Eye Spy with My Little Eye: Secrets to Healthy Vision

Ever wondered why your eyes feel gritty after a night of bad sleep? Or maybe you're curious about the latest tech that can zap away your glasses forever (LASIK, anyone?). This episode, with Dr. Darren Knight, is your one-stop shop for all things eye health! We'll bust some common myths, explore the future of eye care, and give you actionable tips to keep your peepers in tip-top shape.

Here's a sneak peek at the eye-opening secrets you'll uncover:

• Sleep like a baby, see like a hawk: Discover the surprising link between catching those Zzz's and sharp vision.
• Beat the screen blues: Learn how to combat eye strain in our tech-filled world (spoiler alert: it's not just about taking breaks!).
• MythBusters: Eye Health Edition: We debunk some of the most common eye care misconceptions.
• The future is bright (literally): Explore the cutting-edge advancements transforming eye care.
• See clearly, live fully: We'll share resources for those dealing with vision loss, so no one gets left behind.
• Your eyes will thank you: Get ready to implement these easy tips into your daily routine for optimal eye health.

Ready to take control of your eye health and see the world in a whole new light? 

Transcript

Dr. Knight: 0:01

getting good sleep, is very restorative for our brains, for our eyes. It is a natural process that we all need. as far as our eyes themselves and vision, I think just ties into you want your brain functioning at its best. It's got to get enough sleep. easy to say hard to do. I know sometimes his life gets busy, but, that's getting through those sleep cycles is really critical, at having us at our best function. So, doesn't directly help your eyes in that way. Right. I mean, I guess. Closing them, in that sense, will give it time to moisturize people who have very severe dry eye. I do have patients, occasionally, where they might benefit from actually, like a sleep mask. Just to help keep the eyes moist, because sometimes there's an element of myopotomus where their eyelids don't shut quite as tightly as they should. But that's not as common. I would tell everyone you need to wear a sleep mask or anything like that.

John: 1:04

Hi, I'm John,

Erin: 1:06

and I'm Erin. You're listening to connect and power. The podcast that proves age is no barrier to growth and enlightenment

John: 1:13

tune in each week as we break down complex subjects into bite sized enjoyable episodes that will leave you feeling informed, entertained, and ready to conquer the world

Erin (2): 1:26

Our guest today is Dr. Darren Knight, a south bay native M brilliant ophthalmologists. After AC ness studies at USC, Dr. Knight honed his medical skills at Columbia university and later specialized in the intricate world of vitriol retinol diseases at UC San Diego. Known for his groundbreaking work and compassionate approach. He's on a mission to transform lives through cutting edge treatments. From everything diabetic retinopathy to macular degeneration. Dr. Knight. Isn't just a wizard in the clinic. He's also a compassionate teacher, an avid researcher, and a big time Lakers and USC fan.

John: 2:12

let's warmly welcome our guest, Dr. Darren Knight. Welcome Darren. Thank you for being here.

Dr. Knight: 2:18

for having me.

Erin: 2:20

We are so excited, and I know this is such a privilege to have you today, just your background itself. we're excited to learn information from you. But first I love movies and I love TV and I've heard from a little birdie somewhere that you might be interested and you watch lots of movies and TV shows when you have time. Yeah. So if you wouldn't mind sharing, what have been some of your favorite shows? Maybe you're currently not watching it, but what are your, some of your favorite shows? And then if you wouldn't mind sharing your story, how you got into eye care and ophthalmology.

