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there's a lot of misconceptions around how we get bags under our eyes I always assume it's their stressed and they haven't been sleeping so I did research
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to look into this and a lot of people don't know this but it's actually really mhm so if I never want to get mags into
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my eyes again what is the natural easy solution try this Dr Joseph Allen is the board certified eye doctor helping millions of people understand Eye Health and unlocking the secrets behind
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achieving sharper and healthier Vision I really want to talk to you about so many misconceptions because I don't know what's true sure okay so my vision loss
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being inevitable is that true unfortunately there are changes that occur with age that will change your
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eyesight and vision but there's a lot of things that can help prevent and slow down progression and we'll go into them
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and then every once in a while my eyelid starts twitching what is that eyelid mimia so that is your threshold of your
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stress to get more sleep and stop drinking so much caffeine what about blue light is that harmful the blue
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light that comes from your digital screens has consistently shown in research to not increase the risk of Aging eye diseases and research on using
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L like glasses shows that it could just be placebo effect but if you're worried about how blue light's affecting you
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just moving your phone back twice as far will decrease your blue light exposure by 75% and more people are starting to
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care about their Eye Health than ever before but is our Eye Health getting better or worse worse for example right
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now about 30% of the world's population is nearsighted but by about 2050 we will have about 50% of being nearsighted
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because of our lifestyle so how much screen time being indoors reading books up close is okay it depends on age so
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question if you could sit at a table with any four guests from the dire of CEO who would you choose here's a
00:01:39
challenge for the entire D CEO Community if we hit 10 million subscribers by the
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end of 2024 you will get to pick four guests for your dream conversation and you can
00:01:50
make it weird or you can make it wonderful and here is the best part 3,000 of you that subscribe will be
00:01:56
invited to join this conversation live in in person and for free subscribe now and let's make this happen [Music] together who are you what you do and I
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think most importantly of all why is it so important that you do it I am a doctor of Optometry I am a fellow of the
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American Academy of Optometry and I am a diplomat of the American Board of Optometry so I practice iare here in the
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US and I see patients for all sorts of eye conditions whether that be diagnosing
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managing anything from vision problems simply as like near sidess or stigmatism to fitting contact lenses to diagnosing different diseases in the back of the
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eye and then prescribing medications or therapy to try and prevent that from getting worse or to help treat
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it on top of all of this uh I also host various on on various social media channels a educational website about helping people learn about the eyes
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their vision and finding the best Vision products and that really falls back to my mission of just helping people see their very best today but also keeping
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them see their best tomorrow and when you think about where we are as humans as it relates to our
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Eye Health like what's the macro picture like what's going on it I don't know whether it's just because I'm I'm getting older but I'm wondering if more
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people are starting to care about their Eye Health than ever before and if they are why and is our Eye Health getting
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better or worse I I I want to say that the I think people generally are being more interested in eyes and vision unfortunately part of that is probably
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because they're noticing more problems right people are starting to notice dysfunctions or more problems with their eye strain they're noticing more problems with dry eye
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children uh are starting to become nearsighted faster and to Greater degrees and because of those factors we're also seeing a lot more eye health
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conditions in the back of the eye um that also is reflected with other metabolic diseases like diabetes
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significantly causes damage and leads to potential blindness inside the eye so there's there's a lot of factors to it what's changing you know you referred to some of the situations there as becoming
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more or Worse Etc that would suggest that there's something environmental or within our lifestyle that's having an
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impact on that so again there's many factors that go into it certainly just having an aging population our population a lot of people are starting to move into older age
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groups we also have aftermath of poor diet a lot of people with diabetes high blood pressure and these other conditions that cause Ripple effects down the
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road and then our society has changed especially in the form of Lifestyle Beyond Diet also what we do throughout
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the day how much time do we spend on devices up close how much of our society is focused on education and how much time do we spend
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indoors all of these things are pushing us to as a as as a societ to have different changes within the eye and increase our risk for diseases and potential vision loss why does it matter
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you know I ask that question because I think for people to spend time listening to all the education you give out they
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first have to really believe that their eyes matter and I know this sounds like a bit of a crazy question because we all
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can understand that seeing things is useful but sometimes in life I think we don't appreciate things until we lose
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them and I think in your line of work you must see that more than ever pun intended right no you're absolutely
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correct and it's it's so frustrating as an eye care provider of how many patients or how many people just come in because they finally notice something's wrong and usually by the time
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something's wrong they notice it it's already too late and so one of the best things I can recommend for anybody is to whether you think you have a problem with your vision because a lot of people are like I see great I see fine I don't
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need to see an eye doctor it's like no you absolutely need to there's so many different not only just problems with
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your eyesight that we can catch but there's so many there's over 270 different conditions systemic and vision
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conditions that an eye doctor can diagnose from Just One of the simplest non-invasive medical evaluations and that's just getting an eye exam every year give me some examples of of how
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conditions you've spotted by doing an eye exam so patients who don't know their diabetic will catch Diabetes by
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looking inside the eye because diabetes will cause damage to the blood vessels and we can see bleeding happening in the
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retinal tissue we can see high blood pressure high cholesterol I've had patients where I've caught that they've technically had little strokes already inside because it's looking inside the
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eye the eye itself can have a stroke we can see cholesterol plaques stuck in the arteries within the
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eye autoimmune conditions we'll catch those from doing an eye exam unfortunately things like brain tumors and conditions like multiple
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sclerosis we'll catch those I've I had a one one story I'll share I have one patient who was she was young she was 20 years old college
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student she came in for just getting new glasses contact lenses she has to go to school she has to see well and during
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that very routine exam she has no other problems I'm looking inside the eye and I can see a hemorrhage a blood spot but
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there's different types of hemorrhaging that occurs in the back of the eye this specific type of hemorrhage is
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called a WTH spot and typically we only see Roth spots if somebody has a more serious condition going on can you show me on
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that where you saw it sorry so so we for people that aren't watching and just listening on audio we have a model of an eye here so with the model of the
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eyeball during the exam we of course look through the cornea through the pupil usually we dilate the pupils if I
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was to open up the inside of the eye the orange part that you see here that's the
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retinal tissue and you can see the little red lines those are blood vessels the retina is really the eyeball is kind
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of beautiful because it has a dual blood supply so it actually has blood that comes through the back and supplies the
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retina from the back side but then it has blood vessels that go within the retina and Supply nutrients within the
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retina from the front side so this type of bleeding spot was occurring just right here in the back of the eye a
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little bit off angle but it was occurring there and I was like this should not be there especially for somebody that was healthy had no other issues what sort of
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age she was 20year old female college student and usually again we see raw spots in more serious conditions whether somebody's extremely diabetic or they
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have HIV something is going on so I said this is not right we need to do blood work so I ended up referring her um basically did requested a blood blood
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blood panel and she didn't have like a family doctor so I'm like okay we need to refer you but she's heading out to
