In this episode 54 protocols
▶ 7:38 Red Reflex Eye Exam for Newborns Behaviors “First of all, every baby gets an eye exam or should be getting an eye exam. And one of the main things that you really just are screening for right when that baby comes out is the age of the baby. And that's when you're right in the nursery, right in those first few days is to just look for a red reflex.” ▷ 9:38 Pediatric Eye Exam for Abnormal Visual Signs Behaviors “If parents start noticing the baby isn't, you know, isn't making eye contact or looking where a sound is, certainly if they have what's called nystagmus, like these rapid flickering, alternating eye movements, anything like that, of course, you're going to trigger an eye exam.” ▷ 10:09 Elementary School Amblyopia Screening Behaviors “When most kids get to elementary school age, there will often be, often done at the schools, an amblyopia screening exam.” ▷ 13:20 Early Correction of Eye Misalignment in Children Behaviors “If your eyes are actually turned in or slightly less common in children, more common in adults, misalignment turned out, it's really important to correct that early. And the reason is, as you were saying, the brain starts ignoring it.” ▷ 14:30 Retrain the Weaker Eye in Late-Detected Amblyopia Behaviors “Even if you're only, you know, unfortunately detecting that later on in childhood or even sort of the tween years or early teen years, it's still worth a try to really push to retrain the weaker eye and then also realign the muscles so that they can work together to keep the eyes focused.” ▷ 25:19 Outdoor Time for Children Behaviors “As a parent, you may want to be telling your kid like, okay, yeah, I want you to read that book or, you know, if your kid's playing on the phone or something like that or the iPad or something like that, they're allowed that time. Okay, you can have that time, but I want you to spend some of the time that you're doing that outdoors.” ▷ 27:48 Morning Sunlight Exposure Behaviors “I'll go into the grave shouting, you know, or saying rather, and suggesting that people get some morning sunlight in their eyes to set their circadian rhythm.” ▷ 27:53 Far Viewing Outdoors Behaviors “But far viewing a few, at least a few minutes and ideally hours per day, or a mixture of near and far viewing by being outdoors just seems like a good thing to do regardless of age.” ▷ 29:37 Exercise Outdoors Behaviors “There are so many health benefits to exercise. And, you know, if you're getting outdoors, there's a good chance you're going to be walking or bicycling, you know. So exercise value for the health of our eyes and the rest of our body is clearly there.” ▷ 33:19 Safety Goggles Tools “People are at risk, I think, for, you know, for not, and we see too much kind of really unnecessary eye injury, eye trauma, that if people wore either their glasses, because they happen to wear prescription glasses, or goggles, or for more advanced work, you know, safety goggles, of course.” ▷ 36:50 Eye Scrubs Behaviors “A lot of people develop what we call blepharitis, which just means inflammation of the eyelashes. And for that, doing some eye scrubs is a good idea.” ▷ 37:01 Eyelid Cleaning Pads Tools “They actually sell little pads that you can buy, kind of little, that you rip, and you can use to kind of lightly clean the eyelashes.” ▷ 37:51 Sterile Saline Eye Wash Tools “If you feel like you've got something in your eye, your ideal eye wash is actually going to be a sterile saline solution, a saltwater solution. You know, they sell little bottles over-the-counter eye wash solutions like that.” ▷ 38:35 Artificial Tears Tools “You can also just use artificial teardrops. And some of those come in non-preservative. Some of those come in preserved versions. Those are all also completely safe to use in the eye.” ▷ 38:51 Use Artificial Tears to Flush Debris Behaviors “If you feel like you've got something in your eye, a piece of dirt or a lash that's not coming out, just to rinse it. But having like a regular routine, you know, you're not going to hurt anything with the occasional eye rubbing.” ▷ 44:44 Comprehensive Eye Screening Exam Behaviors “It is good to get some kind of screening exam, could be at a public health fair, could be that you go into the local optometrist, just say, hey, I've never been checked, I'd like to be checked once, make sure everything's good.” ▷ 57:28 Reading Glasses Tools “I actually think just give in, use the readers, have your, enjoy your best vision, all the time. And if that means wearing glasses, and by the way, if that means that you're going to have minus two glasses for vision, and you'll eventually need minus two fifties for distance vision, or if you're going to need readers, 1.5 readers now, and in a few years, 2.0 readers.” ▷ 57:59 Wear the Glasses That Work Best Behaviors “So I