198 - Eye health-everything you need to know | Steven Dell, M.D.
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- เผยแพร่เมื่อ 6 มิ.ย. 2024
- View episode show notes here: bit.ly/3txyrBU
Steven Dell is an ophthalmologist, current Medical Director of Dell Laser Consultants, and a leader in refractive eye surgery with over 20 patents to his name. In this episode, Steven explains the anatomy and functional mechanics of the eye and how they relate to common variations in vision. He discusses changes in vision that occur with aging, the fundamentals of different types of vision loss, and provides an in-depth look into the various treatments and procedures available for corrective eye surgery. Additionally, Steven explains how one might protect the eyes and prevent vision loss-a topic particularly important for children in light of the epidemic of myopia.
We discuss:
0:00:00 - intro
0:00:10 - Why Steven chose ophthalmology, and the crossovers to other medical disciplines
0:11:33 - Anatomy of the eye, common types of vision loss, and age-related vision changes
0:25:21 - Eye drops that can potentially improve vision
0:31:25 - The explanation for different eye colors
0:33:04 - Physiology of the eye and its connections to the brain
0:39:37 - Understanding human vision through an evolutionary lens
0:46:06 - Enhancing vision beyond 20/20
0:50:42 - Astigmatism: definition, cause, and high prevalence
0:53:17 - Nearsightedness (myopia): causes, epidemic in children, and prevention strategies
1:04:58 - Cataracts: impact of aging and how they can be repaired
1:20:07 - Lens implants that can correct and improve vision
1:27:50 - Effects of eye trauma
1:30:14 - Corneal abrasion from ‘dry eye’: causes, treatment, and prevention strategies
1:36:54 - Sunglasses for eye protection
1:44:32 - Solutions to correct nearsightedness
1:48:27 - Laser eye surgery-photorefractive keratectomy (PRK)
2:05:41 - Laser eye surgery-LASIK
2:16:01 - Laser eye surgery-small incision lenticule extraction (SMILE)
2:18:02 - Glaucoma: definition, causes, symptoms, and care
2:24:35 - Tips for preserving eye health
2:29:11 - Screen time and eye health
2:32:41 - Contact lenses: good hygiene and considerations
2:34:11 - A bonus benefit from repairing cataracts
2:36:48 - Questions about corrective eye surgery
2:39:05 - How an eye exam can be a window into metabolic illness
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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Great guest. Knowledgeable with no discernible ego.
Great work Peter ,keep inviting experts like this on the podcast.
Jesus Loves You! Romans 10:9!
Great communicator.
I was a candidate for cataract surgery two or three years ago,.. I've put it off but after watching this, we'll , like my ophthalmologist said, "You qualify, when you're ready we can do it ".
My late husband was an ophthalmologist and I loved this interview! I had absorbed so much information from my husband’s teaching me that it was refreshing to be able to follow along and understand it completely. When I did have cataract surgery in 2016 I opted to have mono vision, in which I can see distance with my right eye and read up close with my left eye. I am about to need a capsulotomy in both eyes because my capsule has clouded somewhat. I also suffered from dry eyes having spent 20 years in the high desert and have been successfully treated for it. I was glad that topic was covered. Super interview even though it was quite long. Wouldn’t have cut a minute from it!
what an epic mistake to do, I can tell after huberman episode on the topic of vision
Jesus Loves You! Romans 10:9!
@@gradymilholen9979 What does that have to do with anything?
@@judymiles7186
it has everything to do with everything!
God bless (:
“The one who does not love does not know God, for God is love.”
1 John 4:8
@@szymonbaranowski8184what mistake ? Be more explicit.
My dad taught me to squeeze the thumb and forefingers of both hands together to make a tiny diamond shaped opening if I didn’t have my glasses on and needed to see far. Now I know why it works… I think. Anyone else use this trick?
I can’t believe I almost passed this up to watch something in end that would be completely pointless. So interesting and it was a pleasure to listen to.
