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Huberman Lab
Dr. Jeffrey Goldberg: How to Improve Your Eye Health & Offset Vision Loss
Jun 26, 2023
02:42:06
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Quick takeaways
- Regular eye exams are important for maintaining eye health, especially after the age of 40.
- Using reading glasses or magnifiers for near vision is beneficial and does not accelerate dependence on them.
- Difficulty seeing at night while driving can indicate a need for corrective lenses.
- Refractive errors and cataracts are common causes of vision loss that can be corrected through glasses or surgery.
- Regular eye exams are essential for detecting genetic conditions like retinitis pigmentosa and macular degeneration.
- Supplementation with specific vitamins and minerals can help slow the progression of age-related macular degeneration and glaucoma.
Deep dives
The Role of Optometrists and Ophthalmologists
Optometrists and ophthalmologists have overlapping roles in providing eye care. Optometrists have an optometry degree and focus on primary care and screening exams. Ophthalmologists are medical doctors who have specialized in ophthalmology and can perform surgeries. Both can diagnose and prescribe treatments for eye diseases. Optometrists are more accessible, while ophthalmologists have surgical training.
Frequency of Eye Exams
For adults in their teens, twenties, and even thirties without any vision problems, regular eye exams may not be necessary. However, after the age of 40, it is recommended to get a comprehensive screening exam, including an eye pressure test, a look inside the eye, and a check for retinal and optic nerve health. Depending on the results, the eye care provider will determine the appropriate follow-up routine.
Using Reading Glasses
Using reading glasses or magnifiers for near vision is not harmful and can provide clear and comfortable vision for close-up tasks. While there is some debate about whether it accelerates dependence on readers, the psychological enjoyment and relaxation that clear vision provides outweigh any potential drawbacks. It is recommended to use the appropriate prescription eyewear to support optimal vision.
Night Vision and Corrective Lenses
Difficulty seeing at night while driving can indicate a need for corrective lenses. While stationary night blindness is rare, using readers at night can alleviate visual fatigue and enhance clarity. It is more common to have slightly blurred vision that can be compensated for in brighter light conditions. Driving at night may reveal a need for glasses to improve visual acuity.
Main idea/key point 1
One of the major causes of vision loss is refractive error, which can be corrected with glasses. Cataract, another common cause, can be treated through surgery to remove the clouded lens and replace it with an artificial lens. However, access to cataract surgery is limited in many parts of the world. Glaucoma is the leading cause of irreversible vision loss, as it causes degeneration of the optic nerve. Early detection and treatment are crucial to managing glaucoma and slowing down its progression.
Main idea/key point 2
Retinitis pigmentosa is a genetic condition that leads to progressive vision loss. It affects the retina, causing the death of photoreceptor cells. Macular degeneration is another common cause of vision loss, particularly in older adults. It affects the macula, the central area of the retina, leading to blurred or distorted vision. Regular eye exams are essential for detecting these conditions early on and implementing appropriate management strategies.
Main idea/key point 3
To ensure optimal eye health, individuals should prioritize regular eye exams, especially as they age. These exams can help detect and monitor vision problems, allowing for early intervention and treatment. It is also important to address risk factors such as diabetes, hypertension, and a family history of eye diseases. Following a healthy lifestyle, protecting the eyes from UV rays, and maintaining good eye hygiene through proper cleaning and lubrication can all contribute to maintaining good vision health.
Main idea/key point 4
Addressing vision loss on a global scale requires improved access to care, especially for cataract surgery, which remains limited in many parts of the world. Additionally, ongoing research and advancements in the field of ophthalmology are crucial for developing new treatments and interventions to address various eye diseases. Public awareness, education, and funding are all vital components in the fight against preventable and treatable causes of vision loss.
Glaucoma and Optic Neuropathies
Glaucoma is the most common optic neuropathy and a leading cause of irreversible blindness worldwide. It is characterized by increasing age and high eye pressure as major risk factors. Regular screening and early detection are crucial, as glaucoma often affects peripheral vision first, making it difficult to notice until late stages. Treatment options include eye drops, laser procedures, and surgeries to lower eye pressure. However, accessibility to these treatments varies globally, highlighting the need for improved healthcare access.
Age-Related Macular Degeneration and Diabetic Retinopathy
Age-related macular degeneration and diabetic retinopathy are two major causes of vision loss. Age is the primary risk factor for macular degeneration, with genetics and smoking also playing a role. There are two forms of macular degeneration: dry and wet. Wet macular degeneration involves abnormal blood vessel growth, while dry macular degeneration is characterized by the degeneration of cells in the retina. Treatments for wet macular degeneration include injections that target the molecules causing blood vessel growth. Recently, there have been successful trials for a treatment for dry macular degeneration that slows its progression. Diabetic retinopathy, caused by damage to the retina due to diabetes, can be managed through regular eye exams, blood sugar control, and blood pressure control. Treatment options include laser procedures and injections similar to those used for macular degeneration.
