The No.1 Eye Doctor: They’re Lying To You About Blue Light! The Truth About Floaters!

0:00 there's a lot of misconceptions around how we get bags under our eyes I always assume it's their stressed and they haven't been sleeping so I did research to look into this and a lot of people don't know this but it's actually really mhm so if I never want to get mags into 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 mimia so that is your threshold of your

0:47 stress to 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 L like glasses shows that it could just be placebo effect but if you're worried about how blue light's 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 their Eye Health than ever before but is our Eye Health getting better or worse 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 so question if you could sit at a table with any four guests from the dire of CEO who would you choose here's a challenge for the entire D CEO Community

1:42 if we hit 10 million subscribers by the end of 2024 you will get to pick four guests for your dream conversation and you can make it weird or you can make it wonderful and here is the best part 3,000 of you that subscribe will be invited to join this conversation live in in person and for free subscribe now and let's make this happen [Music] together who are you what you do and I 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 am a diplomat of the American Board of Optometry so I practice iare 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 near sidess or stigmatism 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

2:52 it on top of all of this uh I also host various on on various social media channels a educational website about helping people learn about the eyes 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 it I don't know whether it's just because I'm 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 I I want to say that the I think people generally are being more interested in eyes and vision unfortunately part of that is probably because they're noticing more problems right people are starting to notice dysfunctions or more problems with their eye strain they're noticing

3:58 more problems with dry eye children uh are starting to become nearsighted faster and to Greater degrees and because of those factors we're also seeing a lot more eye health conditions in the back of the eye um that also is reflected with other metabolic diseases like diabetes significantly causes damage and leads to potential blindness inside the eye so there's there's a lot of factors to it what's changing you know you referred to some of the situations there as becoming more or Worse Etc 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 these other conditions that cause Ripple effects down the road and then our society has changed

5:07 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 as as a societ to have different changes within the eye and increase our risk for diseases and potential vision loss why does it matter you know I ask 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 pun intended right no you're absolutely correct and it's it's so frustrating as an eye care provider of how many patients or how many people just come in

6:10 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 of how conditions you've spotted by doing an eye exam so patients who don't know their 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

7:05 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 we'll catch those from doing an eye exam unfortunately things like brain tumors and conditions like multiple sclerosis we'll catch those I've I had a one one story I'll share I have one patient who was she was young she was 20 years old college 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 WTH spot and typically we only see Roth spots if somebody has a more serious

8:11 condition going on can you show me on that where you saw it sorry so so we for people that aren't watching and just listening on audio we have a model of an eye here so with the model of the 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 back side 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

9:06 there especially for somebody that was healthy had no other issues what sort of age she was 20year old female college student and usually again we see raw spots in more serious conditions whether somebody's extremely diabetic or they have HIV something is going on so I said this is not right we need to do blood work so I ended up referring her um basically did requested a blood blood 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 Co happened so I didn't hear anything and so finally a few weeks later they finally allowed uh 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

10:04 like what she's like yeah I a few days later I started feeling really tired and not feeling well so I went into the doctor and I brought your your report they did blood work they found out I had they they put her in intensive care unit for 3 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 immuno thrombocytopenic propura so her immune system because probably a virus but her immune system was attacking her platelets platelets are the thing that sort of clots the blood right correct and that ended up manifesting in the eye so it's it was it was one of the few cases where I was like wow like otherwise if she hadn't come in what 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

11:07 eye I think um 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 you start to believe that story then it kind of disempowers you but it takes away 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 that some just fundamental facts that you don't really have like Supreme control over it's like your hair growing gray like it's going to happen it's kind of accepted yeah with older age you're going to have gray hair MH with the eye there's conditions like that like cataracts age related cataracts eventually will develop presbyopia 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 verif focals so those sort of conditions inevitably do

12:11 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 um and happy to go into that so Global I health and the statistics um one of the really sort of shocking stats I read is that most of us are going to develop nearsightedness when you go into sort of 2050 2060 is that is that true what are the stats around that so A publication that came out in 2016 in Opthalmology author of Holden they looked at the statistics of myop or nearsightedness even going further back we've known that nearsightedness does is is progressing and now between around 20 it's estimated that you know right now about 30% of the world's population is near sided but by about 2050 we will have about 50% of the entire world's population being nearsighted in the US right now uh for

13:25 kids aged 5 to 19 it were already about 42% and by 2030 so in just a few years it's expected in the US will be about 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 mhm how come there's certainly genetics plays a role as more research has come out we know that genetics maybe only plays maybe up to about 30% of the 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 but 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