actually counsel people just wear the glasses that work best for you. You know, you're only minimally changing how your prescription is going to change over time, very minimally. So just enjoy your best vision, even if it's using readers for close or prescription glasses for far.” ▷ 1:07:39 Undercorrection for Eye Alignment Problems Behaviors “There, it's actually quite a common treatment to try to undercorrect and ask people to exercise and not just give a prism that says, hey, if your eye's in sometime, we'll use a prism so the light sort of looks right to you, but rather undercorrect that, and sort of really force you to exercise trying to yoke your two eyes straight together.” ▷ 1:08:55 Plus Lens for Near Overconvergence Tools “using not a prism, but like a little bit of a plus lens in kids, just so they don't have to work quite so hard to turn their eyes in and sort of over-exercise those muscles. These are all great” ▷ 1:11:23 Near-Far Focusing Exercises Behaviors “You're certainly not going to hurt anything. There are other situations where those really do get prescribed and there's definitely some good clinical trial data suggesting that they can actually help, for example, recovery from concussion.” ▷ 1:11:23 Pencil Pushups Behaviors “Yeah. So, um, you're certainly not going to hurt anything. There are other situations where those really do get prescribed and there's definitely some good clinical trial data suggesting that they can actually help, for example, recovery from concussion.” ▷ 1:12:59 Smooth Pursuit Eye Exercises Behaviors “One of the approaches being used and further studied still in recovery from concussion is actually doing those kinds of exercises like pencil pushups, or basically what you've described is focusing from far away to focusing near and doing that back and forth and using that to sort of like help regain the tighter control of our eye movements and that eye brain connection.” ▷ 1:15:48 Stroboscopic Training Goggles Tools “Some athletes train using these special goggles that actually use electrical signals in the glasses part of the goggles to actually black out your vision one-thirtieth of every second, two-thirtieths of every second, three-thirtieths of every second.” ▷ 1:27:55 Daily Disposable Contact Lenses Tools “A lot of people who wear glasses and contacts will report that they have a much higher quality of vision with their contact lens correction than with their glasses correction.” ▷ 1:29:12 Follow Contact Lens Cleaning Instructions Behaviors “We always recommend that if you're going to wear contacts, that you be really attentive to whether you're tolerating them well, and then also to be really attentive to the recommended use and cleaning of the contact lenses.” ▷ 1:33:41 UV-Blocking Eyeglass Lenses Tools “Blocking UV light, I believe, is just absolutely standard in every pair of eyeglasses.” ▷ 1:34:47 Avoid Blue-Blocking Glasses During the Day Behaviors “I'm not sure that there's any data that blocking blue is helpful in any way. And as you say, it may actually play into a sort of circadian entrainment of our natural daily rhythm.” ▷ 1:35:05 Transitions Glasses Tools “They make glasses, by the way, that actually react to UV light. They're called transitions. There may be a few different brands.” ▷ 1:36:50 Brimmed Hat Tools “Brimmed hat's a great idea. That'll get rid of a lot of the direct light into the eye.” ▷ 1:37:00 Sunglasses Tools “Wearing sunglasses outside, even if you don't have corrective lenses, you know, it may also be more comfortable to wear sunglasses outside.” ▷ 1:43:03 Avoid LASIK if You Already Have Dry Eye Behaviors “I do think that if you're a person who already has dry eye, hopefully, if you're asking your eye surgeon about LASIK, hopefully, you're being counseled that if you have dry eye, this might not be a good idea for you.” ▷ 1:43:24 LASIK Surgery Tools “For a lot of people, especially a lot of younger people, it's quite common. I think the statistics suggest maybe 15 or 20 percent of people who would benefit from LASIK, who would otherwise be wearing glasses may get LASIK at some point in their life.” ▷ 1:45:39 Delay LASIK Until Prescription Is Stable Behaviors “You really want to be able to say, hey, my eyeglasses prescription has not changed in the last two or three or five years. Because if you do LASIK and then your eye keeps changing shape, then by the next year, all of a sudden the LASIK's not doing, you're back in glasses again.” ▷ 1:49:27 Use Artificial Tears as Often as Needed Behaviors “You can use those preservative-free ones. We have patients who have had these for a long time, and they're using them every hour if they need to, right?” ▷ 1:49:53 Blink More During Screen Use Behaviors “It turns out that when you read, including when we maybe used to read more books than we do now, but