Dr. Jeffrey Goldberg: How to Improve Your Eye Health & Offset Vision Loss

Introduction

In this section, Andrew Huberman introduces the podcast and his guest, Dr. Jeffrey Goldberg. They discuss the topics that will be covered in the podcast.

Welcome to the Huberman Lab Podcast

• Andrew Huberman introduces the podcast and its purpose.

• The podcast discusses science and science-based tools for everyday life.

Introduction of Dr. Jeffrey Goldberg

• Dr. Jeffrey Goldberg is introduced as a clinician and laboratory scientist who specializes in diseases of the eye such as glaucoma, retinitis pigmentosa, and macular degeneration.

• He is also an expert on vision-related topics such as corrective lenses, sunlight exposure, eye exercises, surgical procedures like LASIK surgery, contact lens care, dry eyes remedies, nutritional approaches for maintaining good vision health etc..

Topics Covered in the Podcast

• The benefits and drawbacks of wearing corrective lenses such as contact lenses or eyeglasses for reading are discussed.

• The benefits and detriments of sunlight exposure are discussed including how it can help reverse or prevent myopia nearsightedness but also how it can lead to cataracts which impair vision.

• Various tools for maintaining and improving Vision across lifespan ranging from behavioral tools so specific Vision tasks and exercises for the eye that you can do that are known to improve or maintain your vision as well as specific surgical procedures such as LASIK surgery are discussed.

• Eye exercises frequency,duration,best practices around Lasik surgery,cleaning contact lenses,dry eyes remedies,nutritional approaches for maintaining good vision health are discussed.

• The podcast also covers the most Advanced Technologies for preventing and offsetting vision loss due to diseases such as glaucoma, retinitis pigmentosa, and macular degeneration.

Conclusion

• Andrew Huberman concludes the introduction by emphasizing that this podcast is separate from his teaching and research roles at Stanford but part of his effort to bring zero cost to Consumer information about science and science-related tools to the general public.

Sponsors

In this section, Andrew Huberman thanks the sponsors of the podcast.

Maui Nui Venison

• Maui Nui venison is introduced as a sponsor of the podcast.

• The importance of high-quality protein in one's diet is discussed, along with how Maui Nui venison can help achieve that goal.

• The deliciousness of Maui Nui venison products like bone broth, ground venison, and venison steaks are mentioned.

• A discount code for 20% off your first order is provided (mauinuyvenison.com/huberman).

Element Electrolyte Drink

• Element electrolyte drink is introduced as a sponsor of the podcast.

• The importance of electrolytes in our body's cells, especially nerve cells or neurons, is discussed.

• How element provides an easy way to ingest correct ratios of electrolytes without consuming extra calories or sugar is discussed.

• The deliciousness of element electrolyte drink and how to consume it are mentioned.

Conclusion

• Andrew Huberman concludes the sponsor section by thanking Maui Nui venison and Element for sponsoring the podcast.

The Importance of Sleep and Eye Health

In this section, the speaker discusses the importance of sleep for mental health, physical health, and performance. They also introduce a product that can help optimize sleep by regulating mattress temperature.

Smart Mattress Covers for Optimal Sleep

• Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity.

• Temperature is a key component to getting a great night's sleep.

• Core body temperature needs to drop by 1-3 degrees to fall and stay deeply asleep.

• Core body temperature needs to increase by 1-3 degrees to wake up feeling refreshed.

• With Eight Sleep mattress covers, you can cool or heat your mattress at the beginning, middle, and end of your night in order to optimize your night's sleep.

Eye Health Discussion with Dr. Jeffrey Goldberg

In this section, Dr. Jeffrey Goldberg joins the speaker for a discussion on vision and eye health. They cover topics such as when children should have their first eye exam and how regularly we should all be doing eye exams.

Eye Exams for Babies

• Every baby gets an eye exam or should be getting an eye exam.

• The first eye exam is done right after birth in the nursery.

• The doctor checks for a red reflex which is very normal.

• If there are any diseases in the eye that can present even in newborn babies including retinoblastoma (the most common pediatric eye cancer), those babies won't have a red reflex in that eye; it'll be kind of whitish or gray reflex.

Eye Exams Through Childhood

• Most babies other than their pediatrician doing that red reflex check when they're in for their regular well-child checks don't need to worry about getting an eye exam.

• As babies age through those first couple of years, it's normal for them to have roving eye movements and be searching their environment.

• If parents start noticing the baby isn't making eye contact or looking where a sound is, certainly if they have what's called nystagmus like these rapid flickering alternating eye movements, anything like that will trigger an eye exam.

• Most kids get their first comprehensive eye exam around early elementary school unless they are presenting with one of a number of features that parents often pick up on.

Early Eye Exams

In this section, the speaker discusses the importance of early eye exams for children and how they can help detect conditions like amblyopia and strabismus.

Importance of Early Eye Exams

• Amblyopia is a disease condition that can occur when an eye is not properly connected to the brain.

• Children in elementary school may complain about not being able to see the board or teacher up front, which could indicate nearsightedness and trigger an exam.

• Misalignment of the eyes (strabismus) can be detected through a screening exam done in elementary school.

• It's important to correct misaligned eyes early on because if left untreated, it can lead to permanent vision loss.

Correcting Misaligned Eyes

• The earlier misaligned eyes are corrected, the better chance there is for full recovery of normal vision.

• Misalignment can be detected by taking a picture where one eye has red-eye reflex and the other doesn't or noticing that a child's eyes are turning in too much.

• If misalignment isn't corrected during childhood development, it can cause permanent loss of vision due to failed development of proper connections from one eye into the brain.

