AMA #6: Eye Health, Why We Yawn & Increasing Motivation

00:00:00.000 | - Welcome to the Huberman Lab Podcast,

00:00:02.260 | where we discuss science and science-based tools

00:00:04.900 | for everyday life.

00:00:05.900 | I'm Andrew Huberman, and I'm a professor of neurobiology

00:00:12.260 | and ophthalmology at Stanford School of Medicine.

00:00:15.340 | Today is an Ask Me Anything episode or AMA.

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00:01:42.500 | And now without further ado, I will answer your questions.

00:01:45.620 | And as always, I will strive to be as thorough as possible,

00:01:49.420 | as clear as possible, and as concise as possible.

00:01:53.160 | The first question is about eye health, in particular,

00:01:57.880 | eye health protocols for people that are aging,

00:02:00.120 | but eye health protocols for people in general.

00:02:03.760 | The question is, I'm noticing that my vision,

00:02:06.640 | both close and far, is deteriorating.

00:02:09.680 | What are the best eye exercises, eye health behaviors,

00:02:12.920 | supplements, et cetera, for the aging eye?

00:02:15.600 | So the answer I'm about to provide

00:02:17.260 | applies to everybody regardless of age,

00:02:19.880 | which is you want to make sure that you view things

00:02:23.200 | both close up and far away across your day.

00:02:26.760 | Many, many people nowadays spend a lot of time

00:02:31.060 | looking at their smartphone,

00:02:32.560 | looking at the computer screen, looking at books and paper.

00:02:35.600 | In other words, looking at things

00:02:36.960 | somewhere between nine inches away from their face

00:02:39.960 | and their eyes,

00:02:41.440 | maybe two and a half feet away from their face and eyes.

00:02:44.280 | This is an unprecedented event in human history,

00:02:48.360 | as far as we know,

00:02:49.680 | because it wasn't until the advent of the smartphone

00:02:53.800 | that we've spent so much time

00:02:55.820 | looking at screens at close range,

00:02:58.180 | relative to looking at things at further distances

00:03:01.700 | from our face throughout the day.

00:03:04.320 | In fact, it should come as no surprise

00:03:06.060 | that the incidence of myopia, of nearsightedness,

00:03:09.800 | is increasing dramatically around the world,

00:03:13.040 | but is increasing particularly fast in children

00:03:16.880 | and in young adults and even in adults

00:03:18.940 | who are viewing things at very close range,

00:03:21.280 | so two and a half feet or less.

00:03:23.260 | Now, I am not saying that viewing things

00:03:25.040 | at two and a half feet or less is bad for your eyes.

00:03:27.460 | That is simply not the case.

00:03:28.940 | However, if you want your vision to be maintained

00:03:31.800 | or even improve, it's going to be very important

00:03:34.920 | for you to view things at a distance as well

00:03:37.980 | for ideally several hours per day.

00:03:40.840 | I realize some people just simply won't accomplish this.

00:03:43.280 | In fact, I'd like everyone to just take a moment

00:03:45.360 | and do a rough estimation in your head

00:03:47.880 | of how much time during your daytime activities

00:03:51.440 | you are viewing things at say two and a half feet

00:03:54.160 | or three feet or less,

00:03:56.080 | so a smartphone, computer screen, paper, books, et cetera,

00:03:59.940 | versus viewing things that are four feet away,

00:04:03.800 | eight feet away, so maybe conversation across a table

00:04:06.440 | with another human being, remember those?

00:04:09.060 | Some of us are doing that more now that we seem

00:04:11.220 | to be emerging from this whole pandemic phase.

00:04:15.400 | However, many people are still mostly just viewing things

00:04:18.700 | within very close range.

00:04:20.360 | And in fact, if you were to ask yourself,

00:04:21.880 | how much time do you spend looking at things

00:04:24.020 | at the distance of many hundreds of feet

00:04:27.000 | or taking a walk where you're not looking at any screen

00:04:30.440 | and you're simply letting visual images

00:04:32.360 | or the visual imagery rather pass by on your eyes?

00:04:35.480 | I think for most of us,

00:04:36.680 | that number is getting progressively smaller

00:04:39.120 | and smaller with each passing year.

00:04:41.640 | So this is an issue because the structure of the eye is such

00:04:46.080 | that the lens of the eye can move,

00:04:48.400 | but also that the length of the eyeball from front to back

00:04:52.360 | is actually impacted by how close

00:04:55.480 | or how far you happen to view things

00:04:58.280 | during the course of your day, especially during development.

00:05:01.280 | There's a classic experiment

00:05:02.520 | that I'd like to just briefly describe to you,

00:05:04.920 | which has been performed in chickens,

00:05:07.340 | it's been performed in mice,

00:05:09.040 | it's also been performed on humans,

00:05:11.400 | where a visual occluder or a visual image,

00:05:16.400 | so an occluder is just a black sort of screen

00:05:20.420 | or a piece of cardboard or an image,

00:05:23.800 | maybe some black and white checks or checkers

00:05:27.080 | are placed at a certain distance from the eye,

00:05:29.960 | either up close or far away.

00:05:32.280 | And the impact of that on the length of the eyeball

00:05:36.380 | and on the structure of the lens

00:05:38.020 | and on the quality and acuity of vision

00:05:41.120 | is then measured.

00:05:42.200 | And to make a long story short,

00:05:43.800 | what these studies show is that if during development,

00:05:47.760 | you or an animal exclusively looks at things

00:05:51.320 | that are up close, very close to the eye

00:05:53.520 | and doesn't ever get long range vision,

00:05:56.320 | the eyeball lengthens and when that happens,

00:05:59.180 | the lens, which of course is in the front of the eyeball,

00:06:01.220 | which focuses the light onto the back of the eyeball,

00:06:03.840 | which is where the so-called neural retina is,

00:06:05.920 | where the cells that sense light are,

00:06:08.940 | that visual image lands in front of,

00:06:13.740 | as opposed to directly on the light sensing portion

00:06:18.080 | of the eyeball and we call the neural retina.

00:06:21.080 | It lands too close or near the lens,

00:06:25.880 | as opposed to on the back of the eyeball.

00:06:27.780 | And that's part of the reason what we call

00:06:29.620 | the consequence of that near-sighted myopia.

