May 7, 2025 • 36 mins
Dr. Christina Prescott, an ophthalmologist at NYU Langone and ocular expert, is helping patients get amazing results from new technologies in lenses. In this episode, Dr. Prescott dives into this under-discussed subject, unveiling the fascinating science behind the eye, and the do’s and don'ts of caring for your own. Screen time, sun protection, diet – which factors really matter? Tune in to learn!
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Episode Transcript
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Speaker 1 (00:04):
Hello, everyone, This is Martha Stewart. William Shakespeare said that
the eyes are the window to your soul, and in
the medical world, it's true that I say a lot
about your health. My guest today is an expert in
I care. Doctor Christina Prescott is an ophthalmologist at NYU Langone,
(00:25):
where she is also Vice chair for Education and director
of the Corneus Service. As an ophthalmologist, she treats patients
for cataracts and other vision disorders. Welcome to my podcast,
doctor Prescott.
Speaker 2 (00:38):
Thank you so much. It's such an honor to be here.
Speaker 1 (00:40):
Well, it's so nice to have you here. May I
call you Christina? Okay, now I have to report that
doctor Prescott, Christina has actually treated my eyes for kind
of pre cataract conditions and inserted trifocal lenses a lens
in each of my eyes. And I I have been
(01:00):
so happy for the last year. I think we just
passed my year's anniversary. I have been so happy. I
have no contexts, I have no eyeglasses, and I have
twenty twenty vision as of last week.
Speaker 3 (01:16):
Yes, I was so excited, and I have to admit
I was a little nervous when Martha came in and
we talked a little bit about possibly doing cataract surgery,
and I asked what you wanted to see and she said,
I'd like to see everything perfectly at every distance. And
the bar was a little high, but luckily, I think
we got there.
Speaker 1 (01:34):
You did it. You did it, and really I'm very happy.
And I think that my age to have vision like
I have, which I can drive and see every single
road sign night and day. I can read in bed,
I can watch movies far away. I can do pretty
much everything with my eyes that eyes were meant to do.
(01:56):
And really and truly it's those little lenses. Can you
describe that operation right off the bat, because I think
it's not magic, it's good science, and I think people
would like to know about that.
Speaker 2 (02:07):
It's so exciting. So I am. I think I have
the best job. Well maybe martha job's a little bit, but.
Speaker 3 (02:12):
Other than Martha's Stewart, I think I have the best
job there is because cautaract surgery, which is the probably
the majority of what I do, is such an amazing surgery.
So literally the surgery is done through about a two
millimeter incision, takes about ten to fifteen minutes, and it
involves removing the cataract, which is the natural lens of
the eye that's become cloudy over time, usually just as
(02:33):
part of the natural maturing process. And then we have
so many different options. Now A basically implantable replacement lens
is and depending on the type of lens that I
implant to replace the cataract will determine the vision afterwards.
And it's been since twenty nineteen that the trifocal lens,
it's called the panoptics came out. And actually it's a
(02:54):
funny story because I've been doing catactort about ten years
at that time, and I was in India doing some
outreach programs and I just gotten the trifocal lens approved there.
But we were waiting in the US in twenty nineteen
and everyone's just going crazy and talking about it, and
I said, there's no way, there's no way it can
be this good. People don't need glasses for anything. They're
happy with the quality of vision. And then I get
back to the US in twenty nineteen and it just
(03:15):
gets have to approved. I just started using it, and
then COVID hits and all of a sudden, we have
to stop doing all surgery for three months.
Speaker 1 (03:22):
Wow. Right, gosh, it was so terrible. Yeah, for everything.
It was for the entire medical community and for all
of us because you were in danger of getting the disease. Yeah,
but it is an incredible progress report to be able
to say that you can actually give back the vision
(03:42):
that we were born with.
Speaker 3 (03:44):
Right, And some people it's even better than the vision
they were born because you were very fortunate in terms
of even before you had the cataracts developing, you didn't
wear glasses for anything, so you had very healthy eyes
to start with. But some people come in and they
say they've worn glasses since age five.
Speaker 1 (03:58):
Oh, I know, I got classes when I was twelve.
No I had I was near sighted. Oh okay, and
I could I was. I had very good vision, but
I couldn't see far enough to get my driver's license.
So I did wear eyeglasses, and then I got contact lenses.
And then when I got your lenses, Oh my gosh.
Speaker 3 (04:16):
So this is the first time you haven't needed anything
then never. No, That's what I'm so happy about.
Speaker 1 (04:21):
Yeah. Yeah, So it's a very extraordinary thing that doctor
Prescott does. She is also a young mother. She is
extremely well educated. Can you describe your education please for us.
Speaker 3 (04:33):
So I went to Columbia in New York, so right
around the corner here for undergraduate, and I was a
biophysics major. I just always really liked biology, physics, optics.
And then I worked at Regeneron, which is a company
that now some of you who are interested in eyes
may be familiar with because they make a product called
Iliyah which has been very successful for macular degeneration. But
(04:54):
I started working there when I was in college, and
I just thought the medical research was so exciting. So
I decided to do an NIH funded program it's called
an mdphd, or the Medical Scientist Training program, where I
did both an MD and then a PhD in neuroscience
out in Colorado. And then during my medical training, I
just fortunately spent a day seeing eye surgery and I
(05:17):
just thought it was the most beautiful thing I'd ever seen.
It was just it's so different from most surgeries where
you'd maybe see on the TV where there's blood and messy,
but eye surgery is nothing like that. There's no blood,
it's all done under a microscope. It's just very beautiful
and elegant. It's so so precise, and then afterwards the
outcomes the patients are so happy, and it was such
an uplifting field, whereas some of medicine I liked, but
(05:40):
I found a little bit sad and it got a
little bit motional to me if the patients were sick
or didn't do so well. So I just the day
I sawp theomology, I decided that was my fit. And
then I came out to Yale for residency, and then
did a fellowship in Corny and refractive surgery and at Harvard.
Then I went to Hopkins for nine years, which I loved,
and then one of my dear friends became chair it
(06:00):
NYU and recruited me back to New York.
Speaker 2 (06:04):
I've been all over.
Speaker 1 (06:05):
Yeah, you have, You've been. And in the meantime you
also have time to get married and have two children.
Speaker 2 (06:09):
Three children.
Speaker 1 (06:10):
Oh, three children, Oh my gosh. How old are they?
Speaker 2 (06:13):
Oh my goodness, they're getting old.
Speaker 3 (06:14):
Seventeen year old who actually had as an intern, which
is I wouldn't necessarily recommend, but it worked out well.
Speaker 2 (06:19):
He's a great kid.
Speaker 3 (06:19):
And then a fifteen year old who I was as
a resident, and then an eight year old, so there's
a bit of a gap, but it's fun.
Speaker 1 (06:25):
Wow. Well, it's so incredible, and you are just the
master of your craft, really and truly, I have been
so thrilled, and I thought maybe we should talk about
besides the lenses which you've been planted in my eyes,
we should really talk about general guidelines for taking care
of one's eyes, because so many of us just don't
have any idea. We know that they're precious, we know
(06:48):
that we need our eyes. If there was one of
the five senses that I could not live without, I
would say it's my eyes. I would be a very
bad blind person. I could do without I could do
without smell, but I couldn't do without eyes. And it's
so incredible to know how to take care of them.
So give us some guidelines for taking care of your eyes.
Speaker 3 (07:09):
Well, the good thing is it's actually pretty simple. I
think overall we've talked about this a little bit. Is
a lot of the things, and as you mentioned so
eloquently earlier, you know, the eyes are really the window
to the solar and the self, and also really most
of the things that affect the eyes are things that
affect the rest of the body. It's just that we
can see them in the eyes. So we have the
epidemic of diabetes and high blood pressure in this country.
(07:31):
And it's amazing because you can actually see the blood
vessels in the back of the eye when you go
in for your eye exam, so your doctor may be
able to tell you, oh, your diabetes control is worse,
or how's that blood pressure doing. I've actually even diagnosed
a patient once with a leukemia because they had these
very unusual bleeding in the back of their eye and
no other systemic symptoms. So you can really see the
(07:52):
see a lot of the pathology that's happening in the
rest of the body, but you.
Speaker 2 (07:55):
Can see it in the eye.
Speaker 1 (07:56):
Your eyes great.
Speaker 2 (07:57):
And the other thing is avoiding smoking.
Speaker 3 (07:58):
I'm sure that's a common theme, but that's the one
thing that makes macro degeneration, which is such a common problem.
Speaker 2 (08:03):
That's the one thing we know we can do to.
Speaker 1 (08:04):
Is that really common?
Speaker 3 (08:06):
It is, It's very common, especially among people as they
become older. It's an unfortunately there's not a cure. We
have better treatments nowadays, but there's still not a cure.
So things you can do to reduce your risk, which
is the main one is smoking, and then there is
some evidence that a Mediterranean diet and a high dose
antioxidan vitamin also help.
Speaker 1 (08:24):
And what are the signs of a healthy eye?
Speaker 3 (08:26):
One thing that's fortunate is most of the time, not
all the time, if you're seeing clearly, that's obvious a
very good sign. Now, sometimes, like with diabetes, sometimes it's
pretty advanced before you actually can get visual loss. Also,
something called glaucoma can develop without you realizing it because
it affects your peripheral vision.
Speaker 2 (08:43):
So even though your vision.
Speaker 3 (08:46):
Is good, it is still good important to get your
eyes checked, especially as we get more mature, so.
Speaker 1 (08:50):
They really do reflect your general health very much. So
vision and eye pressure tend to get worse with age.
I've read. Are there any signs of symptoms people shouldn't
ignore or assume that are part of aging.
Speaker 3 (09:02):
Well, the vision really shouldn't drop dramatically at any or
suddenly at any point. So the sort of normal things
that happen with aging, you know, the kadarct slowly developing,
the eyes getting a little dry, or even the slow
form of macular degeneration are all very slow. So there
should never be a sudden drop in vision, because if
there is, that could be a sign that it's something
more significant, sometimes a bleed or a stroke in the eye,
(09:24):
So if you have a sudden change in vision, that's
never good.
Speaker 1 (09:27):
And is there an age where you need to start
annual exams?
Speaker 3 (09:31):
So it really depends on the person in your family history,
but in general, it is good to get a screening
exam when as a child before you start school, definitely,
because a lot of times children don't necessarily show that
they can't see until they get.