• Even if misalignment is detected later on in childhood or early teen years, it's still worth trying to retrain the weaker eye and realign muscles so they work together.

Brain Plasticity and Critical Period Plasticity

In this section, the speaker discusses brain plasticity and critical period plasticity in relation to vision development.

Brain Plasticity

• The brain is very plastic during early stages of development, which means it's changing rapidly.

• Brain plasticity is best studied in the visual system, where critical period plasticity occurs.

• Critical period plasticity is a type of brain plasticity that occurs during development and can reopen with new therapies.

Correcting Vision Problems

• Even if an amblyopic eye is corrected and realigned with the other eye, some children may never recover full depth perception or stereopsis (the use of two eyes to see depth).

• The speaker shares a personal story about seeing double after swimming without goggles and how patching one eye helped correct the problem.

Misaligned Eyes and Brain Development

The speaker discusses the impact of misaligned eyes on brain development, particularly in cases where there is a misalignment of information coming into the two eyes.

Misaligned Eyes and Brain Development

• Even just a few hours of misalignment of information to the two eyes early in development can permanently rewire the brain unless there are some corrective measures such as patching up one eye.

• For most kids, it would be very unusual for an hour or even a day of practicing with one eye closed to trigger this kind of either strabismus (misalignment of the eyes) let alone amblyopia (weaker eye).

• If someone had years of intermittent isotropia or turning in/out of the eyes that was accumulating damage leading up to double vision, then patching may be necessary.

• For 99.9% of kids who get a corneal scratch or anything rare like that, nothing to worry about. It's unfortunate that we can't tell which kid has been having intermittent amblyopia because we don't do standard eye exams on every five-year-old who's not complaining.

Environmental Conditions and Visual System Wiring

The speaker discusses how environmental conditions affect visual system wiring and whether there are any recommendations from scientific literature regarding healthy visual environments.

Environmental Conditions and Visual System Wiring

• Experimental animal data shows that limiting vision to close range causes eyeball lengthening and near-sightedness.

• Myopia is common among Asian populations, including Asian Americans. Stanford is starting to get thoughtful on myopia control.

• There is a lot of research on myopia control, including outdoor time and atropine eye drops.

• The American Academy of Ophthalmology recommends that children spend more time outdoors to reduce the risk of developing myopia.

The Relationship Between Near Work and Nearsightedness

In this section, the speaker discusses the relationship between near work and nearsightedness. They explain that previous studies have suggested that doing too much near work as a child can lead to nearsightedness, but recent studies suggest that it may be more about the kind of light we're getting into our eyes.

Near Work vs. Outdoor Lighting

• Doing too much near work as a kid can lead to developing nearsightedness.

• Recent studies suggest that it may be more about the kind of light we're getting into our eyes.

• Studies have asked kids how much time they spend indoors in indoor lighting versus how much time they spend outdoors playing in the yard.

• Spending time outside in sunlight provides Full Spectrum Lighting from the sun which is different from typical indoor environment lighting.

Randomized Controlled Trials

• Randomized controlled trials have been conducted where kids are intentionally spending time outdoors versus standard life which is often much more indoor time.

• Kids who spend more time outdoors are progressing in their nearsightedness less than those who spend more time indoors.

• The gold standard for answering these kinds of questions are randomized controlled trials with a control group that's not getting the intervention.

Optimal Time Outdoors

• There seems to be some dose dependence when it comes to spending time outdoors, but there isn't enough evidence yet to determine what's the right dose or if there's an upper limit.

• It's important to note that far viewing is harder to achieve indoors, while outdoor activities provide a mixture of near and far viewing.

Importance of Morning Sunlight

In this section, the speaker emphasizes the importance of getting morning sunlight in our eyes to set our circadian rhythm.

Benefits of Morning Sunlight

• Getting some morning sunlight in our eyes helps set our circadian rhythm.

• The blue light from the sun is important for regulating our sleep-wake cycle.

• Exposure to morning sunlight can help improve mood and energy levels throughout the day.

Development of Nearsightedness

In this section, Dr. Huberman discusses the development of nearsightedness and how it changes with age.

Nearsightedness Development

• The development of nearsightedness happens a lot until age 10, a little more through age 20, and a little more than that into the 20s up to 30.

• By later ages, your prescription might be changing a quarter of a diopter or half a diopter.

• Most of the action on nearsightedness development is happening in younger ages.

Light Modulation for Nearsightedness in Older People

In this section, Dr. Huberman discusses whether light modulation can help prevent nearsightedness in older people.

Premise of Intervening in Older People

• The premise of intervening in an older person using light modulation for nearsightedness is probably not so strong.

• There are many health benefits to exercise and getting outdoors, but there isn't really a strong premise that you're going to change your glasses prescription once you're aging into your 40s, 50s, and beyond.

Eye Health Do's and Don't's

In this section, Dr. Huberman talks about some do's and don't's for eye health across the lifespan.

Environmental Conditions Detrimental to Vision Health

• It's not great to be exposed to extremely bright light; people who weld wear eye shields.

• Eye safety is something that we don't talk about enough; our eyes are delicate and subject to degenerative disease and injury.

• People who are working in certain industries, doing metal grinding, gardening, or cutting things are at risk for eye injury or trauma.

Importance of Eye Safety

• Wearing prescription glasses or goggles can help prevent unnecessary eye injury or trauma.

• Eye safety is important at all ages.

Eye Protection and Cleanliness

In this section, the speaker discusses the importance of eye protection and cleanliness. They also provide recommendations for proper eye washing techniques.

Importance of Eye Protection

• The eyes are an outgrowth of the brain and need to be protected against trauma.

• Rubbing your eyes can cause pressure that may lead to temporary blindness.

