The No.1 Eye Doctor: They’re Lying To You About Blue Light! The Truth About Floaters! Turn This Phone Setting On To Save Your Eyes! | The Diary Of A CEO with Steven Bartlett

There's a lot of misconceptions around how we get bags into our eyes.

I always assume it's stress and they haven't been sleeping.

So I did research to look into this and a lot of people don't know this, but it's actually...

Really? So if I never want to get bags into 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 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 being inevitable.

Is that true? Unfortunately, there are changes that occur with age that will change your eyesight and vision, but there's a lot of things that can help prevent and slow down progression and we'll go into them.

And then every once in a while, my eyelid starts twitching.

What is that? Eyelid myokymia.

So that is your threshold of your stress.

Get more sleep and stop drinking so much caffeine.

What about blue light?

Is that harmful? The blue 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 blue light glasses shows that it could just be placebo effect.

But if you're worried about how blue lights affecting you, just moving your phone back twice as far will decrease your blue light exposure by 75%.

And more people are starting to care about that eye health than ever before.

But is our eye health getting better or worse?

For example, right now, about 30 % of the world's population is nearsighted.

But by about 2050, we will have about 50 % of being nearsighted because of our lifestyle.

So how much screen time being indoors reading books up close is okay?

It depends on age. Who are you?

What you do? And I 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 American Academy of Optometry and I'm a board of optometry.

So I practice eye care here in the US and I see patients for all sorts of eye conditions, whether that be diagnosing, managing, anything from vision problems simply as like nearsightedness or astigmatism to fitting contact lenses to diagnosing different diseases in the back of the eye and then prescribing

medications or therapy to try and prevent that from getting worse or to help treat it.

On top of all of this, I also host various, on various social media channels, an educational website about helping people learn about the eyes, 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 them see their best tomorrow.

And when you think about where we are as humans, as it relates to our eye health, like what's the macro picture?

Like what's going on?

I don't know whether it's just because I'm getting older, but I'm wondering if more people are starting to care about their eye health than ever before and if they are, why?

And is our eye health getting better or worse?

I want to say that I think people generally are being more interested in eyes and vision.

Unfortunately, part of that is probably 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.

Children are starting to become nearsighted, faster, and to greater degrees.

And because of those factors, we're also seeing a lot more eye health conditions in the back of the eye that also is reflected with other metabolic diseases like diabetes.

It significantly causes damage and leads to potential blindness inside the eye.

So there's a lot of factors to it.

What's changing? You referred to some of the situations there as becoming more or worse, et cetera.

That would suggest that there's something environmental or within our lifestyle that's having an 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 groups.

We also have aftermath of poor diet.

A lot of people with diabetes, high blood pressure, and other conditions that cause ripple effects down the road.

And then our society has changed, especially in the form of lifestyle, beyond diet.

Also, what we do throughout 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 indoors?

All of these things are pushing us to, as a society, to have different changes within the eye and increase our risk for diseases and potential vision loss.

Why does it matter?

I asked that question because I think for people to spend time listening to all the education you give out, they first have to really believe that their eyes matter.

And I know this sounds like a bit of a crazy question because we all can understand that seeing things is useful.

But sometimes in life, I think we don't appreciate things until we lose them.

And I think in your line of work, you must see that more than ever.

No pun intended. Right.

No, you're absolutely correct.

And 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 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 need to see an eye doctor.

It's like, no, you absolutely need to.

There's so many different, not only just problems with your eyesight that we can catch, but there's so many, there's over 270 different conditions, systemic and vision 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 how conditions you've spotted by doing an eye exam.

So patients who don't know they're diabetic will catch diabetes by looking inside the eye because diabetes will cause damage to the blood vessels.

And we can see bleeding happening in the 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 eye, the eye itself can have a stroke.

We can see cholesterol plaques stuck in the arteries within the eye.

Autoimmune conditions will catch those from doing an eye exam.

Unfortunately, things like brain tumors and conditions like multiple sclerosis will catch those.

I had one story I'll share.

I have one patient who was, she was young, she was 20 years old, college student.

She came in for just getting new glasses, contact lenses.

She has to go to school, she has to see well.

And during 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 there's different types of hemorrhaging that occurs in the back of the eye.

This specific type of hemorrhage is called a Roth spot.

And typically we only see Roth spots if somebody has a more serious condition going on.

Can you show me on that where you saw it?

So 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 eyeball during the exam, we of course look through the cornea through the pupil.

Usually we dilate the pupils.

If I was to open up the inside of the eye, the orange part that you see here, that's the retinal tissue.

And you can see the little red lines.

Those are blood vessels.

The retina is really, the eyeball is kind of beautiful because it has a dual blood supply.

So it actually has blood that comes through the back and supplies the retina from the backside.

But then it has blood vessels that go within the retina and supply nutrients within the retina from the front side.

So this type of bleeding spot was occurring just right here in the back of the eye, a 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 age? She was 20 -year -old female college student.

And usually, again, we see raw spots in more serious conditions, whether somebody is extremely diabetic or they have HIV.

Something's going on.

So I said, this is not right.

We need to do blood work.

So I ended up referring her basically to requested 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 college.

So I'm like, I'm going to give you my full report.

I need you to go get this done.

And then COVID happened.

So I didn't hear anything.

And so finally, a few weeks later, they finally allowed doctors to 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 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 like, what?

She's like, yeah, a few days later, I started feeling really tired and not feeling well.

So I went into the doctor and I brought your report.

They did blood work.

They found out I had they put her in intensive care unit for three days because they were worried she was going to bleed out.

Her platelets were so low that she could she could have just bled there from doing the blood work.

She had an immunothrombocytopenic purpura.

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. And that ended up manifesting in the eye.

So it was one of the few cases where I was like, wow, like otherwise if she hadn't come in, what could have happened?

Right? So I just use that as a good demonstration because there are so many things that we catch on even a daily, weekly basis.

There's so many misconceptions around vision in the eye.

I think one of the misconceptions I think I found myself living under is that my vision loss is inevitable, really irrespective of what I do.

And the minute you start to believe that story, then it kind of makes for your motivation to do anything about your vision.

Now, is that true? There is changes that occur with age that will change your eyesight and vision.

Some just fundamental facts that you don't really have 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, we're going to have gray hair.

With the eye, there's conditions like that, like cataracts, age -related cataracts.

Eventually will develop.

Press biopia, that's the condition where people are in their 40s and early 50s, they start having a hard time seeing up close.

And they have to push things further back and they start wearing bifocals or a varifocals.

So those sort of conditions inevitably do happen.