Anecdote warning. I work in IT in a trading environment. Long hours staring at computers (12+ hours a day). In my 30s I had super dry eyes and used to use drops all the time (no glasses or contacts). Switched my diet to whole food predominantly plant based, but still eat the odd steak etc. Oddly, a few months after shifting my diet, I realised I hadn’t touched any eye drops for a few weeks. Wasn’t a driver for my change in diet, but nice benefit. In my mid 40s now, still long hours at computer, still no eye drops after 10 years. Anecdotal, YMMV.
ps ACTUAL stories of personal healing are priceless - single-modality isolated testing in a lab is seemingly so unrealistic to the connected complicated gazillion-factor humans we are in a living breathing existence! 💝
Well, that sure was interesting and informative. Dr Dell has a superb way of explaining complex topics without seeming to talk down to his listeners. He kept my attention throughout the whole podcast.
For those who watched this to hear of a nonsurgical way to treat cataracts and perked up At time stamp: 22.45 this medicine/pharmaceutical lipoic acid choline ester is mentioned as being commercially available in early 2022. That did not turn out as it has not had any phase 3 clinical trials completed. It is only available for research purposes. Fear of having my eye cut is pretty strong.
I had LASIK treatment 13 months ago and it's really a joy to have sharp vision. It's like upgrading your resolution from 720p to 4K.
I was 33 when I did the surgery and I only wish I'd done it 10 years earlier.
A fascinating interview. Peter, you ask great questions. But…. Peter, please allow the question to be answered fully! The interruptions change the direction of the response just as your question is being answered! Frustrating and interesting info gets cut-off. Otherwise great. Thank you. I hope you will accept my feedback as constructive, it is made only with best intentions.
Things I’ve never thought about. These videos are a gift. Thank you
Great timing. I’ve had clouded, watery eyes for weeks due to a bad habit of rubbing my eyes from allergies. Thanks for information.
As someone who actually got the PanOptix multifocal IOL, I can tell you that not all cataract surgeries are successful. Each lens has its own light physics and it so happened that this was the wrong lens for me. I'm confronted with all sorts of halos around point light sources such as headlights or street lamps. Emergency vehicle lights are dangerously distracting. And this isn't just at night, but when light hits a metal object such as car, it's a welding torch going off.
And yes, I went to a highly recommended surgeon who I would never go to again. So I'm a little dismayed at friend's brother who's a little glib about cataract surgery successes. It might be for the right patient who's matched with the right IOL. The opposite is true from personal experience.
You are completely correct that not all patients adapt well to a multifocal, trifocals or extended range intraocular implants. I’ve had 2 cases that did really poorly. To be fair, they could read 20/20 in distance and near but they’re vision felt very disfunctional to them. I am very careful who I recommend these IOLs to. The idea of simultaneous vision using refractive physics for distance vision and diffractive physics for near vision and then training the brain to pay attention to one or the other depending on the task is quite complex. I find that most people take 3-8 months before they tell me that it stops feeling “Clear but unnatural.” How long are you post op now?
A. Z. z bc.
Jesus Loves You! Romans 10:9!
@@gradymilholen9979 But can't give you a successful cataract surgery.
B
Fascinating conversation. I had cataract surgery on both eyes about 10 years ago at age 63 & 64.
I’ve worn nearsighted glasses since first grade till then, but none since.
Thanks for bringing on an ophthalmologist, Peter. It's an area I didn't know enough about and I appreciate having a greater understanding of how to take care of another very important part of my body!
Jesus Loves You! Romans 10:9!
What a coincidence! Just last night i was thinking (after a few puffs of course) about how amazing eyes are and how you can't really replace them so taking care of them is crucial but most people (including myself) don't really know how to. Thank you for this conversation!
This was an incredible episode. Thanks, Peter and Steven!
This is such an interesting conversation. Thank you for having Dr. Dell on, I really enjoyed him. 🎉
I appreciate Dr. Dell's ability to clearly explain the remarkable bio-chemical physiology of the eye and the physics of light and lenses. He's the doctor you'd love to have to patiently and reassuringly walk you through a problem.
I did not realize the physical toll surgery takes on surgeons, so I thank all surgeons in all specialties.
Absolutely incredible conversation. Thank you for doing what you do
Jesus Loves You! Romans 10:9!