Dr. Knight: 2:53

Yeah, I'll say right now just because it's top of mind just finished Mr. And Mrs. Smith The remake. I think it's on Amazon Prime. was very, very good. between that, my wife has me keeping up with Love is Blind, which I think the final weeks is next week. going to ophthalmology. I think that I guess just the structure of medical school. You start off two years in the classroom. The last two years, you are more in the clinic and you rotate from specialty to specialty. And I think you'll find that most people will find you're drawn to I'm more of a medical person. I like seeing people in the office, your traditional doctor's visit or more of a surgical person, you know, surgery. I think we all can wrap our mind around that. and then of course, there's other things that are a little bit less both radiology, for example, pathology. And They're not that many fields where you get a really good blend of both, or you have a blend of both, but it's like, where on the spectrum do you want to set? one field might be 50 50 between medical surgical. I would say ophthalmology, at least what I do, is probably more of a 75 25. Now it depends like how you define the surgical. We do a lot of in office procedures, but not necessarily taking people to the operating room. And I was drawn to that because I think Most people, your image of a doctor, depending on your exposures in your life, is going to the office, going for a checkup. That kind of long, Relationship where you can develop with patients. And so I felt like ophthalmology would let me still do both to do surgery, which I love, and also have that relationship with patients in the office. Then I sub-specialized further. So four years of med school, four years of ophthalmology residency, and then I did a fellowship in vitreoretinal surgery and medical and surgical approach, VIO retinal disease. So I do, some more advanced surgeries in some ways, or they're treating certain conditions that are not as common. So retinal detachments, often a lot of emergencies, but from a medical perspective, most retinal diseases are now treated in the office. Macular degeneration being probably number one, maybe number two, some forms of diabetic retinopathy number two. And so I enjoyed doing retina, as we say it, because I liked That I felt like I was going back to like stopping blindness, per se. nowadays, there's, thankfully, in the States, we have lots of resources. You're very rarely coming across a cataract that's, blinding someone, usually. There's so much access to care here. international, of course, things can vary. glaucoma, of course, is something else I considered, that can result in blindness, but it felt like retinal disease. I liked the urgency. I liked The surgical approaches, they're not bread and butter cases. Every case can vary, and your approach can vary, and there's opinion, right? How would you approach this type of retinal detachment versus another surgeon might have a completely different approach, based on somewhat how they trained and where they've, I don't know, their prior experiences. So I liked that, and that really drew me to retina, as we say. ophthalmology though, I think you've already kind of segmented yourself out of the hospital. I do go occasionally, but typically it's in the office outpatient care patients go home after our surgeries. Right after some of those surgeries, they're not under general anesthesia. Yeah. Like in a MAC anesthesia where you're like partially asleep awake. I think the comparison I make for patients is colonoscopy, similar to that. and I just loved that I could still have those acute interventions, but then have patients that I get to know for years. I have patients that see me monthly. for years, you can't help but know each other as time goes, and I think, it's kind of a beautiful thing to be able to keep those relationships and still have the, solve acute problems like surgery.

John: 6:54

that's great. so as we age, our eyes start to change, you know, and so I'm somebody that's constantly looking for ways to maintain my physique or take care of my health, whether it's eating nutritious food. But one thing that. Has been a big challenge for me. It's really understanding eye health. So if you could just go into maybe some of the changes that start to happen and how we can possibly, slow those changes down. I know that they're going to happen, but how we can slow those down.

Dr. Knight: 7:29

Absolutely. I would say number one is your eyes mirror the rest of your health. for a diabetic patient, the best thing they could do is control their diabetes, high blood pressure, control your high blood pressure. And so diet and exercise would definitely provide benefit there. other conditions, such as cataracts, we are all going to have cataracts, I guarantee. But they move faster. in diabetic patients, people who are still actively smoking. So smoking cessation probably be one of the best things you could do for that. and I think controlling your cholesterol Just general overall health, your eyes will tend to mirror. I get a lot of questions about vitamins. There are vitamins that are for macular degeneration. Should I use those? Should I start those early? I have a family member who had macular degeneration. I would say that Understand that for these studies, we have to select a group of patients. We create an intervention and we follow them in time. and if you don't already have signs of that damage, we don't necessarily have proof that using those vitamins in advance would be helpful. There are other vitamins for other conditions, such as Omega threes, fresh oil, being very good for the quality of our tear film. And I think that's totally appropriate. often, I think that's in multivitamins, which a lot of patients use anyway. but I think if I could drill it down to one thing I would advise everyone is to Get your eyes checked. believe it or not, I have lots of patients where my glasses are fine, I can see, I'm driving, I'm happy, and they haven't had their eyes checked in years, more than they know, until their glasses break. And it doesn't necessarily have to be a retina specialist, ophthalmologist, ophthalmologist. Optometrists, just, I think getting an exam is critical because so many of these things we can treat in advance. we have better interventions that will, I think, result in better outcomes. we have patients routinely, come in and, I can't, I'm blurry on this side. And we find out, you probably have had diabetes for years. and it's some of these things are silent. Until they affect you, and sometimes their eyes are what bring the patients to see us, and then we plug them into the rest of their care. But I think yearly eye exams at a minimum would be one of the best things I could, I would advise someone.

