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Millions of Americans have dry eye, a troubling and sometimes serious condition affecting the parts of the eye that are in contact with our external environment. Lauren Gormley, a optometrist at Johns Hopkins, describes some of the known risk factors.

Gormly: Smoking I put that in sort of the lifestyle factor. So other can be contact lens wearing or increased screen time. Women have the highest percentage of dry eye but specifically women over 50. This stems from the hormone changes that start for most women in their 40s when their testosterone levels start to drop as a normal part of aging. And that testosterone is important for maintaining and regulating the oil glands in the eyelids which secrete one of the layers of the tear film.          :30

Autoimmune conditions such as Sjogren’s syndrome may also cause dry eye, and seasonal allergies play a role, too. So when the condition persists seeking an expert opinion is wise, Gormley says. At Johns Hopkins, I’m Elizabeth Tracey.

If you’ve been trying to manage your dry eyes yourself with the multitude of products available over the counter, you may be causing yourself more harm than good. That’s because dry eye may be a symptom of a number of health conditions that should be assessed, and dry eye itself can cause harm over the long term. Lauren Gormley, an optometrist at Johns Hopkins, explains.

It really does come down to that ocular surface being disrupted and it can come to any number of things. There can be environmental factors, there can be health factors, there's gender specific factors, lifestyle specific factors but when that tear film becomes unstable or the tear film becomes deficient that's when you will get eye discomfort, and you will get changes in vision and structurally when the tear film and the ocular surface are out of balance. The inflammation increases and then there's damage to the structures of the ocular surface.              :30

Gormley says successfully managing dry eye must begin with why it’s happening. At Johns Hopkins, I’m Elizabeth Tracey.

You’ve probably experienced the sensation that your eyes are dry. They may also be scratchy or sore. Lauren Gormley, an optometrist at Johns Hopkins, says for millions of Americans these sensations and more serious ones are a daily ordeal and result in a condition known as dry eye. 

Dry eyes sounds very straightforward. Dry eyes, but one of my favorite definitions is that dry eye is a chronic multifactorial disease of the ocular surface characterized by loss of homeostasis of the tear film and accompanied by ocular symptoms, which is a mouthful. The ocular surface is everything that is at the interface between the eyeball and the outside world so that is the cornea, the conjunctiva, the eyelids and the tear film.  :30

Gormley says many factors are involved in producing the condition known as dry eye, so a complete assessment with someone familiar with it is required. She says some simple things may help but for many it is a more complex issue that may require a bit of trial and error to manage. At Johns Hopkins, I’m Elizabeth Tracey.

Fiber comprising a lot of an overall healthy diet may have resulted in weight loss for two groups of people in a recent study- those who ate only during a shortened period while they were awake, so-called time restricted eating or TRE, and those who ate the same types of foods but in a more typical consumption pattern. Nisa Maruthur, the study’s lead investigator and a primary care physician at Johns Hopkins, comments.

Maruthur: One of the things that was interesting and I think this is true for people who end up on more plant based diets. Because it was healthy we're giving them a lot more fiber than they were used to. people who were assigned to TRE and having to eat 80% of their calories before 1:00 PM having like a fibrous meal that you weren't used to it was very difficult. I mean they did it but it was difficult. That was the thing I would hear at the beginning a lot, like there are too many blueberries how are you supposed to eat all those blueberries. For the volumetrics part of this was probably kind of difficult for people. It wasn't so difficult that we didn't end up with really high adherence.   :30

Maruthur says adding much more fiber to a diet helps quality as well as quantity. At Johns Hopkins, I’m Elizabeth Tracey.

Is there any benefit at all to time restricted eating, or TRE, for losing weight when compared to a usual eating pattern? That’s the question addressed in a recent Johns Hopkins study headed by Nisa Maruthur, a primary care expert, and colleagues.

Maruthur: We were looking at a weight change in both arms expecting the TRE arm to look more beneficial if TRE is beneficial for weight loss and basically there was no difference at 12 weeks. Both groups lost some weight which is why you’ve got to have a control group. They probably were eating fewer calories, less sodium, things like that because we were providing a healthy diet. Regardless of what they were eating at baseline we didn't see any effects of the TRE, the time restricted eating compared to the usual eating pattern on glucose measures either which were our secondary outcomes.  :28

Maruthur says the study provided participants with food, support and counseling to enable them to adhere to a healthy diet. Much more fiber comprised the diet in comparison to what participants were accustomed to eating, which may account for why everyone lost weight over the 12 week period. At Johns Hopkins, I’m Elizabeth Tracey.

If you’re thinking of using time restricted eating, where you only consume food for a shortened part of your waking hours, for weight loss, results of a new study from Johns Hopkins may inform. Nisa Maruthur, a primary care physician, and colleagues, rigorously investigated the strategy.

Maruthur: It's a controlled feeding study so we gave them all their food for the 12 weeks they ate on site three times a week we had them fill out a daily diary to kind of figure out what they're eating and there was a lot of coaching and intervention around helping them eat only our food and nothing else the other thing that was crucial for this study is we kept it isocaloric meaning we figured out how many calories you need a baseline and we gave you that number of calories so that was fixed if we figured out you need 2000 calories a day for weight maintenance then we gave you 2000 calories that was a big distinction from other studies we thought was really important for understanding the independent effective timing of feeding.                   :31

Results indicate that time restricted eating did not result in more weight loss or improve other aspects of someone’s overall health compared with a normal eating group. At Johns Hopkins, I’m Elizabeth Tracey.