But there are thankfully a lot of things in our lifestyle that research is paying more attention to that can help prevent, hopefully prevent and even slow down the progression of more devastating blinding eye diseases.

So there are things you can do and be aware of and happy to go into that.

So global eye health and the statistics.

One of the really sort of shocking stats I read is that most of us are going to develop nearsightedness when you go into 2050 -2016.

Is that true? What are the stats around that?

So a publication came out in 2016, an ophthalmology author of Holden.

They looked at the statistics of myopia or nearsightedness.

Even going further back, we've known that nearsightedness is progressing.

And now estimated that right now about 30 % of the world's population is nearsighted.

But by about 2050, we will have about 50 % of the entire world's population being nearsighted.

In the US right now, for kids aged 5 to 19, they were already about 42%.

And by 2030, so in just a few years, it's expected the US will be about 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? How come? There's certainly genetics plays a role.

As more researchers come out, we know that genetics maybe only plays maybe up to about 30 % of the factor.

So if your parents are nearsighted, or if somebody's severely nearsighted, like if your mom's severely 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 go outside in a big city that has streets really close to each other, you're not really in an open field.

Right? You have big, tall buildings right next to you.

And then you go inside and you're inside of a smaller building, a smaller apartment.

Then there's the fact that we spend so much emphasis in our society on education, on being up close beings.

Kids now are not only pushed to excel in education and being introduced to education earlier, and to spend more time studying and learning, but parents are giving their kids digital devices as the babysitter 2 .0.

So kids are staring at tablets even from a very young age.

And then it's the amount of time we're spending indoors.

It's interesting because I don't even think most people realize that the way we live our lives, the things we stare at being indoors can change the eye.

I think we all operate under this assumption that our eyes are just our eyes.

And we think of muscles as being trainable and exercisable.

I can go to the gym, I lift a weight, my muscle changes.

But my eye changing is something that I think is quite a surprising concept to most people.

How do we know this?

So statistically we've watched and data collected for many decades watching people gradually become more and more nearsighted.

And there's been those theories of why that could happen.

The evidence of what changes physiologically with the eyeball is that the eye as you grow and go through adolescence and your body's growing, the eyeball actually grows backward toward the brain into the orbit eye socket a little bit.

And it doesn't need to change much.

The eye growing one millimeter, just one millimeter, will change your prescription for glasses by about three diopters, which is a high amount.

So if somebody gets two millimeters of change, that is already into what we classify as severe myopia, which carries 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 maculopathy, which is a form of kind of macular degeneration that typically occurs with later age.

And that one millimeter or two millimeter growth is linked to lifestyle?

The vast majority of it.

How much screen time, how much being indoors, how much reading books up close is okay?

Is there like a recommended daily allowance?

So there are some recommendations put forth by like the American Academy of Pediatrics.

And it depends a little bit on age, especially for young kids.

I think for the first few years of life, they don't recommend kids look at screens at all.

And then why? Because again, there's research showing that not just for eye development, but also neurological development.

And 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 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 impacts 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 close?

Once you're past the age of like 20, 25, the rate of myopia development thankfully slows down.

That's nearsightedness.

Nearsightedness, correct.

That does slow down, but about 10 % 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.

There have been numerous studies looking at outdoor time and that spending more time outside can offset the onset and progression of nearsightedness.

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 spending sort of 90 minutes to two hours a day, look outside, looking far.

That's a part of it.

The various studies do look at, you know, are they doing things up close while they're 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 individual specific wavelengths of sunlight that are somehow communicating to the back of the eye to grow or not?

There's also the thought that the way 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 done so much research on in terms of how myopia progresses has to do with how light is focusing on different parts of the retina.

I do want to just step back when it comes to all the spending time outside.

It's again, that research is largely based on surveys.

And so they aren't 100 % sure how much light outside or time people are really getting.

So now they're utilizing health trackers and giving it to kids for those studies so they can track truly how much light they're getting when they're stepping outside versus not.

So they can have a better objective data to really understand the risk of myopia progression based on that.

I was wondering if vitamin D plays a role at all there.

That's also theorized and looked at in some studies.

Also just athletics and getting more motion in the daily activities.

So there's many different studies in those regards.

But right now, even a study out of Taiwan, they've been implementing a policy.

It's like, hey, you have to get at least 90 minutes to two hours 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 even a more recent meta -analyses said it wasn't statistically significant for the progression of myopia, but it does delay onset of myopia.

Can you reverse myopia?

No. Okay. So if I become near sighted because of my lifestyle or some other reason, I can't then just spend loads of time outside and reverse it and start gazing off into the distance, et cetera.

So there's the understanding of what true myopia is.

And again, that has to do with the elongation of the eyeball.

So if you were to somehow find a way to truly reverse myopia, you would 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 noticed being in the world of social media, there are people who will claim that they've done this.

Using various things, usually these people who are claiming this are selling something that is not based on science, and doing the research study to prove that would be very easy to do.

And it just doesn't show.

Most people if they are spending more time outside or they are doing eye exercises of any form to try and reverse their nearsightedness, what's likely, what they're going through is that they have something called pseudomyopia, which is where they've overused their eye muscles so much that they're more

or less having a spasm, and their muscle is making them think that they are nearsightedness.

But then finally going outside, spending more time outside, stop staring at their phone so much, they learn to relax their eye muscles, and all of a sudden, now they can see better again.

Well, this is in part one of my personal concerns, because sometimes very rare occasions, I'll spend maybe nine, 10, 12 hours in this studio.

And I'm doing research on the guest before the guest arrives, and then we're sitting at 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 like, I can't see a bloody number play, and I think I'm losing my vision.

But from what you're saying there, it sounds like I'm going through a bit of pseudomyopia.

You could be. Of course, I haven't done an eye exam on you.

I don't know where you're at.

Can I ask, when was the last time you had your eyes checked?

No comment. It was a long time ago, and the reason for that is, again, because I just I always assumed my eyes were fine.

So it would have been, gosh, that's such a good question, maybe seven years ago or something.

So it's tough to say, you know, there is possibility that maybe there's a little bit of nearsightedness there.

It 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 five pound weight, right?

You've held it there all day long, and most 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 and you're just used to holding at five pound weight, at arm level.

So you have to learn to, hey, I can relax this and put it back down.

So that is a component of the internal eye muscle called the salillary body, which unfortunately is not the same type of muscle as your skeletal muscle.

And so even with eye exercises, you can't strengthen that muscle.

So eye exercises don't work?

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 really the coordination of your brain, communicating that information to those muscles to work in coordination.

And so there's some certain binocular vision disorders, like people who have convergence and sufficiency.