John: 9:46

Thank you.

Erin: 9:46

I'm a huge advocate for that. I know my son had keratoconus and it was because that we took them every year and had those eye exams, for school and we're getting ready. And, and I'm so glad we discovered it because who knows what could have happened if we, if we didn't. Didn't jump on the bandwagon and get the surgery needed. I mean, that can lead to blindness, you know, if you let it go too long. So definitely I am a firm believer of getting there and you guys are friendly. That's not like you're doing anything bad to us. It's like the dentist is drilling and doctors are giving you shots and you're just like, let me just open up your eyes and see and puff some air once in a while.

John: 10:25

Yeah.

Dr. Knight: 10:26

Well, until if it gets worse, sometimes we do some interventions, treatments, that people don't love. But, it's true. But, it's a long list of things to take care of our health. And understandably, sometimes the eyes feel like they're in the background. Until something's wrong, if I get it.

Erin: 10:42

That's one of my worst fears is definitely losing the eyesight because I love the beauty of everything. So John had a fun question. He was talking about I'm surprised. He hasn't brought it up yet, but he wanted to know about carrots Do carrots help your eyesight?

John: 10:56

Or is that just an old myth?

Dr. Knight: 10:58

I think that as adults, again, healthy diet, but nutritional deficiencies, of course can affect the development of our eyes as children. So I'm sure like those old wives tales were based in a time when things weren't as plentiful. Yeah. You definitely need enough vitamin A, different things to form our eyes and to allow for, the visual cycle to continue properly. so vitamin A is, That's definitely one of those components, but, you know, I don't think an adult should eat any more carrots than anyone else.

John: 11:27

and one thing that I was thinking about as we've had this discussion is how much more time we're spending on our devices and how that may be affecting our eyes too. I know that eye strain is big for me, I'm in my fifties now and I noticed that I'm spending more time on computers and on my devices and it does seem to affect me more than. I would have thought it would have. So how is that affecting us? And is that dangerous? can you explain maybe what we should do in regards to our devices and so forth and

Erin: 12:00

like the blue light glasses maybe

John: 12:02

yeah, and how we should utilize them.

Dr. Knight: 12:04

Yeah. I'll split that up into two groups, right? I think if we're talking about children, it's definitely something where I think we should probably create limits on the amount of screen time. And a lot of reasons for that, not just even I was like, I think for development, dexterity. but generally there's. been a gradual increase in the amount of nearsightedness, And some of that definitely might ultimately be a result of us being more on our phones, on screens. so for children, I think the general advice is make a 20, 20, 20 roll, 20 minutes, 20 second breaks, look 20 feet away, and just to ease some of the eyestrain for children. For adults, I think a lot of, once our eyes are developed, they're developed, I think a lot of what we feel with eyestrain is that our eyes can get extremely dry and irritated. Anytime we're focusing. Me focusing on the podcast, our blink rate decreases. And as that happens, your eyes get dry, irritated. You feel like you're trying to clear them, that sensation that you get. So I think, using artificial tears to moisturize your eyes. is definitely something beneficial you can do and incorporate. You know, some of us, we're working, we can't get away from the screen, maybe taking that short break to put in a set of drops might help. There's no particular brand that I recommend, but generally the category would be preservative free artificial tears, I think are a good option there. I think wearing the appropriate refraction, so getting your glasses updated, contact lenses, so forth, just doing that regularly, so that you are getting the most out of your eyes that you can. I think that's another piece of advice I'd have.