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college so I'm like I'm going to give you my full report I need you to go get this done and then Co happened so I
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didn't hear anything and so finally a few weeks later they finally allowed uh doctors to
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go back into clinics for emergency care in case I had an emergency and I called up that patient I'm like I just wanted
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to check on her see hey what's going on did you have to get that blood work and she's like you saved my life and I was
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like what she's like yeah I a few days later I started feeling really tired and not feeling well so I went into the doctor and I brought your your report they did blood work they found out I had
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they they put her in intensive care unit for 3 days because they were worried she was going to bleed
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out her platelets were so low that she could she could have just bled there from doing the blood work she had an immuno thrombocytopenic
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propura so her immune system because probably a virus but her immune system was attacking her platelets platelets are the thing that sort of clots the blood right correct
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and that ended up manifesting in the eye so it's it was it was one of the few cases where I was like wow like otherwise if she hadn't come in what
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what could have happened right so I just use that as a good demonstration because there are so many things that we catch
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on even a daily weekly basis there's so many misconceptions around Vision in the eye I think um one of the misconceptions
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I think I found myself living under is that my vision loss is inevitable really irrespective of what I do and the minute you you start to believe that story then
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it kind of disempowers you but it takes away your motivation to do anything about your vision now is that
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true there is changes that occur with age that will change your eyesight and vision that some just fundamental facts that you don't really
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have like Supreme control over it's like your hair growing gray like it's going to happen it's kind of accepted yeah with older age you're going to have gray hair MH with the eye there's conditions
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like that like cataracts age related cataracts eventually will develop presbyopia that's the condition where
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people are in their 40s and early 50s they start having a hard time seeing up close and they have to push things
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further back and they start wearing bifocals or verif focals so those sort of conditions
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inevitably do happen but there are thankfully a lot of things in our lifestyle that research is
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paying more attention to that can help prevent hopefully prevent and even slow down the progression of more devastating blinding eye diseases
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so there are things you can do and be aware of um and happy to go into that so Global I health and the statistics um one of the really sort of shocking stats
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I read is that most of us are going to develop nearsightedness when you go into sort of 2050 2060 is that is that true
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what are the stats around that so A publication that came out in 2016 in Opthalmology author of
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Holden they looked at the statistics of myop or nearsightedness even going further back we've known that nearsightedness does is
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is progressing and now between around 20 it's estimated that you know right now about 30% of the world's population is near sided but by about
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2050 we will have about 50% of the entire world's population being nearsighted in the US right now uh for
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kids aged 5 to 19 it were already about 42% and by 2030 so in just a few years it's expected in the US will be about
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that 50% Mark and then other parts of the world like East Asia like in Japan it's closer to 80 to 90% people are already nearsighted really
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mhm how come there's certainly genetics plays a role as more research has come out we know that genetics maybe only plays maybe up to about 30% of the
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factor so if your parents are nearsighted or if somebody's severely nearsighted like if your mom's severely
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nearsighted you are a much higher risk of developing it but the key other factors of Lifestyle falls down to urbanization really the fact that if you
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go outside in a big city that has streets really close to each other you're not really in an open
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field right you have big but tall buildings right next to you and then you go inside and you're inside of a smaller
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building a smaller apartment then there's the fact that we spend so much emphasis in our society on
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education on being up close beings right kids now are not only push to excel in education and being introduced to education earlier and spend more time studying and learning but parents are
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giving their kids digital devices as the babysitter 2.0 right so kids are staring
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at tablets even from a very young age and then it's the amount of time we're spending
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indoors it's interesting because I don't even think most people realize that the way we live our lives the things we
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stare at being indoors can change the eye I think we all kind of operate under this assumption that our eyes are just our eyes and we we think of muscles as being trainable and exercisable you know
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I can go to the gym I lift a wait my muscle changes but my eyes changing is something that I think is quite
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a um an surprising concept to most people how do we how do we know this so statistically we've watched and data collected for you know for many decades
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watching people gradually become more and more nearsighted and there's been in those theories of why that could happen
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the evidence of what changes physiologically with the eyeball is that the eye as you grow and go
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through adolescence and your body's growing the eyeball actually grows backward toward the brain into the
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orbit eye socket a little bit and it doesn't need to change much the eye growing 1 millimeter just 1 millimeter will change your prescription for glasses by about three
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diopters which is a high amount so if somebody gets two millim of change that is already into the what we classify as severe myopia which carries
00:16:36
a high risk for eye diseases like glaucoma cataracts having a retinal detachment where the retina in the back of the eye peels off the back of the globe and then what's called myopic
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maculopathy which is a form of kind of macular degeneration that typically occurs with later
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age and that's and that 1 millimeter or 2 millimeter growth is linked to Lifestyle the vast majority of it how much screen time how much being
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indoors how much reading books up close is okay like what is there like a recommended daily allowance so there are some recommendations put forth by like
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the American Academy of Pediatrics and it depends a little bit on age especially for young kids I think
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for the first few years of life they don't recommend kids look at screens at all and then why why because again
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there's research showing that not just for eye development but also neurological
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development and I I'm not a specialist on that form of pediatric brain development so I can't really opine on that but we do there are recommendations
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for it and I encourage anybody who's listening if you have a young child if you're thinking about having a child definitely look into those recommendations because it has impact
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acts on your child's development and growth the as far as like adults like you and I are both in our 30s how much time is spending on like looking up
00:18:10
close once you're past the age of like 20 25 the rate of myopia development thankfully slows down that's nearsightedness nearsightedness correct yeah that does slow down but about 10%
00:18:22
of the population can still develop a stronger and stronger prescription and part of that again is your education and how much time you're spending indoors and on near devices the
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there have been numerous studies looking at outdoor time and that spending more time outside can offset the onset and progression of near
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sidedness most studies are quoting somewhere around 90 minutes to two hours a day can kind of offset the all the near work that children are using so
00:19:00
spending sort of 90 minutes to two hours a day look outside looking far that's that's a part of it uh the various studies do look at you know are they doing things up close while they're
00:19:11
outside or is it just being outside it's not fully understood is it sunlight is it the brightness of light outside is it the individ specific wavelengths of
00:19:25
sunlight that are somehow communicating to the back of the eye to grow or not there's also the thought that the way
00:19:34
the world around us focuses on the retina when we're outside may send a different signal to the back of the eye because one of the areas that they've
00:19:44
done so much research on in terms of how myopia progresses has to do with how light is
00:19:51
focusing on different parts of the retina I do wanted to step back when it comes to all the spending time outside
00:19:59
it's that again that research is largely based on surveys and so they aren't 100%
00:20:05
sure how much light outs door time people are really getting so now uh they're utilizing Health trackers and giving it to kids for those studies so they can track truly how much light they're
00:20:16
getting when they're stepping outside versus not so they can have a better objective data to really understand the
00:20:21
risk of myopia progression based on that I was wondering if um vitamin D plays a role at all there that's also theorized
00:20:28
and looked at in some studies uh also just Athletics and getting more um more Motion in in a daily activities so there there's there's many different studies
00:20:41
in those regards but right now even a study out of Taiwan um they've been imple implementing a policy it's like hey you have to get at least 90 to two hour 90 minutes to two hours
00:20:53
