00:00welcome to the huberman Lab podcast
00:01where we discuss science and
00:03science-based tools for everyday life
00:08I'm Andrew huberman and I'm a professor
00:10of neurobiology and Ophthalmology at
00:13Stanford School of Medicine
00:15today my guest is Dr Jeffrey Goldberg Dr
00:17Jeffrey Goldberg is the chair of the
00:19Department of Ophthalmology at Stanford
00:21University School of Medicine he is a
00:23clinician and MD or medical doctor who
00:26sees patients every week as well as a
00:28PhD meaning a laboratory scientist who
00:31directs his own laboratory focused at
00:32understanding the mechanisms and cures
00:35for diseases of the eye Envision such as
00:37glaucoma retinitis Pigmentosa and
00:40macular degeneration indeed Dr Goldberg
00:42is one of the world leaders in
00:44developing methods to cure blindness he
00:46is also intensely knowledgeable about
00:49all things related to Vision so during
00:51today's discussion we indeed cover most
00:54all of visual and Eye Health you will
00:57learn for instance about the benefits as
00:59well as drawbacks of wearing corrective
01:02lenses such as contact lenses or
01:04eyeglasses for reading you will learn
01:06about the benefits and detriments of
01:09sunlight meaning how it can help your
01:12vision in fact how it can help reverse
01:14or prevent my own Opia nearsightedness
01:16as well as the things to be cautious
01:18about with respect to sunlight in terms
01:20of development of cataracts which are
01:23occlusions that prevent Vision we also
01:25discuss many tools for maintaining and
01:27improving Vision across the lifespan
01:29ranging from behavioral tools so
01:31specific Vision tasks and exercises for
01:34the eye that you can do that are known
01:36to improve or maintain your vision as
01:38well as specific surgical procedures
01:40such as LASIK surgery we get into all
01:43the details of for instance how often to
01:45do these various eye exercises how long
01:48the benefits are maintained as well as
01:50age-related considerations for things
01:52like Lasik eye surgery we even get into
01:54how to best clean your contact lenses
01:57whether or not to use disposable contact
01:59lenses or other forms of contact lenses
02:01we also discuss things like dry eye and
02:03the best remedies for dry eye and we
02:06talk about the scientific and clinical
02:07data around nutritional approaches and
02:10supplementation-based approaches for
02:12maintaining and improving Vision so
02:13whether or not you suffer from floaters
02:15or dry eye or you're considering
02:17changing your eye prescription or you
02:19have concerns about whether or not
02:20relying on corrective lenses is
02:22impairing your vision and you want to
02:24enhance your vision or if you're
02:26somebody who has perfect vision today's
02:28episode is going to include science and
02:30protocols that will be highly relevant
02:32to you I should also add that if you are
02:34somebody who suffers from or who has
02:36family members who suffer from diseases
02:37of the eye that can impact Vision such
02:40as glaucoma retinitis Pigmentosa and
02:42macular degeneration we also delve deep
02:45into the discussion about the most
02:47Advanced Technologies for preventing and
02:49offsetting vision loss due to those
02:51diseases as well thanks to Dr Goldberg's
02:54incredible knowledge his Clarity of
02:56communication and his generosity with
02:58that knowledge by the end of today's
03:00episode You Will Be armed with all of
03:02the modern information you need in order
03:04to best maintain and improve your eye
03:07and vision health before we begin I'd
03:09like to emphasize that this podcast is
03:11separate from my teaching and research
03:13roles at Stanford it is however part of
03:15my desire and effort to bring zero cost
03:17to Consumer information about science
03:18and science related tools to the general
03:20public in keeping with that theme I'd
03:23like to thank the sponsors of today's
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06:26now for my discussion with Dr Jeffrey
06:28Goldberg Dr Jeffrey Goldberg welcome
06:31thanks it's great to be here you and I
06:35we will spare people the discussion
06:37about all of that but
06:40I'm really excited for today's
06:41discussion because I get a tremendous
06:43number of questions about vision and Eye
06:45Health and of course as a neuroscientist
06:47who has worked on the visual system I
06:49sometimes have answers or partial
06:51answers but more often than not I don't
06:55and yet I'm confident that you do or
06:57that if you don't you can direct us to
06:59the proper place to get those answers so
07:01to kick things off I want to ask you
07:03what was one of the most commonly asked
07:05questions when I solicited for questions
07:08in anticipation of this episode which is
07:10how early should one do an eye exam on
07:14their child and how regularly should we
07:18all be doing eye exams
07:21is the fact that I think I can see
07:23normally confirmation that I can see as
07:26well as I think I can so that's really
07:28three questions but baby comes out do
07:31they check their eyes right away and if
07:32so how and how often should they check
07:34and what kind of information is there
07:36yeah it's as a great question it's
07:39obviously something that touches us all
07:41so the the answer that really differs a
07:44little bit uh at the different stages of
07:45Life first of all every every baby gets
07:49an eye exam or should be getting an eye
07:50exam and uh one of the main things that
07:53you really just are screening for right
07:55when that baby is born right in the
07:57nursery right in those first few days is
08:00to just look for a red reflex you know
08:01when you take a camera picture a Flash
08:03picture and sometimes you get red eye
08:05that's actually the light from the flash
08:07as you know reflecting against the
08:08retina coming back out of your eye it
08:13um and a red reflex is actually very
08:15normal that's that that's great and if
08:17you have a one of a number of
08:20diseases in the eye that can present
08:22even in babies even in newborn babies
08:25including most concerning but thankfully
08:29least common retinoblastoma which is the
08:31most common pediatric eye cancer which
08:35again thankfully is quite rare uh those
08:38babies won't have a red reflex in that
08:40eye it'll be kind of a whitish or gray
08:42reflex and so even just that first
08:45little you know doctor's taking the
08:47little pen light and even just flashing
08:48it in that's in the baby's eyes so
08:50that's that's that's our first eye exam
08:52and hopefully we've all had that and
08:54hopefully every baby being born today is
08:56getting that getting that first eye exam
08:58is really just looking for that red
09:01uh it's not typical as long as that's
09:05um to worry about getting an eye exam
09:08from there kind of through
09:11um childhood like maybe early Elementary
09:13School unless they your baby is
09:16presenting with one of a number of
09:18features that parents often pick up on
09:20for example as the baby's aging through
09:23those first couple of years you know
09:24through the first couple of years babies
09:26actually don't have great visual Acuity
09:28and so as they're aging over those first
09:31couple years it's normal for them to
09:33have you know roving eye movements for
09:36example be searching their environment
09:38but over those first couple of years if
09:41parents start noticing the baby isn't
09:43you know isn't uh making eye contact or
09:46looking where a sound is certainly if