Great guest !
Thank you both !
Excellent content !
Your absolute best podcast!!! Thank you for this very helpful info. Please this topic and focused on remedies, helpful things to do to help our vision. Also heard light in the bedroom when sleep causing nearsightedness.
What a fascinating topic & episode!!!! And a great guest, Peter, thank you!
I really like this podcast episode. I had a lecture about lens and I like the way Dr. Dell explain things. I am having a hard time remembering the parts of the eye and analogies really help.
Omg! What an eye opener! Thank you Dr Dell for explaining everything so clearly. I have had high eye pressure for about 7 years and use drops everyday to bring it down? My specialist still doesn’t know why or how. Not glaucoma! Am now 68 and my last testing says my cataracts have begun. I can also see it happening in my sight. I am near sighted and around -5
Thanks for this, very interesting. Especially the tips at the end.
Im going in for a lence replacement in May, paying 7300 $ (live in Norway). Sick and tired of flexing between glasses and lences every day. This talk made me feel more comfortable and confident about my choice, thank you so much for great info! 👍☺️
Update? How has it been?
C&&
Yes, update on how the surgery went.
Best podcast till date! What a worthy 3 hours to have spent on this.
Great discussion. I will add that glaucoma can have signs. Mine were halos around lights at night. Glaucoma is worse at night with a dilated pupil, which causes worse drainage and higher IOP. I went to the eye doctor after pain started along with the halos. If you have these signs, see an eye doctor to get your eye pressures checked ASAP.
Jesus Loves You! Romans 10:9!
Amazing information, so much value. I will sign up soon. Thank you
Love this episode Peter. The info is so interesting. Thx
Thanks 😊 so much for this discussion. I’m a type 1 diabetic who works in the medical field. I work in an ICU in New York and I recently had to have retinal detachment surgery. First it was so traumatic and I can of didn’t think I would feel like this because of my experience in health care but eye stuff is very scary.
Jesus Loves You! Romans 10:9!
You don't have to remain type2...it is very reversible.. look up fasting with Dr Jason Fung...diabetes is very curable☺️☺️✌🏾🙏🏽
Great episode, thank you! When I saw a notification about new video I was curiuos if you and your guest would be interested to talk a little bit about any consequences of blefaroplasty, some possible negative effects on eyes if those exist, but alas.) Maybe next time, it is a very interesting and poor covered question. Anyway thanks again for this wonderful conversation! As always it was a great pleasure to listen.
I never thought this topic would be so fascinating!
One of your best podcasts Peter! I had to pause, take notes and do research several times
I wasn't so sure I'd be up to listening to eye ball talk. This was FASCINATING! Thanks so much for the dive into all of that. I learned a ton!
Excelent presentation, thank you very much.
Wow, this was eye opening. Pardon the pun. So much to unpack. Thank you for this.
Very interesting content! Thanks for doing this.
Fantastic interviewee
Thanks peter..mind blowing knowledge as usual..
Love this podcast, I watch all of your episodes
Fascinating. Thank you so much for taking the time to get an in-depth interview. How about others, say, on the kidneys, skin, liver? So helpful and interesting.
Jesus Loves You! Romans 10:9!
Thoroughly enjoyed this conversation and learnt a whole lot too.
I'm surprised that the discussion didn't go down to diet especially when talking about cataract and macular degeneration.
Thanks Dr Attia, yet again! Love seeing the inner workings of this. Surgeons and researchers in America are the best.
Standard of Care is dangerous IMHO, drug-dealing, symptom-trating whack-a-mole.
This interview was just fantastic! I learned so much from your guest and what great questions. Thank you for bringing this knowledge to us!
Jesus Loves You! Romans 10:9!
Fascinating conversation.
Every word- perfect video!!
I've learnt so much watching this not just eye stuff thanks your channel is great
What a fascinating interview!
Awesome podcast!