outside every single day and they have noticed over the last decade there has been a decrease in childhood myopia development there's still some debate if it helps slow down progression because
00:21:07
even a more recent metaanalyses said it wasn't statistically significant for the progression of myopia but it does delay
00:21:13
onset of myopia can you reverse myopia no okay so if if if I'm if I become nearsighted because of my lifestyle or some other reason I can't
00:21:26
then just spend loads of time outside and reverse it and start gazing off into the distance Etc so there's the
00:21:32
understanding of what true myopia is and again that has to do with the elongation
00:21:37
of the eyeball so if you were to somehow find a way to truly reverse myopia you would
00:21:43
have to find a way to somehow shift that part of the eye forward which we have not been able to do there are I noce
00:21:52
being in the world of social media there are people who will claim that they've done this using various things usually
00:22:00
these people who are claiming this are selling something that is not based on science that is and and doing a research
00:22:06
study to prove that is would be very easy to do and it just it hasn't it doesn't
00:22:11
show most people if they are doing spending more time outside or they are doing eye exercises of any form to try and reverse their nearsightedness what's likely what
00:22:24
they're going through is that they have something called pseudomyopia which is where they've
00:22:30
overused their eye muscles so much that they're more or less having a spasm and they've their muscle is making them think that they are nears side inness
00:22:42
but then finally going outside spending more time outside stop staring at their phone so much they learn to relax their
00:22:48
eye muscles and all of a sudden now they can see better again well this is you know in part one of my con my personal
00:22:55
concerns because sometimes very rare occasions I'll spend you know maybe 9 10 12 hours in this studio and you know I'm doing research on the guest before the guest arrives and then we're sitting at
00:23:06
this sort of distance and I'm very intently focused and it's a dark room Etc and then when I walk outside it's
00:23:13
like I can't see a bloody number plate and I think I'm losing my vision but from what you're saying there it sounds
00:23:19
like I'm going through a bit of pseudo myopia you could be you're uh of course I I haven't done an eye exam on you I
00:23:24
don't know where you're at can I ask when was the last time you had your eyes check oh no comment um it was a long
00:23:30
time ago and the reason for that is again because I just I always assume my eyes were were fine so it would have
00:23:36
been gosh that's such a good question maybe seven years ago or something so it's it's tough to say um you know there is possibility that maybe there's a little bit of nearsightedness there it
00:23:49
could be that you've used your eye muscles so much indoors that you're just you're used to lifting it think of it like lifting a 5B weight right you've held it there all day long and most
00:24:00
people can eventually if you hold it there long enough you can have some eye strain and people will feel that at the end of the day but then you step outside
00:24:07
and you're just used to holding it 5 pound weight at Arms level so you have to learn to hey I can relax this and put
00:24:13
it back down MH so that is a component of the internal eye muscle called the sary body which
00:24:21
unfortunately is not the same type of muscle as your skeletal muscle and so even with I exercises you can't strengthen that muscle so eye exercises
00:24:33
don't work they eye exercises in the form of what's called vision therapy or orthoptics can work but they're not building the muscle they are improving
00:24:44
the really the coordination of your brain communicating that information to those muscles to work in coordination okay and so there's a some certain
00:24:57
binocular Vision disorders like people who have convergence and sufficiency they can't move their eyes to bring them
00:25:03
forward to keep a page in front of them single or some people have loss of their
00:25:09
accommodative ability their ability to change Focus to keep something up close clear those type of binocular vision
00:25:17
issues can be trained again through the training of the communication between the brain and those muscles should I be looking for Clues as to what the future of my vision is going to be like from my
00:25:29
parents because my parents are they they hold everything at like one meter length from their face and I when I was younger
00:25:35
used to take the piss out of them thinking like that's so ridiculous and I would show them that I could read from like 1 cimeter away and they're reading
00:25:41
it arms length but I think they're going to have the last laugh when when I get to 50 60 years old sure because of
00:25:48
genetics or whatever so again uh even without genetics just the way the eye ages the lens inside of your eye will change which is so if I open up the eye
00:26:01
model here let me try not to spill everything from the inside of the eye in the front portion of the eye you
00:26:08
have the cornea which is the is that the very front piece it's the Clear Window to the eye okay behind it of course you
00:26:16
have the iris the colored part of the eye so brown eyes blue eyes behind that you have a lens it's called the crystallin lens and this has got a couple different pieces
00:26:27
also to the side but this crystallin lens is actually about the size of an M&M I put these together it's it's kind
00:26:35
of that shape M when you're born this lens is clear and thin and so the muscle inside the
00:26:43
eye actually pulls on this lens to change its shape and that's what helps you as a little kid see all the way
00:26:48
toward the front of your nose as you get older this lens gains an extra layer basically every year of your life and so so as you get older if you
00:27:00
ever look up on images online you can actually see Rings or these little lines and it's like looking at the rings of a
00:27:06
tree so you can basically count those and be like look how old this person is so by the time everybody's about in
00:27:14
their early 40s there's algorithms that predict this with high accuracy and in school I had
00:27:21
memorized them I've I I don't really need to use them as much anymore so I haven't haven't thought about it for a while but these
00:27:29
as this lens gets thicker it basically gets thicker every year it gets to a point where the lens starts to the
00:27:37
crystals within that lens start to change shape they become more crystallized rigid and so even though
00:27:44
the muscle inside the eye still pulling on this lens it's like pulling on a hard stiff marble it doesn't want to change
00:27:50
shape anymore and so that's why people can gradually like I can't quite keep things as clear anymore and so it's
00:27:57
gradually getting worse and worse oh okay eventually once you get closer to the ages of 50 60 70 80 this lens continues to get thicker
00:28:12
harder but then the crystal start to change color they go from being clear to being more of a faint yellow color to a darker yellow whitish
00:28:22
color and that's what we call a cataract and so people lose vision because that cataract is so such a dense color that light is not filtering it's not passing
00:28:33
through to getting to the retina in the back of the eye anymore so what' you do cut it out so there is thankfully
00:28:39
cataract surgery is an amazing surgery I think it's probably one of the more fascinating surgeries that's out there
00:28:46
they what what modern cataract surgery does they either use a laser or they physically have to open up parts of the eye but they use a procedure called f
00:28:58
ification it's basically using ultrasound to shatter the lens into dust and then they have a small vacuum tube that sucks up all the particles out of the eye but then a new plastic lens
00:29:13
is inserted into the eye into that place and that new plastic lens can be made to
00:29:19
account for any glasses prescription that you need okay and what's fascinating for you and I is that so
00:29:26
this form of cataract surgeries been evolving and getting better and better over Generations but the new lens
00:29:33
implants that they've been engineering are just outstanding even right now because now they can make
00:29:39
multifocal lenses they can have lenses that change shape based on how you're using your eyes and then it's basically
00:29:46
not needing bifocals not needing glasses as much in some cases if at all and so I
00:29:53
keep on thinking like wow where this technology is right now where is it going to be in 30 40 years years when
00:29:58
you and I are getting to that point where we might need to think about it who knows what we're going to have I
00:30:04
reckon we'll have like cameras I hope so are people working on that kind of thing I bet someone's working on some kind of camera electric eyeball you know I did hear of some research maybe about
00:30:15
five six years ago of somebody talking about it but um since then I think things have kind of gone quiet they are
00:30:23
probably in the last year one of the the last last few years there's been interest and Research into making like
00:30:30
augmented reality contact lenses that are quite fascinating and then there is the kind of one of the newest things is the first whole eye transplant that was
00:30:42
one of the kind of the coolest things that have come up recently there was an eye transplant so a gentleman was injured in
00:30:51
the he was a US military but something happened on the job electrical damage to his face his eyee he ended up having partial face transplant and then a whole
00:31:03
eye transplant and at this time it is the first one ever done the eye is so unique
00:31:09
and so complex that when they finally did this transplant it's it's sort of shaken the
00:31:16
I care role a little bit the they just I just read like a one-year a publication in jamama that was basically summarizing what it's been like after this last year and it's
00:31:27
amazing amazing because the eye did connect to the optic nerve because the eye again is so complex so they had to
00:31:34
not only connect muscles to the eyeball but they had to connect the optic nerve to the from the donor tissue to the host and keeping that the right amount
00:31:45
of blood supply having it so it didn't reject is is a really tough feat and what they have now they find that the last this last paper I just read that
00:31:56
the eye is still doing well it's still got blood flow it's making aqueous humor the kind of the clear blood within the eye and through functional MRIs and
00:32:07
electroretinograms that we can do in the clinic they have been able to show that there is electrical activity going to
00:32:14
the patient's brain unfortunately he does not have any eyesight or he cannot detect light with it but I think just
00:32:23
this is the first step of showing like wow we actually can try this we can get it so it actually is
00:32:32
safe so it's it's pretty fascinating God it's only going to be a matter of time isn't it um you said there that the eye
00:32:39
is complex I was reading some stats around the eye that blew my mind the eye contains over two million working parts and is considered the second most complex organ in the body I guess this the brain is the first in the eyeball is
00:32:52
really an extension of the brain right the the retina in the back of the eye communicates directly through the optic
00:32:58
nerve to many parts of the brain your eyes are capable of processing 36,000 pieces of information an hour your eyes will process 24 million images throughout your lifetime contributing to
00:33:09
85% of your total knowledge and there's a comment saying that the eye is a window to your soul showing how the eyes
00:33:16
are so expressive that they can reveal a lot about a person's inner state which we talked about a second ago it's just
00:33:22
crazy that that particular stat around um 85% of my total knowledge will basically come from my ey
00:33:29
when you say it I kind of understand it because okay I'm reading I'm seeing I'm you know I'm learning through my eyeballs but it is um it is cause for
00:33:37
protecting our eyes and the things you described there cataracts and these other sort of eye conditions cataracts
00:33:42
in particular is that something that I can Stave off by making better choices with my life so
00:33:49
people who do smoke people who drink more uh that increases their oxid oxidation so the
00:33:58