09:49they have what's called nystagmus like
09:50these rapid flickering alternating eye
09:52movements uh anything like that of
09:55course you're going to trigger trigger
09:56an eye exam but otherwise most babies
09:58other than their pediatrician doing that
10:01red reflex check when they're in for
10:03their regular well child checks uh
10:05that's really all that's uh needed
10:07through that when most kids get to
10:09elementary school age there will often
10:11be often done at the schools and
10:14amblyopia screening exam if kids eyes
10:18either if one eye doesn't see that well
10:20like maybe you're very nearsighted or
10:22farsighted in one eye and pretty normal
10:24sighted in the other or the two
10:26refractive errors are quite different
10:28from each other that can lead to a
10:31condition you've talked about on the
10:33podcast before called amblyopia which is
10:36probably one of the more common or most
10:37common eye diseases of children
10:41or if the eyes are in a line you know
10:43our eye muscles and the Brain behind
10:45them are really responsible for keeping
10:46the two eyes looking straight ahead and
10:49if that's not working properly and one
10:51eye is is off kilter and therefore the
10:54image of what we're looking at is
10:56falling on different spots of the retina
10:57it's not sinking upright in the brain
10:59that can lead to this disease condition
11:01called amblyopia where that eye is no
11:04longer talking to the brain properly and
11:06there's a pretty easy screening exam
11:08that can be done for strabismus the
11:10misalignment of the eyes that kids will
11:12do in elementary school the other main
11:14presenting symptom of kids in elementary
11:16school is when they admit to their
11:18parents I can't see the board or I can't
11:20see the teacher up front and then they
11:22might be quite nearsighted and so that
11:24will also trigger an exam and so those
11:27are usually the parts for for babies for
11:29toddlers for children school-aged
11:31children that might reasonably trigger
11:33an exam a couple of questions about
11:35early eye exams and we'll um get on to
11:39uh eye exams in older visuals in a
11:41second but I want to interrupt you with
11:43this question so you mentioned that um
11:45you know there can be a misalignment of
11:47the eyes I've seen many people's babies
11:49where there is one eyeball that seems to
11:51be kind of drifting around and then it
11:52might correct but sometimes they'll have
11:54a we don't want to get technical here
11:56for our listeners we'll keep it General
11:58but either convergent eyes or one eye
12:01converging cross eyes or walleyed you
12:04know again using uh that non-technical
12:08um and my understanding is that the
12:11brain is taking that information in and
12:13it's very plastic it's changing at these
12:15early stages of development and that
12:16it's fairly critical to get that stuff
12:19corrected early on because if you wait
12:21too long the brain can essentially
12:22become blind to the the um or rather the
12:26the brain cannot learn to handle the
12:29proper alignment so in other words if a
12:33crossed eyes excuse me and they're not
12:36corrected uh until their 20s it's
12:39possible that they will never recover
12:40normal vision whereas if you recover if
12:42you align the eyes properly early in
12:44development they can indeed recover
12:47Vision how early can and should one
12:50consider getting those eye realignments
12:52done yeah yeah pretty much right on what
12:55they'll do is if they detect any eye
12:57misalignment and sometimes parents are
12:58are good at noticing that and sometimes
13:01you take a picture and one eye got the
13:03red eye reflex and the other one didn't
13:05and sometimes people notice that their
13:07kids eyes are sort of turning in it
13:11um sometimes there's what's called
13:13pseudostrabismus which is where actually
13:15depending on your Anatomy if you have a
13:16little extra skin sort of on the inside
13:19corners of your eyes it makes your eyes
13:20look turned in when actually they're
13:22straight but if your eyes are actually
13:25turned in or slightly less common in
13:27children more common in adults
13:29misalignment turned out
13:31it's really important to correct that
13:33early and the reason is as you were
13:35saying the brain starts ignoring it it
13:39fails to fully develop the straw wrong
13:41connections from the for the data coming
13:44in from one of those two eyes into the
13:47brain and if you pass certain sort of
13:49thresholds during development during
13:51childhood without correcting that
13:54connectivity getting those two eyes to
13:56work together properly you can
13:59permanently lose that
14:01um and so we use sort of we used to use
14:05very sort of uh you know gross numbers
14:07like it's fully correctable if you can
14:09intervene before age three it's partly
14:11correctable if you can intervene before
14:13age six you got a chance before age nine
14:17but it turns out in follow-on studies
14:19that even kids into their young teens
14:22have a shot at correcting that I brain
14:25connection that amblyopia that that loss
14:28of vision uh that that can occur during
14:30early development so even if you're only
14:33you know unfortunately detecting that
14:36later on in childhood or even sort of
14:38the tween years or early teen years it's
14:41still worth a try to really push to
14:44um retrain the weaker eye and then also
14:48realign the muscles so that they can
14:51work together to keep the eyes focused
14:53I'll tell you it's interesting and
14:55there's a lot more to learn about brain
14:57plasticity and probably a lot of really
15:01therapies yet to discover that could
15:03reopen what's called critical period
15:05plasticity this this this plasticity
15:08that we have during development that
15:09kind of goes away as we age and and that
15:12critical period plasticity as you know
15:13has been the best studied actually in
15:15the visual system and the idea that we
15:18could reopen that is really fantastic
15:20but for different parts of that ibrain
15:23connection there's different periods for
15:27critical period plasticity for example
15:28even if you get the amblyopic eye to see
15:32well again and then you realign the eyes
15:34and now they're working together a lot
15:36of kids will never recover full depth
15:39perception stereopsis the use of two
15:42eyes to see depth for example so why
15:45that part of the brain doesn't
15:47correct as well as the visual Acuity or
15:50central vision part of the brain I'm not
15:52sure if we understand that yet
15:54I'm going to ask for a curbside consult
15:57as sometimes called right now by telling
15:59you a story when I was a kid I went
16:01swimming without goggles and I had one
16:03eye closed and the other eye open and
16:06closing as it went in and out of the
16:07water because I'm a deficient swimmer
16:09and I only breathe to one side
16:12unless I really consciously forced
16:13myself to breathe to both sides in a
16:15freestyle swim got out of the pool and I
16:19it was pretty eerie and then it became
16:22downright scary because I didn't recover
16:24my double vision until they patched one
16:26of the eyes to forcing me to use the
16:29other eye that had been closed the
16:32and fortunately this was done early
16:35enough and it I was young enough that
16:37within I think it was about a day or so
16:39I restored what normal vision however my
16:43depth perception is terrible
16:46um I'm the kid that you know Fly ball
16:48was hit to me in the Outfield and it's
16:50coming it's coming and then it hit me