Speaker 2 (09:43):
To school, so it's good to do that mostly for
their learning.
Speaker 3 (09:46):
And then when you get a little bit older, you'll
notice you'll start eating reading glasses, usually in the forties,
so it's probably good to make sure that's all it is.
And then once you get into your fifties, it's good
to go more often.
Speaker 2 (09:57):
But if you have a very.
Speaker 3 (09:58):
Normal healthy exams that you go in at forty hor
eyes perfectly healthy of no family risk factors, you don't
necessarily need to go annually. For a lot of people,
every three years would be okay, but you want to
make sure that you don't have many risk factors.
Speaker 1 (10:08):
And I've been noticing lots of little kids with eyeglasses
these days. I think more than when I was in
school as a child. Absolutely so is that because there
is better detection?
Speaker 3 (10:19):
Actually, that's such a huge thing, and I'm so glad
you mentioned that because we actually have and some people
literally are calling this a myopia epidemic, and myopia just.
Speaker 2 (10:26):
Means being nearsighted.
Speaker 3 (10:28):
But actually it's likely due to the increase in screen times,
especially being held very close, the children spending so much
time looking at these screens inside that actually, over the
last ten to twenty years there's been worldwide and worse
in some areas of Asia, but worldwide there's been a
huge increase really, so that now about fifty percent of
children are actually myopic, and it's predicted to get worse
(10:49):
and worse over the next decades.
Speaker 1 (10:52):
And if kids are looking at screens, should they be
looking at screens in a dark room? Is that worse
than looking at screens in a light room? Because I've
been having arguments with my grandchildren. The boy is it's
on his screen a lot. He watches sports, and so
it's a small screen and he's in one hand he
has a book where he's reading, and the other hand
he has the screen watching a soccer game. What's the
(11:14):
best way to watch a small screen if you're going
to right.
Speaker 3 (11:17):
So it's a combination of the size of the screen,
so the smaller and closer or worse, and then also
the lighting. So actually, if you can make them make
him go outside and watch it outside, it actually is better.
Speaker 2 (11:27):
Because then that's what I say, it's actually true. There's
some data.
Speaker 3 (11:30):
I know it sounds like a weird not scientific, was
actually some great scientific data showing that spending time outside
during the time that I was developing, so from birth
up until about age seven to thirteen, you actually can
reduce the amount of nearsightedness with more time spent outside.
There are actually some public health interventions that are geared
towards that.
Speaker 1 (11:50):
So I was trying to wonder why I was myopic
as a young child. But we didn't have screens. We
didn't have screens, we didn't even have a television. So
I read all the time, and I read in the
semi dark because I was turn out your lights, and
so I would read with a flashlight and probably very
close hours and hours reading all the time with a
(12:11):
flashlight in bed, yes, and I think that might have
contributed to it. But I think also I think my
mother was also my out.
Speaker 2 (12:18):
There's a combination.
Speaker 3 (12:19):
There's definitely a genetic tendency, and again this is part
of the reason why Asian countries are such an increased incidence,
but it also is related to near work. And then
the other interesting thing. In some of the different countries
where they have a lot of near sighted children, they've
done studies looking at urban versus rural areas and it's amazing.
There are some urban cities where about ninety percent of
the troldern are nearsighted, and in the same country about
(12:40):
ten percent of children in the rural areas are nearsighted.
So even with similar genetics, there's a huge environmental effect
I see wo So it's a really a big public
health issue right now.
Speaker 2 (12:48):
In ophthalmology, I see.
Speaker 1 (12:50):
So many kids with glasses and it's hard to see them.
They look like little old people in glasses.
Speaker 3 (12:55):
And it's not just the glasses, because I think sometimes
we think of that just cosmetic, and that's true. If
it's a mild prescription like yours, it's a very mild prescription,
so then it's perfectly healthy of a perfectly healthy eye.
But when you get this would call pathologic myopia or
these really near sighted strong prescriptions. It's actually not healthy
for the eye because basically the eye've grown too long,
is why that happens, and so you get thin areas
(13:17):
and they're much more prone to retinal detachment and other
problems as they get older.
Speaker 2 (13:21):
So it's not just a cosmetic thing.
Speaker 1 (13:23):
So suggest to parents to reduce the amount of screen time, right.
Speaker 2 (13:27):
I try, Yeah, I do try.
Speaker 3 (13:30):
No, it's really yeah, it is, and for adults as well,
for it doesn't affect your being nearsighted's so much once
you're adult. But actually dry eye, which is such a
huge problem. I think it's actually the most commonly diagnosed
eye problem in the US, and I think probably worldwide.
And actually screen time is directly contributes to dry eye
symptoms as well, especially to periods. So do take breaks
(13:52):
when you're spending time on the screen. I know it's
easier said than done, but it's an important thing.
Speaker 1 (13:56):
So people pay attention to your kids and pay attention
to screen time and be diligent about it because it
really will have long term effects.
Speaker 2 (14:05):
Yep.
Speaker 1 (14:05):
And go outside and go outside. Yeah. Well, luckily, my
grandchildren go outside all the time. They're out there all
the time, and they don't mind either of being outside
with their screens or inside. They just they're adaptable, but
they have to watch out. Now, people get confused, what's
(14:28):
the difference between an optometrist, an ophthalmologist, and an oculist.
Speaker 2 (14:35):
So that's a great question.
Speaker 3 (14:36):
So I think sometimes people do get confused with optalmalists
versus optomics, and I work with both. I'm an ophthalmologist
and I mostly do surgery. I don't do regular routine
exams or glass or contacts myself. But the way I
think of it is an ophalmologist is a medical doctor.
So I went to medical school, did a residency just
focused mostly on surgery. So after college you do fourias
(14:58):
of medical school, and then four y is of themology
four years after four years, and then if you want to,
you can do an extra year or two of fellowship,
which I did in corneon refractive surgery. So it's a
pretty long program that's to become an optimalogist, so you're
really focused on more problem eyes. Is how I think
of it, as ict of see sick eyes, so people
who need surgery or need some kind of serious medical intervention.
(15:18):
Whereasn optometry is also actually an advanced degree. I think
some people don't realize that, so they actually do four
years after college an optometry school, which is focused a
lot on glasses, contacts and more healthy eye exits, they're no,
so they're what's called an od a doctor of optometry.
So they're not medical doctors. So but if you have
a healthy eye, and especially if need glasses or contacts,
then that's most likely to be your primary eye care provider.
(15:41):
And again I have a lot of people that I
work with in both. But for sick guys or if
you need surgery, then you need an ophthalmologist.
Speaker 1 (15:46):
What's an oculist? Is that a doctor? So no, that's
I think an is that somebody who make cyeglasses.
Speaker 3 (15:52):
I was gonna say, so optician is you? I think
ocus is the old fashioned term for optician.
Speaker 1 (15:56):
So the optician, remember hearing that from childhood, the oculus.
Speaker 3 (16:00):
The oculus, So I think that's what they used to
call an optician. Who is the person who actually makes
class and that's a lost art. Now there are some
really elegant crafts people who can really fine tune lenses.
Now a lot of the lenses are made mechanically, not
by hand, necessarily.
Speaker 1 (16:14):
So so you just you describe the training that Aphalmologies
goes through. That's a long training program.
Speaker 3 (16:20):
Yeah, it's actually gotten quite competitive to I'm the program
director at NYU and we have six lots and we
get over seven hundred applicants every year, so it's become
quite popular.
Speaker 1 (16:30):
Wow wow, But so what is the whole industry of
eye care? It's a vast industry. I was trying to
remember since the time I was twelve when I got
my first little pair of pink rimmed glasses. I remember
they were little cat eyes and I wore those and
I kind of liked I like having I have them.
I's still oh my gosh, But I remember then I
got a pair of blue ones. It was expensive to
(16:52):
get a new pair of glasses, and my mother every
time I grew a pair, and she told me how
I had to take care of them and wash them
and everything. And I remember being proud that I had
glasses and happy that I had them so that I
could see perfectly for school. But children who don't have
the opportunity to get the glasses that are appropriate for them,
(17:14):
is there anything they can do?
Speaker 3 (17:15):
Actually, I'm so glad you mentioned that because it's such
a huge problem, and worldwide there are millions of children
who basically would see perfectly if they had glasses. So
luckily there are some good outreach programs here.
Speaker 2 (17:27):
There's one that I.
Speaker 3 (17:28):
Recently met the founder called ReSpectacle, which I thought was
a really neat concept. And basically what you can do
is you can donate your old glasses. You send them
into this website and they keep a database of all
the prescriptions and the type of glasses, and then anyone
who wants to who needs glasses can go on there
just type in their prescription and they'll make recommendations of
similar ones that they have in sock and send them
the strat yep.
Speaker 1 (17:49):
Oh, just remember that everyone ReSpectacle. It's like hearing aids
and now taking hearing aids. And I remember donating my
mother's hearings when she passed away.
Speaker 3 (17:58):
Because it's people's person changes, even the frames change. And
then some of the different optical shops I know, Warby
Parker is one of the ones that kind of pioneered this,
but some other optical shops have started doing this as well,
where when you buy a pair of glasses, they'll donate
a pair as well to a child in need, which
is there's some great programs out there.
Speaker 1 (18:16):
Are very important, and oh gosh, that is such good news.
So let's talk about these trifocal lenses again. Back to
my eyes and the ability for me to have this
wonderful vision that I have now or is that something
that everyone could have?
Speaker 3 (18:31):
So I'm so glad you asked that, because I love
the trifocal lenses that I tell people, like if I
was getting catac starch brow, that's what I would get.
Speaker 1 (18:37):
My assistant, by the way, Matt, he just told me
today that his eyeglasses are trifocal eyeglasses and they drive
him crazy. They're eyeglasses and he can't read, he can't
see distance, he can't drive at night, all the things
that he's suffering. But he's wearing this one pair of
glasses that supposedly does everything. Does that really work well?
Speaker 3 (18:59):
So it's a lot harder with glasses. And I was
also talking to one of your other colleagues about progressives,
where a lot of times it's hard to actually progressive
eyeglasses where you have far, medium, and close all in
one frame and it basically gradually transitions. And that's actually
probably the most popular type of lens now among people
once they get into their forties or fifties or older.