Erin: 13:44

So John does have a bunch of eyeglasses and I'm like, you gotta wear'em. You have'em right there. Stop straining. Nobody's here but me.

John: 13:51

I have them all over

Erin: 13:52

the place. yeah And you look sexy with them on. No, I don't, but thank you. Thank you. What are some of the red flags or signs that maybe something more significant is going on with my eyes? That I really should take it serious and come in

Dr. Knight: 14:54

Yeah. as I mentioned, many of these diseases are silent. that's what's so hard. in fact, I would bet that the number one referrer of cataract surgery is DMV. People go and suddenly, they don't pass and they get sent over and get their eyes checked. And it's oh, your cataracts are significant enough again. people aren't always going to get their eyes checked yearly. but other diseases completely silent, such as glaucoma, when you notice loss of different glaucoma, it's often very late because it takes the peripheral vision first and it works its way out to in. So again, early screenings, early detection. retinal problems, those that I specialize in, some of them are emergent. Patients suddenly see a shower of floaters. Now, floaters to some extent can be normal, but a sudden change in them, flashing lights, like camera flashes or lightning bolts in the distance, or curtains where you say it feels like someone is covering the vision in some direction, those could be signs of the need for urgent care. those aren't things I would ignore, and I think, pretty soon afterwards, we'd have my eyes checked.

Erin: 15:59

now? I don't really know some of the terms. Like I hear glaucoma. I don't really know what that means. So if you could explain maybe a couple of the different terms you've talked about exactly what they are, because it's scary when you talk about it,

John: 16:12

Yeah. And especially for, people, our main audience, of course, is going to be people over the age of 50. So if you could explain some of the terminology and maybe language that. We might be able to understand, right?

Erin: 16:24

So basically he's saying kiddie terms.

Dr. Knight: 16:26

Oh, absolutely.

John: 16:27

Yeah. Dumb it down for me,

Erin: 16:30

for me, please.

Dr. Knight: 16:30

uh, you know, if you think about the eye as a circle and the cornea is the surface of the eye, we put a contact lens on our eye, the iris, that brown, blue part of the eye that we know, and right behind that, still towards the front of the eye is what starts off as a lens and it gets cloudy as we age and we call it a cataract once it's adjusting the way light comes through it. When I say it's inevitable, it's a natural structure that changes as we age. The retina is the lining on the inside of the eye, so I would call that like the wallpaper in the room. And the space in between is the vitreous. And the optic nerve is that cable that connects our eyes back to our brain. One to each, they come together and connect back to our brain. So that's like our wiring there. So cataracts is when that lens becomes cloudy. Keratoconus, you mentioned, is a corneal problem on the surface of the eye. The retina is that lining on the inside where I mentioned retinal detachments or in tears in the retina. And glaucoma is probably the hardest to explain because it is a gradual decline in the function of the optic nerve. And we don't completely understand why. And there are many different types and subtypes. But I would say most commonly we're speaking about primary open angle glaucoma, meaning the angles are clear where fluid is moving through clearly in the eye. But for some reason that pattern of vision loss is following damage to the optic nerve. when your eye professional looked at your optic nerve and they saw thinning, it might correlate to areas of your peripheral vision that are declined or shortened or lessened that you might not have noticed. glaucoma is a very broad category, and many of those types of glaucoma, not all, have high eye pressures. So, when you go to exams, most people, when they get glasses, they say, I hate that air puff. I don't know if you, you had that. there are other ways to check your eye pressure nowadays, so that's not the only way, but one of the things they're checking for is to estimate the pressure at the inside of the eye, in the front of the eye, and that can give us an idea of your risk of glaucoma, and that is treatable, so we can treat those with eye drops, and help certain procedures, laser procedures, and of course sometimes incisional surgery to lower the eye pressure and treat glaucoma. But it is a difficult concept, and I think it's difficult to explain in every particular patient. You might have a different category of glaucoma. So it's important again to discuss that with your ophthalmologist.