cataract formation mostly occurs due to oxidative stress within the eye in fact the most
00:34:06
vitamin C in the body is within the eye and it bathes it's in a solution that bathes around that lens and helps
00:34:13
prevented from oxidizing so best things is try not to smoke drinking not to do too much the sunlight does play a role in aging of
00:34:27
the lens and so there's epidemological studies on age related eye diseases that have found
00:34:33
that people who spend more time Outdoors without sunlight protection without wide brim hats without sunglasses they are
00:34:39
more likely to develop conditions like cataracts there is a specific there's different types of cataracts there's one
00:34:45
specific type of cataract called a cortical cataract that kind of looks like bicycle spokes if you're do if you
00:34:50
looking in the eye like I do in the exam room you can see these bicycle Spokes and those have been found to be more
00:34:56
related to UV light exposure and then as far as taking supplements vitamins those sort of things because things like vitamin C are a water soluble
00:35:08
vitamin once you have enough vitamin C in your body you just urinate out everything else so there have been
00:35:14
studies on people who are malnourished and don't get enough vitamin C that giving them vitamin C can help slow or
00:35:19
Pro delay the onset of cataracts but if you already are getting proper nutrition taking additional vitamin C's probably not going to delay your onset of cataracts
00:35:35
specifically I learned something from you actually from your Instagram um which I think is really going to do me a
00:35:40
lot of favors because I'm someone that spends a lot of time on my phone admitt and you alerted me to the fact that
00:35:47
there's actually a feature in the iPhone which will help me Stave off my myopia potentially perhaps uh so thankfully again the iare Community is not the only
00:35:59
people who are aware of these issues with using devices up close MH but thankfully whether it be apple
00:36:05
specifically with their iPhone but also this the other phone manufacturers people who are making these devices now
00:36:11
have software that tracks hey you're holding this really close to your face we want you to push it further back so
00:36:17
thankfully they do have those sort of notifications that people can turn on I'll admit that I turned mine on for a
00:36:22
while and I eventually got so annoyed with it I wanted to push it further back uh so I I kept it on for a while I eventually took it off um but maybe I'll
00:36:33
have to put it back on again just be a good just to serve a good example so there's it was a feature released in
00:36:39
2023 and it essentially sends you a notification whenever your phone is is it what 12 in or something I don't remember exactly how close it is but we do know that on average people hold
00:36:52
their phones and devices around 8 in away from their face so pretty close and it's important to consider moving things further back and part of that can be because certainly eye strain
00:37:05
relationships possibly myopia and then even blue light I know people are get really concerned and um interested around the blue light World especially
00:37:15
since Co that really blew up at that time but just moving your phone back twice as far will decrease your blue light exposure by 20 like a full
00:37:26
75% so if if you're worried about how blue light's affecting you it's like just move your phone back a few inches and
00:37:32
that's automatically going to decrease your blue light exposure from that device I I don't think most people know that this feature even exists because I
00:37:38
don't think Apple really ever announced it or did a marketing campaign around it but in the setting section of your phone
00:37:44
and your iPad Etc it's under screen time um and under screen time there's a button called screen distance and it says to reduce eye strain and risk of myopia in children screen distance will
00:37:55
alert you to hold an iPhone or iPad with face ID at a recommended distance um and
00:38:01
in the small print it says screen distance works by measuring the distance between the screen and your eyes the camera is not capturing images or your
00:38:07
face and the data collected remains on the device so if I click continue it then says this is how screen distance Works um screen distance encourages you to move your iPhone and iPad further
00:38:18
away to support your vision health um the next section says V Vision distance or viewing distance iPhone or iPad
00:38:26
should be held at a suggested of 30 cm from your eyes mhm um interesting those are recommendations but how many people actually follow that
00:38:38
it's no one yeah it's tough I mean you'll see people do that and it just gradually over time gets closer and
00:38:44
closer and kids probably are even worse because they automatically have smaller arms right but then they just they just
00:38:51
bring it right up close right they want that phone screen to take up all of their their visual field and so it is I
00:38:57
think it's a a good habit I think it's something tell me have you when have you turned it on has it something that
00:39:03
you've utilized I turned it on when I was in preparation for you coming here today so I I didn't know it existed
00:39:08
until I was researching you and so I've had it on for about a day frankly I haven't actually got the notification yet but okay um it's not been on long
00:39:15
enough I don't think for me to have an opinion on it just yet but you said it was annoying you so it's definitely
00:39:20
going to annoy me if it annoyed you so my my challenge was that in the evenings I wear contacts
00:39:26
most of the time and I take my contact lenses out in the evening and I go back to glasses and sometimes I'll lay I'll
00:39:34
like lay down and I'll take my glasses off because I'm so nearsighted I have to see my I want to see the screen but I
00:39:40
have to hold the screen just a few centimeters in front of my face because I'm that nearsighted and then it would just give
00:39:46
me that warning the whole time and it delays it has like a few seconds of delay once I pull it back before it
00:39:53
actually shows me the screen again so I was doing it so much I'm like I know that I should pull the screen away and I
00:39:59
should just take a break but it was it was delaying my productivity yeah so that that's why but again to set a good example I'll probably have to turn it back on and see how it goes and if you have kids you can always you know
00:40:11
they're not probably doing much that's productive you can always turn it on their devices I guess yeah I think so I
00:40:17
think it's also a good habit to um lead by example for kids and try to be aware of how much time you're spending on your phone in front of your kids because your kids are going to see that and and
00:40:27
they're going to probably mimic that same behavior I want to talk to you about bags under my eyes um subject that
00:40:35
I know a lot of people are interested in and there's a lot of misconceptions around how we get bags under our eyes I think most people think bags under their
00:40:42
eyes are because they're tired or something um and is there a difference between having bags under my eyes and
00:40:47
having sort of dark circles under my eyes so when it comes to having dark circles under eye bags dark circles is something that people are definitely concerned about it's a huge topic online
00:41:00
I see all the time people ask about it in the eye clinic having dark circles under the eyes is technically different
00:41:07
than having under eye bags but if you have under eye bags it'll make the appearance of dark circles worse okay so
00:41:14
dark circles in the clinic we think first what's somebody's skin pigmentation like is the dark circle
00:41:20
just because they have more pigmentation and if you're somebody who spends a lot of time in the sunlight you are more
00:41:25
likely to develop darker skin complexion around the eyelids the eyelids are some of the thinnest most delicate tissue of
00:41:31
skin on your body and in fact a lot of uh people who don't know this but uh under having skin cancer on your lower eyelid is actually pretty high so it's
00:41:44
good to be wearing either a wide brim hat or sunglasses to protect the eyes from sunlight damage the other kind of components is
00:41:53
that if you have vascular changes so myself I have a really pale complexion if I have bad allergies that can cause the blood vessels around my eyelids to dilate and so you'll see that color of
00:42:06
just the blood vessels coming through the skin a lot easier and then there's orbital shadow effects because some
00:42:12
people's orbits they have more prominent brow it may cost kind of cast a shadow onto the lower eyelid and that's where
00:42:20
having under eye bags can also make the eyelids seem like they're uh have kind of a dark circles because the eyelids are puffy and you can have puffiness of
00:42:32
the eyelids for multiple reasons allergies are a big one salt content of the cheer film and even in your body can
00:42:39
make some of those changes I know for myself if I have a cheat day and I eat a bunch of greasy delicious pizza the next morning I'll probably be I can feel that
00:42:51
my skin and my face is maybe a little bit more puffy uh thankfully that goes away within a few hours but that's why a lot
00:42:57
of times even just doing cold compresses right you see people put cucumbers on their eyes a lot of that has more have
00:43:03
to do with just the cooling temperature doing a cold compress for 10 at Max 15 minutes can bring some of that puffiness
00:43:10
down and that can at least help help improve the appearance so if I have a really salty diet the night before I'm
00:43:17
there's a greater probability I'll wake up with bags under my eyes possibly okay
00:43:23
I've tried to research this to find any real Publications to to see if it's really there and I couldn't find
00:43:30
anything but I know from just my own anecdotal experience that if I eat a really high salt diet um and I've done
00:43:38
over the last eight years I've really done a better job I know you have too of like thinking about my diet how that affects me how my body feels after I eat
00:43:45
something and so I've noticed if I if I have a cheat day that sort of thing can happen and where does this what's the
00:43:51
sort of physiological rationale for salt playing a role so your tear film for examp example um your tear like I know some people will say hey if I have a
00:44:02
watch a sad movie and I cry at night time the next morning my eyes are super puffy so your tears have salt in them
00:44:10
and because if you ever cried and tasted your tears they taste salty right so the challenge is that when you have salt
00:44:16
it'll draw fluid into the tissues and so if people cry the night before the salt remaining in the tears
00:44:23
basically get into the tear ducts and sit on the surface of the eye and the eyelids and then that can draw fluid
00:44:28
into those tissues does hydration play a role you that's also something that's been looked at in research is not really
00:44:35
conclusive I think hydration is still something we need to I do encourage people to at least be aware of their
00:44:41
hydration U for dry eye there is some research that indicates that people who are drink more water tend to have less severe symptoms of dry eye when I see
00:44:52
someone with bags into their eyes I used to think well I still kind of do think that it just means that they haven't
00:44:58
slept that again I recently did uh a live stream or I did research first and try to look into this and they have looked at quality of sleep time of sleep
00:45:08
and both the subjective and objective appearance of dark circles under the eyes and they find that it is if you have not been getting good sleep
00:45:19
objectively your under eye dark circles do not change but your subjective appearance of your own image will go down ah okay so you're both they find
00:45:31
that for both sleep and stress so you believe that you've got bigger sort of dark circles or patches under your eyes
00:45:38
but objectively in reality you haven't yeah because they can measure the type of light being reflected off the surface of your skin so they can see how much pigment and what type of light is is
00:45:50
being reflected and so they've been able to find oh that it's purely just your subjective opinion of your own self-image seems worse when you're tired
00:46:01
what about stress cuz I'm thinking about people that I've seen that have like big bags under their eyes and like you know
00:46:07