00:06:33.200 | In farsightedness, the opposite happens.

00:06:35.540 | The visual image is actually focused behind the retina.

00:06:38.920 | It doesn't land directly on the retina,

00:06:40.400 | which is what you want.

00:06:41.520 | It's focused too far behind the retina

00:06:44.760 | and that's due to a shortening of the eyeball.

00:06:47.320 | So what I just described actually explains pretty well

00:06:50.320 | why kids who look at computer screens or books up close

00:06:54.120 | often need glasses.

00:06:55.520 | When I was growing up, they called this nerd syndrome,

00:06:59.160 | raising my hand for those of you that are listening,

00:07:01.760 | I read an awful lot, but I also spend time outside,

00:07:04.920 | fortunately, and running around on the soccer field

00:07:07.460 | and looking at things in the distance

00:07:08.700 | and playing in the neighborhood with my friends.

00:07:11.340 | Kids that spend the vast amount of their time

00:07:14.780 | looking at things up close,

00:07:16.020 | in particular children who do that indoors

00:07:18.320 | for most of their waking time,

00:07:20.580 | well, those kids develop myopia.

00:07:22.380 | This is part of the reason why we have such an increase

00:07:26.320 | of the incidence of myopia nowadays.

00:07:28.200 | What's interesting and I think most people don't realize

00:07:31.340 | is that even as a young adult and adult,

00:07:33.540 | and perhaps even as an older adult, an elderly person,

00:07:37.320 | looking at things up close too much

00:07:39.220 | at the expense of getting some time viewing things

00:07:42.420 | at a distance, in particular outdoors,

00:07:44.680 | can be very problematic because it can exacerbate myopia.

00:07:47.500 | So the short direct prescription here is to make sure

00:07:50.900 | that you're getting at least an hour or so each day,

00:07:53.760 | although ideally it would be more of long viewing

00:07:56.660 | and that could be done by walking outside

00:07:58.300 | and avoiding looking at your phone while walking.

00:08:00.800 | It doesn't require that you look at a particular object

00:08:03.520 | in the distance, although if you are scanning for

00:08:05.940 | and looking for objects in the distance,

00:08:08.480 | the way that you might on a hike

00:08:10.780 | or you're looking out toward or off a vista,

00:08:13.660 | you're looking for someone in the distance,

00:08:15.820 | all of that sort of visual scanning behavior

00:08:18.060 | is going to be very good for your eye health

00:08:20.220 | and for maintaining vision at a distance.

00:08:22.660 | If you're somebody who's farsighted

00:08:24.540 | and you have trouble seeing things up close,

00:08:26.620 | well then you need to ask yourself whether or not

00:08:28.220 | you're spending too much time

00:08:29.100 | looking at things off in the distance.

00:08:30.460 | Although I want to be very clear that nearsightedness

00:08:32.860 | and farsightedness aren't necessarily the consequence

00:08:35.800 | of this near far viewing,

00:08:38.040 | there can be independent causes of nearsightedness

00:08:40.200 | and farsightedness, but for many people out there

00:08:43.360 | who are spending progressively more and more time

00:08:45.420 | just looking at things up close,

00:08:47.020 | you can get this lengthening of the eyeball

00:08:50.220 | or challenges in the way that the elasticity of the lens

00:08:54.780 | is controlled by the musculature in ways that make it hard

00:08:57.560 | to maintain sharp, crisp vision

00:09:00.660 | when you are looking at things at a distance or up close.

00:09:03.400 | Okay, so I can't because there are simply no studies

00:09:06.860 | to support the idea that you need exactly two hours per day

00:09:10.600 | of outside long vision at a particular distance

00:09:12.740 | and or that you want to cut off or have a threshold

00:09:15.400 | of four hours per day of looking at things up close.

00:09:18.080 | But we can say with a high degree of confidence

00:09:19.920 | that if you want to maintain or enhance your vision

00:09:22.740 | at all distances, that for every hour or so

00:09:25.680 | that you spend looking at things,

00:09:28.740 | say a distance of three feet away or less,

00:09:31.880 | you want to get at least one hour per day total,

00:09:34.940 | doesn't have to be all at once,

00:09:36.260 | of looking at things out in the distance

00:09:38.100 | or looking at things beyond three feet

00:09:40.160 | relative to the distance from your eye.

00:09:43.720 | Okay, so I think for some people

00:09:45.920 | who are already badly myopic,

00:09:48.280 | this isn't going to remedy that myopia,

00:09:50.680 | you're still going to need corrective lenses.

00:09:52.400 | But if you're somebody similar to the person

00:09:54.280 | who asked the question that they're quote unquote,

00:09:57.880 | noticing their vision is deteriorating,

00:10:00.600 | really try and balance out the amount of viewing

00:10:03.980 | that you're doing at close distance and long distance.

00:10:06.440 | And again, I would not obsess about the total numbers.

00:10:09.540 | You know, it doesn't have to be three hours and three hours,

00:10:12.660 | but the more time that you can spend at viewing things

00:10:14.820 | at variable distance throughout the day,

00:10:17.220 | the better off you're going to be in maintaining

00:10:19.300 | and perhaps even enhancing your vision somewhat.

00:10:21.720 | Now there's an additional behavioral tool

00:10:23.500 | that we can glean from the recent scientific literature

00:10:26.060 | exploring myopia, which points to the fact

00:10:29.700 | that children who get two hours a day or more

00:10:33.940 | of time outside in sunlight, right?

00:10:37.580 | One of my favorite topics,

00:10:38.700 | I know many people are probably rolling their eyes right now

00:10:41.900 | when they hear me say,

00:10:43.740 | you really want to view morning sunlight,

00:10:45.580 | not through a window windshield,

00:10:46.740 | don't wear sunglasses for that,

00:10:48.060 | try and get as much sunlight as you can

00:10:50.060 | in your eyes early in the day,

00:10:51.060 | never stare at any light so bright,

00:10:52.260 | it's a painful lookout, et cetera.

00:10:53.860 | We've done a lot of episodes on this.

00:10:55.340 | We have a light for health episode.

00:10:57.160 | This isn't all the sleep episodes.

00:10:58.460 | It's just such a basic foundation

00:11:00.220 | of circadian rhythm and health that I just keep repeating it.

