How to Improve Your Eye Health & Offset Vision Loss | Dr. Jeffrey Goldberg

KEYPOINTS

• 01

  Eye checks in childhood screen for a few key problems

  Goldberg, a Stanford ophthalmologist, explains that newborns get a 'red reflex' check in the nursery and then at well-child visits. In elementary school, screening looks for amblyopia, where one eye stops communicating properly with the brain. It can come from very different prescriptions in the two eyes or from strabismus (misaligned eyes). A child saying 'I can't see the board' is another common reason for an exam.

• 02

  Outdoor time, not just less close-up work, seems to slow nearsightedness

  Myopia is described as an epidemic in China and is common at Stanford. Older cohort studies blamed near work, but newer research points to time spent in indoor light versus outdoor full-spectrum light. Early randomized trials found that children assigned to spend time outdoors progressed less over a couple of years. One to two hours a day clearly beats none, but the ideal amount is still unknown.

• 03

  Undercorrecting can help train children's eye muscles

  For misalignment in kids and young adults, clinicians often deliberately give less than a full prism correction so the eye muscles keep working to align both eyes. Sometimes they use a mild plus lens in children who over-converge when reading. An optometrist is usually the right first stop.

• 04

  Needing reading glasses around 40 is presbyopia

  The lens inside the eye stiffens with age, making it harder to shift focus from distance (3 feet or more) to reading distance (12–14 inches). Most people notice it around 40, give or take five to ten years. Goldberg found an abandoned pair of +1.25 readers at about 40–42 and 'got addicted' because his near vision was suddenly sharp.

• 05

  UV blocking is worthwhile, unlike all-day blue blocking

  UV light dries and irritates the eye's surface and, over the long term, speeds up cataract formation, a clouding of the lens caused by oxidation. Very intense UV exposure can damage the retina. Goldberg calls UV filtering 'absolutely standard' and safe in eyeglasses. Huberman adds that blue light isn't inherently bad: get plenty of bright light during the day and avoid bright light of any color late at night.

• 06

  Dry eye worsens with age and screen time

  People blink less while reading, using screens or watching TV, so tears spread less and less oil is released. Preservative-free artificial tears can be used as often as needed, even hourly. Clean the eyelids with lid scrubs or diluted baby shampoo to keep the oil glands working, and treat allergies. In severe cases, eye drops made from a patient's own blood serum, rich in growth factors, can help.

• 07

  Glaucoma is the world's leading cause of irreversible blindness

  Glaucoma is a degenerative disease of the optic nerve and causes no symptoms until late, when peripheral vision is already lost. Screening checks eye pressure, the appearance of the optic nerve head, imaging and peripheral vision. Lowering pressure helps even in people whose pressure is normal. Treatment starts with eye drops or selective laser trabeculoplasty (SLT), then surgery. Even with treatment, 10–20% of patients lose meaningful vision.

• 08

  What's good for the heart is good for the eyes

  Smoking and vaping are 'a no-no' for both macular degeneration and glaucoma. The optic nerve head sits where two blood supplies meet, which makes it vulnerable. Goldberg advises glaucoma patients to eat well, take a multivitamin and exercise.