They can't move their eyes to bring them forward to keep a page in front of them single.

Or some people have loss of their accommodative ability, their ability to change focus, to keep something up close clear.

Those type of binocular vision 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 parents?

Because my parents are, they hold everything at like one meter length from their face.

And when I was younger, I used to take the eye from like one centimeter away and they're reading its arm's length.

But I think they're going to have the last laugh when I get to 50, 60 years old because of genetics or whatever.

So again, even without genetics, just the way the eye ages, the lens inside of your eye will change.

So if I open up the eye model here, let me try not to spill everything from the inside of the eye.

In the front portion of the eye, you have the cornea.

Which is the, is that the very front piece?

It's the clear window to the eye.

Behind it, of course, you have the iris, the colored part of the eye.

So brown eyes, blue eyes.

Behind that, you have a lens.

It's called the crystalline lens.

And this has got a couple of different pieces also close to the side.

But this crystalline lens is actually about the size of an M &M.

I put these together.

It's kind of that shape.

When you're born, this lens is clear and thin.

And so the muscle inside the eye actually pulls on this lens to change its shape.

And that's what helps you as a little kid see all the way toward the front of your nose.

As you get older, this lens gains an extra layer basically every year of your life.

And so as you get older, if you 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 tree.

So you can basically count those and be like, look how old this person is.

So by the time everybody's about in their early 40s, there's algorithms that predict this with high accuracy.

And in school, I had memorized them.

I don't really need to use them as much anymore.

So I haven't thought about it for a while.

But as this lens gets thicker, it basically gets thicker every year, it gets to a point where the crystals within that lens start to change shape.

They become more crystallized, rigid.

And so even though the muscle inside the eye is still pulling on this lens, it's like pulling on a hard stiff marble.

It doesn't want to change shape anymore.

And so that's why people can gradually like, I can't quite keep things as clear anymore.

And so it's gradually getting worse and worse.

Okay. Eventually, once you get closer to the ages of 50, 60, 70, 80, this lens continues to get thicker, harder.

But then the crystals start to change color.

They go from being clear to being more of a faint yellow color to a darker yellow whitish 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 through to getting to the retina in the back of the eye anymore.

So what did you do?

Cut it out? So there is thankfully cataract surgery is an amazing surgery.

I think it's probably one of the more fascinating surgeries that's out there.

They, 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 phacoemulsification.

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 is inserted into the eye, into that place.

And that new plastic lens can be made to account for any glasses prescription that you need.

And what's fascinating for you and I is that, so this form of cataract surgery has been evolving and getting better and better over generations, but the new lens implants that they've been engineering are just outstanding, even right now.

Because now they can make multifocal lenses.

They can have lenses that change shape based on how you're using your eyes.

And then it's basically not needing bifocals, not needing glasses as much, in some cases, if at all.

And so I keep on thinking like, wow, where this technology is right now, where is it going to be in 30, 40 years when 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 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 five, six years ago of somebody talking about it, but since then, things have kind of gone quiet.

They are probably in the last year, one of the last few years, there's been interest and research into making like 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 one of the kind of the coolest things that have come up recently.

There was an eye transplant.

So a gentleman was injured in the, he was a US military, but something happened on the job, electrical damage to his face, his eye.

He ended up having partial face transplant, and then a whole eye transplant.

And at this time, it was the first one ever done.

The eye is so unique and so complex that when they finally do this transplant, it's sort of shaken the eye care role a little bit.

I just read like a one year, a publication in JAMA that was basically summarizing what it's been like after this last year.

And it's amazing because the eye did connect to the optic nerve, because the eye again is so complex.

So they had to not only connect muscles to the eyeball, but they had to connect the optic nerve from the donor tissue to the host.

And keeping that the right amount of blood supply, having it so it didn't reject is a really tough feat.

And what they have now, they find that the last, this last paper I just read, that 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 electro -retinograms that we can do in the clinic, they have been able to show that there is electrical activity going to the patient's brain.

Unfortunately, he does not have any eyesight or he cannot detect light with it.

But I think just this is the first step of showing like, wow, we actually can try this, we can get it so it actually is safe.

So it's pretty fascinating.

God, it's only gonna be a matter of time, isn't it?

You said that the eye is complex, I was reading some stats around the eye.

That blew my mind. The eye contains over 2 million working parts and is considered the second most complex organ in the body.

I guess the brain is the first.

The eyeball is really an extension of the brain.

The retina in the back of the eye communicates directly through the optic 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 85 % of your total knowledge.

And there's a comment saying that the eye is a window to your soul, showing how the eyes 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 crazy that that particular stat around 85 % of my total knowledge will basically come from my eye.

When you say it, I kind of understand it because I'm reading, I'm seeing, I'm learning through my eyeballs, but it is cause for protecting our eyes.

And the things you've described, they're cataracts and these other sort of eye conditions.

Cataracts in particular, is that something that I can stave off by making better choices with my life?

So people who do smoke, people who drink more, that increases their oxidation.

So the cataract formation mostly occurs due to oxidative stress within the eye.

In fact, the most vitamin C in the body is within the eye and it bathes.

It's in a solution that bathes around that lens and helps prevent it 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 the lens.

And so there's epidemiological studies on age -related eye diseases that have found that people who spend more time outdoors without sunlight protection, without wide brim hats, without sunglasses, they are more likely to develop conditions like cataracts.

There's different types of cataracts.

There's one specific type of cataract called a cortical cataract that kind of looks like bicycle spokes.

If you were 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 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 vitamin, once you have enough vitamin C in your body, you just urinate out everything else.

So there have been studies on people who are malnourished and don't get enough vitamin C that giving them vitamin C can help slow or delay the onset of cataracts.

But if you already are getting proper nutrition, taking additional vitamin C is probably not going to delay your onset of cataracts specifically.

I learned something from you actually, from your Instagram, which I think is really going to do me a lot of favors because I'm someone that spends a lot of time on my phone, and you alerted me to the fact that there's a feature in the iPhone which will help me stave off my myopia potentially.

Perhaps. So thankfully, again, the eye care community is not the only people who are aware of these issues with using devices up close.

But thankfully, whether it be Apple specifically with their iPhone, but also the other phone manufacturers, people who are making these devices now have software that tracks, hey, you're holding this really close to your face.

We want you to push it further back.

So thankfully, they do have those sort of notifications that people can turn on.

I'll admit that I turned mine on for a while, and I eventually got so annoyed with it, I wanted to push it further back.

So I kept it on for a while.

I eventually took it off, but maybe I'll have to put it back on again, just to serve a good example.