00:11:02.820 | However, there are also large scale clinical trials

00:11:04.880 | involving thousands of subjects

00:11:06.820 | that have shown that people, children in particular,

00:11:09.780 | who get two hours or more of outside time every day

00:11:12.820 | have a much lower incidence of myopia.

00:11:16.200 | Now what's really interesting about these studies

00:11:18.200 | is that while some of those kids

00:11:21.080 | are looking at things further off in the distance

00:11:24.360 | than they would if they were indoors on their tablets

00:11:26.860 | or screens or with their nose in a book,

00:11:29.400 | it does not seem to be the case

00:11:30.940 | that they have to be looking at things in the distance

00:11:32.700 | in order to see this reduced incidence of myopia.

00:11:35.520 | What's probably happening instead

00:11:38.440 | is that the particular wavelengths of light

00:11:40.940 | that emanate from the sun,

00:11:42.860 | that photon energy in particular

00:11:44.520 | is triggering the activation

00:11:46.040 | of the so-called intrinsically sensitive

00:11:47.560 | melanopsin retinal ganglion cells,

00:11:48.980 | which we know are important for setting circadian rhythm

00:11:51.180 | for enhancing mood focus and alertness during the day

00:11:53.600 | and enhancing the quality and duration of sleep at night.

00:11:56.420 | But those melanopsin intrinsically

00:11:58.900 | photosensitive ganglion cells

00:12:00.660 | are also involved in networks within the eye

00:12:04.560 | that relate to blood flow,

00:12:05.940 | that relate to the ciliary body,

00:12:09.580 | which is a structure within the eye

00:12:11.020 | that controls the aperture

00:12:14.020 | and movement of some key components within the eye

00:12:16.900 | that also relate to the crispness of vision,

00:12:20.420 | that is the acuity of vision

00:12:21.900 | at both short and long range.

00:12:23.960 | So there are a lot of technical details there.

00:12:25.520 | In fact, I really hope to get the great Russ Van Gelder

00:12:29.960 | or Dr. Russ Van Gelder,

00:12:31.420 | who's the chair of ophthalmology

00:12:32.820 | at the University of Washington in Seattle,

00:12:34.940 | who is a world expert in this

00:12:37.340 | and the various aspects,

00:12:39.060 | both molecular and structural,

00:12:40.800 | of the ciliary body and the lens,

00:12:42.580 | and he's an expert in uveitis,

00:12:44.780 | a very interesting topic in its own right,

00:12:46.640 | to come onto the podcast and talk more about eye health,

00:12:49.080 | and we will do that in the not too distant future.

00:12:51.300 | Meanwhile, if the first behavioral protocol

00:12:54.220 | for enhancing and maintaining eye health

00:12:55.780 | is to make sure that you're spending at least some time

00:12:58.540 | balancing out the near vision and far vision during the day,

00:13:02.460 | it also stands to reason that you want to get outside

00:13:05.340 | for at least two hours a day,

00:13:06.640 | which I know sounds like a lot,

00:13:08.440 | in order to prevent myopia if you're a young person

00:13:11.180 | and offset the progression of,

00:13:13.360 | and maybe even reverse some myopia.

00:13:14.880 | We don't know yet based on the data,

00:13:16.260 | but there's some indication that's possible

00:13:18.440 | by getting outside two hours a day.

00:13:20.300 | And the cool thing is,

00:13:21.660 | because many people, including myself,

00:13:23.760 | have a lot of work to do,

00:13:24.640 | and we need to be on our phones quite a lot,

00:13:26.260 | or we choose to be on our phones quite a lot,

00:13:28.300 | this effect of getting sunlight outdoors

00:13:30.740 | during the daytime for two hours or more

00:13:33.980 | does not seem to require that you stay off your phone

00:13:38.360 | or tablet or that you're looking at things

00:13:39.980 | far in the distance the entire time.

00:13:41.600 | What this means is if you can get outside onto a patio

00:13:44.940 | or a deck or an outdoor table if you can,

00:13:48.380 | if weather and conditions permit,

00:13:50.300 | and do some of your phone time and computer time

00:13:53.220 | and reading, et cetera, outdoors.

00:13:55.300 | Now, if you're already making an effort to get outside,

00:13:57.220 | hike, play sports, take walks, et cetera,

00:14:00.300 | that of course counts towards this two hour threshold.

00:14:02.700 | And I know this sounds like a lot, this two hours,

00:14:04.780 | and yet for most people,

00:14:07.080 | certainly will vary depending on time of year,

00:14:10.180 | but I think striving to get on average

00:14:12.320 | about two hours of outdoor time as much as you can,

00:14:14.900 | or opening a window,

00:14:16.420 | which wouldn't be as good as getting outside,

00:14:18.500 | but opening a window and trying to get

00:14:19.880 | some natural light exposure to the eye

00:14:21.340 | to trigger the activity of these intrinsically photosensitive

00:14:23.580 | melanopsin retinal ganglion cells,

00:14:25.260 | that's going to be a really good idea

00:14:27.660 | in trying to offset and maybe even reverse some vision loss.

00:14:30.860 | Now, the other behavioral protocols

00:14:32.180 | which have shown to be useful

00:14:33.980 | in terms of maintaining or improving vision

00:14:37.300 | relate to the musculature around the eye

00:14:39.440 | and the control of the movement of the lens,

00:14:41.900 | and actually the lens of the eye

00:14:43.060 | has its own kind of flexibility.

00:14:44.800 | It's a really, really interesting structure.

00:14:47.000 | I'll geek out on this far too long

00:14:48.420 | if I don't prevent myself from doing so,

00:14:50.640 | but the lens is just incredible.

00:14:52.360 | The fact that it has a specific structure of proteins

00:14:55.960 | like crystallines and things of that sort,

00:14:58.300 | and that it can still derive nourishment from blood flow,

00:15:03.300 | but does not actually have vasculature within it.

00:15:05.500 | So it's not, if you notice, I mean the lens of your eyes

00:15:08.140 | and filled with blood vessels and capillaries

00:15:09.700 | 'cause it needs light to pass through.

00:15:11.780 | Super interesting structure.

00:15:14.160 | I think the only violation of what I just said

00:15:16.860 | is the manatee, right?