14:37 spend so much emphasis in our society on education on being up close beings right kids now are not only push to excel in education and being introduced to education earlier and spend more time studying and learning but parents are giving their kids digital devices as the babysitter 2.0 right 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 kind of operate under this assumption that our eyes are just our eyes and we we think of muscles as being trainable and exercisable you know I can go to the gym I lift a wait my muscle changes but my eyes changing is something that I think is quite a um an surprising concept to most people how do we how do we know this so statistically we've watched and data collected for you know for many decades

15:45 watching people gradually become more and more nearsighted and there's been in 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 1 millimeter just 1 millimeter will change your prescription for glasses by about three diopters which is a high amount so if somebody gets two millim of change that is already into the what we classify as severe myopia which carries 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's and that 1 millimeter or 2 millimeter growth is linked to

17:01 Lifestyle the vast majority of it how much screen time how much being indoors how much reading books up close is okay like what is there like a recommended daily allowance so there are some recommendations put forth by like 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 why because again there's research showing that not just for eye development but also neurological development and I I'm not a specialist on that form of pediatric brain development so I can't really opine on that but we do there are recommendations for it and I encourage anybody who's listening if you have a young child if you're thinking about having a child definitely look into those recommendations because it has impact acts on your child's development and growth the as far as like adults like you and I are both in our 30s how much

18:06 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 yeah 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 the there have been numerous studies looking at outdoor time and that spending more time outside can offset the onset and progression of near sidedness most studies are quoting somewhere around 90 minutes to two hours a day can kind of offset the all the near work that children are using so spending sort of 90 minutes to two hours a day look outside looking far that's that's a part of it uh the various studies do look at you know are they doing things up close while they're outside or is it just being outside it's not fully understood is it sunlight is

19:17 it the brightness of light outside is it the individ 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 wanted to step back when it comes to all the spending time outside it's that again that research is largely based on surveys and so they aren't 100% sure how much light outs door time people are really getting so now uh they're utilizing Health trackers and giving it to kids for those studies so they can track truly how much light they're getting when they're stepping outside versus not so they can have a better objective data to really understand the

20:21 risk of myopia progression based on that I was wondering if um vitamin D plays a role at all there that's also theorized and looked at in some studies uh also just Athletics and getting more um more Motion in in a daily activities so there there's there's many different studies in those regards but right now even a study out of Taiwan um they've been imple implementing a policy it's like hey you have to get at least 90 to two hour 90 minutes to two hours 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 metaanalyses 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 if if I'm if I become nearsighted 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

21:29 the distance Etc 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 noce 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 that is and and doing a research study to prove that is would be very easy to do and it just it hasn't it doesn't show most people if they are doing spending more time outside or they are doing eye exercises of any form to try and reverse their nearsightedness what's likely what 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

22:36 they've their muscle is making them think that they are nears side inness 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 you know in part one of my con my personal concerns because sometimes very rare occasions I'll spend you know maybe 9 10 12 hours in this studio and you know I'm doing research on the guest before the guest arrives and then we're sitting at 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 plate 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 pseudo myopia you could be you're uh of course I 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 check oh no comment um it was a long

23:30 time ago and the reason for that is again because I just I always assume my eyes were were fine so it would have been gosh that's such a good question maybe seven years ago or something so it's it's tough to say um you know there is possibility that maybe there's a little bit of nearsightedness there it could be that you've used your eye muscles so much indoors that you're just you're used to lifting it think of it like lifting a 5B weight right you've held it there all day long and most 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 it 5 pound weight at Arms level so you have to learn to hey I can relax this and put it back down MH so that is a component of the internal eye muscle called the sary body which unfortunately is not the same type of muscle as your skeletal muscle and so even with I exercises you can't

24:30 strengthen that muscle so eye exercises don't work they eye exercises in the form of what's called vision therapy or orthoptics can work but they're not building the muscle they are improving the really the coordination of your brain communicating that information to those muscles to work in coordination okay and so there's a some certain 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 they hold everything at like one meter length from their face and I when I was younger

25:35 used to take the piss out of them thinking like that's so ridiculous and I would show them that I could read from like 1 cimeter away and they're reading it arms length but I think they're going to have the last laugh when when I get to 50 60 years old sure because of genetics or whatever so again uh even without genetics just the way the eye ages the lens inside of your eye will change which is so if I open up the eye 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 okay 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 crystallin lens and this has got a couple different pieces also to the side but this crystallin lens is actually about the size of an M&M I put these together it's it's kind of that shape M when you're born this lens is clear