• Losing vision temporarily can be frightening as we are heavily dependent on our vision.

Eye Cleanliness Recommendations

• For most people, regular eye washing is not necessary as tears contain enzymes that help break down bacteria and bacterial toxins.

• Eyelids and eyelashes can accumulate dead skin bits called scurf, which can lead to inflammation known as blepharitis. Doing some eye scrubs with a dilute No More Tears baby shampoo or using little pads sold over-the-counter can help clean them.

• Ideal eye wash is sterile saline solution or artificial teardrops. Spritzing into your eyes or rinsing with saline solution helps remove dirt or lashes that won't come out.

Proper Eye Washing Techniques

• When doing an eye scrub, gently close your eyes without scrunching them too tight so you don't bury the eyelashes when you do the roots of the eyelashes. Lightly rub with a dilute No More Tears baby shampoo.

• Hold the lid open and give it a little spritz if you feel like you've got something in your eye such as dirt or a lash that's not coming out.

The Importance of Eye Care

In this section, the speaker discusses the importance of eye care and the difference between optometrists and ophthalmologists.

Eye Exams in Adults

• Optometrists and ophthalmologists have different but overlapping roles in eye care provision.

• It is important to get regular eye exams even if you are not experiencing any problems with your vision.

• Optometrists are more accessible than ophthalmologists, but both can diagnose and prescribe treatments for many eye diseases.

• Optometrists typically provide primary care and screening exams, while ophthalmologists specialize in surgical procedures.

Screening for Eye Diseases

• It is good to get some kind of screening exam for eye diseases like glaucoma, especially as you age.

• Optometrists can check your eye pressure using a puff test to screen for glaucoma.

• Ophthalmologists can also check your eye pressure using a technique called ballottement.

Accessing Eye Care

• Access to care is the most important element when it comes to getting regular eye exams.

• If you are not experiencing any symptoms or problems with your vision, you may not need to see an eye care provider until later in life.

• However, it is still important to get screened regularly for common eye diseases.

Eye Pressure and Presbyopia

In this section, the speaker discusses eye pressure and presbyopia. They explain how optometrists and ophthalmologists check eye pressure during a comprehensive screening exam. The speaker also defines presbyopia as the loss of ability to focus on near objects due to the stiffening of the lens inside our eyes.

Eye Pressure Check

• Optometrists and ophthalmologists check eye pressure during a comprehensive screening exam.

• They look at the surface of your eyes, including eyelids and lashes, to ensure everything is healthy.

Presbyopia

• Presbyopia is the loss of ability to focus on near objects due to the stiffening of the lens inside our eyes.

• As we age, we lose our ability to flex our lens, relax it or refocus it from distance to near.

• Most people around age 40 start needing reading glasses even if they can see fine at distance without prescription glasses for distance.

• Reading glasses are used as a booster for near vision when you need extra magnification for reading or other close-up work.

Using Glasses as a Crutch

In this section, the speaker talks about using glasses as a crutch and shares their personal experience with readers.

Personal Experience with Readers

• The speaker shares their personal experience with readers after finding a pair in their closet at age 42.

• They got addicted because good vision is enjoyable and relaxing.

• The musculature responsible for moving the lens and focusing the eye can relax with readers, leading to more energy being devoted to what we're looking at.

Problems with Using Glasses as a Crutch

• The speaker discusses problems with using glasses as a crutch, including forgetting how to use our natural ability to focus and move our eyes.

The Use of Reading Glasses

In this section, the speaker discusses the use of reading glasses and whether they accelerate dependence on them.

Dependence on Reading Glasses

• Studies show mixed results on whether using reading glasses accelerates dependence on them.

• Good vision is addictive, and people may become psychologically dependent on it.

• As people age, their ability to shape the lens weakens, and they need stronger magnifiers to read up close.

• People typically start using reading glasses in their 40s when they have trouble seeing things up close.

Delaying the Use of Reading Glasses

• It's ideal to give your retina and brain the sharpest visual signals possible by using reading glasses.

• Exercising eye muscles by not using strong readers or not using them as often may slow down the progression from weaker to stronger readers.

• However, constantly undercutting reading glasses can feed blurry information to your retina and brain, hampering your vision.

Eye Exams for Readers

In this section, the speaker talks about getting an eye exam if you're having trouble seeing things up close.

Standard Eye Exam

• A standard eye exam includes a full screening exam that checks for all main diseases.

• If you feel like your glasses aren't doing it for you in a year or three years, come back for another exam.

• If someone is already using readers, they should get an eye exam to set up a routine for ongoing eye care.

Delaying the Use of Reading Glasses

• It's not necessary to delay the use of reading glasses if they help you see better.

• Using readers or prescription glasses that work best for you won't significantly change how your prescription changes over time.

Night Blindness and Latent Hyperopia

Dr. Andrew Huberman discusses night blindness and latent hyperopia, which can make it hard for people to see at night without corrective lenses.

Stationary Night Blindness

• Mutation for stationary night blindness was identified in the Colusa horse breed.

• Horses with this mutation cannot see well at night and are easily approached by humans.

Driving at Night

• Dr. Huberman does not have stationary night blindness but gets fatigued when driving at night.

• He sometimes wears plus one readers to remove fatigue even though he is looking more or less at a distance.

• Some conditions make it hard for people to see at night, requiring corrective lenses.

Latent Hyperopia

• Latent hyperopia is more common than congenital stationary night blindness.

• The lens inside some people's eyes is tuned for being beyond infinity, making their vision slightly out of focus at distance.

• People with latent hyperopia constantly use their focusing muscles, especially when tired or after drinking alcohol.

• Wearing plus one readers can help correct latent hyperopia.