00:15:18.400 | Those big sort of underwater elephant-like creatures

00:15:21.080 | that I think were or are endangered down in Florida.

00:15:24.420 | They were getting chopped up by speed boats,

00:15:26.200 | but I think now there's some effort

00:15:27.240 | to preserve those big, gentle giants.

00:15:29.600 | The manatee, as I recall, has a vascularized lens,

00:15:33.580 | which is why their eyes look opaque.

00:15:35.640 | It looks like they have cataracts in any case.

00:15:39.580 | You're not a manatee.

00:15:41.100 | You have no blood vessel supply to the lens.

00:15:44.960 | Keeping that lens clear is vital.

00:15:46.540 | Nowadays, they can do lens replacement.

00:15:48.820 | There's really pretty incredible progress

00:15:52.020 | in the realm of ophthalmology and surgical replacement

00:15:55.900 | of the lens or the cornea, other aspects of the eye.

00:15:59.100 | But if you're somebody who is interested

00:16:01.700 | in maintaining your vision,

00:16:03.080 | you're going to want to maintain the musculature

00:16:05.020 | that controls the movement and the change of shape

00:16:07.700 | in that lens and the movement of the eyes,

00:16:10.540 | which allows you to transition your vision

00:16:12.940 | from very sharp when viewing things up close

00:16:15.600 | to very sharp when viewing things at a distance.

00:16:18.060 | And this is where some of the so-called near-far exercises

00:16:21.800 | can be very useful.

00:16:22.820 | So when we did a full-length podcast on eye health

00:16:25.580 | and improving eyesight,

00:16:26.980 | which I invite you to listen to if you like,

00:16:28.780 | talked about two different types of vision exercises

00:16:32.520 | that have been shown to be useful for improving vision

00:16:35.500 | at the level of acuity that have a lot to do

00:16:38.420 | with improving the musculature

00:16:40.780 | and the movement of the eyes and the lens.

00:16:42.740 | And that's what's called a smooth pursuit task.

00:16:44.740 | So you could go onto YouTube if you like

00:16:46.320 | and put smooth pursuit eye task

00:16:48.860 | and do this for a few minutes each day

00:16:50.840 | if you're trying to keep your vision strong.

00:16:52.780 | And what that task involves is, as the name suggests,

00:16:55.740 | smoothly tracking a small dot or cross hatch

00:16:59.900 | or arrow on the screen,

00:17:01.420 | which is very different than the so-called

00:17:02.820 | saccade type eye movements that we often make.

00:17:05.300 | Saccades are when you dart your eyes

00:17:06.940 | to a particular location to look at something,

00:17:08.760 | then dart it to another location to look at something.

00:17:10.640 | Microsaccades are little tiny versions of those

00:17:12.940 | that we're doing most all of the time, believe it or not.

00:17:16.260 | When you look at a visual scene or image,

00:17:18.980 | if you did not have those little microsaccades,

00:17:21.500 | your brain would adapt or would attenuate

00:17:24.040 | to whatever you were looking at

00:17:25.180 | and the visual image would actually disappear,

00:17:27.620 | which really speaks to how important it is

00:17:29.140 | that your perceptions change in order to maintain them.

00:17:32.120 | This is very similar to where if something is placed

00:17:34.600 | on your hand, say a finger,

00:17:36.800 | you'll notice that change.

00:17:38.340 | But then if you leave it there for a short while,

00:17:40.760 | you'll forget that it's there

00:17:41.780 | because the cells there have adapted out.

00:17:44.020 | There's no change.

00:17:44.860 | So your nervous system is largely responding to change.

00:17:46.600 | This is also why when you walk into a room

00:17:48.300 | and you often notice a novel smell,

00:17:50.420 | let's hope it's a good smell,

00:17:51.720 | after a few minutes or so,

00:17:53.100 | you don't notice the smell anymore

00:17:54.340 | because your olfactory system adapted that away.

00:17:56.440 | So a lot of that adaptation is prevented

00:17:58.220 | by those little microsaccades.

00:17:59.820 | And the macrosaccades, the bigger saccades,

00:18:02.660 | are really for moving your eyes around

00:18:04.300 | to look for things in visual space.

00:18:05.960 | Smooth pursuit is a very particular kind of visual behavior

00:18:09.380 | that you can do in a smooth pursuit task.

00:18:11.540 | Again, zero cost, costs a little bit of time, I suppose,

00:18:13.860 | to do this on YouTube.

00:18:15.700 | And most any of them will do.

00:18:17.300 | We can provide a link in the show note captions

00:18:18.980 | of one that we like or several that we like.

00:18:21.300 | But by doing that smooth pursuit task for a bit each day,

00:18:24.420 | maybe just a minute or two,

00:18:25.900 | you're maintaining your ability

00:18:27.900 | through the musculature of the eye to do smooth pursuit.

00:18:31.300 | And of course you do smooth pursuit

00:18:33.260 | when you move about your day,

00:18:34.620 | but for people that are trying to offset

00:18:36.400 | or reverse vision loss,

00:18:37.340 | doing some additional deliberate smooth pursuit exercises

00:18:39.780 | can be useful.

00:18:40.700 | The other visual exercise that can be very useful

00:18:43.480 | is the so-called near-far exercise.

00:18:45.380 | So this is best accomplished, I think,

00:18:48.320 | by holding out a pen or pencil in front of your eyes,

00:18:53.320 | in front of your head,

00:18:54.520 | and focusing very intensely

00:18:56.160 | through what's called a vergence eye movement,

00:18:57.680 | where you bring both eyes to the tip of the pen,

00:19:00.060 | and then moving that pen closer and closer and closer

00:19:04.420 | to your eyes, where you get close enough

00:19:07.820 | that you actually have to deliberately bring your eyes,

00:19:11.520 | for those of you listening,

00:19:12.360 | this is what I'm doing right now,

00:19:13.460 | to the point where it's blurry

00:19:14.620 | and you can no longer hold it in sharp, crisp relief.

00:19:18.300 | You can't see it sharply, that is.

00:19:20.060 | And then you can move it out a little bit distance

00:19:21.500 | and kind of play right around that threshold

00:19:23.260 | where it's hard to keep it in focus.

00:19:27.100 | Now, and then move it back out again and then in.