Speaker 1 (19:21):
But it's very shard like through the top of the lens.
Speaker 3 (19:23):
One thing exactly distance in the middle in theory computer
and bottoms in theory reading. But it's very hard to
find the right spot to look through and when you
look down it can actually affect your depth perception when
you're walking up and downstairs, whereas with a lens implant,
because of the way they're designed, you actually don't have
to look at a specific diress. It's just based on
the way your eye naturally looks. But one thing I
(19:45):
do want to mention is I know you have a
large follow and I think probably a lot of people
now are saying I'm going to get the trifle lenses
that have it as perfect vision, and hopefully that's true.
But I tell people and the important thing about those
lenses is you have to have an otherwise healthy eye
for them to really give you that perfect vision, because
if you'd had what you know, if you'd had like
a macro degeneration or gaucoma or something like that, or
(20:06):
an unusual shape die, that might not have been an option.
Speaker 2 (20:08):
They're not unfortunately not an option. I was every lucky.
Speaker 1 (20:10):
I was just lucky that my eyes were Yeah, my
eyes were good. I think that if people who have
healthy eyes but at least investigate that option, it would
be something. But you told me that insurance doesn't cover them, right.
Speaker 3 (20:23):
Unfortunately, they are more expensive lenses, so they're not an
option for everyone. But I have had patients tell me, well,
I did the calculation, and this is how much I
paid for the specific lens, and then this is how
much I used to spend on my glasses, and after
that point I'll come out ahead.
Speaker 2 (20:35):
So right, So obviously it depends on.
Speaker 1 (20:37):
The Really, after one year my eyes, I have a
little bit of dry eyes and you've taken care of that,
but generally just so comfortable and no more worrying that
I fell asleep with my contacts in or that I
left my glasses somewhere. It's really a great relief to
be able to have these lenses implanted. Yeah, who is
(20:58):
the surgery for. It's you've just said for people with
healthy guys.
Speaker 3 (21:02):
So cataract surgery is really for anyone who has the
cataractors developing counteracts. But in terms of the trifocal lens
that you really need a healthy eye. But fortunately, even
for people who have other eye issues, there are a
lot of different lens options out there now, and I
think that's that one really gives you the best chance
of not needing any glasses and having that full range
of vision. But even someone who has something like a
macad degenerator.
Speaker 1 (21:22):
You're in Asia, are you too young for trifocals or
I usually.
Speaker 3 (21:26):
Don't recommend having counteract surgery until you at least are
starting to develop the contact and having some visual changes
from that, because if you have a normal, healthy lens,
and say you're in your forties, even if you start
needing reading glasses, that's a pretty big surgery to go
through if your eyes otherwise healthy and just needing reading glasses.
Speaker 2 (21:42):
So usually it's rare.
Speaker 3 (21:44):
To have that surgery before age fifty athough un certain circumstances, we.
Speaker 1 (21:47):
Do so like all fifty year olds, pay attention.
Speaker 3 (21:50):
Exactly see when you start having your vision travel, at
least go get checked.
Speaker 1 (21:53):
I would think that it would work for everybody, but
it doesn't.
Speaker 2 (21:56):
Well if people.
Speaker 3 (21:57):
Have other eye issues, and then the other thing is,
now your surgery went very well, but that lens Basically,
the surgery has to go perfectly and you have to,
as we say, hit the target exactly because it's a
very specific lens. So if you don't think you're going
to be able to get a successful surgery, or the
measurements aren't accurate or reliable, then that might not be well.
Speaker 1 (22:15):
You need an expert like you, you.
Speaker 2 (22:16):
Who does a who does a lot of those surgeries.
Speaker 1 (22:19):
So, and the recovery was very simple. Sure, yeah, two
days it was fine. You're a very healthy person, so
I know I'm lucky. So what do you say to
patients who come to you and have are very fearful
about operating on their eyes? Because I was, people say, oh,
did you have lasik? What is lasik surgery?
Speaker 3 (22:37):
So, lasik surgery is a surgery to it's a laser
eye surgery. I also do that as well, and that's
designed to reduce the need of glasses for someone who
doesn't have cataracts. So, say you're in your twenties or
thirties when you wore glasses all the time, but you
just want to get rid of the glasses or contacts,
use a laser to basically reshape the cornea, almost like
using a laser to etch a permanent.
Speaker 1 (22:55):
Contact you that round perfect eye again exactly, And that's
that is very delicate and very you have to be
an expert at that is a surgeon.
Speaker 2 (23:05):
Right, That's awesome, very spaci.
Speaker 1 (23:07):
I know my sister had that and she's thrilled. She's
thrilled with it.
Speaker 2 (23:09):
Yeah, so that's a great option.
Speaker 3 (23:10):
I tell people when you're in your twenties thirties, lasik
is a great option, and then when you get into
your fifty sixties, the counteract surge is great options. We
still don't have something perfect for that sort of in
the forties, which actually is where I am in the
forties range yet.
Speaker 2 (23:23):
But we're working on it so well.
Speaker 1 (23:25):
Could that be?
Speaker 3 (23:26):
So? There are some surgeons that were developed basically putting
an implant into the cornea to try to reduce the
need for reading glasses, but none of them have quite
panned out because the quality of vision hasn't been there yet.
Speaker 2 (23:37):
But that doesn't mean it won't be. It's just not
there yet.
Speaker 1 (23:39):
Can you describe the eyeball? I just I went through
this with my beautiful dog, Crembreulet recently. She had to
have her eyeball removed because she wounded it. She must
have run into a tree. And I looked at all
the photography and all the drawings of the eye to
see what the doctor was talking about. But can you
describe it? Here? You have a beautiful eye, it is,
(24:00):
so what's the dark center?
Speaker 3 (24:01):
So the very dark center is actually the pupil, which
is not an actual object, it's.
Speaker 2 (24:06):
Just an area where in the space the window.
Speaker 3 (24:09):
Well, so you have the cornea first, which is the
clear front covering of that. And that's one of my
areas interestince I transplant that and actually it's interesting. The
corny was actually the first successful solid organ transplant ever
performed in nineteen oh six Edward zerm. But it's pretty
amazing because it's a vascar. There's no blood vest it's
clear covering of your eye, yep. Because there's no blood vessels.
It's actually the easiest organ to transplant because the rejection
(24:31):
risk is incredibly low. Then you have the sort of
the space we call it the antier chamber, but that's
basically where you have a fluid and then you have
your eye res which I think what people always think
about when they think of the eyes, the colored part.
So I think about that a lot when they think
about the eyes, and you know, there's all the people
prefer one color versus the other, but they're all beautiful.
Speaker 1 (24:48):
And then have you ever operated on an odd colored eye?
Speaker 3 (24:51):
Well, one thing that I should say is the sort
of public safety thing, and I think this is advertised somewhere,
especially for people go online to do a lot of
social media. There was a trend of wild God, I
think it's hopefully abated, but I'm not one hundred percent
sure where people were going to other countries and having
implantable colored irises put in. But unfortunately, it was a
very crude surgery and the implants were not very safe,
(25:11):
and so actually I had a few patients who had
had to have cornial transplants combined with cautaract surgery because
these implantable irises basically destroyed.
Speaker 1 (25:18):
I saw some of these I saw.
Speaker 3 (25:20):
I Unfortunately, I had two of these patients who went
overseas for the surge, but then came back to the
US when they had complications, and very sad.
Speaker 2 (25:27):
Actually, I had a.
Speaker 3 (25:28):
Thirty something year old, beautiful young lady who'd gone overseas
and had this done.
Speaker 2 (25:32):
I had to do a bilatal corner.
Speaker 1 (25:34):
Was she going from to what color she was engined?
Speaker 3 (25:36):
She was middle Eastern, had dark colored eyes, and she
went to blue eyes, but it didn't didn't go so well.
So lucky hair surgeries went well. Her countaract and cornial transplant.
She did well from a vision point of view, but
it was sad.
Speaker 2 (25:50):
Back to brown, but a little bit cloudy because of
all the scarring.
Speaker 1 (25:53):
Gee yes. For Halloween, I always insert colored contact lenses
that you can buy these every color of contact lens.
So one year I did yellow, they look so weird
and beautiful. One year of jagged purple and they look
really good like the tailor violet eyes, and I've done
(26:15):
white eyes. The white are the scariest.
Speaker 3 (26:17):
Yeah, some of them are very disturbing looking. Actually, another
public safety announcement, careful. You'll be careful where you purchase
those lenses because if you go to an optical shop
or you have an optomics or an optician who provides
those for you, there are a lot of beautiful, safe
ones out there.
Speaker 1 (26:29):
Okay, I've got them from I think Faushion.
Speaker 3 (26:31):
Okay, yeah, that's great because that's a great company. But
you do have to be careful because especially around Halloween time,
a lot of drug stores or costume supply stores and.
Speaker 2 (26:38):
The internet will sell it.
Speaker 3 (26:39):
And a lot of them are really not very they're
not sterile, they're not.
Speaker 2 (26:43):
Safe for the eye.
Speaker 3 (26:44):
And every year we see a lot of really pretty
significant cornial ulcers and it actually forget it.
Speaker 1 (26:48):
People do not wear you can.
Speaker 3 (26:50):
Get they just get them from a from a legitimate
optical shop. Don't get them online costume shop. I'd like
to get dressed up for Halloween, so just be careful
where you get them.
Speaker 2 (27:01):
There.
Speaker 1 (27:02):
Okay. So then you have your iris, yes.
Speaker 3 (27:05):
And then we have the vitreous, which is the gel
of the eye that kind of gives you the form
part of the eye, and that's where people get floaters.
I know, floaters are something that a lot of people
probably have and I'm sure some of the people out
there thinking, oh, she's gonna tell me how to fix
my floaters and it's going to be great. But unfortunately
we still don't have a perfect cure for floaters. They
can be removed surgically if if they're rare, really bothers
(27:25):
some but the surgical risk of that is still relatively high.
Then behind the vitreous, you have your retina, which is
really the film of the camera. It is really the
most beautiful I think, cause it's if you see the
photographs of it, you can see these beautiful vessels. You
can actually see the nerve of the eye, which is
amazing because the eyes are only part of the body
where you can actually literally see the optic nerve and
you can tell so much about the health of the
eye based on that. And one thing I was talking
(27:48):
earlier is actually some of those photos there's some evidence
that maybe looking at retina photos and retina imaging can
actually give us some predictive value for certain types of dementia.