their eyes kind of look dark I always assume it's their stress and they haven't been sleeping but you're say saying that that's not accurate
00:46:14
necessarily so at least in the the few studies that I've been able to read that were published in the last five years
00:46:21
don't seem to find that conclusive there are other physiological changes that happen when people don't sleep or stress
00:46:27
right cortisol releases inflammation in the body will change hormones can change so they may all play a role there um but
00:46:35
right now it seems to have a less effect on the true pigmentation of the eyelids okay and the the cucumber and the cold compress and all that kind of
00:46:47
stuff does that stuff work in changing the appearance of dark circles and bags and Dem eyes because when I filmed Dragon's Den TV show in the UK I
00:46:58
sometime it's weird cuz like sometimes when I'm underslept I come into the studio and
00:47:04
the makeup artist she won't say anything to me but she'll just put the Cucumber on and I know what she's saying she's
00:47:09
saying you look like but but she doesn't say it so and it's always when I haven't slept so I put two and two
00:47:15
together and thought okay well she knows that my eyes don't look great today um but is is it actually doing anything the cucumber and the the coolness effect I believe is going to be causing con
00:47:26
restriction of blood vessels it's going to be helping the tissue come down and swelling just like if you bang your knee or elbow really hard on something it
00:47:32
swells there's a little bit inflammation and so putting cool cold down there can help momentarily but I wouldn't do it
00:47:38
longer than 15 minutes the the reason why is because if you do it longer than 15 minutes your blood vessels that can
00:47:43
go the opposite way and cause more inflammation the there's other things like eye creams there's a plethora of different eye creams on the market some
00:47:54
of those do work to help constriction some of those are to help true truly remove pigmentation and a lot of those
00:48:06
products can have effect but it takes months to truly remove the pigment so you're talking you're using that two three times a day for like 14 15 weeks
00:48:18
but uh outside of that if somebody's tried all those other avenues talked with their dermatologist or or an eye
00:48:25
care pro provider of any kind and things still aren't getting better there are some surgical procedures that can be
00:48:31
done to help people with the appearance of under eye bags and some dark circles what do those surgeries do they either
00:48:37
use various forms of light or light therapies to help remove pigmentation you have to be careful around the eyes when it comes to those sort of therapies but they do exist and then there's
00:48:48
fillers like they'll do hyaluronic acid fillers to change the shadowing effects around the eye and then there's forms of
00:48:55
what are called a blop plasty which are true eyelid surgeries and for that you would want to see an opthalmologist who specializes in those type of therapies or or those type of surgeries so if I
00:49:07
never want to get dark circles bags into bags into my again what is the natural easy solution I do still encourage good sleep eating healthy uh staying hydrated
00:49:20
I think all of those things are good habits to have because we know they affect the body in so many other ways if
00:49:27
somebody is truly struggling with it then you can look at those various creams but I definitely encourage people talk to a medical provider or whether a dermatologist or an eye care provider
00:49:42
who specializes in that area what about red light therapy so red light there's so much in red light and this is I'm glad you brought that up because this is something I've been diving kind of head
00:49:52
first into into the research for many things in the eyes with the bag specifically I'll say that there is some
00:49:58
newer Publications showing that red light therapy can help with depigmentation around the eyelids and giving the eyelids more of a youthful appearance I do wave caution though
00:50:11
because there's a lot of products that are online that that offer red light therapy for various reasons but this they're not
00:50:24
really standardized very well and so there are also Publications showing people who've had damage to the eyes because they've used these various
00:50:35
forms of red light therapies devices they bought online because the manua what the
00:50:41
manufacturer States isn't actually what's being measured when they do it in the research and find out hey what type
00:50:46
of wavelength is this how much energy is being produced by the device because it's not the specific wavelength the
00:50:53
wavelength is important but the amount of energy in the red light also super important and if you have too
00:50:59
much energy you can go through the eyelid and go into the eye and cause damage and so I think it's really
00:51:06
important this is still a very early area of research when it comes to the eye and so I think I I just urge caution
00:51:14
to make sure whoever's listening if you're thinking about red light therapy you're thinking about getting a red light device specifically for ey care
00:51:20
definitely talk to a specialist who works in that area okay okay the um but red light have you have you heard much about red light in different areas I've heard a lot about it I don't know a huge
00:51:33
amount about it and I have two red light panels at home which were given to me as
00:51:39
a gift um my my partner has when I have one we basically got each other the same Christmas present one year but we we did
00:51:46
ask ourselves we sat in front of it one day and said what does this like what does this do in terms of our health and
00:51:51
are we allowed to stare at it the devices you come that you got do they come with go
00:51:57
no okay so that that is sort of the concern I have is again what energy is really not just what wavelengths of light is it emitting
00:52:10
but what's the energy and also how far away from the device are you sitting what's the
00:52:15
recommendations and specifically with the I there is evidence that Redlight therapy can help with dry eyes that red light therapy can help with macular degeneration
00:52:27
which is is so age related macular degeneration is one of the leading causes of blindness for older age adults so 50 plus 50 plus in fact if you're
00:52:38
over the age of 40 and somebody's legally blind 50% of them it's due to macular degeneration and so probably some of the best research in red light in the eyes
00:52:49
is on macular degeneration uh in fact there is it's C it's currently approved and being used
00:52:55
in Europe it's not approved in the US just yet but it is going through FDA trials but that
00:53:02
is a form of red light therapy it it doesn't just use red light it uses some near infrared light and a little bit of
00:53:08
kind of a yellow light but they shine that in the eye in intervals and they do it for a few weeks and then a few months you do it again and for macular generation they've been able to show that not only can the protein that
00:53:21
builds up in the back of the eye in that condition diminish but they can slow down and slow
00:53:28
down the progression of macular generation and for some people even restore eyesight they can actually help
00:53:34
people see better using red light therapy using that form of red light therapy so again very early research
00:53:42
right now the challenge with all these at home devices whether it be for dry eye whether it be for Mac
00:53:54
generation there's again concern about the power density and about the potential change in temperature within the eye because that could cause damage
00:54:08
there's also red light being utilized and investigated in Asia and in Australia for myopia for children and so
00:54:16
it's it's something that is really fascinating and I am looking forward to as more information comes out but it's I I personally from digging into it and trying to understand it it does make me
00:54:27
concerned of how I think there's just not as good a standardization or understanding of really how it works and which devices
00:54:37
are safe and which ones are more medically something that you should see a medical provider for I read in the
00:54:44
nature publication that a 2022 study with 20 participants receiving red light therapy twice a week for three weeks
00:54:51
found that they had improved tier reduction tier reduction and other dry eyye symptoms compared to the place placebo group tear reduction what does that mean so dry eye again is an area
00:55:04
where red light therapy is being utilized in right now the there's several studies on red light on its benefits for dry eye but the two
00:55:15
areas where it's believed to help the most is in helping you produce more of your own natural tears because the red
00:55:23
light can shut down inflammation um within the tissues and help you produce uh basically it helps the cell re more energized the mitochondria within the
00:55:35
cell can be activated by forms of red light and nitric oxide is also produced and then you have higher amounts of antioxidants and so these cellular
00:55:48
components in mice and then now in humans they're finding that tiar production can be improved which helps
00:55:54
with dry eyes which helps with dry eyes but then also the red light can help with the myomi glands in the eyelids
00:56:01
your eyelids have about 25 to 30 glands both the bottom and the top part of the eyelid can you show me on that the uh so
00:56:09
it's actually on in the eyelids but the eye lids would be oh in front they're in front yeah so
00:56:16
so my top eyelids have about 30 my Boman glands in them and my bottom eyelid has like 25 to 30 and every time you blink
00:56:23
these glands have to release a little bit of oil that prevents your tear filing from
00:56:30
evaporating and so there's a lot of implications that go into this but what happens is as we get older age is a big
00:56:37
factor but then you also have more we can talk about with device use and the fact that when we're stering at devices we don't blink as often and we don't blink as completely when we're sterring
00:56:48
at a device and so for that along with diet and other inflammatory things the glands stop producing oil as well they become inflamed the oils go from being a
00:57:01
clear liquid to being a thick wax they become yellow they become cloudy and they stop releasing oils into your tier film and so with red light therapy along
00:57:12
with other therapies but red light has been found to help with getting those oils to produce at least a little bit
00:57:18
better I think the research on red light in my Bing gland dysfunction is still in its infancy but we have a different form
00:57:26
of therapy called IPL or intense pulse light which has been even FDA approved for my boming gland dysfunction in treating dry ey is there any research being done on red light and myopia a red
00:57:42
light and shortsightedness I if I look at those red light panels I have at home is that going to help with my
00:57:47
Progressive shortsightedness so there is research going into red light in myopia it's
00:57:53
being done in children when it comes to the device you have at home I have no idea what
00:57:59
wavelength that is I have no idea what power that is the devices that are being researched and used in research are usually a atome desk mounted device yeah
00:58:11
that kids will stare into for about 3 minutes twice a day morning and then night and they are showing in in those
00:58:19
Publications that they're able to slow down the rate of progression of myopia and even for kids who haven't developed
00:58:25
myop myopia they're able to prevent them from developing myopia which is really fascinating there have been at least there is at least one study that looked
00:58:36
at those devices and there is there is some concern that perhaps the power density is too high and could be at risk
00:58:43
of causing damage to Children's eyes so again it's still it's still something heavily in research and I wouldn't recommend people go and purposely stare into a red light unless their doctor is
00:58:55
prescribing it for something and just because I'm an idiot um the red light is basically stimulating the mitochondria
00:59:01
in the cell which is kind of like the engine in the cell and that's making it produce more of the good stuff
00:59:08
specifically ATP uh adenosine triphosphate the which the cell uses for energy what about gazing at the sun because I've been told so many things when I was younger it was like never