00:19:29.620 | Doing that for even a minute or two,

00:19:31.260 | you'll find is a bit of a strain on your eyes,

00:19:33.660 | but you can actually build up the musculature

00:19:35.540 | and the neuromuscular connections

00:19:37.220 | that allow you to do that more efficiently.

00:19:38.940 | And that has been shown to improve certain aspects of vision

00:19:42.020 | especially when people are diligent

00:19:43.220 | about doing those exercises, not necessarily every day,

00:19:45.860 | but let's say three days a week or so.

00:19:47.340 | They can be very fast.

00:19:48.180 | I actually find them kind of fun for reasons

00:19:49.820 | that escape me entirely.

00:19:51.880 | Now, how close you can bring that object

00:19:53.300 | and still maintain it in sharp focus

00:19:55.300 | will vary from person to person based on a number of things.

00:19:59.020 | First of all, how healthy and well-performing

00:20:02.520 | their neural retina is,

00:20:03.900 | whether or not they have myopia or hyperopia,

00:20:07.460 | nearsightedness, et cetera.

00:20:08.780 | Whether or not, for instance, you're like me

00:20:12.260 | and you have a fairly close interpupillary distance

00:20:14.980 | or whether or not you're more wall-eyed

00:20:16.520 | and you have your eyes set further apart.

00:20:18.000 | All those things will dictate the exact performance

00:20:20.820 | of that task.

00:20:21.820 | But nonetheless, it's a very useful task to do

00:20:23.840 | when trying to maintain or improve vision.

00:20:26.220 | Now, of course, there are a lot more behavioral tools

00:20:28.160 | that one could use to maintain or enhance vision.

00:20:30.520 | Really touching on the biggest

00:20:32.620 | and what I consider the most important ones

00:20:34.460 | that are most accessible to people

00:20:35.840 | without the need for any fancy equipment at all.

00:20:38.900 | And if you want to learn more about other behavioral tools

00:20:41.920 | that one can use to maintain or enhance vision,

00:20:43.740 | please see the episode that we did on eyesight.

00:20:45.780 | You can simply go to Hubermanlab.com,

00:20:47.380 | put into the search function eyesight or vision,

00:20:49.960 | and it'll take you right to it.

00:20:50.800 | In fact, everything on that website is keyword indexed

00:20:53.100 | and will take you to the various episodes and timestamps

00:20:56.300 | that you're interested in according to that keyword.

00:21:00.620 | Now, the person who asked this question,

00:21:02.080 | who by the way is Paige Singer, thank you, Paige Singer.

00:21:05.200 | And the question got a lot of upvotes

00:21:06.600 | because apparently there's a lot of interest in this,

00:21:09.360 | understandably so, asked about nutrition and supplements

00:21:12.880 | for maintaining or improving vision.

00:21:15.820 | That could be a very lengthy conversation,

00:21:17.600 | but let's just summarize it with a few brief points

00:21:19.880 | that we know stand based on the clinical

00:21:22.760 | and scientific research.

00:21:24.120 | We've all heard that carrots are good for your eyes.

00:21:26.900 | Well, it's not carrots per se that are good for your eyes.

00:21:29.400 | It's vitamin A that's essential

00:21:31.280 | for the so-called phototransduction cascade.

00:21:33.600 | The phototransduction cascade is the process

00:21:37.080 | by which the photoreceptors,

00:21:38.280 | which are in the back of the retina,

00:21:40.240 | at least if you're a human,

00:21:41.080 | they're in the back of the retina,

00:21:42.800 | take photons, light energy,

00:21:44.440 | and convert it into electrical signals

00:21:45.980 | that's then conveyed to the other cells

00:21:48.320 | and neurons within the retina

00:21:49.800 | and then passed into the brain to create visual percepts.

00:21:53.080 | Most people can get enough of this fat soluble vitamin

00:21:56.080 | we call vitamin A by making sure

00:21:58.540 | that they eat at least some dark green leafy vegetables

00:22:02.120 | and that they do that in their closest to raw form,

00:22:06.800 | maybe cooked a little bit, but not overly cooked.

00:22:09.160 | There are other sources of vitamin A out there.

00:22:10.920 | You can look those up online just for sources of vitamin A.

00:22:14.360 | Most people will be able to get enough vitamin A

00:22:16.660 | from their nutrition and won't require it from a supplement

00:22:19.580 | provided that it's not present at excessively high levels

00:22:23.500 | in a foundational supplement or vitamin mineral supplement.

00:22:26.620 | Getting some additional vitamin A from a foundational

00:22:29.160 | supplement or vitamin mineral supplement

00:22:31.620 | is probably not going to be an issue

00:22:32.820 | unless you really take in far too much of that vitamin A

00:22:36.760 | and it could potentially provide some insurance.

00:22:38.720 | But again, I think most people can get enough vitamin A

00:22:40.920 | from their diet if they're taking care to eat the foods

00:22:44.360 | that contain vitamin A, green leafy vegetables being one.

00:22:47.320 | The other food that's known to be highly enriched

00:22:49.200 | in vitamin A is liver, one of my least favorite foods,

00:22:52.720 | regardless of what animal that liver comes from.

00:22:55.020 | Liver is somewhat of a popular/controversial organ meat

00:23:00.020 | in the nutrition space for reasons that aren't interesting

00:23:02.960 | for sake of this discussion anyway.

00:23:04.760 | I suppose for those of you that like liver,

00:23:07.040 | you could eat a little bit of liver every once in a while.

00:23:08.880 | It is rich in a number of things

00:23:10.960 | that are beneficial to health,

00:23:12.040 | although for you vegans out there,

00:23:13.240 | I'm sure you'll want to avoid liver entirely.

00:23:15.480 | I avoid liver 'cause I just simply

00:23:16.760 | don't like the way it tastes.

00:23:18.000 | Maybe once or twice I've tasted liver

00:23:19.520 | that was appetizing to me and it can be okay,

00:23:22.120 | but it's just not, or at least by my read,

00:23:24.120 | it can be okay, but it's not a food

00:23:26.540 | that I actively seek out, order,

00:23:28.180 | or prepare for myself on a regular basis.

00:23:30.760 | So fortunately there are other sources of vitamin A as well.