So that's a really exciting area of study right now.
Speaker 1 (27:59):
But what could you do it?
Speaker 3 (28:00):
Well, I guess there's not necessarily anything you could do
since we don't have a treatment right now, but at least.
Speaker 1 (28:04):
To be aware, yeah you're going to fit Alzheimer.
Speaker 3 (28:08):
That you're the higher risk maybe and maybe a venture
we have a treatment.
Speaker 1 (28:11):
Come in and you can look at me and make sure.
Speaker 2 (28:14):
I think there's lots of evidence that you're doing just fine.
Speaker 1 (28:17):
Goodness, So that's it.
Speaker 3 (28:19):
That's the eye, not the Yeah, it's very simple, but
very beautiful. Where do you transplant from from donor donor.
It's actually pretty amazing. In the US, we have a
great I banking system, so for people who are organ donors,
that's one of the most utilized organs that can be used.
Speaker 1 (28:34):
I never thought of it that way because my sister
who passed away gave her eyes. So somebody has her eyes. Yes,
well they have her.
Speaker 3 (28:41):
Right the corny is the only part of the eye
that can be transmit It's pretty amazing. And sometimes, you know,
you see the stories about the donors and the recipients,
and I always ask my patients, I said, do you
want to know who gave the cornia? Because sometimes it's
a sad story and they can write letters to the
family and things saying thank you. And especially when I
have a child who gets the cornea as the recipient,
a lot of times I think it's really nice.
Speaker 1 (29:00):
To And so why would you have to have your
corny replaced? Is it so there are there or something not?
Speaker 3 (29:05):
Usually so there are some congenital reasons for children and
then an adult. There's something called Fuchs corneal dystrophy, which
is basically genetic conditions. It's actually pretty common where you
lose the inner cells of your corny over time as
you get older.
Speaker 2 (29:20):
But it's really neat.
Speaker 3 (29:21):
Now instead of having to replace the whole cornea for that,
we can literally just replace the inner layer of cells
with a donor layer of cells.
Speaker 2 (29:27):
And now there's some new things going on that just.
Speaker 1 (29:29):
Got approved in you inject the cells.
Speaker 3 (29:31):
So actually, it's funny you asked that you're ahead of
your time and a lot. Yeah. Yeah, Shaguru Kinoshita in
Japan actually just got approved in Japan a cell injection
therapy and he's been working on that for decades and
he finally got approved in Japan and now we'll see
if if that gets approved in the US.
Speaker 2 (29:47):
But I think we're getting pretty close.
Speaker 1 (29:49):
Wow.
Speaker 2 (29:49):
So it's amazing. It's amazing.
Speaker 1 (30:00):
Our eyes one of the most worked on organs.
Speaker 3 (30:04):
Actually, a cataracts ARET is most common surgery performed in
the US.
Speaker 1 (30:07):
It is.
Speaker 3 (30:07):
It is probably because it's so successful and as you mentioned,
people care so much about their vision. That's something that
people are likely to have operated on eyes you want
to see and I think our outcomes are just really good.
Speaker 1 (30:21):
It's so amazing. I'm so thrilled about this. So what
are some of the risks to eye health from weight
loss drugs. I've been hearing that there are some problems.
Speaker 3 (30:30):
So that's such a good question because it's such a
hot topic right now. I mean, the drugs have been
such an incredible thing for so many people. A lot
of my patients are on it and really have had
a great result. Initially, there was quite a worry because
there are a few cases of what's called naion, which
is almost like a mini stroke to the eye that
can happen. It usually happens overnight and people notice it
when they wake up in the morning with basically half
(30:51):
their visual field is usually missing. And there was a
few episodes of that reported right surely after people started
these medications. But it's a little hard to tell because
the main risk factors for those type of strokes in
the eye developing are being overweight, having unstable blood pressure,
being older men, so a lot of the same risk
factors for people that might be on these medications. So
(31:13):
it's still being looked at right now. They're not saying
don't take the medication, but they're saying if you have
any of these sudden visual loss, especially upon first waking up,
it's make sure you get seen right away. And then
the other thing that's happenings interesting is when people I
talked a lot about diabetes control, when you have a
really sudden drop in your blood sugar, so you're all
of a sudden, your control goes from being very poor.
Speaker 2 (31:33):
To being very good.
Speaker 3 (31:34):
That's a great thing overall, but sometimes it can actually
that that sudden change can actually cause some changes in
the blood vessels of the eye and actually can make
the diabetic retinopathy worse if you already have that.
Speaker 2 (31:44):
So that's something you want to be aware.
Speaker 3 (31:45):
If you start those medications, especially if you have diabetes,
to make sure you have your retin a check before
you start the medication, that have someone who can follow
that because's usually treatable, but you want to be aware
of that.
Speaker 1 (31:55):
The other thing that concerns us is sudden exposure with
the demise of the protective layers of the atmosphere because
of global warming and stuff. How important is it to
wear sunglasses.
Speaker 3 (32:06):
Well, it is, and it is important, and part of
the reason isn't so much what people think for the
inside of the eyes, also for the eyelids, because the
eyelids are actually one of the most common sights of
skin cancer because that skin is so delicate, and people
don't always realize that those are the main reasons for that.
Speaker 1 (32:22):
Sunglasses.
Speaker 3 (32:22):
Yeah, and your new fancy lens actually have a UV
filter built into them.
Speaker 1 (32:25):
A lot of the and you know what, notice that
you didn't tell me that. Oh sorry, but I noticed
that because I don't feel like I have to put
sunglasses on them all the time.
Speaker 2 (32:33):
A lot of the newer, higher end lenses have that.
Speaker 1 (32:35):
Welt into it, So that is brilliant. So if you
aren't wearing sunglasses, should you wear a hat?
Speaker 3 (32:41):
Do you want to do something to protect again, especially
the delicate skin around the lids and then the white
part of the eye.
Speaker 1 (32:47):
And what about you said, smoking is like one of
the worst things for eyesight, Yes, and for lungs and
for everything else. It's really damaging to your eyesight.
Speaker 3 (32:56):
Yeah, especially for a mac of the degeneration. And then
thyroid eye disease, which you may see there's a lot
of advertising now about five rid eye disease. When you
see people their eyes come out, they look like it're
almost like popping out. Smoking is the biggest respector for
that as well, and that affects younger people.
Speaker 2 (33:09):
A lot of the time.
Speaker 1 (33:10):
So is Lasik less popular now because this is the
laser treatment for irregular eye shapes right.
Speaker 2 (33:17):
Right, for being nearsight or foresight?
Speaker 1 (33:19):
Is it less popular now?
Speaker 2 (33:20):
Well, it's interesting. I think it's reached a steady state.
Speaker 3 (33:23):
I think what happened is when Lasik first came out,
so it's FT approved in nineteen ninety nine, there were.
Speaker 1 (33:27):
You know that's very not so long A yeah, I guess.
Speaker 3 (33:31):
FT approved in nineteen ninety nine, And I think what
happened is so many people were excited, so there's this
huge boom, right, I mean, everyone who didn't like glasses
or contact was getting the Lasik surgery, so there was
that huge wave. And I think now it's happened is
it's more of a steady state where most people want Lasik.
I've already had Lasik, but there are still new people
every year who are getting to the age or just
aside they're tired of their glasses. So I think it's
(33:52):
still popper, but it's not as popper as it was
back in the early two thousands where it was really
just incredibly popular.
Speaker 1 (33:58):
Now I wanted to talk about diet because people always say, oh,
eat carrots, they're good for your eyes kerotene? What about foods?
Which foods are really good for your eyesight?
Speaker 3 (34:07):
So the only evidence we really have is the Mediterranean diet,
which I'm sure you're much more familiar with the exact
details than I am. And then one thing that's it's
concerning about. Actually, this is something that I don't think
we really think about in this country, is actually a
vitamin A. So usually and it's only we thought of
it only as a developing world issue where people have
a vitamin A deficiency. But recently I've seen a few
(34:27):
cases in some very severe where people have come in.
One actually was a child that came in with the
hole in the cornea because of a severe vitamin A deficiency,
and because what happened is he had a very restrictive
diet due to a lot of other behavioral and psychological issues,
and so he ate no vitamin A.
Speaker 1 (34:42):
At allain A most readily found.
Speaker 3 (34:45):
So you've got your carrot, your leafy greens, so most
of your vegetables, but even you can take a supplement
if you're in someone who doesn't get that. But I've
seen a couple of children now again the one who
is very severe. Who with these restrictive diets who come
in with problems?
Speaker 1 (34:59):
Now, who ever restrict vegetables from a child? Yes, it was,
it happens.
Speaker 2 (35:05):
I don't think they're getting the home cooked meals from you.
Speaker 1 (35:08):
Well, we have covered so much territory in such a
short period of time, and you were so eloquent about it.
This is really an amazing amount of information to digest.
Is there a book? Have you written a book about
the eye? Yet?
Speaker 3 (35:19):
I've written, have several chapters and articles. I don't have
my own particular book.
Speaker 1 (35:24):
Can we reference those somewhere?
Speaker 2 (35:25):
Absolutely?
Speaker 1 (35:26):
So where do we look? We look under Christina, doctor
Christina Prescott.
Speaker 3 (35:30):
I think you just type in my name in n
YU and then a page will come up with a
little bit about me, and then have some reference with
some articles and things that I've written. And also if
you know you need tripical lenses or are other issues,
then has a number to call.
Speaker 1 (35:43):
Okay, So this is at NYU Lango and doctor Christina
Prescott p R. E. S C O T T. We
do have a lot of research that you have contributed
to and written, so that's very useful. I am so
interested in the eye. I am so interested in good eyesight,
and I am so interested in seeing the world, so
we have to protect our eyes. And thank you for
(36:04):
all this information. I'm really happy to have talked to you.
This is fantastic and thank you, and our listeners will
really benefit tremendously from this.
Speaker 3 (36:11):
Well, thank you so much. I'm just gonna say that
I have to ad make I've done so many eyes surcher.
I don't usually get nervous, but I was a little
nervous doing Martha's eye surgery.
Speaker 2 (36:18):
But I was so happy it went well.
Speaker 3 (36:20):
I think she's an amazing woman who's been up personal
hero of mine for a while.