So it was a feature release in 2023, and it essentially sends you a notification whenever your phone is 12 inches or something.

I don't remember exactly how close it is.

But we do know that on average, people hold their phones devices around eight inches 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 relationships, possibly myopia, and then even blue light.

I know people are get really concerned and interested around the blue light world, especially since COVID that really blew up at that time.

But just moving your phone back twice as far will decrease your blue light exposure by a full 75%.

So if you're worried about how blue light is affecting you, it's like just move your phone back a few inches, and that's automatically going to decrease your blue light exposure from that device.

I don't think most people know that this feature even exists because I don't think Apple really ever announced it or did a marketing campaign around it.

But in the settings section of your phone and your iPad, etc., it's under screen time.

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 alert you to hold an iPhone or iPad with face ID at a recommended distance.

And in a 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 face and the data collected remains on the device.

So if I click continue, it then says this is how screen distance works.

Screen distance encourages you to move your iPhone and iPad further away to support your vision health.

The next section says vision distance or viewing distance.

iPhone or iPad should be held at a suggested distance of 30 centimeters from your eyes.

Interesting. If those are recommendations, but how many people actually follow that?

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 closer.

And kids probably are even worse because they automatically have smaller arms, right?

But then they just, they just 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 think it's a good habit.

I think it's something, tell me, have you when you have you turned it on?

Has it something that you've utilized?

I turned it on when I was in preparation for you coming here today.

So I didn't know it existed 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 it's not been on long 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 going to annoy me if it annoys you.

So my challenge was that in the evenings, I wear contacts most of the time.

And I take my contact lenses out in the evening, I go back to glasses.

And sometimes I'll lay, I 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 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 me that warning the whole time and it delays, it has like a few seconds of delay, once I pull it back before it 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 should just take a break.

But it was it was delaying my productivity.

So that's why, but again, to set a good example, I'll probably turn it back on and see how it goes.

And if you have kids, you can always, you know, they're not probably doing much that's productive, you can always turn it on their devices, I guess.

Yeah, I think so. I think it's also a good habit to 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 they're going to probably mimic that same behavior.

I want to talk to you about bags under my eyes, subject that 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 into their eyes are because they're tired or something.

And is there a difference between having bags into my eyes and 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.

I see all the time people ask about it in the eye clinic.

Having dark circles under the eyes is technically different than having under eye bags.

But if you have under eye bags, it'll make the appearance of dark circles worse.

Okay. So dark circles in the clinic, we think first what somebody's skin pigmentation like is the dark circle just because they have more pigmentation.

And if you're somebody who spends a lot of time in the sunlight, you are more likely to develop darker skin complexion around the eyelids.

The eyelids are some of the thinnest, most delicate tissue of skin on your body.

And in fact, a lot of people who don't know this, but having skin cancer on your lower eyelids is actually pretty high.

So it's good to be wearing either a wide brim hat or sunglasses to protect the eyes from sunlight damage.

The other kind of components is 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 just the blood vessels coming through the skin a lot easier.

And then there's orbital shadow effects.

Because some people's orbits, they have more prominent brow.

It may kind of cast a shadow onto the lower eyelid.

And that's where having under eye bags can also make the eyelids seem like they have kind of dark circles because the eyelids are puffy.

And you can have puffiness of the eyelids for multiple reasons.

Allergies are a big one.

Salt content of the cheer film and even in your body can 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 feel, I can feel that my skin and my face is maybe a little bit more puffy.

Thankfully, that goes away within a few hours.

But that's why a lot of times even just doing cold compresses, right?

You see people put cucumbers on their eyes.

A lot of that is more have to do with just the cooling temperature.

Doing a cold compress for 10 at max 15 minutes can bring some of that puffiness down.

And that can at least help improve the appearance.

So if I have a really salty diet the night before, there's a greater probability I'll wake up with bags under my eyes?

Possibly. Okay. I've tried to research this to find any real publications to see if it's really there.

And I couldn't find anything.

But I know from just my own anecdotal experience that if I eat a really high salt diet, and I've done over the last eight years, I've really done a better job, I know you have too, of thinking about my diet, how that affects me, how my body feels after I eat something.

And so I've noticed if I have a cheat day, that sort of thing can happen.

And where does this, what's the sort of physiological rationale for salt playing a role?

So your tear film, for example, your tears...

Like I know some people will say, hey, if I have a watch a sad movie and I cry at nighttime the next morning, my eyes are super puffy.

So your tears have salt in them.

And because if you ever cried and tasted your tears, they taste salty, right?

So the challenge is that when you have salt, it'll draw fluid into the tissues.

And so if people cry the night before, the salt remaining in the tears basically get into the tear ducts and sit on the surface of the eye and the eyelids, and then that can draw fluid into those tissues.

Does hydration play a role?

That's also something that's been looked at in research.

It's not really conclusive.

I think hydration is still something we need to...

I do encourage people to at least be aware of their hydration.

For dry eye, there is some research that indicates that people who drink more water tend to have less severe symptoms of dry eye.

Well, I see some with bags into their eyes.

I used to think, well, I still kind of do think that it just means that they haven't slept.

That, again, I recently did a live stream, I did research first and tried to look into this.

And they have looked at quality of sleep, time of sleep, and both this subjective and objective appearance of dark circles under the eyes.

And they find that it is, if you have not been getting good sleep, objectively your under eye dark circles do not change.

But your subjective appearance of your own image will go down.

So you're both... They find that for both sleep and stress.

So you believe that you've got bigger sort of dark circles or patches under your eyes, 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 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.

What about stress? Because I'm thinking about people that I've seen that have big bags under their eyes and their eyes kind of look dark.

I always assume it's their stress and they haven't been sleeping, but you're saying that that's not accurate necessarily.

So at least in the few studies that I've been able to read that were published in the last five years don't seem to find that conclusive.

There are other physiological changes that happen when people don't sleep or under stress, right?

Cortisol releases, inflammation in the body will change, hormones can change.

So they may all play a role there, but right now it seems to have a less effect on the true pigmentation of the eyelids.

Okay. And the cucumber and the cold compress and all that kind of stuff, does that stuff work in changing the appearance of dark circles and bags under my eyes?

Because when I film Dragon's Den, a TV show in the UK, it's weird because sometimes when I'm under slept, I come into the studio and 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 saying, you look like shit, but she doesn't say it.

And it's always when I haven't slept.

So I put two and two together and thought, okay, well, she knows that my eyes don't look great today.

But is it actually doing anything, the cucumber and the...

The coolness effect, I believe, is going to be causing constriction of blood vessels.

It's going to be helping the tissue come down and swelling.