Supplementation and Eye Health
Supplementation can play a role in eye health, particularly in the cases of age-related macular degeneration and glaucoma. Studies have shown that the ARIDS formula, which includes vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin, can slow the progression of macular degeneration. High-dose vitamin B3 supplementation has shown promise in clinical trials for glaucoma. However, caution is advised when it comes to other supplements and claims of their effectiveness. It is important to consult with healthcare professionals and rely on evidence-based treatments.
The Eye-Brain Connection
The retina is a part of the central nervous system and can provide valuable insights into neurodegenerative diseases. Imaging the retina has shown correlations between retinal degeneration and degeneration in other areas of the brain, such as in Alzheimer's disease, Parkinson's disease, and multiple sclerosis. These discoveries open up possibilities for using retinal imaging as a diagnostic tool and biomarker for tracking the progression of neurodegenerative diseases. Exciting research is being conducted in this area, with the potential for developing personalized medicine approaches.
In this episode, my guest is Jeffrey Goldberg, MD, PhD, professor and chair of the department of ophthalmology at the Byers Eye Institute at Stanford University. His clinical and research efforts focus on retinal and optic nerve diseases such as glaucoma and discovering stem cell and nanotechnology treatments to cure blindness. We discuss how to maintain and improve eye health throughout life, the advantages and disadvantages of corrective lenses, including if you should wear “readers,” the use and risks of contact lenses, considerations for LASIK eye surgery, floaters, dry eye, the importance of sunlight and UV protection and specific exercises to improve eye and vision health. Dr. Goldberg also explains age-related conditions: cataracts, glaucoma, macular degeneration and diabetic retinopathy; and the behavioral and supplementation-based, prescription and surgical tools used to promote eye health. This episode provides essential tools for listeners of any age and background to maintain eye health and offset vision loss.
For the full show notes, visit hubermanlab.com.
Thank you to our sponsors
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Timestamps
(00:00:00) Dr. Jeffrey Goldberg
(00:03:25) Sponsors: LMNT & Waking Up
(00:06:29) Childhood & Eye Exams
(00:11:36) Eye Misalignment & Recovery
(00:20:38) Myopia (Near-Sightedness), Children & Sunlight
(00:27:03) Sponsor: AG1 (Athletic Greens)
(00:31:18) Eye Safety & Protection; Eye Hygiene
(00:40:07) Adults & Eye Exams; Optometrist vs Ophthalmologist
(00:46:35) Presbyopia (Age-Related Vision Decline), Reading Glasses
(00:54:54) Reading Glasses: Use & Recommendations
(00:58:34) Night Vision & Glasses
(01:03:54) Corrective Eye Glasses, Exercises
(01:09:52) Near-Far Exercise & Presbyopia; Smooth Pursuit Exercise & Concussion
(01:13:25) Supranormal Vision & Performance Training
(01:19:11) 20/20 Vision; Visual Acuity
(01:24:51) Contact Lenses: Use, Risks & Aging
(01:31:34) UV Protection & Cataracts, “Blue Blockers”
(01:38:20) Light Sensitivity & Eye Color
(01:40:29) LASIK Eye Surgery
(01:46:26) Dry Eye, Tears & Age
(01:53:24) Dry Eye, Serum Tears & Preservative-Free Artificial Tears; PRP
(02:00:46) Vision Loss: Cataracts, Glaucoma
(02:09:23) Age-Related Macular Degeneration, Dry & Wet Forms
(02:14:02) Diabetic Retinopathy, Type I vs Type II Diabetes
(02:18:54) Diabetic Retinopathy Treatment, Blood Pressure
(02:22:17) Glaucoma Screening & Treatment
(02:28:07) Smoking, Vaping & Vision Diseases; Cannabis & Eye Pressure
(02:35:13) Eye Pressure & Sleep Position
(02:37:48) Macular Degeneration, Optic Neuropathies & Red-Light Therapy
(02:42:23) “Floaters”
(02:45:29) Eye Twitching
(02:48:10) AREDS2 Supplementation & Age-Related Macular Degeneration
(02:53:39) Glaucoma & Vitamin B3 Supplementation
(02:58:42) Retinal Imaging & Neurodegeneration Screening, Multiple Sclerosis
(03:06:30) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Social Media, Neural Network Newsletter
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