Speaker 1 (36:24):
So thank you, but don't be nervous with that. I
wasn't nervous. I wasn't that all nervous. I was just
so happy with the result, and thank you so much.
Speaker 3 (36:33):
Cher,
Hello, everyone, This is Martha Stewart. William Shakespeare said that
the eyes are the window to your soul, and in
the medical world, it's true that I say a lot
about your health. My guest today is an expert in
I care. Doctor Christina Prescott is an ophthalmologist at NYU Langone,
(00:25):
where she is also Vice chair for Education and director
of the Corneus Service. As an ophthalmologist, she treats patients
for cataracts and other vision disorders. Welcome to my podcast,
doctor Prescott.
Speaker 2 (00:38):
Thank you so much. It's such an honor to be here.
Speaker 1 (00:40):
Well, it's so nice to have you here. May I
call you Christina? Okay, now I have to report that
doctor Prescott, Christina has actually treated my eyes for kind
of pre cataract conditions and inserted trifocal lenses a lens
in each of my eyes. And I I have been
(01:00):
so happy for the last year. I think we just
passed my year's anniversary. I have been so happy. I
have no contexts, I have no eyeglasses, and I have
twenty twenty vision as of last week.
Speaker 3 (01:16):
Yes, I was so excited, and I have to admit
I was a little nervous when Martha came in and
we talked a little bit about possibly doing cataract surgery,
and I asked what you wanted to see and she said,
I'd like to see everything perfectly at every distance. And
the bar was a little high, but luckily, I think
we got there.
Speaker 1 (01:34):
You did it. You did it, and really I'm very happy.
And I think that my age to have vision like
I have, which I can drive and see every single
road sign night and day. I can read in bed,
I can watch movies far away. I can do pretty
much everything with my eyes that eyes were meant to do.
(01:56):
And really and truly it's those little lenses. Can you
describe that operation right off the bat, because I think
it's not magic, it's good science, and I think people
would like to know about that.
Speaker 2 (02:07):
It's so exciting. So I am. I think I have
the best job. Well maybe martha job's a little bit, but.
Speaker 3 (02:12):
Other than Martha's Stewart, I think I have the best
job there is because cautaract surgery, which is the probably
the majority of what I do, is such an amazing surgery.
So literally the surgery is done through about a two
millimeter incision, takes about ten to fifteen minutes, and it
involves removing the cataract, which is the natural lens of
the eye that's become cloudy over time, usually just as
(02:33):
part of the natural maturing process. And then we have
so many different options. Now A basically implantable replacement lens
is and depending on the type of lens that I
implant to replace the cataract will determine the vision afterwards.
And it's been since twenty nineteen that the trifocal lens,
it's called the panoptics came out. And actually it's a
(02:54):
funny story because I've been doing catactort about ten years
at that time, and I was in India doing some
outreach programs and I just gotten the trifocal lens approved there.
But we were waiting in the US in twenty nineteen
and everyone's just going crazy and talking about it, and
I said, there's no way, there's no way it can
be this good. People don't need glasses for anything. They're
happy with the quality of vision. And then I get
back to the US in twenty nineteen and it just
(03:15):
gets have to approved. I just started using it, and
then COVID hits and all of a sudden, we have
to stop doing all surgery for three months.
Speaker 1 (03:22):
Wow. Right, gosh, it was so terrible. Yeah, for everything.
It was for the entire medical community and for all
of us because you were in danger of getting the disease. Yeah,
but it is an incredible progress report to be able
to say that you can actually give back the vision
(03:42):
that we were born with.
Speaker 3 (03:44):
Right, And some people it's even better than the vision
they were born because you were very fortunate in terms
of even before you had the cataracts developing, you didn't
wear glasses for anything, so you had very healthy eyes
to start with. But some people come in and they
say they've worn glasses since age five.
Speaker 1 (03:58):
Oh, I know, I got classes when I was twelve.
No I had I was near sighted. Oh okay, and
I could I was. I had very good vision, but
I couldn't see far enough to get my driver's license.
So I did wear eyeglasses, and then I got contact lenses.
And then when I got your lenses, Oh my gosh.
Speaker 3 (04:16):
So this is the first time you haven't needed anything
then never. No, That's what I'm so happy about.
Speaker 1 (04:21):
Yeah. Yeah, So it's a very extraordinary thing that doctor
Prescott does. She is also a young mother. She is
extremely well educated. Can you describe your education please for us.
Speaker 3 (04:33):
So I went to Columbia in New York, so right
around the corner here for undergraduate, and I was a
biophysics major. I just always really liked biology, physics, optics.
And then I worked at Regeneron, which is a company
that now some of you who are interested in eyes
may be familiar with because they make a product called
Iliyah which has been very successful for macular degeneration. But
(04:54):
I started working there when I was in college, and
I just thought the medical research was so exciting. So
I decided to do an NIH funded program it's called
an mdphd, or the Medical Scientist Training program, where I
did both an MD and then a PhD in neuroscience
out in Colorado. And then during my medical training, I
just fortunately spent a day seeing eye surgery and I
(05:17):
just thought it was the most beautiful thing I'd ever seen.
It was just it's so different from most surgeries where
you'd maybe see on the TV where there's blood and messy,
but eye surgery is nothing like that. There's no blood,
it's all done under a microscope. It's just very beautiful
and elegant. It's so so precise, and then afterwards the
outcomes the patients are so happy, and it was such
an uplifting field, whereas some of medicine I liked, but
(05:40):
I found a little bit sad and it got a
little bit motional to me if the patients were sick
or didn't do so well. So I just the day
I sawp theomology, I decided that was my fit. And
then I came out to Yale for residency, and then
did a fellowship in Corny and refractive surgery and at Harvard.
Then I went to Hopkins for nine years, which I loved,
and then one of my dear friends became chair it
(06:00):
NYU and recruited me back to New York.
Speaker 2 (06:04):
I've been all over.
Speaker 1 (06:05):
Yeah, you have, You've been. And in the meantime you
also have time to get married and have two children.
Speaker 2 (06:09):
Three children.
Speaker 1 (06:10):
Oh, three children, Oh my gosh. How old are they?
Speaker 2 (06:13):
Oh my goodness, they're getting old.
Speaker 3 (06:14):
Seventeen year old who actually had as an intern, which
is I wouldn't necessarily recommend, but it worked out well.
Speaker 2 (06:19):
He's a great kid.
Speaker 3 (06:19):
And then a fifteen year old who I was as
a resident, and then an eight year old, so there's
a bit of a gap, but it's fun.
Speaker 1 (06:25):
Wow. Well, it's so incredible, and you are just the
master of your craft, really and truly, I have been
so thrilled, and I thought maybe we should talk about
besides the lenses which you've been planted in my eyes,
we should really talk about general guidelines for taking care
of one's eyes, because so many of us just don't
have any idea. We know that they're precious, we know
(06:48):
that we need our eyes. If there was one of
the five senses that I could not live without, I
would say it's my eyes. I would be a very
bad blind person. I could do without I could do
without smell, but I couldn't do without eyes. And it's
so incredible to know how to take care of them.
So give us some guidelines for taking care of your eyes.
Speaker 3 (07:09):
Well, the good thing is it's actually pretty simple. I
think overall we've talked about this a little bit. Is
a lot of the things, and as you mentioned so
eloquently earlier, you know, the eyes are really the window
to the solar and the self, and also really most
of the things that affect the eyes are things that
affect the rest of the body. It's just that we
can see them in the eyes. So we have the
epidemic of diabetes and high blood pressure in this country.
(07:31):
And it's amazing because you can actually see the blood
vessels in the back of the eye when you go
in for your eye exam, so your doctor may be
able to tell you, oh, your diabetes control is worse,
or how's that blood pressure doing. I've actually even diagnosed
a patient once with a leukemia because they had these
very unusual bleeding in the back of their eye and
no other systemic symptoms. So you can really see the
(07:52):
see a lot of the pathology that's happening in the
rest of the body, but you.
Speaker 2 (07:55):
Can see it in the eye.
Speaker 1 (07:56):
Your eyes great.
Speaker 2 (07:57):
And the other thing is avoiding smoking.
Speaker 3 (07:58):
I'm sure that's a common theme, but that's the one
thing that makes macro degeneration, which is such a common problem.
Speaker 2 (08:03):
That's the one thing we know we can do to.
Speaker 1 (08:04):
Is that really common?
Speaker 3 (08:06):
It is, It's very common, especially among people as they
become older. It's an unfortunately there's not a cure. We
have better treatments nowadays, but there's still not a cure.
So things you can do to reduce your risk, which
is the main one is smoking, and then there is
some evidence that a Mediterranean diet and a high dose
antioxidan vitamin also help.
Speaker 1 (08:24):
And what are the signs of a healthy eye?
Speaker 3 (08:26):
One thing that's fortunate is most of the time, not
all the time, if you're seeing clearly, that's obvious a
very good sign. Now, sometimes, like with diabetes, sometimes it's
pretty advanced before you actually can get visual loss. Also,
something called glaucoma can develop without you realizing it because
it affects your peripheral vision.
Speaker 2 (08:43):
So even though your vision.
Speaker 3 (08:46):
Is good, it is still good important to get your
eyes checked, especially as we get more mature, so.
Speaker 1 (08:50):
They really do reflect your general health very much. So
vision and eye pressure tend to get worse with age.
I've read. Are there any signs of symptoms people shouldn't
ignore or assume that are part of aging.
Speaker 3 (09:02):
Well, the vision really shouldn't drop dramatically at any or
suddenly at any point. So the sort of normal things
that happen with aging, you know, the kadarct slowly developing,
the eyes getting a little dry, or even the slow
form of macular degeneration are all very slow. So there
should never be a sudden drop in vision, because if
there is, that could be a sign that it's something
more significant, sometimes a bleed or a stroke in the eye,
(09:24):
So if you have a sudden change in vision, that's
never good.
Speaker 1 (09:27):
And is there an age where you need to start
annual exams?
Speaker 3 (09:31):
So it really depends on the person in your family history,
but in general, it is good to get a screening
exam when as a child before you start school, definitely,
because a lot of times children don't necessarily show that
they can't see until they get.
Speaker 2 (09:43):
To school, so it's good to do that mostly for
their learning.
Speaker 3 (09:46):
And then when you get a little bit older, you'll
notice you'll start eating reading glasses, usually in the forties,
so it's probably good to make sure that's all it is.