26:39 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 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've I I don't really need to use them as much anymore so I haven't haven't thought about it for a while but these as this lens gets thicker it basically gets thicker every year it gets to a point where the lens starts to the crystals within that lens start to change shape they become more crystallized rigid and so even though

27:44 the muscle inside the eye still pulling on this lens it's like pulling on a hard stiff marble it doesn't want to change 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 oh okay eventually once you get closer to the ages of 50 60 70 80 this lens continues to get thicker harder but then the crystal start to change color they go from being clear to being more of a faint yellow color to a darker yellow whitish 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' 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 what modern cataract surgery does they either use a laser or they

28:52 physically have to open up parts of the eye but they use a procedure called f ification it's basically using ultrasound to shatter the lens into dust and then they have a small vacuum tube that sucks up all the particles out of the eye but then a new plastic lens 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 okay and what's fascinating for you and I is that so this form of cataract surgeries 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 years when

29:58 you and I are getting to that point where we might need to think about it who knows what we're going to have I 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 um since then I think things have kind of gone quiet they are probably in the last year one of the the last 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 eyee he ended up having partial face transplant and then a whole eye

31:04 transplant and at this time it is the first one ever done the eye is so unique and so complex that when they finally did this transplant it's it's sort of shaken the I care role a little bit the they just I just read like a one-year a publication in jamama that was basically summarizing what it's been like after this last year and it's amazing 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 to the from the donor tissue to the host and keeping that the right amount of blood supply having it so it didn't reject is is a really tough feat and what they have now they find that the last this last paper I just read that 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 electroretinograms that we can do in the

32:09 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 it's pretty fascinating God it's only going to be a matter of time isn't it um you said there that the eye is complex I was reading some stats around the eye that blew my mind the eye contains over two million working parts and is considered the second most complex organ in the body I guess this the brain is the first in the eyeball is really an extension of the brain right the 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

33:12 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 um 85% of my total knowledge will basically come from my ey when you say it I kind of understand it because okay I'm reading I'm seeing I'm you know I'm learning through my eyeballs but it is um it is cause for protecting our eyes and the things you described there 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 uh that increases their oxid 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 prevented from

34:15 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 epidemological 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 is a specific 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're do if you 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

35:16 and don't get enough vitamin C that giving them vitamin C can help slow or Pro delay the onset of cataracts but if you already are getting proper nutrition taking additional vitamin C's probably not going to delay your onset of cataracts specifically I learned something from you actually from your Instagram um 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 admitt and you alerted me to the fact that there's actually a feature in the iPhone which will help me Stave off my myopia potentially perhaps uh so thankfully again the iare Community is not the only people who are aware of these issues with using devices up close MH but thankfully whether it be apple specifically with their iPhone but also this 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

36:17 thankfully they do have those sort of notifications that people can turn on I'll admit that I turned mine on for a while and I eventually got so annoyed with it I wanted to push it further back uh so I I kept it on for a while I eventually took it off um but maybe I'll have to put it back on again just be a good just to serve a good example so there's it was a feature released in 2023 and it essentially sends you a notification whenever your phone is is it what 12 in or something I don't remember exactly how close it is but we do know that on average people hold their phones and devices around 8 in away from their face so pretty close and it's important to consider moving things further back and part of that can be because certainly eye strain relationships possibly myopia and then even blue light I know people are get really concerned and um interested around the blue light World especially since Co that really blew up at that time but just moving your phone back

37:21 twice as far will decrease your blue light exposure by 20 like a full 75% so if if you're worried about how blue light's affecting you it's like just move your phone back a few inches and that's automatically going to decrease your blue light exposure from that device I I don't think most people know that this feature even exists because I don't think Apple really ever announced it or did a marketing campaign around it but in the setting section of your phone and your iPad Etc it's under screen time um and under screen time there's a button called screen distance and it says to reduce eye strain and risk of myopia in children screen distance will alert you to hold an iPhone or iPad with face ID at a recommended distance um and in the small print it says screen distance works by measuring the distance between the screen and your eyes the camera is not capturing images or your face and the data collected remains on the device so if I click continue it

38:12 then says this is how screen distance Works um screen distance encourages you to move your iPhone and iPad further away to support your vision health um the next section says V Vision distance or viewing distance iPhone or iPad should be held at a suggested of 30 cm from your eyes mhm um interesting those are recommendations but how many people actually follow that 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 a good habit I think it's something tell me have you when 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 I didn't know it existed

