Using Contact Lenses & Potential Risks | Dr. Jeff Goldberg & Dr. Andrew Huberman
00:00:00.000 | Is there any detriment to having a piece of glass or a piece of plastic on the front of
00:00:07.440 | your eye all the time?
00:00:08.440 | And the reason I ask is not because I think we should live necessarily exactly like our
00:00:13.320 | ancestors, but it's a pretty bizarre adaptation to put a lens directly onto the front of the
00:00:20.160 | eye.
00:00:21.160 | You have to imagine that the cells and tissues there are accustomed to getting a certain
00:00:24.360 | amount of oxygen.
00:00:25.360 | They're accustomed to getting a certain amount of interaction with the environment, and you
00:00:30.040 | also are now adding another surface.
00:00:32.320 | The way that the tears are going to interact with the cornea of the eye are probably changed,
00:00:38.340 | and who knows?
00:00:39.340 | Maybe it doesn't make any negative difference at all, but putting a contact lens on the
00:00:43.480 | front of the eye is about as close to putting a device on your brain as I can think of,
00:00:49.520 | except for maybe the cochlear implant.
00:00:54.400 | That's a great question.
00:00:55.400 | Now, first of all, I want to distinguish.
00:00:59.100 | There are a few really medical uses for different kinds of contact lenses, like scleral contact
00:01:06.520 | lenses.
00:01:07.520 | For people who have certain diseases, there are other kinds, but I think what we really
00:01:10.720 | want to talk about right now is just kind of the run of the mill.
00:01:14.000 | I want to get my prescription taken care of, but instead of wearing glasses, I'm going
00:01:17.880 | to wear contacts.
00:01:20.520 | Contacts, even the newest generation contacts, yes, they sort of change the tear dynamics
00:01:28.120 | on the surface of your eye.
00:01:32.660 | They decrease the oxygen diffusion that's just sort of out in the air onto the surface
00:01:37.960 | of our eye, onto the cells that are on the surface of our eye.
00:01:42.360 | But most of us, especially as we're younger, have enough tear film reserve, enough oxygen
00:01:50.160 | reserve that we can easily tolerate these polymer gel soft contact lenses and wear them
00:01:57.840 | happily.
00:01:58.980 | The advantage of contact lenses over glasses, purely from the perspective of correcting
00:02:06.520 | your vision, is that there's different elements of the shape of your eye that need to be corrected
00:02:15.600 | if you need corrective lenses.
00:02:17.960 | And so for example, if the basketball shape of your eye is a little too steep or a little
00:02:24.220 | too shallow, that's what the standard glasses correct.
00:02:29.960 | You may have been told that you have something called astigmatism.
00:02:33.840 | That's where instead of having a basketball-shaped eye, you have a slightly football-shaped eye.
00:02:38.920 | It's not round in the same dimensions on both axes.
00:02:42.240 | And again, glasses can correct that.
00:02:45.320 | But then there's higher order aberrations in our corneas, in the clear window in the
00:02:49.960 | front of our eyes, or to some degree in the lens inside the eye that are focusing the
00:02:55.400 | light, that the glasses prescription can't correct.
00:02:58.920 | But if you have a nice, smooth contact lens on the front, it can correct.
00:03:03.200 | So a lot of people who wear glasses and contacts will report that they have a much higher quality
00:03:08.620 | of vision with their contact lens correction than with their glasses correction.
00:03:13.680 | And again, in service of enjoying the best vision that you can enjoy in your daily life,
00:03:20.960 | that's an upside to seeing if contacts could work for you.
00:03:24.840 | Now there's another element, though, and that's like, gosh, is there a risk of contact lenses?
00:03:30.240 | And especially as we age, we have less tear film reserve, so contacts may become less
00:03:37.840 | tolerable as we age.
00:03:41.040 | And the other thing is being really good about the cleaning, because the contacts can trap
00:03:46.160 | bacteria or fungus.
00:03:48.400 | And if you get a corneal infection from a contact lens, it actually can be quite devastating
00:03:53.920 | to your cornea.
00:03:54.920 | Even if you successfully treat the infection, you can be left with some corneal scarring.
00:03:59.120 | Thankfully, this happens very rarely.
00:04:02.320 | But when it does happen, it can be quite difficult on the person thereafter to sort of suffer
00:04:07.480 | through having maybe a scar from that infection on the surface of their cornea that leads
00:04:12.600 | to some blurring vision, for example.
00:04:15.360 | So we always recommend that if you're going to wear contacts, that you be really attentive
00:04:20.720 | to whether you're tolerating them well, and then also to be really attentive to the recommended
00:04:26.240 | use and cleaning of the contact lenses.
00:04:29.560 | I actually recommend that even though they're a little more expensive to afford, that people
00:04:34.520 | should almost always be just using the daily contact lenses that they don't have to clean
00:04:40.080 | or use for two weeks or four-week period.
00:04:43.760 | So these are disposable contact lenses?
00:04:45.400 | Daily disposable.
00:04:46.400 | And I hate to think of, I don't know, filling our oceans or what have you with more polymer
00:04:51.680 | or plastic.
00:04:52.680 | But at least the contact lenses are small.
00:04:54.600 | And it's much safer for your eye to use a daily disposable than to use a two-week or
00:05:00.160 | a four-week and be responsible for the cleaning.
00:05:03.480 | The other thing to be really responsible about is sleeping in them overnight.
00:05:08.440 | Because overnight when your eyelids are closed, of course, now you're getting even less oxygen
00:05:12.640 | to the surface of your eye.
00:05:14.000 | And actually, most bacteria, especially many of the infectious bacteria to our bodies and
00:05:19.320 | to the surface of our eye, are actually bacteria that don't really like oxygen.
00:05:25.060 | And so we've got a low risk of getting bacterial infections on the surface of our eye.
00:05:30.240 | But if we use contacts too much, don't clean them, or sleep in them overnight when our
00:05:34.840 | eyelids are closed.
00:05:35.840 | And now there's even less oxygen kind of helping keep the surface more clean, if you will.
00:05:42.140 | That increases the risk a lot.
00:05:43.480 | So being really good with the recommended use and cleaning of the contacts is critical
00:05:49.220 | considering daily use contacts.
00:05:51.080 | You don't have to.
00:05:52.080 | And look, most contacts are going to be the two-week or four-week kind where you put them
00:05:55.240 | in the cleaning solution overnight each time, give them a good rinse, and put them back
00:05:58.660 | in the next day.
00:05:59.660 | And again, most people, 99.99-some percent of people, are going to do just fine with
00:06:06.080 | that, follow the instructions, and never get into trouble.
00:06:09.600 | As we age, they're going to become less tolerable.
00:06:12.120 | People are going to say, I used to wear my contacts for 12 hours.
00:06:14.600 | Now my eyes feel really dry after 6 or 8 or 10 hours.
00:06:19.360 | Maybe some years after that, they say, gosh, I could barely use it for four hours.
00:06:22.520 | I only use them when I go out on a Saturday night.
00:06:26.320 | And that's OK.
00:06:27.320 | You can back off as you need to back off.
00:06:30.040 | But in the meantime, if it helps you, especially in the younger decades, if it helps you really
00:06:34.900 | enjoy your best vision, great.
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