Inside Tracker Sponsorship

Dr. Andrew Huberman talks about the benefits of getting regular blood work done and introduces Inside Tracker as a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and reach your health goals.

Benefits of Blood Work

• Regular blood work can assess factors that impact immediate and long-term health that cannot be assessed otherwise.

Inside Tracker Platform

• Inside Tracker analyzes data from your blood and DNA to provide information about hormones, metabolic factors, lipids, etc.

• The platform assesses what sorts of behavioral, nutritional, or other interventions you might want to use to bring those numbers into the ranges that are appropriate and optimal for you.

• Use code "huberman" at insidetracker.com/huberman to get 20% off any of Inside Tracker's plans.

Corrective Lenses and Eye Position

In this section, the speakers discuss the impact of corrective lenses on eye position and muscle use. They also touch on the importance of natural vision and sunlight exposure.

Corrective Lenses and Eye Position

• One prism lens can be a crutch that affects eye position.

• Natural vision should be prioritized over relying on active lenses.

• There is a distinction between muscles inside and outside the eye that affect eye position.

• Intermittent esotropia or turning in of the eyes can cause issues with eye position.

Under Correction vs Prism Correction

This section discusses under correction versus prism correction for yoking eyes straight together.

Under Correction vs Prism Correction

• Optometrists often intentionally under correct to help exercise yoking muscles.

• Inadequate correction can lead to eye strain and headaches from inside-eye muscle use.

• Exercise is important for yoking muscles, rather than using prisms to force it.

• Plus lenses may be used in children to prevent over-exercising inside-eye muscles.

Medical Care Providers

The speakers discuss how medical care providers approach treatment for vision issues.

Medical Care Providers

• Optometrists are often the first place to start for vision issues.

• Treatment is not always perfect science, but providers do their best to give the right approach.

• Different approaches may be taken for different individuals, even with the same issue.

Eye Exercises and Vision Performance

In this section, the speaker discusses eye exercises and their benefits. He explains that doing pencil push-ups can help improve convergence insufficiency, which is the inability to properly turn eyes in. The speaker also talks about smooth pursuit eye movements and how they can be disrupted after a concussion. He suggests that doing exercises like pencil push-ups can help regain control of eye movements.

Pencil Push-Ups

• Pencil push-ups involve taking a pen or pencil, looking at it at arm's distance, slowly moving it towards your nose while focusing on it, then moving it back out again.

• Doing 10 to 25 repetitions of pencil push-ups once or twice a day for a few times a week can help exercise eye muscles.

• Pencil push-ups are not harmful and may slow down the progression to presbyopia or needing reading glasses.

• People with convergence insufficiency or double vision at near but not at distance may benefit from doing pencil push-ups.

Smooth Pursuit Eye Movements

• Smooth pursuit is the ability to follow an object smoothly with your eyes.

• After a concussion, smooth pursuit eye movements can become choppy and disrupted.

• Doing exercises like pencil push-ups can help regain control of eye movements after a concussion.

Vision Performance Center

• The speaker mentions that there is an area of science focused on understanding how to move people from normal vision to super-normal vision.

• Athletes have faster visual reflexes and higher visual acuity than non-athletes, but it is unclear how much of this is genetic versus trained.

• There is evidence that training using special goggles that black out vision for short periods of time can improve performance in passing tasks.

Training Vision for Supernormal Performance

In this section, the speaker discusses the idea of training and understanding the biology of training to get eyes from normal to supernormal performance. The discussion also touches on a new program at Stanford through the department of Ophthalmology that is linked up with human performance.

Understanding Human Performance

• There has been a lot of focus over the years in human performance.

• A new human performance Alliance and Center has been established.

• The speaker gives an example of how understanding vision can help diagnose mild concussion in athletes.

Normal vs. Supernormal Vision

• Studying and understanding what's the difference between normal and supernormal vision.

• Exploring ways to measure that difference and ultimately train into that difference.

• This could be exciting not just for athletes but also for regular people who want to improve their vision.

Defining 20/20 Vision

• 20/20 vision means you can read the smallest letters at 20 feet away that an average healthy person can read at 20 feet away.

• Worse than 20/20 vision would be 20/25, 20/40, or even as low as 2200 (which is considered legal blindness).

• Better than normal vision is possible, such as having 2015 or even 2010 vision.

Variations in Visual Acuity

• Visual acuity can differ dramatically between two eyes in most healthy people.

Vision, Optics, and Contact Lenses

In this section, the speaker discusses vision and optics. They explain how newborn babies have poor eyesight but can still see some things. The speaker also talks about visual acuity and how our eyes work to fill in gaps in our peripheral vision. Finally, they discuss contact lenses and their advantages over glasses.

Newborn Eyesight

• Newborn babies have poor eyesight.

• Hawks, raptors, owls that hunt have much better vision than humans.

• There is potential for humans to have better than 20/20 vision.

Visual Acuity

• Visual acuity is the ability to see fine details of an object.

• Our highest visual acuity is in the center of our vision.

• Our peripheral vision has lower visual acuity.

Contact Lenses vs Glasses

• Contact lenses can change tear dynamics on the surface of your eye.

• Contacts decrease oxygen diffusion onto the cells on the surface of our eye.

• Most people can tolerate contact lenses well when they are younger.

• Contacts correct different elements of the shape of your eye compared to glasses.

• Contacts can correct higher order aberrations that glasses cannot correct.

• People may experience a higher quality of vision with contacts compared to glasses correction.

Risks Associated with Contact Lenses

• Wearing contact lenses may be detrimental because it changes how tears interact with the cornea of your eye.

• As we age, we may have less tear film reserves making contacts less tolerable as we age.