Natural vision acuity has been measured as high as 20/05, so 20/20 vision is just the statistical norm for good vision; the 2 things that many parents are slack with are orthodontic and visual acuity checks; I had mild myopia almost certainly throughout primary school, but it wasn't until high school, where I really suffered scholastically from my inability to read the chalkboard, that I told my mother and she then got my eyes checked; she never bothered to get my teeth checked, other than occasional general dentist checks for decay and it wasn't until my teeth started wearing badly in middle age that I had my teeth assessed by an orthodontist, who informed me that basic orthodontic treatment as a teenager would have prevented my teeth damage.
Absolutely fascinating discussion and such valuable information. Going to ensure the grandkids are outside and off those devices more often
Such a amazing interview. Love it especially as a contact wearing person.
Great interview! I had to get PRK because my cornea wasn't thick enough to get Lasik. That's the other important thing people will need to know about. Both expensive too lol but it pays for itself in the end after a few decades because you don't need to wear contacts or glasses anymore... those are not cheap to buy either each month. If you want to prevent cataracts - you need a combo of healthy eating and HIIT exercise, try basic multivitamins + zeaxanthin, lutein, and astaxanthin. The latter will also improve your skin, hair and more. Combo of HIIT and IF will stimulate autophagy to recycle all damaged cells.
Please more about the intrinsically photosensitive retinal ganglion cells, circadian entrainment through skin and eye light exposure regime. ... discussions with Stasha Gominak? Roger Seheult? Specific wavelengths - interplay, for instance, with hormones through different opsins in eyes (as well as skin)?
So interesting
Thank you so much 😊
The timing is great, I just got a new pair of glasses yeterday. It seems the case of myopia will just increase exponentially with the lifestyle of most people, it's really important to get out and expose ourselves to bright light in the morning.
Great episode, great conversation. In 0:43:00 when you talk about the importance of vision I have been thinking how we all understimate the importance of hearing the same as you were commenting about taste. Maybe not from a survival perspective but for individual construction and development. I remembered my (almost) deaf sister crying just for a change in her audition devices (technical improvements for sure) only because of a change in tone or timbre; the whole world had become, I don't know, metallic or underwater in the blink of an eye. And those born deaf have to struggle with subjective learning; emotions, colors, etc in a more severe way than blind people (well not for colors jeje). Oh and sorry for my English from Spain.
Great English, much better than my French. Tres bien - I was thinking about the word ‘timbre’ today. It was an adjustment on my father’s 1950’s RCA stereo
Very interesting, many thanks
I wish you would have talked about eye floaters.
I know some people got floaters after their c19 jabs, sometimes with headaches.
Last month my dad was complaining about eye floaters, so I told him to take a COVID test.
His rapid test was negative* but he came down with COVID symptoms the very next day.
So maybe floaters are an evolutionary advantage, an early COVID detection system? ;)
* = Rapid tests seem terrible for early detection of omicron.
They can be caused by certain vitamin deficiency and that's why they come and go. I know I saw a video about this on TH-cam!
Would like to hear a conversion about dry eye.
Wow, what a great pod cast
Absolute brilliant show. So much information and so well explained. One of the best ever. Thanks so much to Peter and Steven.
More please !
Great informations, thank you Drs.
This was a completely fascinating conversation and honestly, I almost skipped over it, thinking I wouldn’t be interesting. Thank you Peter for helping me be open minded and learn new things! Great start to my week!
Sad to hear about surgeons suffering neck, shoulder and back strain. I'd suggest a monthly chiropractic check up followed by massage and physical therapy to keep vertebrae aligned and the proper bend in the neck
Excellant ! I was a "blue baby" and irradiated with a xray machine as an infant. My 78 years are interesting to learn from. Learning what happened then and still happening now. Of all of the "head to toe problems". the vestibulum is most amazing and the eyes most interesting. Simplified example, my "age related" macular degeneration started as an infant and has not finished yet. I will probably not be able to continue over 20 minutes but will try....Thank you!
The name of those new drops they were making reference to are called Vuity. Not sure if it was mentioned; I may have missed it. Got my Rx today! excited to try. Thanks for the great pod!
Excellent video. All 2+ hours
Very interesting! Thanks!