00:23:33.040 | And again, I just invite you to all put into a web search,

00:23:37.120 | you know, food sources of vitamin A,

00:23:39.140 | and figure out how to get your daily dose of vitamin A

00:23:42.180 | by taking in foods that you like for you.

00:23:44.560 | And then in terms of supplementation

00:23:46.660 | of things that can enhance vision,

00:23:48.620 | this is a newer area.

00:23:50.080 | And frankly, it's an area where most of the data point

00:23:52.920 | to some supplements that can potentially be beneficial

00:23:57.460 | in certain disease conditions.

00:23:59.300 | So for instance, in fairly progressed

00:24:02.320 | age-related macular degeneration.

00:24:04.280 | Age-related macular degeneration is fairly common

00:24:08.040 | or more common than we would like, we should say.

00:24:11.240 | And it does appear that supplementing

00:24:13.440 | with certain things like lutein,

00:24:15.880 | which is present in eggs or egg yolks in particular,

00:24:19.280 | especially egg yolks that aren't overly cooked,

00:24:21.660 | or that can be supplemented,

00:24:23.680 | can potentially help with some instances

00:24:27.800 | of age-related macular degeneration.

00:24:30.240 | But the data on this are still emerging.

00:24:31.800 | I consulted with our chair of ophthalmology at Stanford

00:24:34.060 | about lutein and some of the other things

00:24:36.060 | that you'll see out there like zeaxanthine

00:24:37.900 | and astaxanthines.

00:24:39.240 | And you know, these xanthines come from certain fruits

00:24:44.240 | like blueberries, and they're present in supplements

00:24:46.500 | and things of that sort.

00:24:47.780 | The consensus I got talking to him

00:24:50.640 | and talking to some other ophthalmologists

00:24:52.240 | are that if you're really aiming to get a healthy diet,

00:24:55.460 | you're avoiding cigarette smoking.

00:24:57.860 | And by healthy diet, I mean getting sufficient amounts

00:25:01.720 | of vitamin A and lutein through food sources.

00:25:04.140 | Again, you can look up where those food sources are.

00:25:06.960 | Egg yolks just being one of them.

00:25:09.560 | Well then chances are you're not going to need

00:25:10.980 | to supplement with lutein or the zeaxanthines

00:25:14.400 | or the astaxanthines.

00:25:15.440 | However, I have heard anecdotal reports

00:25:18.600 | from a number of people that they'll start taking

00:25:20.780 | a supplement for eye health.

00:25:22.300 | There are a number of them out there.

00:25:23.780 | We are not as a podcast affiliated

00:25:25.340 | with any of those eye health supplements, by the way.

00:25:27.900 | And people are reporting enhanced vision.

00:25:29.940 | You know, I receive emails all the time that say,

00:25:33.300 | you know, I'm taking this, you know,

00:25:34.380 | lutein at 20 milligrams per day.

00:25:36.900 | And there I should mention that the dosage

00:25:38.940 | that's been explored in a couple of studies

00:25:40.860 | is 10 to 20 milligrams per day.

00:25:42.440 | Again, you could get that from foods.

00:25:44.860 | You could go above that if you're, you know,

00:25:47.340 | more cavalier or you could go toward the lower end

00:25:50.980 | of that 10 to 20 milligrams per day

00:25:53.420 | if you are somebody who tries to,

00:25:55.900 | who's more conservative, I should say.

00:25:57.760 | Well, there aren't people out there who are, you know,

00:26:00.380 | looking at lutein, they think it's fairly safe

00:26:02.200 | and they're taking higher dosages of lutein,

00:26:03.860 | so 20, 30 milligrams per day.

00:26:05.420 | They're also taking supplements that contains zeaxanthines

00:26:08.440 | and astaxanthines and are reporting anecdotally

00:26:11.860 | that their vision is enhanced.

00:26:13.460 | I don't dispute those claims, but as of now,

00:26:17.580 | there aren't many papers.

00:26:19.180 | I could only find about four, three really solid ones,

00:26:23.340 | and then a fourth that point to

00:26:26.020 | the specific disease instances where supplementing

00:26:29.320 | with lutein, zeaxanthine, or astaxanthine can be beneficial

00:26:32.300 | for slowing the progression of things like advanced onset,

00:26:35.280 | age-related macular degeneration.

00:26:37.100 | And the degree of offset for that macular degeneration

00:26:40.500 | was slight, it wasn't enormous, but it was robust enough

00:26:44.740 | that it warranted reporting in the paper.

00:26:47.380 | Or things like Liebers, which is a particular eye disease,

00:26:49.760 | it impacts a whole different set of systems in the eye.

00:26:52.040 | So basically what I'm trying to say is

00:26:53.220 | when it comes to supplements to support eye health,

00:26:54.980 | make sure you're getting enough vitamin A from your diet.

00:26:56.740 | If you're not, consider supplementation

00:26:59.460 | or consider changing your diet somewhat

00:27:01.180 | to make sure you can get that lutein and vitamin A.

00:27:04.100 | And if you are interested in it and it's within your budget,

00:27:07.160 | I don't know of any evidence that supplementing

00:27:11.060 | with additional lutein, zeaxanthine, and astaxanthine

00:27:13.960 | can be dangerous at all.

00:27:15.000 | So for those of you that are really interested

00:27:16.360 | in maintaining or improving your vision,

00:27:18.220 | that might be an area that you want to explore.

00:27:20.360 | I personally am not taking lutein, zeaxanthine,

00:27:23.080 | or astaxanthine, at least not at this time.

00:27:25.840 | I do take a foundational supplement,

00:27:28.360 | which is my source of vitamin A

00:27:30.200 | in addition to my food sources,

00:27:32.800 | but I don't suffer from vision loss.

00:27:34.520 | I do wear it at readers at night and I have for a long time.

00:27:37.360 | I have a little bit of a muscular weakness in one of my eyes

00:27:41.600 | that originated in childhood.

00:27:43.600 | So occasionally if I get very fatigued,

00:27:45.240 | one of my eyes will deviate a little bit,

00:27:46.680 | a little bit of almost strabismus,

00:27:49.360 | especially if I've been awake

00:27:50.640 | for very long periods of time.

00:27:52.200 | It tends to recover once I get a good night's sleep.

