June 26, 2023 • 2hr 42min
Dr. Jeffrey Goldberg: How to Improve Your Eye Health & Offset Vision Loss
Huberman Lab
Key Takeaways
- Regular eye exams are crucial for detecting issues early, especially for conditions like glaucoma that often have no noticeable symptoms until advanced stages
- Spending time outdoors in natural sunlight is beneficial for eye health and development, particularly for children to reduce risk of nearsightedness
- Proper nutrition, exercise, not smoking, and controlling blood pressure are important for overall eye health and reducing risk of conditions like diabetic retinopathy
- Blue light from screens is likely not harmful during the day, but avoiding bright lights at night is important for circadian rhythms and sleep
- Contact lenses can provide better vision correction than glasses for some people, but proper hygiene and care is critical to avoid infections
- LASIK surgery can effectively correct vision for many people, but is not recommended until the prescription has stabilized, usually in the 20s
- Major causes of vision loss include glaucoma, macular degeneration, and diabetic retinopathy - early detection and treatment is key
- Red light therapy shows promise for treating macular degeneration and other eye conditions, but more research is needed on optimal protocols
Introduction
In this episode, Dr. Andrew Huberman interviews Dr. Jeffrey Goldberg, chair of ophthalmology at Stanford University School of Medicine. Dr. Goldberg is both a clinician who sees patients and a researcher studying mechanisms and potential cures for eye diseases. They discuss a wide range of topics related to eye health, vision, and treating eye conditions across the lifespan.
Topics Discussed
Childhood Eye Exams and Development (6:29)
Dr. Goldberg explains that all newborns should have a basic eye exam to check for a normal "red reflex." For children, regular vision screenings are typically done in schools to check for issues like amblyopia (lazy eye). Parents should be alert for any signs of eye misalignment or difficulty seeing.
- Newborns get a basic eye exam to check for normal "red reflex"
- School-age children typically get vision screenings to detect issues like amblyopia
- Early detection and treatment of eye misalignment is important for proper visual development
Myopia and Outdoor Time for Children (20:38)
Recent research shows that spending time outdoors in natural sunlight is beneficial for children's eye development and can reduce the risk of developing myopia (nearsightedness). Dr. Goldberg notes that it's not just about avoiding close-up activities, but getting exposure to full-spectrum outdoor light.
- Spending time outdoors in natural sunlight can reduce risk of myopia in children
- Full-spectrum light exposure seems to be more important than just avoiding close-up activities
- Exact "dose" of outdoor time needed is still being researched, but some is better than none
Eye Safety and Protection (31:18)
Dr. Goldberg emphasizes the importance of eye protection to prevent injuries, especially for activities like gardening, woodworking, or sports. He also discusses proper eye hygiene and cleaning.
- Wear appropriate eye protection for activities that could cause eye injuries
- Most people don't need to regularly clean the surface of their eyes
- Gentle cleaning of eyelids/lashes can help with conditions like blepharitis
Adult Eye Exams (40:07)
The discussion covers when adults should get eye exams and the difference between optometrists and ophthalmologists. Dr. Goldberg recommends adults get comprehensive eye exams starting around age 40, or earlier if there are any vision concerns.
- Adults should get comprehensive eye exams starting around age 40
- Optometrists and ophthalmologists have overlapping roles in eye care
- Comprehensive exams check eye pressure, look for signs of disease, and assess vision
Presbyopia and Reading Glasses (46:35)
Dr. Goldberg explains presbyopia, the age-related loss of near vision that typically starts in the 40s. He discusses the use of reading glasses and whether they could potentially worsen vision over time.
- Presbyopia is normal age-related loss of near vision focusing ability
- Reading glasses can help, but may lead to dependence on them
- Using readers likely doesn't significantly worsen vision, but more research is needed
Contact Lenses: Use and Risks (1:24:51)
The benefits and risks of contact lenses are discussed. Dr. Goldberg notes that contacts can provide better vision correction for some people, but proper hygiene and care is critical to avoid infections.
- Contact lenses can provide better vision correction than glasses for some people
- Proper cleaning and care is essential to avoid infections
- Daily disposable lenses may be safest option, though more expensive
UV Protection and Blue Light (1:31:34)
Dr. Goldberg explains that UV protection in lenses is beneficial for eye health, but "blue blocking" lenses likely aren't necessary or helpful for most people during the day. Avoiding bright lights at night is more important for circadian rhythms.
- UV protection in lenses is beneficial for eye health
- "Blue blocking" lenses likely unnecessary during the day for most people
- Avoiding bright lights at night is important for circadian rhythms and sleep
LASIK Eye Surgery (1:40:29)
The discussion covers what LASIK surgery entails, who might benefit from it, and potential risks. Dr. Goldberg notes it can be very effective but isn't recommended until the prescription has stabilized, usually in the 20s.
- LASIK reshapes the cornea to correct vision
- Can be very effective but isn't recommended until prescription stabilizes (usually 20s)
- Small risk of side effects like dry eye
Dry Eye (1:46:26)
Dr. Goldberg explains the causes of dry eye, which becomes more common with age. He discusses various treatments including artificial tears, serum tears, and addressing underlying inflammation.
- Dry eye becomes more common with age due to decreased tear production/quality
- Preservative-free artificial tears are safe to use frequently
- More severe cases may benefit from serum tears or anti-inflammatory treatments
Major Causes of Vision Loss (2:00:46)
The major causes of vision loss are discussed, including cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Dr. Goldberg explains the mechanisms of each and current treatment approaches.
- Cataracts: Clouding of the lens, treatable with surgery
- Glaucoma: Damage to optic nerve, treated by lowering eye pressure
- Macular degeneration: Damage to central retina, some treatments for "wet" form
- Diabetic retinopathy: Damage to retina from diabetes, treated with injections/laser
Glaucoma Screening and Treatment (2:22:17)
Dr. Goldberg emphasizes the importance of regular screening for glaucoma, as it often has no symptoms until advanced. He discusses various treatment options to lower eye pressure and slow progression.
- Regular screening is crucial as glaucoma often has no early symptoms
- Treatments aim to lower eye pressure: eye drops, laser procedures, surgery
- Lifestyle factors like not smoking and cardiovascular health may also help
Red Light Therapy for Eye Conditions (2:37:48)
The potential benefits of red light therapy for conditions like macular degeneration are discussed. Dr. Goldberg notes it shows promise but more research is needed on optimal protocols.
- Red light therapy shows promise for treating macular degeneration and other conditions
- May work by improving mitochondrial function in retinal cells
- More research needed on optimal wavelengths, durations, and frequencies
Conclusion
This wide-ranging discussion with Dr. Jeffrey Goldberg provides valuable insights into maintaining eye health across the lifespan and understanding major eye conditions. Key takeaways include the importance of regular eye exams, spending time outdoors (especially for children), and addressing modifiable risk factors like smoking and poor diet. While there have been significant advances in treating eye conditions, prevention and early detection remain crucial. Emerging therapies like red light treatment show promise but require further research. Overall, being proactive about eye health through lifestyle choices and regular check-ups is the best approach for maintaining good vision throughout life.