16:51this is why I've generally focused on
16:53foot Sports throughout my entire life as
16:55opposed to you know precise hand-eye
16:57coordination I'm better at throwing
16:58darts and things with one eye closed
17:00than I ever would be with both eyes
17:01maybe that's true for most people
17:06is it true that even just a few hours of
17:09misalignment of information to the two
17:12eyes early in development can
17:13permanently rewire the brain unless
17:16there are some corrective measures such
17:18as patching up one eye and the example I
17:21gave is just one but for instance if um
17:23uh you know someone injures you know
17:26gives a scratch on their cornea and they
17:28close they patch the eye and the person
17:29happens to be 10 years old is it
17:31important to then patch the other
17:33healthy eye after the the um you know
17:36the scratched eye is feeling better in
17:38other words how critical is it to ensure
17:40the balance of information coming into
17:43the two eyes even on the order of hours
17:45or days yeah your story is uh it has
17:49some features of uh you know totally
17:51usual how we think about misaligned eyes
17:54leading to amblyopia where one eye is
17:56weaker patching the strong eye so the
17:59weak eye can recover but not necessarily
18:01fully regaining depth perception and so
18:04that part of it is you know quite
18:07stereotypical the part of your story
18:09that's atypical is that for most kids
18:13um an hour to let alone minutes an hour
18:16to even an hour to a day if you were I
18:20don't know if you were a young kid and
18:21you just really were training up on
18:23throwing darts and you were just keeping
18:25one eye closed to throw the darts you
18:27know really practicing for an hour a day
18:28it'd be very unusual for that to trigger
18:32this kind of either strabismus
18:35misalignment of the eyes let alone
18:36amblyopia and the strabismus is what's
18:39giving you the double vision because
18:40they're misaligned let alone the
18:42amblyopia of one eye turning out weaker
18:44if I had to guess of course not having
18:47you know done your exam before that
18:49fateful day in the swimming pool if I
18:51had to guess I would guess that you may
18:53have had some intermittent business and
18:57your brain was already getting kind of
19:00and and you neither you nor your parents
19:02may have even noticed it it could be
19:04happening you know at other times a day
19:06or you're not kind of really paying
19:07attention it doesn't kind of stand out
19:09in the way that that that day that you
19:12got out of the swimming pool you really
19:13noticed it and it may not have been that
19:15strong it may have been quite
19:15intermittent but if you had had some
19:18years of intermittent isotropia or
19:20turning in of the eyes or exotropia
19:23turning out of the eyes that just
19:25happened here and there but was
19:26accumulating sort of uh damage or
19:30failure to connect over years leading up
19:32to that day in the swimming pool and
19:34that day just tipped you over the edge
19:36and you've got double vision you really
19:37noticed it that led to an eye exam and
19:40an eye care provider and they said wait
19:42a second this size stronger this size
19:43weaker you've got a little amblyopia
19:45we're going to start patching your
19:47strong eyes so you can get your weak eye
19:48back so for 99.9 percent of the kids who
19:51like you know yeah they get a little
19:53corneal scratch or they're patching one
19:55eye closed or or uh you know anything
19:59that's sort of a rare event like that
20:01nothing to worry about parents don't
20:03have to worry kids can be kids they can
20:05play they can do that kind of thing and
20:07uh and not have to worry and and it's
20:09unfortunate that we can't tell in
20:12which kid's been having the intermittent
20:14amblyopia because we don't do a standard
20:16eye exam on every five-year-old who's
20:18not complaining of anything but but yeah
20:21so that's a that's an unusual case in
20:23yours and if I had to guess I I would
20:24bet that you were having some sort of
20:27subclinical untracked Uncharted
20:30unnoticed maybe strabismus leading up to
20:33that point okay great thank you you can
20:36send me a bill at the end
20:40I'm 47 years old so I was part of the
20:44generation that grew up with some
20:45computers in the classroom but not a lot
20:49kids from a very young age are looking
20:53phones and screens and things very close
20:57up and there is a wealth of experimental
21:00animal data showing that if you limit
21:02Vision to just close range that the
21:06eyeball lengthens and therefore the
21:09visual image Falls in front of and not
21:11directly onto the neural retina the
21:14essentially the light sensing portion of
21:16the of the eye and those animals become
21:20myopic or nearsighted
21:23what can we say about the environmental
21:25conditions in which kids are seeing
21:29from the time they're born through let's
21:32say adolescents and their teen years in
21:35how their visual system wires up and are
21:38there any recommendations that are
21:41coming from the scientific literature
21:42clinical studies clinical trials excuse
21:45me or otherwise that indicate what a
21:48healthy visual environment consists of
21:51yeah yeah that's a great question and
21:54actually it's really relevant these days
21:57because uh you know myopia is so common
22:05an Asian populations you know it's
22:08called an epidemic in China in
22:11California we have a lot of Asian
22:13Heritage or Asian Americans and so we
22:16see a lot like at Stanford we see a lot
22:20um you know myopia in kids on adults and
22:23really starting to get thoughtful on the
22:25science of myopia control how do we how
22:28do we provide the right environments now
22:30what's interesting is that for decades
22:32the Assumption some of the data really
22:37led us to the path of thinking like gosh
22:39the more you spend near activities and
22:42these are Mouse model experiments like
22:44you described but also well-designed
22:46human cohort studies you know figuring
22:48out like asking you know kids and
22:51families like how long is your kid
22:52reading or in front of the computer how
22:54myopic are they how nearsighted are they
22:56versus how much time is your kid in
22:59front of the computer doing near work
23:01how myopic or nearsighted are they and
23:04these well-designed cohort studies did
23:06Point tour words this concept that if
23:09you do too much near work as a kid that
23:12you're more likely to develop
23:14nearsightedness as you get through those
23:16those sort of you know uh pre-teen and
23:19even into the teen years which is when
23:21most of that myopia progression or
23:23eyeball elongation is actually happening
23:26to cause nearsightedness
23:28it's only been in the last few years
23:30that some really exciting Studies have
23:32actually pointed in a slightly different
23:36and that's that maybe it's not all not
23:39to say it's not about near activity but
23:41maybe it's not all about near activity
23:43maybe it's actually a little more about
23:45the kind of light we're getting into our
23:47eyes and I think you've talked about
23:49this before and it's really important
23:51when they've now studied and asked the
23:53kids instead of just how much near and
23:55how much far are you doing how much time
23:57are you spending indoors in indoor
23:59lighting which doesn't have full
24:00spectrum light in a typical indoor
24:02environment versus how much time are you
24:05playing in the yard you could be reading
