut oil intake, it is still saturated fat and can have the same damaging effects

Fats to Use:

• Olive oil on salads, for low heat cooking, to top-dress vegetables
• Avocado oil for high heat cooking, baking, and anywhere you want a neutral-tasting oil
• Walnut oil, for salads, in smoothies, or drizzling on cooked dishes, not for cooking
• Sesame oil, to add flavor
• Nuts and seeds of all sorts (macadamia are higher in saturated fat, consume in moderation)
• Fatty fish like salmon, sardines, anchovy, herring, limit tuna to once a week, avoid shark and swordfish entirely

Thoughtful swaps:

• Choose egg or bacon, not both, add avocado
• Replace cheese with avocado on sandwiches, or pumpkin seeds in salads
• Replace sour cream with plain yogurt in dips, on baked potatoes or base for salad dressing (use regular, not Greek for a milder flavor)
• Use avocado oil in pancake batters, muffins, and other baked goods
• Use avocado as a base for salad dressing by blending into a bit of olive oil and vinegar
• Reduce butter in a recipe by 1/2 and replace with avocado oil
• Reduce use of fat by using applesauce or ground flaxseed to replace some of the fat in baked goods
• Replace eggs in baked goods with a flax egg

Remember, when making changes to your diet, make one or two changes at a time. Read labels and do the best you can. It’s a learning experience well worth your time that will benefit your health immediately.