also read on the computer or stare at the computer screen or work on the computer or actually just even watch the TV, I've done very careful studies. You blink less when you're doing any of those activities.” ▷ 1:53:18 Reduce Eye Inflammation From Allergy Behaviors “Reducing inflammation is also important, whether that's inflammation from allergy. And of course, a lot of people's dry eye gets much worse in the spring with seasonal allergies. So, you know, when pollen is around, if you have dust allergies in your home, that worsens your symptomatic dry eye.” ▷ 1:54:38 Serum Tears Tools “If you're one of those people who's been really struggling with dry eye, you might ask your eye care provider, hey, I heard about serum tears. Is that something that could help me?” ▷ 2:15:29 Annual Eye Exam for Diabetes Behaviors “that's, that's an indication where you definitely have to be going in and getting your at least annual exam with an eye care provider or having someone take a photograph of the inside of your eye” ▷ 2:20:06 Control Blood Sugar Behaviors “The number one most important element to prevent diabetic retinopathy is to control your diabetes and having a real good blood sugar control, keeping your hemoglobin A1c, which is one of the blood tests that gets used to measure how your kind of long-term diabetes management is going.” ▷ 2:21:04 Control Blood Pressure Behaviors “So in addition to controlling blood sugar, really important to have blood pressure under great control.” ▷ 2:21:29 Lifestyle Changes for Type 2 Diabetes Control Behaviors “So these are definitely on that list of how do you get to good blood sugar and blood pressure control.” ▷ 2:23:04 Glaucoma Screening Exam Behaviors “Most important is to get screened with a formal exam at your optometrist or ophthalmologist because you won't notice, you won't have any symptoms. If your eye pressure is too high, you won't know, you're not likely to notice until very late in the disease.” ▷ 2:23:52 Glaucoma Eye Drops Tools “We have treatments and you're absolutely right, whether you start with a abnormally high pressure, or you start with a pressure that's on the face of it in the normal range. In either case, lowering the pressure has been shown in large, properly controlled clinical trials to slow the progression of optic nerve damage and vision loss.” ▷ 2:24:45 Selective Laser Trabeculoplasty Tools “There's very good data that there's a very benign non-invasive laser. It's not the same kind of laser that gets used for LASIK, but there's a benign, very safe type of laser called selective laser trabeculoplasty, SLT, we call it. And that's also very effective as a first line.” ▷ 2:26:47 Take Prescribed Glaucoma Drops Consistently Behaviors “Okay, so get your pressures checked, folks. And if you are prescribed, add drops, take your drops.” ▷ 2:28:41 Avoid Smoking and Secondhand Smoke, Including Vaping Behaviors “Smoking, including exposure to secondhand smoke, major risk factor for macular degeneration and for the progression of vision loss, potentially associated with macular degeneration.” ▷ 2:30:31 Multivitamin Supplements “I also always counsel glaucoma patients. It's not just no smoking, but eat healthy, have a multivitamin, get some exercise.” ▷ 2:30:31 Heart-Healthy Lifestyle for Glaucoma Risk Reduction Behaviors “I also always counsel glaucoma patients. It's not just no smoking, but eat healthy, have a multivitamin, get some exercise. All those things that are good for your cardiovascular system are going to be good for your eyes in general, and in particular, if you have glaucoma or are at risk, high risk for glaucoma.” ▷ 2:33:16 Edible Cannabis Diet “I certainly have patients who are using it in a responsible way, especially edible forms. And, and in select cases, like that could make the difference for them helping to keep the pressure down.” ▷ 2:34:12 Use Cannabis Before Bed in Select Glaucoma Cases Behaviors “Some patients, I certainly have some patients who are using the eye pressure at night, but it's actually quite a bit higher when they're using these products, like let's say before bed.” ▷ 2:35:48 Sleep With Head Elevated Behaviors “We will sometimes counsel patients with severe glaucoma, especially if they're, you know, poorly responsive to standard therapies or poorly able to tolerate standard therapies. We'll counsel them if they're able to sleep up on a couple pillows, get kind of a 30-degree sleep angle going.” ▷ 2:38:54 Red Light Therapy for Eye Health Behaviors “The data are very compelling that this kind of red or near infrared light therapy can be at some level neuroprotective.” ▷ 2:44:41 Ignore Floaters Behaviors “I actually like to tell patients, it's nothing to worry about. Just ignore them. And actually, if you stop focusing on them, your brain will actually start filtering them out.”