24:07outside but what are you just what kind
24:09of time are you spending outside and and
24:13of course when you're outside in
24:14sunlight even it's in direct sunlight
24:16you're getting a different spectrum of
24:18kind of Full Spectrum Lighting from the
24:20sun and it looks like it's pretty clear
24:23now actually that it has maybe more to
24:26do with outdoor lighting time than just
24:30near work and so I think that you know
24:34we we've we've actually already seen the
24:36first couple randomized controlled
24:39trials where they're having kids
24:41intentionally spending time Outdoors
24:44versus sort of Standard Life which you
24:46know is going to be often much more
24:48indoor time and uh and seeing some
24:51effects you follow those kids over a
24:53couple of years and the kids who spend
24:56time Outdoors are are progressing in
24:59their nearsightedness less like they're
25:01they're nearsighted prescription is not
25:04getting as strong as the kid kids who
25:06are spending more time indoors and
25:08there's some pretty good biology that's
25:09getting worked out going back to animal
25:11models more about about how that might
25:13be working in the retina in this inside
25:16the eye but it's pretty compelling uh
25:19concept and and so you know as a parent
25:21uh you you may want to be you may want
25:24to be telling your kid like okay yeah I
25:26want you to read that book or you know
25:28if your kids plan on the phone or
25:30something like that or the iPad or
25:32something like that they're allowed that
25:33time okay you can have that time but I
25:36want you to spend some of the time that
25:37you're doing that Outdoors are there any
25:39thresholds for the amount of time that
25:41one would suggest their child be
25:43outdoors to get that full spectrum light
25:46it's a great question you know we talk
25:48about cohort studies where we just ask
25:51people what are they doing and there
25:53seems to be you know a little bit of
25:54what we would call a dose dependent
25:56response maybe the more time Outdoors
25:58might be better we don't know if there's
26:00an upper limit like gosh if you go over
26:01two or three hours there's no additional
26:03benefit talk about that cohort studies
26:06the real gold standard for answering
26:09these kinds of questions are randomized
26:12controlled trials and specifically
26:14placebo-controlled or or a control group
26:17that's not getting the intervention
26:18that's our highest level of evidence for
26:21clinical evidence for for any of this
26:23kind of science when we're talking about
26:25humans or pre-clinical models in the
26:27laboratory and the study that hasn't
26:30been done yet to really answer that
26:32question is to randomize kids to telling
26:36this group of kids you just do your
26:38normal life tell this group of kids we
26:40want you outside an hour this group of
26:42kids we want you outside two hours a day
26:44this group occurred three hours a day
26:46and see between the groups is there a
26:49big difference like we have pretty good
26:51evidence now from the studies that have
26:52been done that the difference between
26:56and one or two hours is clearly There is
26:59five minutes enough is five hours better
27:02I don't think we know the answers to
27:04those questions yet like what's the
27:05right dose but there's probably at least
27:08some dose dependence to that and it I
27:11can imagine it's a little bit hard to
27:13tease apart the near far viewing from
27:15the indoor outdoor because yes of course
27:17a child could be outside on an iPad up
27:21but it's hard to imagine that at some
27:23point they aren't seeing off into the
27:24distance far viewing as it's called and
27:28the reverse is also true if you're
27:29indoors unless you live in a very very
27:31large home or you're staring off a
27:33balcony far viewing is much harder to
27:36achieve yeah so it's and perhaps it
27:39isn't important to isolate these
27:40variables although I can see the
27:41challenge in developing a really good
27:43clinical trial randomized clinical trial
27:45for this meanwhile I I you know I'm con
27:47I'll go into the grave shouting you know
27:50or saying rather and suggesting that
27:52people get some morning sunlight in
27:54their eyes to set their circadian rhythm
27:56um but far viewing a few at least a few
27:59minutes and ideally hours per day or a
28:02mixture of near and far viewing by being
28:04outdoors just seems like a good thing to
28:06do regardless of age so are there any
28:08data in older people not necessarily
28:11elderly but older people so um people in
28:13there from say 25 years of age into
28:16their 60s or 70s that getting outdoors
28:18and getting this full spectrum light is
28:21healthy for the eye in ways that are
28:23separate from the known healthy effects
28:25of doing that on circadian rhythm
28:26setting yeah yeah the Circadian Parts
28:32and most patients and most in most
28:34people the new the development of
28:36nearsightedness happens a lot until age
28:3810 little more through age 20. a little
28:42more than that into the in you know in
28:44through the 20s up to 30. tiny bit in
28:47the 30s up to 40. but usually by those
28:50later ages your prescription might be
28:52changing a quarter of a diopter that's
28:55the measurement that we use when we you
28:57know give you your glasses prescription
28:59a quarter of a diopter half a diopter it
29:02could get a half after more nearsighted
29:04or less nearsighted you know once you're
29:06aging into your 40s 50s and Beyond so
29:09most of the action on nearsightedness
29:12development is actually really happening
29:14in the younger ages so again the the
29:17premise of intervening in an older
29:19person and I'll just include you and me
29:21and older people for the sake of this
29:23definition as much as I'm reticent to do
29:27um I think the the premise of Inc of of
29:30sort of light modulation from
29:32nearsightedness in older people is
29:35probably probably not so strong I think
29:37there are a lot of other benefits you've
29:39talked a lot about circadian rhythm
29:41there are so many health benefits to
29:43exercise and you know if you're getting
29:45Outdoors there's a good chance you're
29:47going to be walking or bicycling you
29:49know so so exercise value for the health
29:52of our eyes and the rest of our body is
29:55um but I don't know that there's really
29:57a strong premise that you're going to
29:59change your glasses prescription you
30:01know in our 40s or 50s or Beyond I'd
30:04like to take a quick break and
30:06acknowledge one of our sponsors athletic
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30:26twice a day is that it gets to be the
30:28probiotics that I need for gut health
30:30our gut is very important it's populated
30:32by gut microbiota that communicate with
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30:57try athletic greens you can go to
30:58athleticgreens.com huberman and they'll
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31:14to get the five free travel packs and
31:16the year supply of vitamin D3 K2 it's
31:19probably worth touching on some of the
31:20do's and some of the don'ts for Eye
31:22Health generally and then I promise I'm
31:25going to get us back to adult eye exams
31:26because I have a lot of questions about
31:30I can imagine that it's probably not a
31:32great idea to be exposed to extremely
31:34bright light and this is why people who
31:36weld wear eye Shields but of course most
31:40people are not welding
31:43what other sorts of environmental