And then once you get into your fifties, it's good
to go more often.
Speaker 2 (09:57):
But if you have a very.
Speaker 3 (09:58):
Normal healthy exams that you go in at forty hor
eyes perfectly healthy of no family risk factors, you don't
necessarily need to go annually. For a lot of people,
every three years would be okay, but you want to
make sure that you don't have many risk factors.
Speaker 1 (10:08):
And I've been noticing lots of little kids with eyeglasses
these days. I think more than when I was in
school as a child. Absolutely so is that because there
is better detection?
Speaker 3 (10:19):
Actually, that's such a huge thing, and I'm so glad
you mentioned that because we actually have and some people
literally are calling this a myopia epidemic, and myopia just.
Speaker 2 (10:26):
Means being nearsighted.
Speaker 3 (10:28):
But actually it's likely due to the increase in screen times,
especially being held very close, the children spending so much
time looking at these screens inside that actually, over the
last ten to twenty years there's been worldwide and worse
in some areas of Asia, but worldwide there's been a
huge increase really, so that now about fifty percent of
children are actually myopic, and it's predicted to get worse
(10:49):
and worse over the next decades.
Speaker 1 (10:52):
And if kids are looking at screens, should they be
looking at screens in a dark room? Is that worse
than looking at screens in a light room? Because I've
been having arguments with my grandchildren. The boy is it's
on his screen a lot. He watches sports, and so
it's a small screen and he's in one hand he
has a book where he's reading, and the other hand
he has the screen watching a soccer game. What's the
(11:14):
best way to watch a small screen if you're going
to right.
Speaker 3 (11:17):
So it's a combination of the size of the screen,
so the smaller and closer or worse, and then also
the lighting. So actually, if you can make them make
him go outside and watch it outside, it actually is better.
Speaker 2 (11:27):
Because then that's what I say, it's actually true. There's
some data.
Speaker 3 (11:30):
I know it sounds like a weird not scientific, was
actually some great scientific data showing that spending time outside
during the time that I was developing, so from birth
up until about age seven to thirteen, you actually can
reduce the amount of nearsightedness with more time spent outside.
There are actually some public health interventions that are geared
towards that.
Speaker 1 (11:50):
So I was trying to wonder why I was myopic
as a young child. But we didn't have screens. We
didn't have screens, we didn't even have a television. So
I read all the time, and I read in the
semi dark because I was turn out your lights, and
so I would read with a flashlight and probably very
close hours and hours reading all the time with a
(12:11):
flashlight in bed, yes, and I think that might have
contributed to it. But I think also I think my
mother was also my out.
Speaker 2 (12:18):
There's a combination.
Speaker 3 (12:19):
There's definitely a genetic tendency, and again this is part
of the reason why Asian countries are such an increased incidence,
but it also is related to near work. And then
the other interesting thing. In some of the different countries
where they have a lot of near sighted children, they've
done studies looking at urban versus rural areas and it's amazing.
There are some urban cities where about ninety percent of
the troldern are nearsighted, and in the same country about
(12:40):
ten percent of children in the rural areas are nearsighted.
So even with similar genetics, there's a huge environmental effect
I see wo So it's a really a big public
health issue right now.
Speaker 2 (12:48):
In ophthalmology, I see.
Speaker 1 (12:50):
So many kids with glasses and it's hard to see them.
They look like little old people in glasses.
Speaker 3 (12:55):
And it's not just the glasses, because I think sometimes
we think of that just cosmetic, and that's true. If
it's a mild prescription like yours, it's a very mild prescription,
so then it's perfectly healthy of a perfectly healthy eye.
But when you get this would call pathologic myopia or
these really near sighted strong prescriptions. It's actually not healthy
for the eye because basically the eye've grown too long,
is why that happens, and so you get thin areas
(13:17):
and they're much more prone to retinal detachment and other
problems as they get older.
Speaker 2 (13:21):
So it's not just a cosmetic thing.
Speaker 1 (13:23):
So suggest to parents to reduce the amount of screen time, right.
Speaker 2 (13:27):
I try, Yeah, I do try.
Speaker 3 (13:30):
No, it's really yeah, it is, and for adults as well,
for it doesn't affect your being nearsighted's so much once
you're adult. But actually dry eye, which is such a
huge problem. I think it's actually the most commonly diagnosed
eye problem in the US, and I think probably worldwide.
And actually screen time is directly contributes to dry eye
symptoms as well, especially to periods. So do take breaks
(13:52):
when you're spending time on the screen. I know it's
easier said than done, but it's an important thing.
Speaker 1 (13:56):
So people pay attention to your kids and pay attention
to screen time and be diligent about it because it
really will have long term effects.
Speaker 2 (14:05):
Yep.
Speaker 1 (14:05):
And go outside and go outside. Yeah. Well, luckily, my
grandchildren go outside all the time. They're out there all
the time, and they don't mind either of being outside
with their screens or inside. They just they're adaptable, but
they have to watch out. Now, people get confused, what's
(14:28):
the difference between an optometrist, an ophthalmologist, and an oculist.
Speaker 2 (14:35):
So that's a great question.
Speaker 3 (14:36):
So I think sometimes people do get confused with optalmalists
versus optomics, and I work with both. I'm an ophthalmologist
and I mostly do surgery. I don't do regular routine
exams or glass or contacts myself. But the way I
think of it is an ophalmologist is a medical doctor.
So I went to medical school, did a residency just
focused mostly on surgery. So after college you do fourias
(14:58):
of medical school, and then four y is of themology
four years after four years, and then if you want to,
you can do an extra year or two of fellowship,
which I did in corneon refractive surgery. So it's a
pretty long program that's to become an optimalogist, so you're
really focused on more problem eyes. Is how I think
of it, as ict of see sick eyes, so people
who need surgery or need some kind of serious medical intervention.
(15:18):
Whereasn optometry is also actually an advanced degree. I think
some people don't realize that, so they actually do four
years after college an optometry school, which is focused a
lot on glasses, contacts and more healthy eye exits, they're no,
so they're what's called an od a doctor of optometry.
So they're not medical doctors. So but if you have
a healthy eye, and especially if need glasses or contacts,
then that's most likely to be your primary eye care provider.
(15:41):
And again I have a lot of people that I
work with in both. But for sick guys or if
you need surgery, then you need an ophthalmologist.
Speaker 1 (15:46):
What's an oculist? Is that a doctor? So no, that's
I think an is that somebody who make cyeglasses.
Speaker 3 (15:52):
I was gonna say, so optician is you? I think
ocus is the old fashioned term for optician.
Speaker 1 (15:56):
So the optician, remember hearing that from childhood, the oculus.
Speaker 3 (16:00):
The oculus, So I think that's what they used to
call an optician. Who is the person who actually makes
class and that's a lost art. Now there are some
really elegant crafts people who can really fine tune lenses.
Now a lot of the lenses are made mechanically, not
by hand, necessarily.
Speaker 1 (16:14):
So so you just you describe the training that Aphalmologies
goes through. That's a long training program.
Speaker 3 (16:20):
Yeah, it's actually gotten quite competitive to I'm the program
director at NYU and we have six lots and we
get over seven hundred applicants every year, so it's become
quite popular.
Speaker 1 (16:30):
Wow wow, But so what is the whole industry of
eye care? It's a vast industry. I was trying to
remember since the time I was twelve when I got
my first little pair of pink rimmed glasses. I remember
they were little cat eyes and I wore those and
I kind of liked I like having I have them.
I's still oh my gosh, But I remember then I
got a pair of blue ones. It was expensive to
(16:52):
get a new pair of glasses, and my mother every
time I grew a pair, and she told me how
I had to take care of them and wash them
and everything. And I remember being proud that I had
glasses and happy that I had them so that I
could see perfectly for school. But children who don't have
the opportunity to get the glasses that are appropriate for them,
(17:14):
is there anything they can do?
Speaker 3 (17:15):
Actually, I'm so glad you mentioned that because it's such
a huge problem, and worldwide there are millions of children
who basically would see perfectly if they had glasses. So
luckily there are some good outreach programs here.
Speaker 2 (17:27):
There's one that I.
Speaker 3 (17:28):
Recently met the founder called ReSpectacle, which I thought was
a really neat concept. And basically what you can do
is you can donate your old glasses. You send them
into this website and they keep a database of all
the prescriptions and the type of glasses, and then anyone
who wants to who needs glasses can go on there
just type in their prescription and they'll make recommendations of
similar ones that they have in sock and send them
the strat yep.
Speaker 1 (17:49):
Oh, just remember that everyone ReSpectacle. It's like hearing aids
and now taking hearing aids. And I remember donating my
mother's hearings when she passed away.
Speaker 3 (17:58):
Because it's people's person changes, even the frames change. And
then some of the different optical shops I know, Warby
Parker is one of the ones that kind of pioneered this,
but some other optical shops have started doing this as well,
where when you buy a pair of glasses, they'll donate
a pair as well to a child in need, which
is there's some great programs out there.
Speaker 1 (18:16):
Are very important, and oh gosh, that is such good news.
So let's talk about these trifocal lenses again. Back to
my eyes and the ability for me to have this
wonderful vision that I have now or is that something
that everyone could have?
Speaker 3 (18:31):
So I'm so glad you asked that, because I love
the trifocal lenses that I tell people, like if I
was getting catac starch brow, that's what I would get.
Speaker 1 (18:37):
My assistant, by the way, Matt, he just told me
today that his eyeglasses are trifocal eyeglasses and they drive
him crazy. They're eyeglasses and he can't read, he can't
see distance, he can't drive at night, all the things
that he's suffering. But he's wearing this one pair of
glasses that supposedly does everything. Does that really work well?
Speaker 3 (18:59):
So it's a lot harder with glasses. And I was
also talking to one of your other colleagues about progressives,
where a lot of times it's hard to actually progressive
eyeglasses where you have far, medium, and close all in
one frame and it basically gradually transitions. And that's actually
probably the most popular type of lens now among people
once they get into their forties or fifties or older.
Speaker 1 (19:21):
But it's very shard like through the top of the lens.