39:08 until I was researching you and so I've had it on for about a day frankly I haven't actually got the notification yet but okay um it's not been on long 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 annoyed you so my my challenge was that in the evenings I wear contacts most of the time and I take my contact lenses out in the evening and I go back to glasses and sometimes I'll lay I'll 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

39:59 should just take a break but it was it was delaying my productivity yeah so that that's why but again to set a good example I'll probably have to turn it back on and see how it goes and if you have kids you can always you know 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 um lead by example for kids and try to be aware of how much time you're spending on your phone in front of your kids because your kids are going to see that and and they're going to probably mimic that same behavior I want to talk to you about bags under my eyes um 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 under their eyes are because they're tired or something um and is there a difference between having bags under my eyes and having sort of dark circles under my

40:50 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's 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 uh people who don't know this but uh under having skin cancer on your lower eyelid is actually pretty high so it's good to be wearing either a wide brim hat or sunglasses to protect the eyes from sunlight

41:48 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 cost 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're uh have kind of a 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 be I can feel that my skin and my face is maybe a little bit more

42:53 puffy uh 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 has 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 help improve the appearance so if I have a really salty diet the night before I'm 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 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 um and I've done over the last eight years I've really done a better job I know you have too of like thinking about my diet how that affects me how my body feels after I eat something and so I've noticed if I if I have a cheat day that sort of thing can

43:49 happen and where does this what's the sort of physiological rationale for salt playing a role so your tear film for examp example um your tear like I know some people will say hey if I have a watch a sad movie and I cry at night time the next morning my eyes are super puffy so your tears have salt in them 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 you that's also something that's been looked at in research is not really conclusive I think hydration is still something we need to I do encourage people to at least be aware of their hydration U for dry eye there is some research that indicates that people who are drink more water tend to have less

44:49 severe symptoms of dry eye when I see someone with bags into their eyes I used to think well I still kind of do think that it just means that they haven't slept that again I recently did uh a live stream or I did research first and try to look into this and they have looked at quality of sleep time of sleep and both the subjective and objective appearance of dark circles under the eyes and they find that it is if you have not been getting good sleep objectively your under eye dark circles do not change but your subjective appearance of your own image will go down ah okay so you're both they find 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 is being reflected and so they've been able to find oh that it's purely just your

45:55 subjective opinion of your own self-image seems worse when you're tired what about stress cuz I'm thinking about people that I've seen that have like big bags under their eyes and like you know their eyes kind of look dark I always assume it's their stress and they haven't been sleeping but you're say saying that that's not accurate necessarily so at least in the 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 stress right cortisol releases inflammation in the body will change hormones can change so they may all play a role there um but right now it seems to have a less effect on the true pigmentation of the eyelids okay and the the cucumber and the cold compress and all that kind of stuff does that stuff work in changing the appearance of dark circles and bags and Dem eyes because when I filmed Dragon's Den TV show in the UK I

46:58 sometime it's weird cuz like sometimes when I'm underslept 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 but but she doesn't say it so 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 um but is is it actually doing anything the cucumber and the the coolness effect I believe is going to be causing con restriction of blood vessels it's going to be helping the tissue come down and swelling just like if you bang your knee or elbow really hard on something it swells there's a little bit inflammation and so putting cool cold down there can help momentarily but I wouldn't do it longer than 15 minutes the the reason why is because if you do it longer than 15 minutes your blood vessels that can go the opposite way and cause more inflammation the there's other things

47:49 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 true 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 uh outside of that if somebody's tried all those other avenues talked with their dermatologist or or an eye care pro 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 dark circles what do those 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

48:53 around the eye and then there's forms of what are called a blop plasty which are true eyelid surgeries and for that you would want to see an opthalmologist who specializes in those type of therapies or or those type of surgeries so if I never want to get dark circles bags into bags into my again what is the natural easy solution I do still encourage good sleep eating healthy uh staying hydrated 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 head first into into the research for many things in the eyes with the bag

49:57 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 wave caution though because there's a lot of products that are online that that offer red light therapy for various reasons but this 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 devices they bought online because the manua 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 super important and if you have too much energy you can go through the eyelid and go into the eye and cause

51:04 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 I just urge caution to make sure whoever's listening if you're thinking about red light therapy you're thinking about getting a red light device specifically for ey care definitely talk to a specialist who works in that area okay okay the um but red light have you have you heard much about red light in different areas I've heard a lot about it I don't know a huge amount about it and I have two red light panels at home which were given to me as a gift um my my partner has when I have one we basically got each other the same Christmas present one year but we we did ask ourselves we sat in front of it one day and said what does this like what does this do in terms of our health and are we allowed to stare at it the devices you come that you got do they come with go no okay so that that is sort of the concern I have is again what energy is really not just