31:45conditions are detrimental to our vision
31:47health across the lifespan including
31:50brightness of light we talked a little
31:52bit about near far obviously we want to
31:55keep toxins and acids and solvents and
31:57things out of the eye but what do you
32:00I'm not because hopefully not commonly
32:02but what are some of the things that you
32:03feel might not be discussed enough in
32:05terms of Eye Health yeah you know I
32:08think at all ages eye safety is
32:12something that we don't talk about
32:15um you know our eyes are delicate the
32:19front surface of the eye the cornea the
32:21Clear Window that lets the light go into
32:23your eye that's a delicate very
32:25sensitive structure it's thin maybe a
32:28millimeter at the thickest a half
32:30millimeter in the center of our eye
32:32uh the retina is it it's neural tissue
32:36this is like really an outgrowth of the
32:37brain this is very sensitive it's
32:39subject to degenerative disease and
32:41injury our eyes even if they just get
32:44hit can get very inflamed our eyes can
32:47be more inflammatory than a bruise on
32:49our skin on our shoulder might be so eye
32:52safety is a big one and people who are
32:54working in certain industries
32:58um you know anyone who's doing any metal
32:59grinding people who are even just
33:02gardening you know and if you're if
33:03you're doing some significant gardening
33:05and cutting and you could you know Fleck
33:07a little bit of dirt you know there's a
33:09lot of there's a lot of for example
33:11fungus that lives in the ground natural
33:13stuff it's all very normal in the in the
33:15Earth but you know our eyes aren't
33:17really made to absorb that fungus and
33:21and have have a piece of dirt kind of
33:23stick in our eye like that and so people
33:26are at risk I think for you know for not
33:28and we see too much kind of
33:30really unnecessary eye injury eye trauma
33:34that if people wore either their glasses
33:37because they happen to wear prescription
33:38glasses or goggles or for more advanced
33:42work you know safety goggles of course
33:45um if you're sanding doing wood shop
33:48projects anything like that sawing
33:50including you know again in the garden
33:54um you know I think I think eye safety
33:57you know eye trauma is a big one and you
34:00know we probably see one or two
34:03um what we call open Globes a week come
34:06into the Opera into the emergency room
34:11um you know those are tough because you
34:13know again the eyes delicate and it can
34:14do a lot of healing but but not infinite
34:17right and so we really you know that's
34:19that's one that I think is really
34:22an untapped opportunity is just a little
34:24more education around
34:27um around eye protection protecting
34:29against eye trauma what about eye
34:31cleanliness there's some pretty dramatic
34:33videos also I've put some of these on my
34:36Instagram handle of these are MRIs of
34:39people rubbing their eyeballs and people
34:41really getting a sense of first of all
34:43a restatement of what you said getting a
34:45real sense of just how much the eyes are
34:47an outgrowth of the brain because of the
34:49op when you see with the optic nerves
34:51and all their beauty and the eyeballs
34:54moving around as someone rubs their eyes
34:55I have to imagine that rubbing your
34:56eyeballs a little bit isn't bad but I
34:58actually called you I don't know if you
34:59remember when I was a junior Professor I
35:01woke up from a nap one day and I
35:03couldn't see out of one eye I was
35:04freaking out so of course I called you
35:06and I had pressure blinded Myself by
35:09falling asleep on my hand or something
35:11like that and you assured me that my
35:12vision would come back and indeed it did
35:14so you play dual role of ophthalmologist
35:16and psychiatrist thank you and indeed I
35:19can see out both eyes
35:25rubbing our eyes getting gunk in our
35:28eyes you know I think unless somebody
35:29has lost their Vision temporarily
35:32it's hard to imagine this is like a big
35:34deal but when it happens it is truly
35:36frightening we're so dependent on Vision
35:39so um you know what are your
35:41recommendations about rubbing or not
35:42rubbing eyeballs about
35:44um hand washing and cleanliness and also
35:46how do you wash an eye properly yeah do
35:49you use soap and flush it with water or
35:50do you just flush it with water or
35:52should you not even do that should use
35:53saline I didn't realize these might
35:54sound like low level questions but these
35:56are the things that people deal with on
35:57an all too frequent basis yeah you know
36:00for most people most of the time
36:01actually the eyes are a very good clean
36:04environment and actually are tears are
36:08are contain enzymes that help break down
36:11bacteria and bacterial toxins and so for
36:14most people regular eye washing doesn't
36:17have to be any part of their standard
36:19routine in terms of the surface of the
36:21eye the part of your eye the conjunctiva
36:23uh over the whites of the eyes
36:25underneath the eyelids anything
36:26underneath the eyelids it's pretty
36:28self-cleaning and actually our tear
36:30production and blinking is very good at
36:33keeping our eyes clean the eyelids
36:36eyelashes can be another story and
36:39especially as we age uh we can you know
36:42like our skin is breaking down a little
36:44differently than when we were younger
36:45you can develop what we sort of
36:48nicknamed scurf which is like kind of
36:50little dead skin bits that accumulate
36:52around the eyelashes a lot of people
36:54develop what we call blepharitis which
36:56is just just means inflammation of the
36:58eyelashes yeah and for that doing some
37:01eye scrubs is a good idea they actually
37:04sell little pads that you can buy kind
37:06of little that you rip open and you can
37:08use to kind of lightly clean the
37:10eyelashes but you can also just use like
37:13a No More Tears baby shampoo just pump a
37:16little bit into the palm of your hand
37:18once or twice a day let a little uh
37:21dilute it with a little water and under
37:23the sink and either with your finger or
37:25an edge of a washcloth just very lightly
37:27rub the eyelashes what I like to do with
37:29the eyes closed with the eyes closed and
37:31don't scrunch them closed too tight
37:34because you're actually burying the
37:35eyelashes when you do the roots of the
37:38eyelashes when you really scrunch so
37:40just gently close your eyes just you
37:42know real gentle closure and then just
37:44lightly scrub it shouldn't be abrasive
37:46you're not trying to exfoliate the
37:48eyelids or eyelashes in any way just
37:51lightly rub with that kind of dilute No
37:53More Tears baby shampoo and that can
37:55really help people with their eye
37:58Comfort if you feel like you've got
38:00something in your eye your ideal eye
38:03wash is actually going to be a sterile
38:05Salient solution a saltwater solution
38:07that you know they sell little bottles
38:09over the counter eye wash Solutions like
38:12that a lot of people wear contacts will
38:14have that kind of eye wash solution just
38:16a sterile saline eye wash just pure salt
38:20water doesn't have to have any other
38:21chemicals or preservatives in it you can
38:24of course use not actual uh seawater or
38:27salt water not salt water thank you yeah
38:29not salt water out of your salt pool not
38:31salt water out of the ocean but like a
38:34saline salt water that's available in a
38:36sterile now you can also just use
38:38artificial teardrops and some of those
38:40common non-preservatives some of those