• Cleaning contacts properly is important because they can trap bacteria or fungus which could lead to corneal infections.

Contact Lenses and UV Protection

In this section, the speaker discusses the importance of being attentive to the recommended use and cleaning of contact lenses. They recommend using daily disposable contacts to reduce the risk of bacterial infections. The speaker also talks about the importance of blocking UV light in eyeglasses and contact lenses.

Recommended Use and Cleaning of Contact Lenses

• It is important to be attentive to whether you are tolerating contact lenses well.

• Daily disposable contacts are recommended as they reduce the risk of bacterial infections.

• Sleeping in contacts overnight increases the risk of bacterial infections due to reduced oxygen flow.

• As people age, they may become less tolerant to wearing contacts for extended periods.

UV Protection in Eyeglass Lenses and Contacts

• UV light can have adverse effects on our eyes, including accelerating cataract formation.

• Blocking UV light is standard in every pair of eyeglasses.

• Blue blockers are different from UV blockers and have become popular during the pandemic due to increased screen time.

Blue Light and Bright Lights at Night

In this section, the speaker discusses blue light and its effects on melatonin production. They also talk about avoiding bright lights at night for better sleep.

Effects of Blue Light on Melatonin Production

• Avoiding bright lights late at night is important for normal melatonin production.

• Blue blockers may help with melatonin production but avoiding bright lights is more important.

Avoiding Bright Lights at Night for Better Sleep

• Bright lights at night can suppress melatonin production and affect sleep.

• Avoiding bright lights late at night is important for normal melatonin production.

Eye Health and Sunlight Exposure

In this section, the speaker discusses how glasses that react to UV light work, why they don't work in cars, and the benefits of morning sunlight viewing. The speaker also talks about what people who don't wear corrective lenses can do to protect their eyes from UV light.

How Glasses That React to UV Light Work

• Glasses that react to UV light are called transitions.

• They turn dark when exposed to UV wavelengths.

• These sunglasses won't work in a car because standard car glass filters out UV light.

Benefits of Morning Sunlight Viewing

• Low solar angle sunlight viewed for 10 minutes a morning is not harmful to the eyes.

• It's only when the sun is directly overhead that we get a lot of UV exposure.

Protecting Eyes from UV Light

• People who don't wear corrective lenses can wear brimmed hats or sunglasses outside.

• Wearing sunglasses outside may also be more comfortable.

• A wide-brimmed hat can help keep sun off your face and prevent skin cancer on areas like cheeks and nose.

Sensitivity to Light and LASIK Surgery

In this section, the speaker discusses sensitivity to light and whether eye color affects it. The speaker also briefly touches on LASIK surgery.

Sensitivity to Light

• There may be a correlation between eye color and sensitivity to light due to differences in iris muscles.

• People with blue or light-colored eyes may have more sensitivity than those with darker eyes.

LASIK Surgery

• The speaker does not provide much information on LASIK surgery but mentions it briefly.

LASIK Eye Surgery

In this section, the speaker talks about how LASIK eye surgery works and who can benefit from it.

How LASIK Works

• The Lasik procedure reshapes the cornea by ablating or getting rid of a little ring or rim of that corneal tissue.

• If you were too steep on your cornea, then you're flattening it out by shaving off a little bit of the tip of that basketball.

• Lasik procedures can correct not just regular aberrations but also some higher-order aberrations.

• Wavefront-guided Lasik uses light waves to measure with exact localization exactly how much and where to laser for each individual eye.

Who Can Benefit from LASIK

• A few percent of patients may have dry eye problems after Lasik because it interferes with those corneal nerves.

• For people who already have dry eyes, Lasik might not be a good idea.

• People who are very athletic or spend a lot of time doing athletics may be quite irritated to deal with glasses or contacts.

• People who have severe prescriptions really change their daily lives by getting out of glasses or contacts and taking advantage of Lasik.

Children and LASIK

• It is ideal not to do Lasik on children or even young teenagers because they are more likely to change the shape of their eyes while still growing.

• You want your eyeglasses prescription to remain stable for at least two or three years before considering Lasik.

Cost of LASIK

• Lasik costs more than a pair of glasses, but it doesn't cost more money than 10 pairs of prescription glasses over the course of a decade or two.

• There is a cultural element to not wanting to wear glasses and contacts.

Dry Eye and Tears

In this section, the speaker discusses the underlying causes of dry eye and the different components of tears.

Causes of Dry Eye

• Dry eye is caused by a deficiency in the lacrimal gland that produces tears for the eye.

• As we age, our tear quantity and quality go down, which can exacerbate dry eye symptoms.

• We have two major elements to tears: salt water and essential oils. The salt water part is made primarily by the lacrimal gland, while the oils come from other types of glands including glands in our eyelids called meibomian glands.

Artificial Tears

• The eye drop industry has solved replacing the salt water part of our tears with artificial tears that are available over-the-counter.

• Preservative-free artificial tears are also available for those who need to use them frequently.

• However, as an industry, we haven't figured out how to effectively replace or treat the oil part of our tear film.

Effects on Activities

• Activities such as reading on a computer or staring at a screen can cause us to blink less frequently, which can lead to less effective redistribution of tears and squeezing out less oils.

• Aging also affects our eyelids and oil glands, making it harder for them to produce good-quality oils.

Management

• For most people with dry eye, regular over-the-counter artificial teardrops are sufficient management.

• However, for some people with severe symptoms, managing dry eye can be challenging.

Maximizing High Quality Tear Production and Reducing Inflammation

Dr. Rhonda Patrick discusses the importance of reducing inflammation to improve tear production, especially for people with allergies or dust allergies.

Importance of Reducing Inflammation

• Reducing inflammation is important for maximizing high-quality tear production.