Just like if you bend your knee or elbow really hard on something, it swells.

There's a little bit of inflammation.

And so putting cold on there can help momentarily, but I wouldn't do it longer than 15 minutes.

The reason why is because if you do it longer than 15 minutes, your blood vessels actually can go the opposite way and cause more inflammation.

There's other things like eye creams.

There's a plethora of different eye creams on the market.

Some of those do work to help constriction.

Some of those are to help truly remove pigmentation.

And a lot of those 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.

But outside of that, if somebody's tried all those other avenues, talked with their dermatologist or an eye care provider of any kind and things still aren't getting better, there are some surgical procedures that can be done to help people with the appearance of under eye bags and some duct circles.

What do the surgeries do?

They either 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 fillers, like they'll do hyaluronic acid fillers to change the shadowing effects around the eye.

And then there's forms of what are called a blepharoplasty, which are true eyelid surgeries.

And for that, you would want to see an ophthalmologist who specializes in those type of therapies or those type of surgeries.

So if I ever want to get dark circles, bags and bags into my eyes again, what is the natural, easy solution?

I do still encourage good sleep, eating healthy, staying hydrated.

I think all of those things are good habits to have because we know they affect the body in so many other ways.

If 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 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 headfirst into the research for many things in the eyes.

With the eye bags specifically, I'll say that there is some 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 wage caution though, because there's a lot of products that are online that offer red light therapy for various reasons, but they're not 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 forms of red light therapies, the devices they bought online.

Because what the manufacturer states isn't actually what's being measured when they do it in the research and find out, hey, what type of wavelength is this?

How much energy is being produced by the device?

Because it's not the specific wavelength.

The wavelength is important, but the amount of energy in the red light also is super important.

And if you have too much energy, you can go through the eyelid and go into the eye and cause damage.

And so I think it's really important.

This is still a very early area of research when it comes to the eye.

And so I think I just urge caution to make sure whoever's listening, if you're thinking about red light therapy, if you're thinking about getting a red light device, specifically for eye care, definitely talk to a specialist who works in that area.

But red light, have you heard much about red light in different areas?

I've heard a lot about it.

I don't know a huge amount about it.

And I have two red light panels at home, which were given to me as a gift.

My partner has one.

I have one. We basically got each other the same Christmas present one year.

But we did ask ourselves, we sat in front of it one day and said, what does this do in terms of our health?

And are we allowed to stare at it?

The devices you got, do they come with goggles?

No. Okay. So that is sort of the concern I have, is again, what energy is really not just what wavelengths of light is it emitting, but what's the energy?

And also how far away from the device are you sitting?

What's the recommendations?

And specifically with the eye, there is evidence that red light therapy can help with dry eyes.

That red light therapy can help with macular degeneration.

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 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 is on macular degeneration.

In fact, it's currently approved and being used in Europe.

It's not approved in the US just yet, but it is going through FDA trials.

But that is a form of red light therapy.

It doesn't just use red light.

It uses some near infrared light and a little bit of 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 degeneration, they've been able to show that not only can the protein that builds up in the back of the eye in that condition diminish, but they can slow down the progression of macular degeneration and for some people even restore eyesight.

They can actually help people see better.

Using red light therapy.

Using that form of red light therapy.

So again, very early research right now.

The challenge with all these at -home devices, whether it be for dry eye, whether it be for macular degeneration, there's again concern about the power density and about the potential change in temperature within the eye because that could cause damage.

There's also red light being utilized and investigated in Asia and in Australia for myopia for children.

And so it's something that is really fascinating and I am looking forward to as more information comes out.

But I personally, from digging into it and trying to understand it, it does make me concerned of how I think there's just not as good a standardization or understanding of really how it works and which devices are safe and which ones are more medically something that you should see a medical provider

for. I read in the nature publication that a 2022 study with 20 participants receiving red light therapy twice a week for three weeks found that they had improved tear reduction, tear reduction, and other dry eye symptoms compared to the placebo group.

Tear reduction, what does that mean?

So, dry eye again is an area where red light therapy is being utilized in right now.

There's several studies on red light on its benefits for dry eye.

But the two areas where it's believed to help the most is in helping you produce more of your own natural tears because the red light can shut down inflammation within the tissues and help you produce basically it helps the cell more energized.

The mitochondria within the 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 components in mice and then now in humans they're finding that tear production can be improved.

Which helps with dry eyes.

But then also the red light can help with the mybomian glands in the eyelids.

Your eyelids have about 25 to 30 glands both the bottom and the top part of the eyelid.

Can you show me on that?

So it's actually on the eyelids but the eyelids would be in front.

They're in front, yeah.

So my top eyelids have about 30 mybomian glands in them and my bottom eyelid has like 25 to 30.

And every time you blink these glands have to release a little bit of oil that prevents your tear filming from 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 factor.

But then you also have more we can talk about with device use and the fact that when we're staring at devices we don't blink as often and we don't blink as completely when we're staring 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 clear liquid to being a thick wax.

They become yellow.

They become cloudy and they stop releasing oils in your tear film.

And so with red light therapy along with other therapies but red light has been found to help with getting those oils to produce at least a little bit better.

I think the research on red light and mybomian gland dysfunction is still in its infancy but we have a different form of therapy called IPL or Intensed Pulse Light which has been even FDA approved for mybomian gland dysfunction in treating dry eye.

Is there any research being done on red light and myopia i .e.

red light and short -sightedness?

If I look at those red light panels I have at home is that going to help with my progressive short -sightedness?

So there is research going into red light in myopia.

It's being done in children.

When it comes to the device you have at home I have no idea what wavelength that is.

I have no idea what power that is.

The devices that are being researched and used in research are usually an at -home desk mounted device that kids will stare into for about three minutes twice a day morning and the night.

And they are showing in in those publications that they're able to slow down the rate of progression of myopia.

And even for kids who haven't developed 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 at those devices and there is some concern that perhaps the power density is too high and could be at risk 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 prescribing it for something.

And just because I'm an idiot the red light is basically stimulating the mitochondria in the cell which is kind of like the engine in the cell and that's making it produce more of the good stuff.

Specifically ATP adenosine triphosphate 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 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's true.

Yeah don't stare at the sun.

Even for like a second?

Don't. So the challenge is sunlight 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 the signals to your brain to hey the sun is coming up the sun is going down way to kind of influence your melatonin production.

The staring directly into the 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 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 diagnose as solar retinopathy and so and I'm like have you been staring at the sun?

She's like yeah I've been sun gazing since I was little.

I was in Florida recently and I stared at the sun and I was doing 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 colored part is 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 fovea or the macula.