38:42come preserved versions those are all
38:44also completely safe in the to use in
38:46the eye and there you can you know you
38:48can sort of Spritz into your eye you
38:50know hold the lid open and give it a
38:52little Spritz if you feel like you've
38:53got something in your eye a piece of
38:55dirt or A Lash that's not coming out
38:57just to rinse it but but having like a
38:59regular routine you know you're not
39:02going to hurt anything with the
39:04occasional eye rubbing we all do these
39:06things just kind of as a you know even a
39:08nervous habit or just absent-mindedly
39:10you know you might you know scratch your
39:12arm or rub your eyes or things like that
39:14that's fine you're not going to hurt
39:16anything there are conditions where
39:18people sort of develop kind of a almost
39:21like a psychological habit there are
39:23certain conditions where people actually
39:25do too much eye rubbing it can be
39:27dangerous if you're in that group but
39:28for the regular run-of-the-mill every
39:31day occasional I rubbing fine if you
39:34certainly if you get a lash in there and
39:35you're trying to rub it and blink it and
39:37tear it out and again in that situation
39:40you can use some artificial tears
39:42wedding drops saline drops those would
39:45be the way to do it what an incredible
39:47tissue the way you describe it you know
39:50the self-cleaning and yet so delicate
39:53a piece of the brain literally lining
39:55the back of each of our eyes like like a
39:58pie crust I mean it's a really
40:01um biological system of course I don't
40:03have to tell you that it's just it it
40:05never ceases to to amaze me
40:08let's talk about eye exams in adults
40:12people are aware presumably that they're
40:15optometrists and ophthalmologists I
40:17think it's important that we Define
40:18their different and also overlapping
40:23for those that you know are past High
40:25School age probably not getting eye
40:26exams unless they're sensing a problem
40:29perhaps not even with blurry vision or
40:32difficulty seeing at a distance but
40:34sometimes just what feels like fatigue
40:37of the eyes or a hard time maintaining
40:39alignment of the eyes
40:41um so how often do you recommend people
40:42get eye exams what is a true regular eye
40:45exam and is it important that people go
40:47to an ophthalmologist or will an
40:49optometrist suffice typically
40:51optometrists are a little bit easier for
40:53most people to access because there's
40:54usually one someplace near an eyeglass
40:56store so what are their roles how often
40:59should we get our eyes checked yeah
41:02um optometrists and ophthalmologists do
41:04have very overlapping roles in being Eye
41:08Care Providers there are something over
41:1040 or 50 000 optometrists in the United
41:13States or somewhere around 20 000
41:16ophthalmologists in the United States
41:18optometrists get an optometry degree
41:21they often have OD after their name
41:24ophthalmologists usually went you know
41:26went to medical school so they either
41:28have an MD after their name or they kind
41:30of a do version of a medical degree and
41:34uh and then optometrists will have done
41:36additional clinical training in that
41:38area in their area of Eye Care provision
41:41ophthalmologist MD doctor
41:43ophthalmologist Eye Care providers in
41:46addition to that training will have done
41:48surgical training in Ophthalmology
41:52um now there's a lot of overlap and
41:56um in both scenarios uh you can be
41:59getting your sort of General exam taken
42:01care of maybe a screening exam I think
42:04that there's been a traditional
42:06differentiation between optometrists and
42:09ophthalmologists with optometrists
42:11providing a little more of the primary
42:14care eye screening maybe managing early
42:18disease common diseases as well with
42:22more advanced disease often sort of
42:24upgrading to perhaps specialist
42:27ophthalmologists in those areas but that
42:31distinction has been declining over time
42:34it's still true that in I think most if
42:36not all states only the MD
42:38ophthalmologists surgeons can do eye
42:41surgeries but both both groups of eye
42:45care providers can diagnose both can
42:48prescribe appropriate eye drop
42:51treatments including prescription eye
42:53drop treatments for for many of our
42:55diseases eye diseases
42:58and um and in some states
43:01optometrists have successfully lobbied
43:04for uh sort of expanded rights of
43:06providing Air Care Eye Care and again
43:09um access to care for you know the
43:12regular person wherever they may live is
43:15is the most important element and so
43:18being able to access eye care whether
43:20it's with an optometrist in your
43:22community or an ophthalmologist that may
43:24be in your community or maybe at a
43:26distance I think that's the the really
43:28important thing is to access care now
43:30kind of like we were talking about with
43:32kids uh if you're in your teens 20s
43:35maybe even 30s and not having any
43:38problem you've got no complaints you can
43:41see a distance you can see it near
43:44um you know so you can read without
43:45classes you can drive without classes
43:49um you're not having any eye pains you
43:51know pains around the eyes you know
43:54redness of the eyes you may never
43:57present to an eye care provider through
44:00the first four Decades of life
44:02and almost all the time it's going to be
44:06okay right if you're not symptomatic the
44:09chance you've got some terrible lurking
44:11disease in there is low
44:15but we do wish that we had a little more
44:18screening going on because there are
44:20some diseases glaucoma for example my
44:22specialty the two main risk factors for
44:25glaucoma are increasing age and that
44:28usually presents you know in most cases
44:30actually after age 40 but also
44:33increasing eye pressure and if your eye
44:35pressure is too high you can't feel that
44:37that won't feel funny to you if it sort
44:39of slowly is crept up over the years and
44:42so from a screening perspective it is
44:44good to get some kind of screening exam
44:48could be at a public health fair could
44:50be that you go into the local
44:51optometrist just say hey I've never been
44:54checked I'd like to be checked once make
44:56sure everything's good could you ask for
44:57sorry to interpret could somebody say
44:59I'd like my pressures checked as I
45:01recall the optometrist they're going to
45:02do a puff test so they're going to blast
45:03some air get a sense of how how rigid or
45:06or soft again using non-clinical
45:09non-technical language here the eyeball
45:13um not right now by the way I'm sure
45:14there are are several hundreds of
45:16thousands of people who are with eyes
45:18closed touching the sides of their
45:19eyeballs and I'm only half joking please
45:21don't do this folks I'm given the
45:23conversation we just had about eye
45:24cleanliness and eye rubbing but my
45:26understanding is that the old fat truly
45:28old-fashioned eye pressure exam was you
45:31would close your eyes and the
45:32ophthalmologist would gently press to
45:35see whether or not your eyes were more
45:37rigid than last time yeah is that right
45:38yeah that's called ballot mint and you
45:40can kind of you can you can kind of just
45:42take one second if you're listening and
45:44press on your eyes just very lightly and
45:46you there's a little give of course the
45:48eyelids part of that give but but it's
45:50not it's not like rock hard and if we
45:52press and it feels under the eyelid like
45:55gosh something under there is a rock