00:59:20
look at the Sun and then I got older and people are like no like stare at the Sun and now I don't know what true yeah
00:59:27
don't stare at the sun even for like a second don't the so the challenge is sunlight
00:59:35
is good for the eyes especially early on in the day and of course toward the end of the day just so that you're getting
00:59:41
the signals to your brain to hey U the sun is coming up the Sun is going down way to kind of influence your melatonin production the staring directly into the
00:59:52
sun though the sun is so powerful it can very quickly burn holes inside your retina and I have a patient right now who she you know she's comes in her
01:00:05
vision is not getting to 2020 we look inside the eye and she has burn holes a burned hole in her retina that is we
01:00:14
diagnose as solar retinopathy and so and I'm like have you been staring at the sun she's like yeah
01:00:20
I've been sungazing since I was little uh I was in Florida recently and I stared at the Sun and and I was doing
01:00:26
this for how many minutes and now she has permanent little blind spots where she cannot see 2020 anymore where in there is that the colored part of the eye no so the the colored part is
01:00:39
the iris but the light going through the eye is magnified so strongly by the cornea and the lens inside the eye that ends up focusing on the part of the eye called the FIA or the macula which is at
01:00:52
the back of the it's in the back part of the eye imagine if we're going to play darts we're going to go to the pub we're
01:00:57
going to throw darts the center Bullseye of the eye called the macula that part is your reason you see
01:01:05
so sharply is the reason that it's the part of the eye that you're using when you're reading words when you're studying when you're looking at your
01:01:11
friends and family in the face you're using that Bullseye in the back of the eye so when someone looks at the sun
01:01:16
they're putting all of that light energy focused right in that area and in just a few seconds you can overwhelm that
01:01:23
tissue causing chemical damage to the r because people this phrase Su gazing mhm
01:01:30
is this like a spiritual thing like I I think I was in Bali and people like no you can you can sungaze you should
01:01:36
sungaze because it's good for you sungazing what is this term that is usually in some sort of either religious or spiritual practice people will gaze
01:01:48
toward the sun usually from my understanding it's people doing it in the early morning or
01:01:54
late afternoon when the sun is largely going down the Horizon mhm and because the light is indirectly being bent
01:02:01
perhaps it's not giving as much energy to cause thermochemical damage to the back of the eye but the there is still a
01:02:10
high risk and so uh it's always best to not stare directly into the Sun or you know try to look off center from it and especially during the high UV times of the day you know 10 to 400 p.m. usually
01:02:23
uh it's good to be wearing UV light protection not just because UV can penetrate into the eye but because UV
01:02:29
light damages the skin of the eyelid it can cause changes to the front surface of the eye people can get sunburn on the
01:02:35
surface of the eye okay that's good to know I'm not going to look at the sun I was being torn because I got a friend
01:02:40
who uh who told me that sun gazing is good for you and you should do it and stuff but I'll take your word for it you
01:02:46
you mentioned blue light a second ago which is the light that comes off our devices um is that harmful for my eyes
01:02:53
there's blue light that comes from the sun yeah really high energy that could potentially cause
01:03:00
aging changes inside the eye the blue light that comes from your digital screens does not have enough power and
01:03:08
has consistently shown in research to not increase the risk of Aging eye diseases it just impacts my sleep
01:03:15
potentially impacts your sleep there's also some claims that blue light can affect your eye strain but again
01:03:22
research on Blue Light glasses on us devices shows that blue light does not impact IE strain a lot of people will claim that they will I have a lot of patients who come in and anecdotally
01:03:34
like oh my eyes feel so much better from getting the blue light glasses and that could just be placebo
01:03:42
effect it could potentially be the fact that a lot of blue light glasses will have anti-glare or glare-free protection
01:03:49
put on to it and the anti-glare is probably improving their focus and they're not having as much glare issues
01:03:55
when considering at the device but right now there's still just no concrete evidence showing that blue
01:04:03
light is contributing to IE strain but then the Sleep Cycle we do know that blue light can influence your sleep what
01:04:10
kind of gadgets do you have I I don't know why but I assume as someone who is an an eye doctor you must have loads of
01:04:16
gadgets around your house that you use to because you know all of the information about eyes and vision and
01:04:22
stuff is that am I wrong I mean I I've yeah we're I have multiple computer screens open I have my phone screen open all day uh I the other day I was texting
01:04:32
a friend I'm like I've got two laptops open at a coffee shop you know I'm like I'm doubling down on the blue light here
01:04:39
uh so there's a lot going on there but yeah or practices is are there any practices
01:04:46
that you've been disciplined with because you're aware of the impacts it will have on your eye specifically on
01:04:52
Blue Light No all of it just your overall Eye Health so the biggest things for myself is Diet okay let's talk about
01:05:01
diet then sure what do I need to know in terms of what I'm eating and drinking to make sure that my eye Health stays
01:05:08
optimal so they've been looking at lifestyle factors on Aging eye diseases for for Gen for for a long time many decades the biggest one thing when it comes to diet and they even have more
01:05:20
recent Publications um a mentor of mine Julie potit she's a past present pres of
01:05:26
the ocular wellness and nutrition Society who I'm who which I'm a member of she even brought my attention to a
01:05:32
publication just this year from the American Journal of nutrition they looked at the original publication of
01:05:39
aeds the age related eye disease study that has large cohort of people like 4,000 people they watched over nine
01:05:45
years tracking their diet tracking uh their eye health and how things were changing and they find that just eating
01:05:52
a Mediterranean diet green leafy vegetables oily fish reduces your risk of developing conditions like macular degeneration specifically slowing down the pro the progression of that
01:06:04
condition in that specific study this publication that just came out they showed that just having 2.7 servings of
01:06:10
green leafy vegetables in a week not a day but just even a week right we're supposed to have more than more than
01:06:17
that in a day but just 2.7 servings or more can slow down your risk of progression of that condition macular degeneration by 25% from going from early to more of an
01:06:28
advanced stage Immaculate degeneration leads to blindness it can yeah especially as we get older because that
01:06:36
condition and we can go into it but that condition has a lot to do with your inflammation it has to do with metabolism and oxidative stress that occur within the
01:06:47
eye but green leafy vegetables at least 2.7 servings a week that's that specific
01:06:53
study they find that oily fish eating two servings of oily fish a week slowed it down by 21% and then they found a
01:07:00
synergistic effect for people who ate both it was a 41% reduced risk of progressing in that disease so and that's not just the only study they find
01:07:10
that people who eat diets that have more fruits and vegetables that have oily fish reduced risk of developing
01:07:17
conditions like macgeneration reduced risk of things like diabetic retinopathy and so I try to focus on
01:07:24
eating a good healthy diet I mean the thing that I heard growing up was that you need to eat lots
01:07:30
of carrots and then carrots will help your vision so carrots do you know where that came from no that's actually a it was propaganda started in the UK by uh
01:07:43
Great Britain um from what I understand I'm sure there's like a historian out there who's just like grumbling at me
01:07:48
but from what I have read and studied is that I believe it was World War II that Britain had was being attacked by the Germans and they were worried about German Wares
01:07:59
dropping bombs on them especially at nighttime and they had already established radar to detect war planes coming but they didn't want Germany to know
01:08:11
that so they put out their own propaganda saying hey our Scouts can detect German war planes better because they eat their carrots because carrots have beta carotene which your body can
01:08:25
convert to vitamin A which is essential for nighttime vision and retinal Health oh okay cuz I always also used to hear that you e if you ate carrots you could see in the dark yeah so it's a I mean it
01:08:38
is based on some like vitamin A is essential for photo receptors in the back of the eye but most people are not vitamin A deficient by
01:08:50
far and so it's pretty rare that we see vitamin A deficiency in the in the eye clinic unless you uh happen to live in a
01:08:57
place that's pretty malnourished you mentioned oily fish I was on your YouTube channel and I saw that you did
01:09:02
an experiment where you took omega-3 for 90 days uh I guess because there's some
01:09:09
kind of implications for vision with omega-3 omega-3 does play a role in the eyes for two rays uh that specific video
01:09:16
uh I was really looking at Omega-3s and its relationship to my own dry eye symptoms MH because there's a lot of
01:09:23
studies looking at omega-3 and and its dry eye and the research is still a bit all over the place most most Eye Care providers who specializ in dry eye will
01:09:34
say that you know there is a role for Omega-3s in helping reduce inflammation that contributes to dry eye because a
01:09:40
lot of dryeee disease has to do with inflammation and so there is a large belief that it does work there are some publications of course that say no it doesn't it's just the same as Placebo
01:09:51
and so there's still some debate but Omega-3s also play a huge role in the retina in the back of the eye the photo
01:09:59
receptors in the back of the eye within the retina this again this kind of orange pink tissue in the back that
01:10:05
picks up all the light that you see the colors that you see it sends those signals through the optic nerve to the
01:10:10
brain so the retina is essential so the photo receptors about 50 to 60% of the fatty acid content of the photoreceptor is DHA omega-3 h and so
01:10:26
there have been interestingly enough research showing that diets that have more oily fish those people are less likely to develop macular degeneration and they're less likely to have problems
01:10:37
with diabetic retinopathy if they happen to be diabetic but then a lot of the Publications on using Omega-3s supplements have not seen the
01:10:49
same results when terms of this form of retinal health and there is some insight they're thinking they've kind of figured this out and this is still very early research but so
01:11:03
there is a transporter called the mfsd2a this transporter helps transport specific forms of DHA
01:11:16
omega-3 into BL through the blood brain barrier into neural tissue and they're finding that that same transporter works for the blood retinal barrier as well and so newer studies looking mainly at
01:11:28
Alzheimer's disease but they're doing it on mice and they're formulating a specific type of DHA called Li lysop
01:11:37
phospholipid DHA that binds to that transporter and helps that get into neural tissue and
01:11:44
the current research is showing that with mice at least I haven't found anything in humans but at least with mice that the retinal health is
01:11:51
improving they're having better signals through the retina as well as less risk of things like retinopathy so still very early research but so the omega-3 that I've got in my cup at home is probably
01:12:03
not going to help but the the new versions of Omega 3 that they're working on probably will might and the reason
01:12:10
why the current Omega-3s don't seem to have that effect on the retina is because omega-3 fish oils are in the
01:12:17