00:27:54.840 | Some of you that have experienced this

00:27:56.200 | where you have one eye that might just drift a little bit,

00:27:58.000 | I could do this for the camera if you want.

00:27:59.400 | Okay, this is weird.

00:28:00.320 | I used to do this to my sister across the table

00:28:03.520 | when we were at a friend's houses for dinner,

00:28:04.960 | so I can actually move one of my eyes in like this,

00:28:07.280 | which actually just reflects that there's a muscle,

00:28:10.000 | extracurricular muscle, closer to my nose that's rather weak,

00:28:12.640 | which allows me to kind of do that.

00:28:13.840 | I can't do it so well with the opposite eye.

00:28:15.880 | Anyway, now I need to blink to kind of clear my vision.

00:28:18.280 | But the point is that if you're somebody

00:28:20.360 | who has a slightly deviating eye, slightly,

00:28:23.100 | often if you go to the ophthalmologist or optometrist,

00:28:26.920 | they're going to give you a prism lens,

00:28:28.300 | which is going to redirect the image

00:28:30.440 | onto that slightly deflected eyeball.

00:28:33.100 | One thing you'll really want to discuss

00:28:34.560 | with that ophthalmologist or optometrist

00:28:38.020 | is whether or not there are exercises

00:28:39.620 | that you could do to overcome that issue

00:28:42.440 | without the need for a prism,

00:28:43.700 | because what I saw and what many other people see

00:28:45.720 | when they put on a prism lens is that indeed

00:28:48.380 | it can line up their vision

00:28:50.400 | or their visual perception better,

00:28:52.280 | but indeed it can lead to progressive weakening

00:28:54.780 | of the muscle further and further

00:28:56.680 | so then that eyeball starts to deviate further and further.

00:28:59.360 | And that raises a larger question,

00:29:00.900 | which is should we wear corrective lenses?

00:29:03.440 | In fact, if you go online,

00:29:04.420 | you'll find or hear about these examples of people

00:29:06.740 | that stopped wearing their corrective lenses,

00:29:08.800 | their glasses or contacts,

00:29:10.000 | in order to bring their vision back

00:29:12.360 | or improve their vision on their own.

00:29:14.160 | Now, if your vision is quite impaired,

00:29:15.640 | you're going to need corrective lenses or contacts.

00:29:18.320 | However, there are a number of people out there

00:29:19.760 | who find that if their vision is somewhat impaired,

00:29:23.400 | that forcing themselves to view things at a distance,

00:29:26.180 | to do smooth pursuit, to do near far,

00:29:29.000 | and to make sure that they're getting adequate nutrition

00:29:31.580 | and things of that sort,

00:29:32.820 | can all sum to help offset some of the visual impairment

00:29:36.900 | that would occur if they were to just pop glasses

00:29:39.360 | on their face and rely on the corrective lenses

00:29:43.040 | in order to focus the light onto the correct area

00:29:46.160 | within the eye, onto the neural retina.

00:29:48.160 | So I'm not telling people to throw off

00:29:49.560 | or get rid of their corrective lenses and contacts,

00:29:52.860 | but you can be overly reliant on these things like a crutch

00:29:56.480 | in a way that perhaps you want to do a little bit of work

00:29:58.720 | to try and overcome,

00:29:59.740 | and then maybe work with a weaker prescription.

00:30:01.500 | And certainly in the case of prism lenses,

00:30:03.940 | what I mentioned before is a real consideration.

00:30:06.100 | It's one I'm very familiar with.

00:30:07.320 | So as a last, but I think very important and exciting

00:30:10.620 | feature of visual improvement is red light.

00:30:14.240 | I talked a little bit about this on the episode

00:30:16.000 | of the Human and Lab Podcast, all about light and health,

00:30:18.440 | but there's some really spectacular, I think,

00:30:20.640 | I consider it spectacular,

00:30:22.120 | many other people consider it spectacular,

00:30:23.680 | research out of University College London.

00:30:25.840 | And the work I'm referring to is Glenn Jeffrey's work.

00:30:28.320 | I've known Glenn for a long time.

00:30:29.760 | These are animal studies and now two human studies

00:30:32.580 | exploring how exposure to red light early in the day

00:30:37.580 | can offset some of the vision loss

00:30:40.360 | related to age-related macular degeneration

00:30:43.080 | or simply age-related visual decline.

00:30:45.560 | And there's a whole mechanism here

00:30:46.700 | that's discussed in that episode,

00:30:48.040 | but it has to do with the fact that red light

00:30:50.360 | and near infrared light together, or maybe even separately,

00:30:54.640 | when viewed for even just a minute to three minutes once

00:30:58.080 | or maybe two or three times per week maximum,

00:31:01.640 | can actually reduce the number

00:31:04.000 | of what are called reactive oxygen species

00:31:05.740 | in the photoreceptors that convert photons

00:31:07.360 | into electrical signals

00:31:08.280 | the rest of the visual system can understand.

00:31:09.760 | So that's a mouthful.

00:31:10.800 | Basically what they found was for people 40 years or older,

00:31:15.460 | if they viewed this red light at a distance

00:31:19.300 | of about a foot and a half,

00:31:21.520 | although I wouldn't get too specific with this,

00:31:23.800 | for a few minutes each week total,

00:31:26.640 | they were able to offset some of the vision loss

00:31:28.680 | within a particular domain of vision.

00:31:31.500 | And I don't have time to go into the details here,

00:31:33.960 | 'cause I do that in the light for health episode,

00:31:35.900 | but you have different types of photoreceptors,

00:31:38.360 | cones and rods.

00:31:39.200 | You have different types of cone photoreceptors

00:31:41.040 | that respond to different wavelengths of light,

00:31:43.000 | short, medium, and long wavelengths of light,

00:31:44.940 | so-called blue, green, and red cones,

00:31:48.120 | they're sometimes called.

00:31:49.760 | When these people who are 40 years or older

00:31:52.060 | viewed red light on a consistent basis early in the day,

00:31:54.960 | and it did have to be early in the day,

00:31:56.760 | there was a real circadian effect there,

00:31:58.760 | there was a offset of some of the vision loss

00:32:03.080 | that would normally occur

00:32:04.400 | in a particular wavelength of light range

00:32:07.480 | that resulted in better visual acuity overall.