Which is at the back of the.

It's in the back part of the eye imagine if we were going to play darts we're going to go to the pub I'm going to throw darts the center bullseye of the eye called the macula that part is your reason you see 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 friends and family in the face you're using that bullseye in the back of the eye so when someone looks at the sun they're putting all of that light energy focused right in that area and then just a few seconds you can overwhelm that tissue causing

chemical damage to the retina.

Because people this phrase sun gazing is this like a spiritual thing like I think I was in Bali and people like no you can you can sun gaze you should sun gaze because it's good for you sun gazing what is this term?

That is usually in some sort of either religious or spiritual practice people will gaze toward the sun.

Usually from my understanding it's people doing it in the early morning or late afternoon when the sun is largely going down the horizon and because the light is indirectly being bent perhaps it's not giving as much energy to cause thermochemical damage to the back of the eye but there is still a high

risk and so 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 4 pm usually it's good to be wearing UV light protection not just because UV can penetrate into the eye but because UV light damages

the skin of the eyelid it can cause changes the front surface of the eye you can get sunburn on the 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've got a friend 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 mentioned blue light a second ago which is the light that comes off our devices is that harmful for my eyes?

There's blue light that comes from the sun yeah really high energy that could potentially cause aging changes inside the eye the blue light that comes from your digital screens does not have enough power and has consistently shown in research to not increase the risk of aging eye diseases it just impacts

my sleep potentially.

Impacts your sleep.

There's also some claims that blue light can affect your eye strain but again research on blue light glasses on using devices shows that blue light does not impact eye strain a lot of people will claim that they will I have a lot of patients who come in and anecdotally like oh my eyes feel so much better

from getting the blue light glasses and that could just be placebo effect it could potentially be the fact that a lot of blue light glasses will have anti -glare or glare free protection put onto it and the anti -glare is probably improving their focus and they're not having as much glare issues when staring

at the device but right now there's still just no concrete evidence showing that blue light is contributing to eye strain but then the sleep cycle we do know that blue light can influence your sleep what kind of gadgets do you have I don't know why but I assume as someone who is an eye doctor you must

have loads of gadgets around your house that you use to because you know all of the information about eyes and vision and stuff is that am I wrong I mean I yeah we're I have multiple computer screens open I have my phone screen open all day I the other day I was texting 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 so there's a lot going on there but yeah all practices is that are there any practices that you've been disciplined with because you're aware of the impacts it will have on your eye specifically on blue light no all

of it just all the overall eye health so the biggest things for myself is diet okay let's talk about 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 optimal so they've been looking at lifestyle factors on aging eye diseases for for a long

time many decades the biggest one thing when it comes to diet and they even have more recent publications a mentor of mine Julie Poteet she's a past president of the ocular wellness and nutrition society who I'm which I'm a member of she even brought my attention to a publication just this year from the American Journal

of Nutrition they looked at the original publication of AREDS the age -related eye disease study that has large cohort of people like 4 ,000 people they watched over nine years tracking their diet tracking their eye health and how things were changing and they find that just eating a Mediterranean diet

green leafy vegetables oily fish reduces your risk of developing conditions like macular degeneration specifically slowing down the progression of that condition in that specific city this publication that just came out they showed that just having 2 .7 servings of green leafy vegetables in a week not a day

but just even a week right we're supposed to have more than more than 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 advanced stage and macular degeneration needs to blindness it can yeah

especially as we get older because that 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 eye but green leafy vegetables at least 2 .7 servings a week that's that specific study they find that oily

fish eating two servings of oily fish a week slowed it down by 21 % and then they found a 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 that people who eat diets that have more fruits and vegetables

that have oily fish reduced risk of developing conditions like macular degeneration reduced risk of things like diabetic retinopathy and so i try to focus on eating a good healthy diet i mean the thing that i heard growing up was that you need to eat lots of carrots and 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 great britain um from what i understand i'm sure there's like a historian out there who's just like grumbling at me but from what i have read and studied is that i believe it was world war two that britain had

was being attacked by the germans and they were worried about german warplanes dropping bombs on them especially at nighttime and they had already established radar to detect warplanes coming but they didn't want germany to know that so they put out their own propaganda saying hey our scouts can detect

german warplanes better because they eat their carrots because carrots have beta carotene which your body can convert to vitamin a which is essential for nighttime vision and retinal health okay because i always also used to hear that you eat if you ate carrots you could see in the dark yeah so it's

a i mean it is based on some like vitamin a is essential for photoreceptors in the back of the eye but most people are not vitamin a deficient by far and so it's pretty rare that we see vitamin a deficiency in the in the eye clinic unless you happen to live in a place that's pretty malnourished you

mentioned oily fish i was on your youtube channel and i saw that you did an experiment where you took omega 3 for 90 days uh i guess because there's some kind of implications for vision with omega 3 omega 3 does play a role in the eyes for two rays that specific video i was really looking at omega 3s

and its relationship to my own dry eye symptoms because there's a lot of studies looking at omega 3 and and it's dry eye and the research is still a bit all over the place most most eye care providers who specialize in dry eye will say that you know there is a role for omega 3s in helping reduce inflammation that contributes

to dry eye because a lot of dry eye 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 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 photoreceptors in the back of the eye within the retina this again this kind of orange pink tissue in the back that picks up all the light that you see the colors that you see it sends those signals through the optic nerve to the brain so the retina is essential so the photoreceptors

about 50 to 60 percent of the fatty acid content of the photoreceptor is dha omega 3 and so 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 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 same results when in 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 there is a transporter

called the mfsd2a this transporter helps transport specific forms of dha omega 3 into blood through the blood brain barrier into neural tissue and they're finding that that same transporter works with a blood retinal barrier as well and so newer studies looking mainly at alzheimer's disease but they're

doing it on mice and they're formulating a specific type of dha called lysophospholipid dha that binds to that transporter and helps that get into neural tissue and 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 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 cupboard at home is probably not going to help but the the new versions of omega 3 that they're working on probably will might and the reason why

the current omega 3s don't seem to have that effect on the retina is because omega 3 fish oils are in the form of what is called a triacylglycerol which your body can convert in the liver to get to neural tissue but 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 often on sushi fish roe those types of like salmon i've read it has like up to 1 to 1 .7 percent of these phospholipid type of dha so not very much but krill can be up to about 30 percent fish eggs can be somewhere between 35 up to

like 70 of these phospholipid dha's and your body is able to either turn those into triacylglycerol which is similar to the omega 3 fatty acid supplements or it can turn that into this lysophospholipid dha which your body can transport into neural tissue at a better bioavailability what did you discover