52:08 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 I there is evidence that Redlight therapy can help with dry eyes that red light therapy can help with macular degeneration which is is so age related macular degeneration is one of the leading causes of blindness for older age adults so 50 plus 50 plus in fact if you're 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 uh in fact there is it's C 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 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

53:11 that in the eye in intervals and they do it for a few weeks and then a few months you do it again and for macular generation they've been able to show that not only can the protein that builds up in the back of the eye in that condition diminish but they can slow down and slow down the progression of macular generation 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 Mac generation 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 it's something that is really fascinating and I am looking forward to as more information comes out but it's I

54:23 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 tier reduction tier reduction and other dry eyye symptoms compared to the place placebo group tear reduction what does that mean so dry eye again is an area where red light therapy is being utilized in right now the there's several studies on red light on its benefits for dry eye but the two 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 um within the tissues and help you produce

55:30 uh basically it helps the cell re 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 tiar production can be improved which helps with dry eyes which helps with dry eyes but then also the red light can help with the myomi 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 the uh so it's actually on in the eyelids but the eye lids would be oh in front they're in front yeah so so my top eyelids have about 30 my Boman glands in them and my bottom eyelid has like 25 to 30 and every time you blink these glands have to release a little bit of oil that prevents your tear filing 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

56:37 factor but then you also have more we can talk about with device use and the fact that when we're stering at devices we don't blink as often and we don't blink as completely when we're sterring 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 into your tier 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 in my Bing gland dysfunction is still in its infancy but we have a different form of therapy called IPL or intense pulse light which has been even FDA approved for my boming gland dysfunction in treating dry ey is there any research being done on red light and myopia a red

57:42 light and shortsightedness I if I look at those red light panels I have at home is that going to help with my Progressive shortsightedness 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 a atome desk mounted device yeah that kids will stare into for about 3 minutes twice a day morning and then 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 myop myopia they're able to prevent them from developing myopia which is really fascinating there have been at least there is at least one study that looked at those devices and there is there is some concern that perhaps the power density is too high and could be at risk

58:43 of causing damage to Children's eyes so again it's still it's still something heavily in research and I wouldn't recommend people go and purposely stare into a red light unless their doctor is prescribing it for something and just because I'm an idiot um 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 uh adenosine triphosphate the which the cell uses for energy what about gazing at the sun because I've been told so many things when I was younger it was like never look at the Sun and then I got older and people are like no like stare at the Sun and now I don't know what true yeah don't stare at the sun even for like a second don't the 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 U the

59:44 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 sungazing since I was little uh I was in Florida recently and I stared at the Sun and 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 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 FIA or the macula which is at

1:00:52 the back of the it's in the back part of the eye imagine if we're going to play darts we're going to go to the pub we're 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 in just a few seconds you can overwhelm that tissue causing chemical damage to the r because people this phrase Su gazing mhm is this like a spiritual thing like I I think I was in Bali and people like no you can you can sungaze you should sungaze because it's good for you sungazing what is this term that is usually in some sort of either religious or spiritual practice people will gaze toward the

1:01:49 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 mhm 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 the there is still a high risk and so uh it's always best to not stare directly into the Sun or you know try to look off center from it and especially during the high UV times of the day you know 10 to 400 p.m. usually uh 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 to the front surface of the eye people 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 got a friend who uh who told me that sun gazing is good for you and you should do it and

1:02:43 stuff but I'll take your word for it you you mentioned blue light a second ago which is the light that comes off our devices um 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 us devices shows that blue light does not impact IE strain a lot of people will claim that they will I have a lot of patients who come in and anecdotally 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

1:03:46 have anti-glare or glare-free protection put on to it and the anti-glare is probably improving their focus and they're not having as much glare issues when considering at the device but right now there's still just no concrete evidence showing that blue light is contributing to IE strain but then the Sleep Cycle we do know that blue light can influence your sleep what kind of gadgets do you have I I don't know why but I assume as someone who is an an eye doctor you must have loads of 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 I've yeah we're I have multiple computer screens open I have my phone screen open all day uh I the other day I was texting 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 uh so there's a lot going on there but yeah or practices is are there any practices

1:04:46 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 your 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 Gen for for a long time many decades the biggest one thing when it

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