00:32:10.580 | So if you're very concerned about your vision

00:32:12.620 | or you're into red light therapies, et cetera,

00:32:15.460 | there are a number of different red light devices out there.

00:32:18.720 | At some future point,

00:32:19.840 | the human lab podcast may partner

00:32:21.360 | with one of these red light companies.

00:32:23.320 | So right now, I'm not going to mention any of them.

00:32:25.360 | In particular, they're prominent online.

00:32:26.960 | What you're looking for is a red light unit

00:32:29.080 | that provides red light

00:32:30.360 | and maybe far and near infrared, excuse me, light as well.

00:32:34.080 | So something in the 650 to 720-ish nanometer range.

00:32:39.080 | So really, it's going to look red or almost invisible to you

00:32:42.680 | if it's really far into the infrared.

00:32:45.600 | And you'll want to view that at a distance

00:32:47.720 | of about a foot and a half to two feet,

00:32:49.720 | and you don't want it to be so bright

00:32:50.920 | that it's painful to look at, okay,

00:32:52.160 | 'cause you don't want to damage your eyes.

00:32:53.320 | But that's essentially what they used

00:32:55.040 | in these studies from the Jeffrey Lab.

00:32:56.580 | And they showed some pretty impressive offset

00:32:59.080 | of some of the aspects of vision loss

00:33:01.260 | in these people 40 and older.

00:33:02.400 | So that's an area that you may want to explore as well,

00:33:05.140 | especially for folks 40 and older.

00:33:07.320 | And again, this red light exposure

00:33:09.120 | had to be done early in the day.

00:33:10.520 | So hopefully that collection of behavioral tools,

00:33:12.640 | near, far, smooth pursuit,

00:33:14.680 | some of the discussion about lutein, nutrition,

00:33:16.920 | vitamin A, supplementation, zeaxanthines, astaxanthines,

00:33:20.720 | getting two hours of light exposure outside,

00:33:23.320 | sunlight exposure, get outside to do some of your work,

00:33:26.760 | and perhaps even deliberate red light exposure

00:33:29.520 | for certain people can be used to offset your concerns

00:33:33.740 | and your actual potential vision loss,

00:33:36.620 | and maybe even improve your vision

00:33:38.240 | regardless of what age you are.

00:33:39.860 | Everything I described is supported

00:33:41.260 | from the peer review literature.

00:33:43.020 | And again, if you want to get the deep dive on mechanism

00:33:45.500 | and further information about dosages,

00:33:47.880 | please check out the episode on eyesight

00:33:50.560 | and improving your eyesight

00:33:51.580 | and the light for health episode,

00:33:53.000 | again, at Hubermanlab.com.

00:33:55.080 | Thank you for joining for the beginning

00:33:56.640 | of this Ask Me Anything episode.

00:33:58.580 | To hear the full episode and to hear future episodes

00:34:01.960 | of these Ask Me Anything sessions,

00:34:03.560 | plus to receive transcripts of them

00:34:05.820 | and transcripts of the Huberman Lab podcast

00:34:08.040 | standard channel and premium tools

00:34:10.640 | not released anywhere else,

00:34:12.040 | please go to Hubermanlab.com/premium.

00:34:15.200 | Just to remind you why we launched

00:34:16.400 | the Huberman Lab podcast premium channel.

00:34:18.600 | It's really twofold.

00:34:19.480 | First of all, it's to raise support

00:34:21.400 | for the standard Huberman Lab podcast channel,

00:34:23.880 | which of course will still be continued

00:34:26.140 | to be released every Monday in full length.

00:34:28.600 | We are not going to change the format

00:34:30.000 | or anything about the standard Huberman Lab podcast

00:34:33.600 | and to fund research,

00:34:35.040 | in particular research done on human beings.

00:34:37.080 | So not animal models, but on human beings,

00:34:39.120 | which I think we all agree is a species

00:34:40.920 | that we are most interested in.

00:34:43.120 | And we are going to specifically fund research

00:34:46.120 | that is aimed toward developing further protocols

00:34:48.760 | for mental health, physical health, and performance.

00:34:50.800 | And those protocols will be distributed

00:34:52.700 | through all channels, not just the premium channel,

00:34:55.120 | but through all channels,

00:34:55.940 | Huberman Lab podcast and other media channels.

00:34:58.120 | So the idea here is to give you information

00:35:00.680 | to your burning questions in depth

00:35:02.880 | and allow you the opportunity to support

00:35:05.080 | the kind of research that provides those kinds of answers

00:35:07.800 | in the first place.

00:35:08.820 | Now, an especially exciting feature of the premium channel

00:35:11.160 | is that the tiny foundation has generously offered

00:35:14.120 | to do a dollar for dollar match on all funds

00:35:16.480 | raised for research through the premium channel.

00:35:19.400 | So this is a terrific way that they're going to amplify

00:35:22.000 | whatever funds come in through the premium channel

00:35:23.960 | to further support research for science

00:35:26.040 | and science related tools for mental health,

00:35:27.800 | physical health, and performance.

00:35:29.320 | If you'd like to sign up

00:35:30.160 | for the Huberman Lab premium channel,

00:35:31.920 | again, there's a cost of $10 per month,

00:35:34.000 | or you can pay $100 upfront for the entire year.

00:35:36.760 | That will give you access to all the AMAs.

00:35:39.080 | You can ask questions and get answers to your questions.

00:35:42.000 | And you'll, of course, get answers to all the questions

00:35:44.600 | that other people ask as well.

00:35:45.960 | There will also be some premium content

00:35:47.900 | such as transcripts of the AMAs

00:35:49.720 | and various transcripts and protocols

00:35:51.620 | of Huberman Lab podcast episodes not found elsewhere.

00:35:54.840 | And again, you'll be supporting research

00:35:57.160 | for mental health, physical health, and performance.

00:35:59.520 | You can sign up for the premium channel

00:36:00.920 | by going to HubermanLab.com/premium.

00:36:03.600 | Again, that's HubermanLab.com/premium.

00:36:06.480 | And as always, thank you for your interest in science.

00:36:09.400 | (upbeat music)

00:36:11.980 | (upbeat music)

AMA #6: Eye Health, Why We Yawn & Increasing Motivation

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