form of what is called a tri asog glycerol which your body can convert into liver to get to neural tissue but
01:12:24
it's not very efficient okay there are some forms of so if you are eating fish fish Krill and then like fish eggs do you like sushi yeah so fish eggs are
01:12:37
often on Sushi um fish row those types of like salmon I've read has like up to 1 to 1.7% of these phospholipid type of DHA so not very
01:12:49
much but Krill can be up to about 30% fish eggs can be somewhere between 35 up to like 70% of these phospholipid dhas and your body is able to either turn
01:13:03
those into triog glycerol which is similar to the omega-3 fatty acid supplements or it can turn that into
01:13:10
this lyso phospholipid DHA which your body can transport into neural tissue at a at a better bioavailability what did
01:13:16
you discover when you started taking omega-3 for 90 days as part of that experiment so that was again looking
01:13:22
more at dry eye yeah and and specifically I took first I just looked at hey what's my blood level of Omega-3s right now just by diet and it was pretty low at that time it was like 4.7 or
01:13:36
something like that which you want between 8 and 12% then I started taking I also did
01:13:43
measurements of my dry eye symptoms uh my dry symptoms I took dry measurements that we do in the clinic to diagnose
01:13:50
objectively what's going on with the dry eye the dryness components and then I took it for 90 days
01:13:55
and then I also tested my my blood again at the end and I found that after taking
01:14:01
those Omega-3s that specific formula that it ended up getting to about 99.5% omega-3 it's like a 100 more than
01:14:08
100% increase so it was a dramatic increase in the omega-3 in my blood and my dry eye symptoms also improved now
01:14:15
again that's just an N of one you know I'm just one person uh there's a lot of dry eye is really complicated too what
01:14:22
is dry eye I don't think I've ever had dry eye so dry eyye disease is a disease of the eye I think everybody can have symptoms of dry eye just if you walk outside you know it's a windy day maybe
01:14:33
you're sitting around a bonfire or something smoke hits your eye your eyes can feel a little dry you blink a few
01:14:39
times but dry eyye disease enters a whole different state and dryeee disease occurs when not only is there a there could be a reduced amount of production of Tears it could be that your tears
01:14:52
evaporate too quickly that's a lot lot of people and then what happens is that there's a little bit of damage on the surface of the eye because the the tear film has to stay stable to protect the
01:15:04
tissue underneath if the tears are gone the tissue underneath gets exposed to air
01:15:10
and salt content of your tears ends up going up what we call hyperosmolarity of the tear that higher salt content irritates the surface of the cells and the surface of the eye here on the
01:15:22
cornea it then has little micro damage which your body tries to heal inflammatory proteins come out to try and heal that now again if it's just
01:15:33
a small episode you're walking on the street wind comes up dry your body heals it but if it's a chronic condition
01:15:39
you're dealing with dryness all day long every day for weeks months the inflammatory proteins never go away and the inflammatory proteins start signaling your lacro gland to stop
01:15:51
producing as much tears the inflammation prevents your eye from healing and then
01:15:56
the inflammation can cause the oil glands of the eyelids to start to basically cause more irritation and stop
01:16:03
producing as well is there one food in particular that is in your view the top food for Good Eye
01:16:11
Health so green leafy vegetables what about sweet potatoes sweet potatoes can certainly have help help you with things like vitamin A they've got other nutrients in them I think are really
01:16:23
good um sweet potatoes technically have beta carotene right same thing as carrots if you're deficient in vitamin A
01:16:30
your body will convert that beta carotene to vitam a which is good but uh mainly in green leafy vegetables you can not only get things like beta carotene but you can get lutein and zanthin which
01:16:43
uh are amazing for Eye Health in many ways not just Eye Health but also brain health what about sugar what impact does
01:16:51
because you mentioned diabetes earlier I think if I'm having a sugar in my diet will that have an impact on my eye
01:16:58
Health it can for patients who don't or for people who are diabetic or have elevated blood sugars when you're have too much sugar in your blood it can enter into the eye
01:17:10
it can cause the the lens inside the eye to swell and so with that swelling you can
01:17:15
see a refractive change your power of your glasses contact lenses that can shift and so that can sometimes be a tip
01:17:22
off if you were to see me in the clinic and I know your prescription suddenly change like two steps I'm like why is it
01:17:28
making this big of a change it may be a tip off that hey maybe the blood sugar's
01:17:33
off we have to send you in for like a diabetic workup do people with diabetes suffer more with their Vision they can
01:17:41
uh diabetes is it is devastating for the the health of the eye because with diabetes when your blood sugar is elevated it causes damage to the endothelium of the blood vessels in the
01:17:52
arteries in the back of the eye the things that the back of those things there yeah because the the back of the eye is one of the most highly
01:17:59
vascularized area of your body so because we can because you have blood vessels again on the inside of the
01:18:04
retina you have blood vessels on the backside of the retina and so when people have damage to those blood
01:18:10
vessels the blood the vessels can start to Hemorrhage they can start to have little aneurysms they start to bleed in the back of the eye and then the function of the retinal tissue because
01:18:21
the retinal tissue is not getting the nutrients the oxygen and the nutrients it needs to stay alive and so then
01:18:29
people's Vision can deteriorate you can have a swelling in the back of the eye in the retinal tissue itself we call
01:18:35
macular edema and ultimately if people unfortunately are diabetic they don't know it or they're poorly controlled they can bleed so much in the back of
01:18:46
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it every once in a while my eyelid starts twitching what is that eyelid myoa is that what it's called it is that's the that's the medical definition for it twitching eye I call it twitching eye twitching eyelid like the eyelid starts
01:21:03
going what is that so that is your threshold of your eyelids to Blink is your level of stress you're like holding really tight muscles and so they find
01:21:16
and this is historically even in in textbooks they call it basically The Med medical student twitching eye because
01:21:23
it's usually people who are stressed out people who are not sleeping very well they're fatigued and then people are
01:21:30
drinking way too many stimulants like drinking caffeine so I have a lot of patients who come in they're like I'm having my eyelid twitch and I look over
01:21:36
on the counter and they sure enough have a have an energy drink with them and I'm like okay so that that is largely what it is
01:21:44
some people can have a true BFRO spasm where the eyelids close involuntarily and that's more of an advanced medical
01:21:58
condition so I think if people are having just a little flutter on their eyelid it's usually not a concern it's
01:22:03
just get more sleep stop drinking so much caffeine try to look at your stress levels and that's a tough thing because even myself I remember in college I
01:22:14
remember saying the same thing to my doctor he's like you're just too stressed and I'm like I'm not stressed I'm not I'm doing great then I go home
01:22:20
and I start making a list of everything I'm trying to control in my life I'm tring trying to control this for grades
01:22:25
I'm trying to do this and Excel in athletics I'm trying to do this at home I'm trying to manage this with my
01:22:31
friends and you know halfway through I look at the list I'm like whoa there is so much going on in my life no wonder I actually am stressed I've just I've come so accustomed to it I haven't I didn't
01:22:42
realize it haven't been that self-aware glycom now glycom is something that people over 60 typically
01:22:48
get um from what I've understood m is that preventable at all or is that just a consequence of Aging and what is
01:22:54
glycom so glycom is where the nerve the nerve in the back here that connects the
01:23:00
eyeball to the brain so this thing here yes so the nerve that all of the retinal
01:23:06
cells converge onto the ganglion cells which are essentially sending the information from the eye to the brain and so glaucoma there's different types
01:23:17
of glaucoma but the nerves die for some reason so the nerves at the back here mhm okay those nerves go send the
01:23:30
information back toward the brain so that you can see the challenge is that that nerve if it gets damaged the nerves
01:23:38
die off and when they die you can't get them back so glaucoma again there's different types
01:23:44
of them the most common one that people think about is what's called primary open angle
01:23:49
glaucoma and this is where pressure inside of the eye builds up and if you think of a bike tire if you fill that full of air and it gets to a point where it's so filled the weakest
01:24:02
part of the bike tire blows out mhm and that basically happens with the eye but the weakest part of the eye is the nerve
01:24:08
in the back so that increased pressure pushes on the nerve and slowly pinches it each of the ganglion cells to a point where it starts to die off that's not
01:24:21
reversible is it unfortunately no when you when you lose the ganglion cells they
01:24:27
die we know that pressure plays a role in it the internal pressure of the eye and so most treatments right now for
01:24:33
Goma are focused on treating the pressure but more Publications and research right now are also going into how do we better support the health of the nerve in the back whether that be
01:24:44
through uh blood flow is it better for us to have some sort of nutrients getting to the to the optic nerve to give it more of a robust health and structure to withstand the pressure MH
01:24:58
so there there's more research going into it and the other thing that I heard about when I was I was researching your work is this term eye floaters I'd never
01:25:05
heard about this before what is an eye floater so floaters inside the eye are so many people have these issues and do do you see them at all do you see little black specs when you look left and right
01:25:17
do you see little things probably I'm going to say that maybe sometimes but I can't recall a time as we get older
01:25:24
floaters do naturally start to to occur these are the gel inside the eye called the vitus Vitus humor so opening up the eye
01:25:36
again this large area that holds the shape of the eye this is the vitus humor and it's mostly water collagen and a little bit of hyaluronic acid but it's like a
01:25:48
jelly but as we get older this gel starts to break down and the collagen begins to Clump and it sits there suspended in whatever's gel or fluids
01:25:59
left and so when people go outside it's a bright sunny day they look at the computer screen it's a back you know
01:26:06
bright backlight they'll see these little specks floating around and they'll shift their eyes left and right and you'll see it continue to drift and
01:26:12
it gets really annoying it's like looking at a gat or a little bug flying around and really what's happening is
01:26:18
the light is hitting those collagen clumps it's casting a shadow on the retina and you see those floating spots
01:26:23
the concern is that some people develop suddenly a whole bunch of floaters and if you have a whole bunch of floaters that could be because the gel which is attached to the retina in
01:26:37
the back of the eye that gel can tug on the retina and create a small tear or it
01:26:45
can create a full Detachment of the retina can pull the retina off from the back of the eye usually though if you
01:26:52
ever have symptoms of a flash of light like a lightning bolt is going off somewhere in Your Vision that no one
01:26:58
else saw or you're having a dark shadow coming down from the top of your top of your vision or rising up from the floor or from the side that would be an indication that perhaps a sudden change
01:27:11