when you started taking omega 3 for 90 days as part of that experiment so that was again looking more at dry eye yeah 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 something like that what you

want between 8 and 12 percent then i started taking i also did measurements of my dry eye symptoms my dry eye symptoms i took dry measurements that we do in the clinic to diagnose objectively what's going on with the dry eye the dryness components and then i took it for 90 days and then i also tested

my my blood again at the end and i found that after taking those omega 3s that specific formula that it ended up getting to about 9 .5 percent omega 3 it's like a hundred more than a hundred percent increase so there's a dramatic increase in the omega 3 in my blood and my dry eye symptoms also improved

now again that's just an n of one you know just one person uh there's a lot of dry eyes really complicated too what is dry eye i don't think i've ever had dry eye so dry eye 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 sitting around a bonfire or something smoke hits your eye your eyes can feel a little dry you blink a few times but dry eye disease enters a whole different state and dry eye disease occurs when not only is there a it could be a reduced amount of production of tears it could be that your tears

evaporate too quickly that's a lot of people and then what happens is that there's little bit of damage on the surface of the eye because the the tear film has to stay stable to protect the tissue underneath if the tears are gone the tissue underneath gets exposed to air and salt content of your tears

ends up going up what we call hyperosmolarity of the tears that higher salt content irritates the surface of the cells on the surface of the eye here on the 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

a small episode you're walking on the street wind comes up dry your body heals it but if it's a chronic condition 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 lacquer gland to stop producing

as much tears the inflammation prevents your eye from healing and then the inflammation can cause the oil glands of the eyelids to start to basically cause more irritation and stop producing as well is there one food in particular that is in your view the top food for good eye 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 good sweet potatoes technically have beta carotene right same thing as carrots if you're deficient in vitamin a your body will convert

that beta carotene to vitamin a which is good but mainly in green leafy vegetables you can not only get things like beta carotene but you can get lutein and zeaxanthin which are amazing for eye health in many ways not just eye health but also brain health what about sugar what impact does it you because you

mentioned diabetes earlier i think if i'm having a lot of sugar in my diet will that have an impact on my eye health it can for patients or for people who are diabetic or have elevated blood sugars when you have too much sugar in your blood it can enter into the eye it can cause the lens inside the eye

to swell and so with that swelling you can see a refractive change your power of your glasses contact lenses that can shift and so that can sometimes be a tip off if you were to see me in the clinic and i noticed your prescription suddenly changed like two steps i'm like why is it making this big of a change

it may be a tip off that hey maybe the blood sugar's off we have to send you in for like a diabetic work up do people with diabetes suffer more with their vision they can 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 and the arteries in the back of the eye the things at the back of those things there yeah because the the back of the eye is one of the most highly vascularized area of your body see as we can because you have blood vessels again on the inside of the retina you

have blood vessels on the back side of the retina and so when people have damage to those blood 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 the retinal tissue

is not getting the nutrients the oxygen and the nutrients it needs to stay alive and so then people's vision can deteriorate you can have a swelling in the back of the eye in the retinal tissue itself we call 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 the eye that fibrous scar tissue starts to form and it can even pull on the retina and create a retinal detachment let's pause for a minute and talk about today's sponsor WOEP what do you have planned for the next 31 days if this month is shaping

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community keep your eye on the app this month for the sober october challenge if you haven't joined yet now is a great time to join just head to join .woop .com slash CEO to start your free trial today that is join .woop .com slash CEO now is the time to transform your life every once in a while my eyelid

starts twitching what is that eyelid myokymia is that what it's called it is that's that's the medical definition for it twitching eye i call it twitching eye twitching eyelid like the eyelid starts 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 and this is historically even in textbooks they call it basically the meds medical student twitching eye because it's usually people who are stressed out people who are not sleeping very well they're fatigued and then people are drinking way too many

stimulants like drinking caffeine so i have a lot of patients who'll come in they're like i'm having my eyelid twitch and i look over 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 some people can have a true blepharospasm

where the eyelids close involuntarily and that's more of an advanced medical condition so i think if people are having just a little flutter on their eyelids usually not a concern it's 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 remember saying the same thing to my a doctor who's like you're just too stressed and i'm like i'm not stressed i'm doing great and then i go home and i start making a list of everything i'm trying to control in my life i'm trying to control this for grades trying to do

this and excel in athletics i'm trying to do this at home i'm trying to manage this with my friends and you know halfway through i look at the list i'm like whoa there's 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 realize it

haven't been that self -aware glycoma now glycoma is something that people over 60 typically get um from what i've understood is that preventable at all or is that just a consequence of aging and what is glycoma so glycoma is where the nerve the nerve in the back here that connects the eyeball to the brain so this thing

here yes so the nerve that all of the retinal 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 of glaucoma but the nerves die for some reason so the nerves at the back here okay those nerves go send

the information back toward the brain so that you can see the challenge is that that nerve if it gets damaged the nerves die off and when they die you can't get them back so glaucoma there's again there's different types of them the most common one that people think about is what's called primary open

angle 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 part of the bike tire blows out and that basically happens with the eye but the weakest part of the eye is the nerve

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 reversible is it unfortunately no when you lose the ganglion cells they die we know that pressure plays a role in it the internal pressure of the eye

and so most treatments right now for glaucoma 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 through 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 so 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 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 specks when you look left and right 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 floaters do naturally start to occur

these are the gel inside the eye called the vitreous the vitreous humor so opening up the eye again this large area that holds the shape of the eye this is the vitreous humor and it's mostly water collagen and a little bit of hyaluronic acid but it's like a 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 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 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 it gets really annoying it's like looking at a gnat or a little bug flying around and really what's happening is the light is just hitting those collagen clumps it's casting a shadow on the retina and you see those floating spots 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 the back of the eye that gel can tug on the retina and create a small tear or it can create a full detachment of the retina can pull

the retina off from the back of the eye usually though if you ever have symptoms of a flash of light like a lightning bolt is going off somewhere in your vision that no one 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 has happened and you should see a doctor as soon as possible but otherwise the development of those small little 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 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 are likely to experience these eye floaters in their lifetime basically every decade of life you gain another 10 chance of having these

floaters so by the time you're yeah by the time you're 80 years old you have an 80 chance of having these floaters most people that i see coming in because of a complaint of floaters are usually in their 40s 50s i've heard you talk about pineapple helping to cure floaters so there there is a study that came

out several years ago that looked at using a type of supplement called bromelain and that's found in pineapple and that was a study that looked to see if people eating pineapple could reduce their floaters that study was not the best study ever done they did it was kind of a i think it makes me excited