• Dry eye may be caused by inflammation working against our tear glands.

• Prescription drops for severe dry eye are anti-inflammatory or low-dose steroid types of eye drops.

Next Generation Treatments

• Next-generation treatments aim to better understand the nerves on the cornea and ocular surface to help regenerate and rejuvenate how the nerves and tissue cells interact underneath the tear film.

• Serum tears made from blood serum rich in growth factors can be helpful for people with advanced or severe hard-to-control dry eye symptoms.

• Companies are researching ways to identify and package just the growth factor in serum tears as a product for dry eye patients.

Recommendations

• Use preservative-free artificial tears if using more than a couple of drops here and there for dry eye control, as preservatives can be irritating or inflammatory to the ocular surface.

• Consider asking your healthcare provider about serum tears if you have been struggling with dry eyes.

Understanding Eye Health

In this transcript, the speaker discusses various aspects of eye health, including normal visual development, common vision problems, and potential treatments. The speaker also emphasizes the importance of proper eye care and regular check-ups.

Common Vision Problems

• PRP plasma is being studied as a potential treatment for certain conditions like glaucoma and macular degeneration.

• Properly controlled randomized trials are needed to test if PRP plasma really works.

• Glaucoma, retinitis pigmentosa, and macular degeneration are some of the most debilitating forms of vision loss.

• Refractive error is the number one cause of low vision worldwide.

• Cataracts are a normal aging process that can be treated with surgery but access to care is limited in developing countries.

• Glaucoma is the number one cause of irreversible vision loss in the world.

Normal Visual Development

• Babies are born with poor eyesight but their vision improves rapidly during the first few months of life.

• By six months old, babies should have good color vision and depth perception.

• Children's eyes continue to develop until around age 8 or 9.

Importance of Eye Care

• Properly studying new treatments is important before they become standard practice in eye care.

• Careful testing in a few people should be done before moving on to properly controlled randomized trials.

• Regular eye check-ups can help detect and offset the progression of vision problems.

• Access to care is a major issue in treating common vision problems like cataracts.

Glaucoma, Age-Related Macular Degeneration, and Diabetic Retinopathy

In this section, the speaker discusses three major causes of irreversible vision loss: glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy. The speaker explains the risk factors for each condition and the current treatments available.

Glaucoma

• Glaucoma is the most common optic neuropathy that leads to permanent vision loss.

• Two major risk factors for glaucoma are increasing age and increasing eye pressure.

• Screening for glaucoma includes checking eye pressure during a comprehensive eye exam.

• Treatments for glaucoma target reducing high eye pressure through medications, lasers, or surgeries.

• Glaucoma affects peripheral vision first before central vision. Early detection is crucial as it can lead to irreversible blindness.

Age-related Macular Degeneration (AMD)

• AMD is a leading cause of vision loss in elderly populations with two forms: dry and wet.

• Dry AMD causes slow degeneration of rods, cones, and support cells in the retina while wet AMD involves new blood vessels growing under or into the retina.

• There are currently no treatments that target the degenerative process of AMD.

Diabetic Retinopathy

• Diabetic retinopathy is caused by damage to blood vessels in the retina due to diabetes.

• Early detection through regular eye exams can prevent severe vision loss.

• Treatment options include laser surgery or injections to stop abnormal blood vessel growth.

Eye Diseases and Treatments

In this video, the speaker discusses various eye diseases and treatments. The speaker talks about macular degeneration, retinitis pigmentosa, diabetic retinopathy, and other eye diseases.

Macular Degeneration

• Antibodies can be injected into the eye to control wet macular degeneration.

• Successful trials of a treatment for dry form of macular degeneration have been shown in phase three clinical trials.

• New treatments slow down the progression of the disease by 20 or 25 percent.

• Retinitis Pigmentosa is an inherited form of macular degeneration that affects rods, cones, and support cells in the back of the eye.

Diabetic Retinopathy

• Diabetes causes damage to the retina inside the eye called diabetic retinopathy.

• Some new blood vessels grow or blood vessels are leaky in diabetic retinopathy which can be treated with injectable drugs or lasers.

• Early screening is important for patients with diabetes to detect any signs of diabetic retinopathy.

Type 1 vs Type 2 Diabetes

• Type 1 diabetes usually presents suddenly in childhood or teenage years while type 2 diabetes can be on a continuum and people may not realize they have it at first.

• It takes some years after diagnosis for type 1 diabetics to show any signs of diabetic retinopathy whereas type 2 diabetics may already have insulin resistance when diagnosed.

Other Eye Diseases

• Other devastating eye diseases include glaucoma, cataracts, and uveitis.

• Glaucoma is a disease that damages the optic nerve and can lead to blindness if left untreated.

• Cataracts are a clouding of the lens in the eye that can be treated with surgery.

• Uveitis is an inflammation of the uvea which can cause vision loss and other complications.

Eye Health and Disease Prevention

In this section, the speaker discusses eye health and disease prevention. The speaker talks about diabetic retinopathy, its causes, and how to prevent it. The speaker also talks about glaucoma, how to detect it, and how to treat it.

Diabetic Retinopathy

• Diabetic retinopathy is caused by leaky blood vessels and new blood vessel growth in the retina.

• To prevent diabetic retinopathy, control your diabetes by keeping your blood sugar levels under control.

• High blood pressure can also damage the retina. It's important to have good blood pressure control.

• Regular eye exams are important for detecting diabetic retinopathy early on. If detected, there are treatments available such as drugs that can be injected into the eye.

Glaucoma

• Glaucoma is a disease that causes death of the retinal ganglion cells which connect the eye to the brain.