Great information 🔥
Very enlightening
Dr. Attia, I enjoy your content very much :) This time, it was just slightly jarring as you kept interrupting Dr. Dell with your questions in the middle of sentences (yeah, he is a slow talker ^_^). I'm sure that it was curiosity and desire to not forget/get the important message across, just a bit of feedback from a listener. Good luck, I'm a bit anxious about your latest connection to Dr. Sinclair, I hope that no negative publicity will impede your future endeavours.
i was actually thinking to do clear lens replacement instead of lasik since my vision is so bad that lasik would have thinned my corneas to near the limit and i will eventually get cataracts anyway. the added bonus of doing it younger before you actually get cataracts, would be you heal faster and can enjoy additional years of good vision. the downside was the costs would not be covered by insurance...
Same
I am 70, wear glasses, and hate them. I don't have cataracts. I don't smoke or drink and am in good health. I so want to have lassie but maybe lens replacement might be better.
@@bluewaters3100how bad are your eyes? uncorrected, im legally blind so they'd have to shave so much for lasik i'd be right on border of ineligible. didn't want to risk it. there are also other downsides to CLR like losing the ability to focus (if you still have it) and somewhat increased risk of retinal detachment. ymmv.
Bless your heart Bill!! ❤
I’m also a Christian, and I’m praying for you and rooting for you!! 🙏🙏 I’m so excited for your future 🤗🤗
Happy Thanksgiving from Alberta, Canada!! 🦃🦃🦃
i'm all in on that study
Very interesting enjoyed it very much..greaT speakers😊
Those tiny positional movements you were talking about releasing ppl down away from your ears are called Feldenkrais - it is Awareness Through Movement. My son had 4 years of this training as a music performance major in college as a way to prevent repetitive strain injuries.
This made me feel so much better about my upcoming cataract surgery Thank you!
I didn't expect the eye to be so interesting. Very insightful (p.i)
From now on I'll take better care of my eyes,so lucky to have them naturally in good health.
About 5 years ago I bought a projector to use in my pc because I wanted to avoid looking at a close screen all day. Of course the entertainment value doesn't hurt either.
So your computer screen gets projected on the wall instead of an LCD monitor? That's... not a bad idea, actually.
Reminds me of university lectures halls. I might have to dust off the ole projector one of these days.
Non entry level discussion. I love it.
@1:54:15 You mentioned about flattening the cornea (comparing to sanding down a piece of wood) in order to change the shape. If lasik changes the shape of the cornea then how come the vision doesn't stay 20/20 forever? Does the ideal shape that you created eventually just convert back to the old shape?
If you ever have another eye specialist on the show, would love to hear about orthokeratology. Basically a contact you wear at night that reshapes your cornea so you don’t have to wear anything during the day.
Loved the interview. Was hoping the subject of “floaters” would have been discussed.
ive seen so many podast set ups and this is still the cleanest one lol
Great interview! What about floaters treatment's? 😢
Some very important facts towards the end people see your optometrist for a check up more important than seeing your doctor for a physical!
I wish someone would talk about central serous retinopathy. I have it both eyes and it makes some days such a chore....
Very good, this subject is so serious that I even recorded a video about it..
I have a question regarding sunglasses : what about the sunrays that's still hitting your eye with an angle when the sun is in your eye field of view but out of your eye+glass field of view ?
Great episode. I wonder if an adult in mid 20s who is nearsighted spend far more time outdoors looking at things in the distance would improve their vision at all? or is the case that once you're an adult that nearsightedness is fixed?
Great information! I have macular degeneration treated with Eylia shots every 11 weeks. My left eye is significantly worse than the right. I am female, 77 years old. My eye doctor says my cataracts are at a stage where they could be removed. I know there is retinal scarring in the left and maybe the right. If I have the cataracts removed, can the interocular lens they insert be tailored so the incoming light is focused on the unscarred section of the retina? I realize it’s a question for my doctor, but is it feasible and could it improve my visual impairment?
Amazing.
This episode made me crave M&Ms.
I grew up in the 80s and 90s in Southern California and Arizona. I was outside in the light all day, every day. I still have myopia. I require a high power corrective lense. I also have a bunch of skin damage from the sun 🤦🏻♀️