Speaker 3 (19:23):
One thing exactly distance in the middle in theory computer
and bottoms in theory reading. But it's very hard to
find the right spot to look through and when you
look down it can actually affect your depth perception when
you're walking up and downstairs, whereas with a lens implant,
because of the way they're designed, you actually don't have
to look at a specific diress. It's just based on
the way your eye naturally looks. But one thing I
(19:45):
do want to mention is I know you have a
large follow and I think probably a lot of people
now are saying I'm going to get the trifle lenses
that have it as perfect vision, and hopefully that's true.
But I tell people and the important thing about those
lenses is you have to have an otherwise healthy eye
for them to really give you that perfect vision, because
if you'd had what you know, if you'd had like
a macro degeneration or gaucoma or something like that, or
(20:06):
an unusual shape die, that might not have been an option.
Speaker 2 (20:08):
They're not unfortunately not an option. I was every lucky.
Speaker 1 (20:10):
I was just lucky that my eyes were Yeah, my
eyes were good. I think that if people who have
healthy eyes but at least investigate that option, it would
be something. But you told me that insurance doesn't cover them, right.
Speaker 3 (20:23):
Unfortunately, they are more expensive lenses, so they're not an
option for everyone. But I have had patients tell me, well,
I did the calculation, and this is how much I
paid for the specific lens, and then this is how
much I used to spend on my glasses, and after
that point I'll come out ahead.
Speaker 2 (20:35):
So right, So obviously it depends on.
Speaker 1 (20:37):
The Really, after one year my eyes, I have a
little bit of dry eyes and you've taken care of that,
but generally just so comfortable and no more worrying that
I fell asleep with my contacts in or that I
left my glasses somewhere. It's really a great relief to
be able to have these lenses implanted. Yeah, who is
(20:58):
the surgery for. It's you've just said for people with
healthy guys.
Speaker 3 (21:02):
So cataract surgery is really for anyone who has the
cataractors developing counteracts. But in terms of the trifocal lens
that you really need a healthy eye. But fortunately, even
for people who have other eye issues, there are a
lot of different lens options out there now, and I
think that's that one really gives you the best chance
of not needing any glasses and having that full range
of vision. But even someone who has something like a
macad degenerator.
Speaker 1 (21:22):
You're in Asia, are you too young for trifocals or
I usually.
Speaker 3 (21:26):
Don't recommend having counteract surgery until you at least are
starting to develop the contact and having some visual changes
from that, because if you have a normal, healthy lens,
and say you're in your forties, even if you start
needing reading glasses, that's a pretty big surgery to go
through if your eyes otherwise healthy and just needing reading glasses.
Speaker 2 (21:42):
So usually it's rare.
Speaker 3 (21:44):
To have that surgery before age fifty athough un certain circumstances, we.
Speaker 1 (21:47):
Do so like all fifty year olds, pay attention.
Speaker 3 (21:50):
Exactly see when you start having your vision travel, at
least go get checked.
Speaker 1 (21:53):
I would think that it would work for everybody, but
it doesn't.
Speaker 2 (21:56):
Well if people.
Speaker 3 (21:57):
Have other eye issues, and then the other thing is,
now your surgery went very well, but that lens Basically,
the surgery has to go perfectly and you have to,
as we say, hit the target exactly because it's a
very specific lens. So if you don't think you're going
to be able to get a successful surgery, or the
measurements aren't accurate or reliable, then that might not be well.
Speaker 1 (22:15):
You need an expert like you, you.
Speaker 2 (22:16):
Who does a who does a lot of those surgeries.
Speaker 1 (22:19):
So, and the recovery was very simple. Sure, yeah, two
days it was fine. You're a very healthy person, so
I know I'm lucky. So what do you say to
patients who come to you and have are very fearful
about operating on their eyes? Because I was, people say, oh,
did you have lasik? What is lasik surgery?
Speaker 3 (22:37):
So, lasik surgery is a surgery to it's a laser
eye surgery. I also do that as well, and that's
designed to reduce the need of glasses for someone who
doesn't have cataracts. So, say you're in your twenties or
thirties when you wore glasses all the time, but you
just want to get rid of the glasses or contacts,
use a laser to basically reshape the cornea, almost like
using a laser to etch a permanent.
Speaker 1 (22:55):
Contact you that round perfect eye again exactly, And that's
that is very delicate and very you have to be
an expert at that is a surgeon.
Speaker 2 (23:05):
Right, That's awesome, very spaci.
Speaker 1 (23:07):
I know my sister had that and she's thrilled. She's
thrilled with it.
Speaker 2 (23:09):
Yeah, so that's a great option.
Speaker 3 (23:10):
I tell people when you're in your twenties thirties, lasik
is a great option, and then when you get into
your fifty sixties, the counteract surge is great options. We
still don't have something perfect for that sort of in
the forties, which actually is where I am in the
forties range yet.
Speaker 2 (23:23):
But we're working on it so well.
Speaker 1 (23:25):
Could that be?
Speaker 3 (23:26):
So? There are some surgeons that were developed basically putting
an implant into the cornea to try to reduce the
need for reading glasses, but none of them have quite
panned out because the quality of vision hasn't been there yet.
Speaker 2 (23:37):
But that doesn't mean it won't be. It's just not
there yet.
Speaker 1 (23:39):
Can you describe the eyeball? I just I went through
this with my beautiful dog, Crembreulet recently. She had to
have her eyeball removed because she wounded it. She must
have run into a tree. And I looked at all
the photography and all the drawings of the eye to
see what the doctor was talking about. But can you
describe it? Here? You have a beautiful eye, it is,
(24:00):
so what's the dark center?
Speaker 3 (24:01):
So the very dark center is actually the pupil, which
is not an actual object, it's.
Speaker 2 (24:06):
Just an area where in the space the window.
Speaker 3 (24:09):
Well, so you have the cornea first, which is the
clear front covering of that. And that's one of my
areas interestince I transplant that and actually it's interesting. The
corny was actually the first successful solid organ transplant ever
performed in nineteen oh six Edward zerm. But it's pretty
amazing because it's a vascar. There's no blood vest it's
clear covering of your eye, yep. Because there's no blood vessels.
It's actually the easiest organ to transplant because the rejection
(24:31):
risk is incredibly low. Then you have the sort of
the space we call it the antier chamber, but that's
basically where you have a fluid and then you have
your eye res which I think what people always think
about when they think of the eyes, the colored part.
So I think about that a lot when they think
about the eyes, and you know, there's all the people
prefer one color versus the other, but they're all beautiful.
Speaker 1 (24:48):
And then have you ever operated on an odd colored eye?
Speaker 3 (24:51):
Well, one thing that I should say is the sort
of public safety thing, and I think this is advertised somewhere,
especially for people go online to do a lot of
social media. There was a trend of wild God, I
think it's hopefully abated, but I'm not one hundred percent
sure where people were going to other countries and having
implantable colored irises put in. But unfortunately, it was a
very crude surgery and the implants were not very safe,
(25:11):
and so actually I had a few patients who had
had to have cornial transplants combined with cautaract surgery because
these implantable irises basically destroyed.
Speaker 1 (25:18):
I saw some of these I saw.
Speaker 3 (25:20):
I Unfortunately, I had two of these patients who went
overseas for the surge, but then came back to the
US when they had complications, and very sad.
Speaker 2 (25:27):
Actually, I had a.
Speaker 3 (25:28):
Thirty something year old, beautiful young lady who'd gone overseas
and had this done.
Speaker 2 (25:32):
I had to do a bilatal corner.
Speaker 1 (25:34):
Was she going from to what color she was engined?
Speaker 3 (25:36):
She was middle Eastern, had dark colored eyes, and she
went to blue eyes, but it didn't didn't go so well.
So lucky hair surgeries went well. Her countaract and cornial transplant.
She did well from a vision point of view, but
it was sad.
Speaker 2 (25:50):
Back to brown, but a little bit cloudy because of
all the scarring.
Speaker 1 (25:53):
Gee yes. For Halloween, I always insert colored contact lenses
that you can buy these every color of contact lens.
So one year I did yellow, they look so weird
and beautiful. One year of jagged purple and they look
really good like the tailor violet eyes, and I've done
(26:15):
white eyes. The white are the scariest.
Speaker 3 (26:17):
Yeah, some of them are very disturbing looking. Actually, another
public safety announcement, careful. You'll be careful where you purchase
those lenses because if you go to an optical shop
or you have an optomics or an optician who provides
those for you, there are a lot of beautiful, safe
ones out there.
Speaker 1 (26:29):
Okay, I've got them from I think Faushion.
Speaker 3 (26:31):
Okay, yeah, that's great because that's a great company. But
you do have to be careful because especially around Halloween time,
a lot of drug stores or costume supply stores and.
Speaker 2 (26:38):
The internet will sell it.
Speaker 3 (26:39):
And a lot of them are really not very they're
not sterile, they're not.
Speaker 2 (26:43):
Safe for the eye.
Speaker 3 (26:44):
And every year we see a lot of really pretty
significant cornial ulcers and it actually forget it.
Speaker 1 (26:48):
People do not wear you can.
Speaker 3 (26:50):
Get they just get them from a from a legitimate
optical shop. Don't get them online costume shop. I'd like
to get dressed up for Halloween, so just be careful
where you get them.
Speaker 2 (27:01):
There.
Speaker 1 (27:02):
Okay. So then you have your iris, yes.
Speaker 3 (27:05):
And then we have the vitreous, which is the gel
of the eye that kind of gives you the form
part of the eye, and that's where people get floaters.
I know, floaters are something that a lot of people
probably have and I'm sure some of the people out
there thinking, oh, she's gonna tell me how to fix
my floaters and it's going to be great. But unfortunately
we still don't have a perfect cure for floaters. They
can be removed surgically if if they're rare, really bothers
(27:25):
some but the surgical risk of that is still relatively high.
Then behind the vitreous, you have your retina, which is
really the film of the camera. It is really the
most beautiful I think, cause it's if you see the
photographs of it, you can see these beautiful vessels. You
can actually see the nerve of the eye, which is
amazing because the eyes are only part of the body
where you can actually literally see the optic nerve and
you can tell so much about the health of the
eye based on that. And one thing I was talking
(27:48):
earlier is actually some of those photos there's some evidence
that maybe looking at retina photos and retina imaging can
actually give us some predictive value for certain types of dementia.
So that's a really exciting area of study right now.
Speaker 1 (27:59):
But what could you do it?