45:57hard then we know something is wrong
45:59that is way too high pressure if it's
46:01raw card but I'll tell you our ability
46:03to differentiate the fine points of eye
46:05pressure other than Rock Hard or not
46:09rock hard is pretty limited so yeah the
46:12optometrist office or the
46:14ophthalmologist office office as part of
46:16a comprehensive screening exam they'll
46:18check the eye pressure they'll look at
46:20the surface of your eyes make sure
46:21everything's looking healthy there
46:23including the eyelids and lashes and
46:25they'll look inside the eye and be able
46:26to screen for these diseases that way
46:28too in addition to checking if you're
46:30complaining of any you know blurriness
46:32at distance or at near now after age 40
46:36or so a lot of people will present to an
46:40eye care provider because we all get
46:42what's called presbyopia and presbyopia
46:46just translates to disease a vision of
46:50the agent so you know myopia is our word
46:53for nearsighted hyperopia is farsighted
46:56actually amatropia means normal sighted
46:59so I can see it distance without any
47:00glasses I'm amitropic
47:03but then we all get presbyopia and as we
47:07age the lens inside our eye that's
47:10helping focus light onto our retina gets
47:14such that our eye muscles are no longer
47:17able to relax and reshape that lens and
47:20we're not as good as we age at
47:23moving our Focus from distance Vision
47:26distance Vision by the way is basically
47:28anything three feet or further away
47:30You're basically viewing light rays
47:33coming from Infinity once you're past
47:35three feet so three feet or further
47:38being able to focus that into 14 inches
47:40or 12 inches which might be a normal
47:42comfortable reading space for you
47:45we lose that ability to flex our lens
47:48relax our lens uh refocus our lens from
47:52distance to near and most people around
47:55age 40 could be a couple years before
47:57could be five or ten years later that
47:59you notice it but sort of around that
48:01time you start needing reading glasses
48:04you need a little extra even if you can
48:06see fine at distance and don't need
48:08prescription glasses for distance you
48:10need a booster you need reading glasses
48:12for near I don't know if you're
48:13experiencing this yet and yeah I'm
48:16really intrigued by this but maybe you
48:18could clarify when you say reading
48:20glasses do you mean just a magnifier
48:22because I use a you know a 0.5 or a 0.75
48:25magnifier for reading but I try and rely
48:29as little as possible and I want to get
48:31to this about using glasses as a crutch
48:33and the problems with that I have a
48:36story about that too you know it's no
48:38coincidence I decided to work on Vision
48:42um I had a bunch of vision issues that
48:44fortunately are corrected but you know I
48:47I do experience for instance when I wake
48:49up in the morning if I look at my phone
48:51which by the way folks I try and get
48:53outside and see sunlight first before
48:54ever looking at the phone but I'll
48:57notice when I first look at my phone in
49:00the morning that I can see it very
49:02clearly through my right eye but that if
49:04I cover my right eye my left eye is
49:06extremely blurry to the point where I'm
49:07like oh I'm calling Jeff you know I'm
49:09I'm afraid but then over the course of
49:11maybe 10-15 minutes it resolves and I
49:13don't think it's because something's in
49:15my eye I don't think it's pressure of
49:17having slept on that side I don't think
49:18it's a lubrication of the eye issue
49:21um but the two eyes seem to come into
49:23Focus so to speak um at different rates
49:26early in the day and if I pop my readers
49:29on I can see right away so I will use
49:31readers late in the day often
49:34um if I want to read at night or
49:35something that's right just it feels so
49:37much more relaxing I feel like like I
49:39can finally relax whereas otherwise I
49:41realize that I'm straining in order to
49:43see does is there any um clinical
49:45clinical data and what I just described
49:47yeah you know Andy I'll tell you my
49:50story that's like that and
49:52um we were living down in San Diego when
49:55you and I were both professors at UC San
49:57and uh we had moved into a house and I
50:02found a pair of glasses a pair of
50:04reading glasses uh in a closet and you
50:07know we asked around you know did any of
50:09the grandparents uh leave some glasses
50:11behind nobody seemed to know who they
50:13were so we finally just decided like
50:15well I guess the people who moved out of
50:17the house just left a pair of glasses
50:19you know in this in the back of this
50:21and then I tried the glasses on
50:24and I looked at my phone up close and
50:27was just like oh my God wait a second I
50:30didn't realize how blurry my near Vision
50:33was and this is back I was about 40 42
50:36something like that so
50:38so I didn't even realize until I put on
50:41the readers and these were
50:43you know 1.25 magnifiers you know so
50:52I got addicted because who doesn't like
50:55good Vision right right I mean oh my God
50:57now I can make the type smaller on my
51:00phone I can you know it was wonderful
51:02and you can relax a bit I mean the
51:04musculature that's responsible for for
51:06moving the lens and focusing the eye and
51:07then all this extraocular musculature
51:09and we forgot I mean I'm definitely
51:12um around my eyes uh probably because I
51:16you know squint or something but you
51:18know just the ability to relax one's
51:20face it just feels like you know more
51:22more energy I feel like can be devoted
51:24to what we're actually looking at yeah
51:25we're not making light of this yeah well
51:27pretty soon I just kept that one pair of
51:30glasses with me all the time and I would
51:32just keep them in a pocket and whip them
51:34out whenever I was you know working at
51:35near using my phone at a little greater
51:38distance like a typical computer
51:39distance I could still see the computer
51:41fine so it really started for like kind
51:42of that close-up phone it was it was I
51:45could get into here but not all the way
51:48and um yeah and then pretty soon I was
51:51just totally addicted and so you know
51:54then I had to go buy 10 pairs and leave
51:57them one by the bedside table you know
52:00one in the car one in the computer bag
52:02one on everything I work at yeah because
52:05I'd leave them anywhere and forget them
52:07yeah exactly you know yeah
52:14whether using the readers
52:18accelerates the progression of
52:22dependence on the readers is still uh
52:27not you know that's still up for debate
52:29you know some studies say maybe yeah
52:31some studies say maybe no but certainly
52:34psychologically we get addicted to good
52:37easy vision and if you don't have to
52:39squint and if you're not straining your
52:42muscles and all of a sudden the text on
52:44your phone looks crisper again uh boy
52:47that's addictive you're gonna like good
52:49vision and so it feels like you're
52:51getting dependent and how much of that
52:53is changing the eye muscles and how much
52:55of that is just the psychology of
52:57wanting to have good Vision I think
52:59probably the jury's a little bit out on
53:00that point but point being you're either
53:03either way your dependence will grow and
53:06as you continue to age 40s 50s up until
53:12the ability to shape that lens gets
53:15weaker and weaker and weaker and so you
53:18need to move from the 0.5 to the 1.0 to
53:21the 1.5s and to the coke bottle to the