has happened and you should see a doctor as soon as possible but otherwise the development of those small little
01:27:16
floating spots those gradually occur with age and is there a way to treat them so there are two Surgical procedures to try to get rid of them
01:27:27
however most surgeons won't want to do them because there's always a higher risk of damage causing damage or other complications in the eye how many people
01:27:38
are likely to experience these eye floaters in their lifetime basically every a decade of life you gain another
01:27:44
10% chance of having these floaters so by the time most people yeah by the time you're 80 years old you have an 80%
01:27:50
chance of having these floaters most people that I see coming in because of a complaint of floaters are usually in
01:27:56
their 40s 50s I've heard you talk about pineapple helping to cure floaters so there there is a a study that came out several years ago
01:28:07
that looked at using a type of supplement called Brolin and that's found in pineapple and
01:28:15
that was a study that looked to see if people eating pineapple could reduce their
01:28:20
floaters that study was not the best study ever done uh they did it was kind of a a I think
01:28:28
it makes me excited that at least there's PE there's researchers looking into hey how is there a way we can get rid of these floaters because they can
01:28:34
be really annoying if they're really large they can obstruct people's Vision a more recent publication from
01:28:41
2021 looked at a different formulation of different enzymes and vitamin supplements that include vitamin C Eline zinc
01:28:54
these can help preventing the glycation of collagen and specifically within the vitus of the eye and they did find after six months of supplementation that people's symptoms of floaters reduced
01:29:08
it's only one study and I want to see more but that right now is probably the only uh supplement on the market that
01:29:15
has probably the best research behind it being it was a placebo control trial the pineapple study was in 2019 in the
01:29:21
Journal of American Science and the study said that people who had three slices of pineapple a day had a 75% eye
01:29:27
floater Improvement but you're saying that that study is not super robust the medical community the iare community we
01:29:35
don't look at that with having the most scientific validity we do want to see more research in that area anecdotally I've had people certainly
01:29:47
message me on email and on YouTube and on Instagram saying that it did help them but it's hard to say if it truly Placebo or not it's helpful I get
01:29:59
five one in my left yeah I just one day I saw it come in what you need to do is you need to get the pineapple yeah what is it that you have it conly
01:30:10
come in I remember one day it came in it really freaked me out didn't know what it was yeah I thought I was getting some sort of disease or something I went on
01:30:16
line and it was quite normal yeah but yeah occasion it would just come and I can kind of shift it around I can look
01:30:22
at it and like shift it around look in a c Direction but it's not there all the time just will suddenly just
01:30:28
drift into my if somebody even especially for anybody who's having floaters or seeing
01:30:35
a spot like that I think it's still really important to have it evaluated because there is a chance it's not a
01:30:42
huge chance but it's like a 5% that you could have a small tear or a hole in the far edge of the eye when the gel
01:30:48
separated mhm and in those cases then if it's needed they can use a laser to just
01:30:54
zap it and Tack it down so that you don't develop a retinal detachment because if you get a retinal detachment
01:31:01
it's an urgent procedure where they need to repair the retina and get it back into place because it can otherwise lead to permanent vision loss you know when you get something in your eye and it
01:31:12
gets annoying I had it the other day when I was in bed in in La I was I I had something in my eye and I could just
01:31:17
feel it and you know you you look in the mirror and you can't see it and you someone tries to blow in your eye and
01:31:23
get it out and doesn't work either and you just feel you can feel it for maybe like 30 minutes an hour what's the best
01:31:28
thing to do in that situation to get rid of that feeling in your opinion and is it like a hallucination because I can't
01:31:34
see anything there so the eyeball it has some of the most nerve endings on your body so even just something small piece of dust gets on your tier film you can feel that and it can really irritate the
01:31:46
eyes some of the easiest things to do are using eye drops you know get a get even just over the counter ey drops using those to rinse the eye if somebody gets a chemical in the eye then you
01:31:57
really want to rinse the eye really good with with just even tap water you want to get water to flush it out you know if
01:32:03
some you know obviously you're at a a workplace they have wash stations for those sort of things so that's going to
01:32:09
be the most important if the eye remains red irritated the body will produce more
01:32:14
mucus to try and fix the problem and so a lot of people if you get a little irritation it just never seems to go away it's because some there's inflammation developing on the surface
01:32:26
your body's producing more mucus things your body can sense that there's more swelling there so the best thing to do
01:32:31
is rinse it out and goes to the eye doctor especially if it's not getting better so how often do you think I
01:32:37
should get my eyes tested yearly every year you should I say that because they've had
01:32:45
multidisciplinary um of different Eye Care Professionals not just ey care but different medical professionals in different fields look at the statistics and again it's the fact that it is one
01:32:56
of the easiest least invasive medical procedures you can do to detect the most medical conditions that can potentially prevent you from
01:33:07
having more serious comorbidities later in life Dr Joseph what's the most important thing we didn't talk about
01:33:15
that maybe we should have talked about today I think probably the one of the biggest things that I personally really like to reflect
01:33:26
on we've touched on diet a little bit but I think diet and lifestyle paying attention to how much
01:33:34
not only what you eat how much you eat exercise sleep hydration focusing on these sort of things can have a ripple effect on
01:33:45
the eyeball but so many other parts of the body and that the eyes are an extension of your brain and what's good for the eyes is also good for the heart it's also good for your brain and so I
01:33:57
think we need to be really aware of that and how important the eyes are for your
01:34:03
learning for your development for your risk if if you have poor vision your risk of developing demena and Alzheimer's in later years is greater that vision and eyesight is
01:34:15
really important for the development for children and their minds and so we we need to be aware of
01:34:22
how all of that is connected and how our lifestyles on devices all the time and being indoors so much can also have an impact so seeing an eye doctor on a
01:34:34
regular basis is really important even if you feel like your vision is great and you see fine you don't want to lose
01:34:43
that we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're going to be leaving it for
01:34:49
and the question that has been left for you is what is your most important early
01:34:58
memory that you've ever had ever one that does impact me on a regular basis is just making
01:35:11
friends when I was a kid I didn't have many friends and I remember finely making friends from sport
01:35:24
and just having people over to play have sleepovers and finally feeling like I had companionship of some kind I think
01:35:37
it kind of proved that I was that I that I mattered that I had value was just or being seen being that
01:35:51
I had a role in this world Beyond just me being on my own did your childhood tell you
01:35:59
otherwise I have a memory that I've shared mainly with my therapist where I was in trouble I was
01:36:08
grounded to my bedroom I didn't feel safe leaving my bedroom because my older brother bullied
01:36:14
me at that age and I felt that I did not matter that I was not wanted that I was only in the
01:36:33
way and I think over the course of my life that feeling that I needed to perform Excel was
01:36:47
the only way for me to get attention to prove that I had value and worth and so I think that's driven me to excel in academics to excel in
01:37:05
extracurriculars it was a very subconscious thing something I was not aware of and I only recently in the last year
01:37:14
have come more to terms with those early experiences in my life and how they maybe have driven
01:37:20
me and it's goes through a lot of work to reflect on those experiences and make friends with that part of your life and come to terms that like no I've grown up
01:37:32
I do matter I do bring value I am worthy of friendship and love those are tough real things that I think internally we batter battle and
01:37:48
sometimes don't even realize it how much of that early experience inspired you to pursue the line of work that you do now I know that
01:38:00
you said it pushed you to excel but specifically focusing on the eyes somewhat connected and when I was a kid again I
01:38:11
was lonely I was an indoors kid i' played a lot of video games watched movies my brother he was the fisherman
01:38:18
Outdoors kid when I turned 13 entering into junior high my mother wanted me to pick a sport and so I did the manly thing I want to play football you know American
01:38:30
football I'm gonna tackle people it's hard to play tackle football with thick glasses on you had thick glasses mhm I
01:38:38
was a I was a nerdy kid sat inside all day again I was inside had thck glasses because that was
01:38:43
myopic I went to the eye doctor got fit for contacts and fit being fit in contacts changed me because suddenly I could play
01:38:55
sports making friends for the first time in a long time to having self-confidence because
01:39:04
of that and having that level of self-confidence I started to attract the attention of the opposite sex girls start paying attention to me and at age of 13 that was like the most important
01:39:16
thing in the world and so continuing to grow up I was always was fascinated with eyes with contact lenses and I knew in later High School when people are like hey what are you
01:39:29
going to do when you grow up what are you going to do for college I'm like I don't really
01:39:34
know but when I see the dentist I don't like that guy he pokes and prods and makes my gums bleed but when I see the
01:39:41
eye doctor that guy's cool every part of the eye exam is like black magic I thought you know what I could be that guy and so that definitely influenced my
01:39:53
that amazing experience influenced me and I think most eye doctors have some experience like that where their life was changed by what an amazing eye doctor they had before and they just
01:40:04
want to pass that on I want to help people have an amazing experience with their eyesight and
01:40:10
experience the world and have more freedom in their life to pursue education to experience and see just the beauty of color nature
01:40:24
really to experience the world and so I really want to just give that as a gift to as many people as I
01:40:30
can and I guess the confidence that it gives those people as well as it did for you at a young age MH isn't to be
01:40:38
underrated well thank God you did because you know you've helped many millions of people with a wide variety
01:40:44
of eye related issues and conditions and helping them understand both the more superficial elements of their eyes but
01:40:51
also the more sort of deeper Progressive disas es that might risk taking away their freedom in the ways that you've
01:40:57
described just there um but I just want to say a big thank you for um let me think of a nice eye related pun allowing
01:41:05
me to see more clearly as it relates to the subject of Eye Health and vision and
01:41:12
and everything that's interconnected so thank you so much Joseph you Stephen appreciate you man this is
01:41:20
great I don't know how to say this you in a way that you're going to understand but perfect Ted is banging I'm an
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founders of perfect Ted wanted to create an energy drink that wouldn't create that horrible crash cycle that many of
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