Speaker 3 (28:00):
Well, I guess there's not necessarily anything you could do
since we don't have a treatment right now, but at least.
Speaker 1 (28:04):
To be aware, yeah you're going to fit Alzheimer.
Speaker 3 (28:08):
That you're the higher risk maybe and maybe a venture
we have a treatment.
Speaker 1 (28:11):
Come in and you can look at me and make sure.
Speaker 2 (28:14):
I think there's lots of evidence that you're doing just fine.
Speaker 1 (28:17):
Goodness, So that's it.
Speaker 3 (28:19):
That's the eye, not the Yeah, it's very simple, but
very beautiful. Where do you transplant from from donor donor.
It's actually pretty amazing. In the US, we have a
great I banking system, so for people who are organ donors,
that's one of the most utilized organs that can be used.
Speaker 1 (28:34):
I never thought of it that way because my sister
who passed away gave her eyes. So somebody has her eyes. Yes,
well they have her.
Speaker 3 (28:41):
Right the corny is the only part of the eye
that can be transmit It's pretty amazing. And sometimes, you know,
you see the stories about the donors and the recipients,
and I always ask my patients, I said, do you
want to know who gave the cornia? Because sometimes it's
a sad story and they can write letters to the
family and things saying thank you. And especially when I
have a child who gets the cornea as the recipient,
a lot of times I think it's really nice.
Speaker 1 (29:00):
To And so why would you have to have your
corny replaced? Is it so there are there or something not?
Speaker 3 (29:05):
Usually so there are some congenital reasons for children and
then an adult. There's something called Fuchs corneal dystrophy, which
is basically genetic conditions. It's actually pretty common where you
lose the inner cells of your corny over time as
you get older.
Speaker 2 (29:20):
But it's really neat.
Speaker 3 (29:21):
Now instead of having to replace the whole cornea for that,
we can literally just replace the inner layer of cells
with a donor layer of cells.
Speaker 2 (29:27):
And now there's some new things going on that just.
Speaker 1 (29:29):
Got approved in you inject the cells.
Speaker 3 (29:31):
So actually, it's funny you asked that you're ahead of
your time and a lot. Yeah. Yeah, Shaguru Kinoshita in
Japan actually just got approved in Japan a cell injection
therapy and he's been working on that for decades and
he finally got approved in Japan and now we'll see
if if that gets approved in the US.
Speaker 2 (29:47):
But I think we're getting pretty close.
Speaker 1 (29:49):
Wow.
Speaker 2 (29:49):
So it's amazing. It's amazing.
Speaker 1 (30:00):
Our eyes one of the most worked on organs.
Speaker 3 (30:04):
Actually, a cataracts ARET is most common surgery performed in
the US.
Speaker 1 (30:07):
It is.
Speaker 3 (30:07):
It is probably because it's so successful and as you mentioned,
people care so much about their vision. That's something that
people are likely to have operated on eyes you want
to see and I think our outcomes are just really good.
Speaker 1 (30:21):
It's so amazing. I'm so thrilled about this. So what
are some of the risks to eye health from weight
loss drugs. I've been hearing that there are some problems.
Speaker 3 (30:30):
So that's such a good question because it's such a
hot topic right now. I mean, the drugs have been
such an incredible thing for so many people. A lot
of my patients are on it and really have had
a great result. Initially, there was quite a worry because
there are a few cases of what's called naion, which
is almost like a mini stroke to the eye that
can happen. It usually happens overnight and people notice it
when they wake up in the morning with basically half
(30:51):
their visual field is usually missing. And there was a
few episodes of that reported right surely after people started
these medications. But it's a little hard to tell because
the main risk factors for those type of strokes in
the eye developing are being overweight, having unstable blood pressure,
being older men, so a lot of the same risk
factors for people that might be on these medications. So
(31:13):
it's still being looked at right now. They're not saying
don't take the medication, but they're saying if you have
any of these sudden visual loss, especially upon first waking up,
it's make sure you get seen right away. And then
the other thing that's happenings interesting is when people I
talked a lot about diabetes control, when you have a
really sudden drop in your blood sugar, so you're all
of a sudden, your control goes from being very poor.
Speaker 2 (31:33):
To being very good.
Speaker 3 (31:34):
That's a great thing overall, but sometimes it can actually
that that sudden change can actually cause some changes in
the blood vessels of the eye and actually can make
the diabetic retinopathy worse if you already have that.
Speaker 2 (31:44):
So that's something you want to be aware.
Speaker 3 (31:45):
If you start those medications, especially if you have diabetes,
to make sure you have your retin a check before
you start the medication, that have someone who can follow
that because's usually treatable, but you want to be aware
of that.
Speaker 1 (31:55):
The other thing that concerns us is sudden exposure with
the demise of the protective layers of the atmosphere because
of global warming and stuff. How important is it to
wear sunglasses.
Speaker 3 (32:06):
Well, it is, and it is important, and part of
the reason isn't so much what people think for the
inside of the eyes, also for the eyelids, because the
eyelids are actually one of the most common sights of
skin cancer because that skin is so delicate, and people
don't always realize that those are the main reasons for that.
Speaker 1 (32:22):
Sunglasses.
Speaker 3 (32:22):
Yeah, and your new fancy lens actually have a UV
filter built into them.
Speaker 1 (32:25):
A lot of the and you know what, notice that
you didn't tell me that. Oh sorry, but I noticed
that because I don't feel like I have to put
sunglasses on them all the time.
Speaker 2 (32:33):
A lot of the newer, higher end lenses have that.
Speaker 1 (32:35):
Welt into it, So that is brilliant. So if you
aren't wearing sunglasses, should you wear a hat?
Speaker 3 (32:41):
Do you want to do something to protect again, especially
the delicate skin around the lids and then the white
part of the eye.
Speaker 1 (32:47):
And what about you said, smoking is like one of
the worst things for eyesight, Yes, and for lungs and
for everything else. It's really damaging to your eyesight.
Speaker 3 (32:56):
Yeah, especially for a mac of the degeneration. And then
thyroid eye disease, which you may see there's a lot
of advertising now about five rid eye disease. When you
see people their eyes come out, they look like it're
almost like popping out. Smoking is the biggest respector for
that as well, and that affects younger people.
Speaker 2 (33:09):
A lot of the time.
Speaker 1 (33:10):
So is Lasik less popular now because this is the
laser treatment for irregular eye shapes right.
Speaker 2 (33:17):
Right, for being nearsight or foresight?
Speaker 1 (33:19):
Is it less popular now?
Speaker 2 (33:20):
Well, it's interesting. I think it's reached a steady state.
Speaker 3 (33:23):
I think what happened is when Lasik first came out,
so it's FT approved in nineteen ninety nine, there were.
Speaker 1 (33:27):
You know that's very not so long A yeah, I guess.
Speaker 3 (33:31):
FT approved in nineteen ninety nine, And I think what
happened is so many people were excited, so there's this
huge boom, right, I mean, everyone who didn't like glasses
or contact was getting the Lasik surgery, so there was
that huge wave. And I think now it's happened is
it's more of a steady state where most people want Lasik.
I've already had Lasik, but there are still new people
every year who are getting to the age or just
aside they're tired of their glasses. So I think it's
(33:52):
still popper, but it's not as popper as it was
back in the early two thousands where it was really
just incredibly popular.
Speaker 1 (33:58):
Now I wanted to talk about diet because people always say, oh,
eat carrots, they're good for your eyes kerotene? What about foods?
Which foods are really good for your eyesight?
Speaker 3 (34:07):
So the only evidence we really have is the Mediterranean diet,
which I'm sure you're much more familiar with the exact
details than I am. And then one thing that's it's
concerning about. Actually, this is something that I don't think
we really think about in this country, is actually a
vitamin A. So usually and it's only we thought of
it only as a developing world issue where people have
a vitamin A deficiency. But recently I've seen a few
(34:27):
cases in some very severe where people have come in.
One actually was a child that came in with the
hole in the cornea because of a severe vitamin A deficiency,
and because what happened is he had a very restrictive
diet due to a lot of other behavioral and psychological issues,
and so he ate no vitamin A.
Speaker 1 (34:42):
At allain A most readily found.
Speaker 3 (34:45):
So you've got your carrot, your leafy greens, so most
of your vegetables, but even you can take a supplement
if you're in someone who doesn't get that. But I've
seen a couple of children now again the one who
is very severe. Who with these restrictive diets who come
in with problems?
Speaker 1 (34:59):
Now, who ever restrict vegetables from a child? Yes, it was,
it happens.
Speaker 2 (35:05):
I don't think they're getting the home cooked meals from you.
Speaker 1 (35:08):
Well, we have covered so much territory in such a
short period of time, and you were so eloquent about it.
This is really an amazing amount of information to digest.
Is there a book? Have you written a book about
the eye? Yet?
Speaker 3 (35:19):
I've written, have several chapters and articles. I don't have
my own particular book.
Speaker 1 (35:24):
Can we reference those somewhere?
Speaker 2 (35:25):
Absolutely?
Speaker 1 (35:26):
So where do we look? We look under Christina, doctor
Christina Prescott.
Speaker 3 (35:30):
I think you just type in my name in n
YU and then a page will come up with a
little bit about me, and then have some reference with
some articles and things that I've written. And also if
you know you need tripical lenses or are other issues,
then has a number to call.
Speaker 1 (35:43):
Okay, So this is at NYU Lango and doctor Christina
Prescott p R. E. S C O T T. We
do have a lot of research that you have contributed
to and written, so that's very useful. I am so
interested in the eye. I am so interested in good eyesight,
and I am so interested in seeing the world, so
we have to protect our eyes. And thank you for
(36:04):
all this information. I'm really happy to have talked to you.
This is fantastic and thank you, and our listeners will
really benefit tremendously from this.
Speaker 3 (36:11):
Well, thank you so much. I'm just gonna say that
I have to ad make I've done so many eyes surcher.
I don't usually get nervous, but I was a little
nervous doing Martha's eye surgery.
Speaker 2 (36:18):
But I was so happy it went well.
Speaker 3 (36:20):
I think she's an amazing woman who's been up personal
hero of mine for a while.
Speaker 1 (36:24):
So thank you, but don't be nervous with that. I
wasn't nervous. I wasn't that all nervous. I was just
so happy with the result, and thank you so much.
Speaker 3 (36:33):
Cher,
Host
Martha Stewart
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