• Screening exams with an optometrist or ophthalmologist are important for detecting glaucoma early on.

• Lowering eye pressure has been shown to slow down progression of optic nerve damage and vision loss in patients with glaucoma.

Conclusion

In this section, the speaker concludes by summarizing key points discussed in the video regarding eye health and disease prevention.

• Controlling diabetes through good blood sugar control is key in preventing diabetic retinopathy.

• Regular screening exams with an optometrist or ophthalmologist are important for detecting eye diseases such as glaucoma early on.

• Lowering eye pressure has been shown to slow down progression of optic nerve damage and vision loss in patients with glaucoma.

Glaucoma Treatment Options

In this section, the speaker discusses different treatment options for glaucoma and their effectiveness.

Eye Drops vs. Laser Treatment

• Selective laser trabeculoplasty (SLT) is a safe and effective first-line treatment option for glaucoma.

• In a clinical trial called the LIGHT trial, SLT was found to be at least as effective as eye drops in treating glaucoma over the long term.

• SLT has advantages over eye drops, including not having to remember to use them every night.

Surgical Approaches

• If eye drops or lasers are not enough early in the disease, surgical approaches can be used to lower eye pressure further.

Risks of Vision Loss

• Despite all available treatments, 10-20% of patients with glaucoma will lose meaningful functional vision and 5-15% may go blind, depending on where they live in the world.

Importance of Compliance with Medications

In this section, the speaker emphasizes the importance of compliance with prescribed medications for glaucoma.

Difficulty with Compliance

• Patients may neglect to take their medication due to forgetfulness or difficulty with daily routines.

• Compliance is particularly difficult when patients do not feel or notice a difference from taking their medication daily.

Motivation for Compliance

• It is important for patients to stay compliant with prescribed medications in order to prevent vision loss from glaucoma.

• Eye doctors should reinforce the message about compliance with their patients and encourage them to take their medication as prescribed.

Risk Factors for Glaucoma and Macular Degeneration

In this section, the speaker discusses risk factors for glaucoma and macular degeneration.

Risk Factors for Glaucoma

• Age is a major risk factor for glaucoma.

• Smoking or vaping nicotine and alcohol are also risk factors for glaucoma.

Risk Factors for Macular Degeneration

• Aging and smoking (including exposure to secondhand smoke) are major risk factors for macular degeneration.

• There are also genes associated with macular degeneration that have been sequenced in the human genome.

Importance of Heart Health

• Everything that is heart healthy is almost certainly true for glaucoma as well. Patients should strive to eat healthy, not smoke, and limit alcohol consumption.

Cannabis and Glaucoma

In this section, the speaker discusses the use of cannabis in treating glaucoma.

Cannabis and Eye Pressure

• The speaker mentions that cannabis can lower eye pressure, which may help with glaucoma.

• However, smoking cannabis is bad for lung health and can cause inflammation and dryness in the eyes.

• The speaker notes that it's not practical for most patients to be high on cannabis 24/7 for years.

• Edible forms of cannabis are a more responsible option for some patients.

Circadian Rhythm and Eye Pressure

• Eye pressure undergoes a circadian rhythm, with levels being highest at night while sleeping.

• Some patients have higher eye pressure at home than during clinic visits due to this rhythm.

• Sleeping with the head elevated above the feet can help lower eye pressure during these critical hours.

Future Possibilities

• The speaker suggests that companies could develop more potent, long-lasting drugs derived from cannabinoids to treat glaucoma without negative side effects.

• Research into which compounds within cannabinoids are responsible for lowering eye pressure could lead to better treatments.

Eye Health and Sleep

In this section, the speaker discusses whether sleeping on a particular side affects glaucoma and how it is almost always a disease of two eyes. The speaker also talks about macular degeneration and how red light exposure can offset some vision loss associated with age-related macular degeneration.

Sleeping Position and Glaucoma

• Glaucoma is almost always a disease of two eyes but can present asymmetrically.

• Studies have been conducted to determine if sleeping on one side affects glaucoma.

• Results from studies are inconclusive, suggesting that it probably doesn't matter which side you sleep on.

• People toss and turn all night, so over the course of the night, they spend a similar amount of time on each eye.

Red Light Exposure for Macular Degeneration

• Red light exposure done early in the day to the eye at a distance of about two feet for just a couple of minutes a few times a week could offset some vision loss associated with age-related macular degeneration in people older than 40.

• There's biological premise that red or near-infrared light therapy can be neuroprotective by activating neuroprotective pathways in the retina.

• Data suggests that ramping up high-functioning mitochondria is part of activating neuroprotective pathways in the retina.

• Studies are still ongoing to determine what's the right dose, how much brightness is needed, optimal wavelength, when during the day to provide that light or how many minutes or hours.

Phototherapy for Eye Health

• Light therapy might be leveraged maximally to maximize eye health both during development and at the other end of the spectrum as we age.

• Red light and violet light in small daily doses can also be used to prevent progression of nearsightedness in children in school-aged children.

• Phototherapy is a very hot topic for research right now, and there's biological premise that it could be a therapeutic approach.

Floaters in the Eye and Eyelid Twitching

In this section, Dr. Mike discusses floaters in the eye and eyelid twitching.

Floaters in the Eye

• The eye is filled with a jelly that contains collagen fibers.

• As we age, these fibers shrink and contract, causing them to peel off of the back of the retina.

• This can result in little tissue bits floating around in our vision, which we perceive as floaters.

• Most floaters will go away on their own over time, so it's not necessary to undergo surgery to remove them.

• Ignoring them can help your brain filter them out over time.

Eyelid Twitching

• Most of the time, eyelid twitching is caused by a bad nerve ending or one dying nerve cell.