that at least there's researchers looking into hey how is there a way we can get rid of these floaters because they can be really annoying if they're really large they can obstruct people's vision a more recent publication from 2021 looked at a different formulation of different enzymes and vitamin supplements

that include vitamin c a lysine zinc these can help preventing the glycation of collagen and specifically within the vitreous of the eye and they did find after six months of supplementation that people's symptoms of floaters reduced it's only one study and i want to see more but that right now is probably

the only supplement on the market that has probably the best research behind it being it was a placebo control trial the pineapple study was in 2019 in the journal of american science and the study said that people who had three slices of pineapple a day had a 75 percent eye floater improvement we are saying

that that study is not super robust the medical community the eye care community we 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 message me on email and on youtube and instagram saying that it did help

them but it's hard to say if it's truly placebo or not i just one day saw it come in what you need to do is you need to get the pineapple yeah what is it that you have it constantly i remember one day it came in really freaking out didn't know what it was yeah i thought i was getting some sort of disease

or something went online you know it was quite normal yeah but yeah okay never did come and i kind of shifted around i could look at it and like shift around like look in direction but it's not there all the time it's all suddenly just dripped into my side i think if somebody even especially for anybody

who's having floaters or seeing a spot like that i think it's still really important to have it evaluated because there is a chance it's not a huge chance but it's like a five percent that you could have a small tear or a hole in the far edge of the eye when the gel separated and in those cases then

if it's needed they can use a laser to just zap it and tack it down so that you don't develop a retinal detachment because if you get a retinal detachment 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 gets annoying i had it the other day when i was in bed in in l .a i was i had something in my eye and i could just 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 get it out and that doesn't

work either and you just feel you can feel it for maybe like 30 minutes an hour what's the best thing to do in that situation to get rid of that in your opinion and is it like a hallucination because i can't 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 tear film you can feel that and it can really irritate the eyes some of the easiest things to do are using eye drops you know get a person get even just over the counter eye drops using those to rinse the eye if somebody gets a chemical in the eye then

you 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 some you know obviously you're at a workplace they have wash stations for those sort of things so that's going to be the most important if the eye remains red irritated the body

will produce more 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 somehow there's inflammation developing on the surface your body's producing more mucus things your body can sense that there's more swelling there so the best

thing to do is rinse it out and go see the eye doctor especially if it's not getting better so how often do you think i should get my eyes tested yearly every year you should i say that because they've had multi disciplinary um of different eye care professionals not just eye care but different medical

professionals in different fields look at the statistics and again it's the fact that it is one of the easiest least invasive medical procedures you can do to detect the most medical conditions that can potentially prevent you from having more serious comorbidities later in life dr joseph what's the most

important thing we didn't talk about that maybe we should have talked about today i think probably the one of the biggest things that i personally really like to reflect on we've touched on diet a little bit but i think diet and lifestyle paying attention to how much not only what you eat how much you

eat exercise sleep hydration focusing on these sort of things can have a ripple effect on 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 think we need to be

really aware of that and how important the eyes are for your learning for your development for your risk if you if you have poor vision your risk of developing dementia and alzheimer's in later years is greater that vision and eyesight is really important for the development for children and their minds

and so we we need to be aware of 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 regular basis is really important even if you feel like your vision is great and you see fine you don't want to

lose 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 and the question that has been left for you is what is your most important early memory that you've ever had ever had?

one that does impact me on a regular basis is just making friends when i was a kid i didn't have many friends and i remember finally making friends from sports and just having people over to play have sleepovers and finally feeling like i had companionship of some kind i think it kind of proved that i

was that i that i mattered that i had value was just or being seen being that i had a role in this world beyond just me on my own did your childhood tell you otherwise i have a memory that i've shared mainly with my therapist where i was in trouble i was grounded to my bedroom i didn't feel safe leaving

my bedroom because my older brother bullied me at that age and i felt that i did not matter that i was not wanted that i was only in the way and i think over the course of my life that feeling that i needed to perform excel was 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 extracurriculars it was a very subconscious thing something i was not aware of and not only recently in the last year have come more to terms with those early experiences in my life and how they maybe have driven 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 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 sometimes don't even realize

how much of that early experience inspired you to pursue the line of work that you do now i know that you said it pushed you to excel but specifically focusing on the eyes somewhat connected and when i was a kid again i was lonely i was an indoors kid i'd played a lot of video games watch movies my

brother he was the fisherman outdoors kid when i turned 13 entering into junior high my mother wanted me to pick a sport and so i did the mainly thing i want to play football you know american football i'm going to tackle people it's hard to play tackle football with thick glasses on your thick glasses

that was a i was a nerdy kid sat inside all day again i was inside thick glasses because i was myopic i went to the eye doctor to get fit for contacts and fit being fit in contacts changed me because suddenly i could play sports making friends for the first time in a long time to having self -confidence

because 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 13 that was like the most important thing in the world and so continuing to grow up i was always fascinated with eyes with contact lenses and i

knew in later high school when people are like hey what are you gonna do when you grow up what are you gonna do for college i'm like i don't really 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 eye doctor that guy's cool every part

of the eye exam is like black magic and i thought you know what i could be that guy and so that definitely influenced my 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 want to pass that on i want to help people have an amazing experience with their eyesight and experience the world and have more freedom in their life to pursue education to experience and see just the beauty of color nature really to experience the world and so i really wanted to give that as

a gift to as many people as i can and i guess the confidence that it gives those people as well as it did for you at a young age isn't to be underrated well thank god you did because you know you've helped many millions of people with a wide variety of eye related issues and conditions and helping them

understand both the more superficial elements of their eyes but also the more sort of deeper progressive diseases that might risk taking away their freedom in the ways that you've described just there but i just want to say a big thank you for um let me think of a nice eye related pun allowing me to

see more clearly as it relates to the subject of eye health and vision and everything that's interconnected so thank you so much Joseph and thank you Stephen appreciate you man this is great so i don't know how to say this in a way that you're going to understand but perfect ted is banging i'm an investor in the company

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[The Secrets of Eye Health: Debunking Myths and Protecting Your Vision]-[The No.1 Eye Doctor: They’re Lying To You About Blue Light! The Truth About Floaters! Turn This Phone Setting On To Save Your Eyes! ]

📋 Summary

Introduction

The Macro Picture: Why Our Vision is Declining

Debunking Myths: Blue Light and Eye Strain

The Importance of Proactive Eye Exams

Nutrition and Lifestyle for Optimal Vision

Addressing Common Concerns: Bags, Floaters, and Sun Gazing

Conclusion

🎯Key Sentences

📝Key Phrases

📖 Transcript