53:25code well thankfully not you eventually
53:27max out at about plus 2.5 or plus three
53:31because that's the amount of extra
53:34refractive power that you need in
53:36magnifiers to take the equivalent of
53:39your Infinity viewing and bring it up to
53:4214 inches to read it near basically you
53:45need a plus three and then you don't
53:49lens eye muscle action whatsoever so you
53:54kind of max out around 2.5S or threes
53:57so because most people will hit this
54:01somewhere in their 40s this sort of like
54:03gosh I'm having trouble on the phone
54:06I think most people actually use that
54:08that's like kind of the first time for a
54:10lot of people they're like well I guess
54:12I should go to the eye office right see
54:14the optometrist or maybe ophthalmologist
54:15and when they go in they should be
54:18getting the standard in either of those
54:20offices will be to give you a full
54:23screening exam including maybe it's the
54:26puff test or a blue light test or a
54:28little pen that can check your eye
54:29pressure and having a look inside and
54:32seeing if you're retina optic nerve look
54:34healthy it's kind of screening for all
54:36the main diseases and so and they'll
54:39tell you at that point hey you look
54:41great if you feel like your glasses
54:43aren't doing it for you in a year or
54:44three years come back or they might say
54:47hey I've detected something I'm worried
54:49about you and they'll set up a routine
54:51for your ongoing Eye Care
54:54assuming that somebody doesn't have
54:57um you know some form of amblyopia or
55:00the need for some a really robust
55:04and they are already using readers let's
55:10or so you know plus one plus or minus
55:14would you recommend based on my
55:16experience and based on your experience
55:17that people strive to avoid using them
55:20for as long as they can because in some
55:23sense if that's the recommendation then
55:26the recommendation is that people kind
55:27of deal with the fact that they're
55:28seeing a little less well or a lot less
55:30well than they possibly could so I'm
55:31assuming that people can still drive
55:33well people can still read but it
55:35involves a little bit more effort in
55:36other words are we weakening Our Eyes by
55:38using these these readers I I realize
55:40you said that the data are a little bit
55:41mixed but as long as one can perform
55:44their required daily activities would we
55:48delaying the use of readers
55:51there's two important answers to that
55:54question one is regarding the lens and
55:58the eye muscles that control the lens
56:00and it's entirely plausible that's what
56:03I was saying kind of the data is mixed
56:04on but it's plausible that if we would
56:06just exercise like work a little harder
56:09kind of not use as strong a reader as we
56:12want or not use that reader as often as
56:15we might really enjoy uh are we
56:18exercising those muscles and kind of
56:20exercising the ability to to stretch
56:23versus relax the lens and kind of slow
56:27the progression from the 1.0 reader to
56:31the 1.25 reader to the 1.5 reader Etc
56:34right and so that that's why I'm saying
56:36the data is mixed but there's a good
56:38premise that maybe if you're exercising
56:40but let me give you the on on the other
56:42hand it's probably ideal
56:46to give your retina and your brain the
56:50sharpest visual signals you can
56:53so why hamstring your retina and your
56:58brain and your vision and your enjoyment
57:01and ability to read or do near work by
57:05constantly undercutting the the reading
57:08glasses or leaving them out or you're
57:12not helping the whole back part of yours
57:15maybe you're maybe you're helping the
57:17lens but you're definitely not helping
57:19your retina and brain by feeding it
57:21blurry information all of that time so I
57:25actually think just give in use the
57:29readers have your enjoy your Best Vision
57:32all the time and if that means wearing
57:35glasses and by the way if that means
57:37that you're going to have minus two
57:39glasses for vision and you'll eventually
57:41need minus 250s for distance Vision or
57:45if you're going to need readers 1.5
57:47readers now and in a few years 2.0
57:50readers okay so you'll get the next
57:53reader it's it's it's actually not a big
57:55deal you can you can you know you're not
57:57you're not hurting you're probably
57:59helping and in the meantime it's an
58:02enormous enjoyment to actually have good
58:04Vision all the time right so so I
58:07actually counsel people
58:09just wear the glasses that work best for
58:11you you know you're only minimally
58:13changing how your prescription is going
58:16to change over time very minimally so
58:18just enjoy your Best Vision even if it's
58:22using readers for clothes or
58:23prescription glasses for far
58:26I appreciate that recommendation I do
58:28enjoy you using the readers at night it
58:30really helps for all the reasons I
58:35I've noticed that driving at night
58:37presents an enormous strain on my visual
58:39system and I've noticed this for a
58:40number of years are there any I know
58:43there's something called stationary
58:44night blindness I don't think I'm
58:45stationary night blind
58:47um I think the mutation for stationary
58:49night blindness was identified in the
58:51Colusa horse or something like that
58:53these were horses that you could walk up
58:54to very easily and they wouldn't even
58:56see you until you're right there
58:57someone's going to correct me on this
58:58it's the internet but I think that the
59:00mutation was identified
59:02um Etc but I don't think I'm stationary
59:04night blind but I do find that driving
59:06at night I get very fatigued and then
59:10I'll sometimes even wear my plus one
59:11readers when I drive at night which
59:15removes the fatigue even though I'm
59:17looking more or less at a distance are
59:19there some conditions that make it hard
59:20for people to see at night for which
59:22they would want corrective lenses
59:25um and what what sorts of biology
59:27underlies that assuming that somebody is
59:30not stationary night blind or a Colusa I
59:33think is the name of the breed horse
59:35yeah that's a great question you know we
59:38for the for the optical defects in our
59:41eyes most or many of which can be
59:44corrected with just having the right
59:45prescription lenses we can get away with
59:49it without using those Corrections in
59:53and so during the daytime
59:56um you know you could be slightly blurry
59:59you know if I have a real bright light
01:00:02uh and a good high contrast book you
01:00:05know with black letters on the white
01:00:06page I can get away with reading that
01:00:08without my readers unlike if if I'm in
01:00:12dim light then I feel and that might be
01:00:13kind of what you're describing if you're
01:00:15reading at night you actually prefer to
01:00:16use the readers a little more even at
01:00:18night because we can make up for a lot
01:00:21of that blur if we just have bright
01:00:24enough signal and contrast coming into
01:00:26our eyes makes sense yeah so when you're
01:00:29driving at night and noticing this this
01:00:31might be revealing a little bit of a
01:00:33need for glasses now I'm not suggesting
01:00:36this is the answer but far more common
01:00:39than having congenital stationary night
01:00:42blindness would be being what's called a
01:00:45latent hyper rope okay now we talked
01:00:49about already how the lens inside our
01:00:51eye goes from focusing it distance to
01:00:54then we squeeze the muscles the lens
01:00:56actually rounds up and allows us to