• Occasionally, chronic spasming of certain nerves can cause blepharospasm.

• Botox injections can be used to treat severe cases of blepharospasm.

Eye Health and Nutrition

In this section, the speaker discusses the role of nutrition and supplements in promoting eye health. They highlight some studies that have been conducted on the topic.

Supplementation for Eye Health

• The photosynthesis pathway converts light into electrical and chemical signals that the rest of the eye brain can use.

• There has been a proliferation of supplements on the market to promote eye health and longevity of vision.

• Ophthalmology has explored supplementation in rigorous randomized control trials more than other areas of neuroscience.

• Two age-related eye disease studies (ARIDS) showed that patients randomized to vitamin C, E, zinc, copper, and beta-carotene had less progression of their dry macular degeneration in moderate to severe ranges.

• ARIDS II formula without beta-carotene but with lutein and zeaxanthin was even better at slowing dry macular degeneration in moderate to severe population.

• High dose vitamin B3 is being studied for its potential benefits in glaucoma.

Nutrition for Eye Health

• Indirect effects of nutrition are important for maintaining eye health.

• Patients should not ingest too many calories such that they become obese or diabetic as it can affect their eyesight.

The Eye as a Window to the Brain

In this section, the speaker discusses how the neural retina is part of the brain and how imaging the eye and retina can be used to detect neurodegeneration.

The Eye as a Window to the Brain

• The eye is lined with a three-cell layer thick neural retina that connects to the rest of the brain.

• Imaging of the neural retina can be used as a diagnostic tool for predicting and tracking Alzheimer's disease and other forms of neurodegeneration.

• Degeneration of the retina has been found to be correlated with degeneration of structures deeper in the brain.

High-Dose Vitamin B3 for Optic Neuropathies

In this section, the speaker discusses high-dose vitamin B3 supplementation as a potential treatment for optic neuropathies.

High-Dose Vitamin B3 Supplementation

• Limited randomized controlled clinical trials have shown that high-dose vitamin B3 is safe and may improve retinal function in patients with optic neuropathies such as glaucoma.

• Large phase 3 clinical trials are currently underway around the world to further investigate this potential treatment option.

• While there are many other supplements and alternative therapies available, caution should be exercised when considering them due to lack of data supporting their effectiveness.

Supplement Use and Neurodegeneration

In this section, the speaker discusses supplement use in relation to overall health and medication use.

Supplement Use

• Supplements should be used as a supplement to an already healthy lifestyle and medication use where prescribed.

• Caution should be exercised when considering supplements due to lack of data supporting their effectiveness.

• Inappropriate advertising and misinformation can lead to patients using alternative therapies that do not have data to support them, potentially leading to negative outcomes.

Overall, the speaker emphasizes the importance of caution when considering alternative therapies and supplements, and highlights the potential benefits of high-dose vitamin B3 supplementation for optic neuropathies such as glaucoma. The eye is also discussed as a window to the brain, with imaging of the neural retina being a promising diagnostic tool for predicting and tracking neurodegeneration.

Eye Health and Precision Medicine

In this section, the speaker discusses how laser scans of the retina can detect degeneration associated with Alzheimer's disease, Parkinson's disease, and multiple sclerosis. The speaker also talks about the challenges in differentiating between these diseases and the potential for new discoveries to lead to biomarkers for measuring disease.

Laser Scans of Retina

• Laser scans of the retina can detect degeneration associated with Alzheimer's disease, Parkinson's disease, and multiple sclerosis.

• There is good sensitivity in detecting these diseases but not necessarily good specificity in differentiating between them.

• New imaging techniques are giving cellular resolution and even subcellular resolution to see structures smaller than cells inside our retina.

• Recent discovery of specialized unusual novel structures that they can detect in the retina of patients with multiple sclerosis.

Precision Medicine

• Biomarkers could be used to measure disease, diagnose who has it, figure out who is getting worse from it, and who is responding to therapies.

• The future of eye care as well as medicine is precision medicine which aims at figuring out who is at risk of getting some diseases so that interventions can be made early enough before they get into trouble.

Personal Reflection

• The speakers met 20 years ago when he was a graduate student. Jeff skipped his postdoc directly to being a faculty member.

• Vision restoration research is being done effectively in the department.

Discussion Wrap-Up

In this section, the host wraps up the discussion with Dr. Jeffrey Goldberg and provides information on how to support the podcast, discusses supplements, and provides information on where to find more content.

Podcast Support

• The host encourages listeners to subscribe to their YouTube channel, Spotify, and Apple podcasts.

• Listeners can leave a five-star review on both Spotify and Apple podcasts.

• The host also encourages listeners to check out the sponsors mentioned in the episode.

Supplements

• While not necessary for everyone, many people benefit from supplements for things like improving sleep, hormone support, and focus.

• The Huberman Lab podcast is partnered with Momentous Supplements.

• Listeners can go to livemomentous.com/huberman to see the supplements discussed on the podcast.

Social Media and Newsletter

• The host can be found on social media platforms such as Instagram, Twitter, Facebook, and LinkedIn under "Huberman Lab."

• They discuss science-related tools that overlap with some of the content of the podcast but are distinct from it.

• Listeners can sign up for the Huberman Lab Podcast Neural Network Newsletter at hubermanlab.com/newsletter.

• The newsletter includes monthly summaries of podcast episodes as well as protocols for enhancing various aspects of mental health, physical health, and performance.

Conclusion

The wrap-up section provides listeners with ways they can support the podcast through subscriptions or leaving reviews. Additionally, they discuss supplements that may benefit some individuals. Finally, they provide information about where listeners can find more content through social media platforms or by signing up for their newsletter.