John: 19:01

Yeah. You know, I, I, Erin and I have had many discussions and I love. Outdoors. I love adventures. I love exploring, but I love all that because of my eyes, right? Of what I see. And then it brings all these amazing memories back to your brain and you can take pictures and then you can, of course, look at your phone or however you're taking those photos and remember those special moments. And so I'm very, very protective over that part of my body. You know, if one of my hands goes bad or one of my feet, I'll make it, but your eyes are such an incredibly vital. part of happiness. I think, you know, it's, it's incredibly important.

Erin: 19:37

I was going to ask about double vision because I know I started getting double vision when I had my children. I see fine, but when I close one eye or the other, I have the double vision, right? So I'm just, is there something people can do? Is that more common as we age? is there surgery for it?

Dr. Knight: 19:55

it's important to divide double vision into different things. So when we say double vision, we usually mean, Hey, I'm looking with both eyes open and I'm seeing two of, truly two of things. two computer screens, two cups, right? Now that usually represents a misalignment of the eye muscles. So one eye is here, another eye is here. Here we're here in any direction that for business is something we approach completely differently, especially if it's new in an adult, and there's a very broad differential reasons for that to happen that I would think need to be worked up. But most people, when they say double vision, they're referring to, like you mentioned, I close one eye, I have double vision. Different type of doubling. You might look at print and feel like the letters don't quite overlap the way they could, and that could represent astigmatism or That usually can be corrected with a good refraction, glasses, contact lenses. But I think it's important to split those up, which I think, it's hard to do, but it's not common to actually have true double vision if it is that absolutely needs to be examined pretty quickly.

Erin: 21:06

And when you have that, normally they would go in and do like a surgery just to pull the muscle or tighten the most muscle in whichever side. Is that sound correct?

Dr. Knight: 21:15

Yeah. depends on the cause. for example, a stroke, some of the muscle function might be lost because there's the nerve and the signal from the brain is not getting there. So the eye could be pointed in the wrong direction. The problem in that case, isn't the muscle. There are kids who have, for example, esotropia in their eyes. Come inward and they might benefit from a surgery to realign the muscles. So yes, but it's important that it be worked properly to make sure that it's the right ideology. But yeah, we do have surgeries. And sometimes, even in glasses, they can put prisms bring the image, so that your brain is perceiving it coming from the right direction. those prisms, Can be very subtle. There's probably plenty of people walking around with a little prism in the glasses that someone else might not perceive. So again, exams yearly. think it's a great idea.

John: 22:10

when I first get up in the morning, I, or even in the middle of the night, I'll. You grab my phone and just use my phone's light on the face to help get me to the bathroom safely however, sometimes I'll go into the bathroom to use the bathroom and I'll get on my phone and that bright light, is that really an unhealthy thing to do? And because, I want our listeners to know we got to take care of our eyes. And so, Is it smart to flip our light on directly and then be faced with that immediate brightness? Is it smart to look at something in a dark room like your device? It's really bright. can you educate our listeners on probably best practices when it comes to some of that?

Dr. Knight: 22:51

Yeah, I get those questions a lot. And I think one thing to think about is our eyes don't turn off right when we're sleeping. Our eyes are still functioning. It's just a connection to our brain. So they are meant to be used all the time. You can look at them and look at objects in the dark and dim light, right? You may not see it well, but you are not damaging the eyes. By doing that. So I actually, I'll tell patients, you know, be free. Use your eyes. Turn that light on. feel free. That's what they're for. They don't turn off. Now that being said, as we talked about earlier, eye strain, you can feel very tired, fatigued, your eyes can be very dry, so you may feel like you need to rest. I think artificial tears to moisturize the eye is a good idea, but I wouldn't worry too much about, the amount of light and, trying to minimize being in dim light or strain. I know that was definitely a concern that I've heard a few times.

Erin: 23:53

is there a way to strengthen our eyes for night vision?

Dr. Knight: 23:57

No, most people. of course, we see better with more light. We get more contracts, but there are people who in dim light their need for glasses is slightly different, and they might benefit from a slightly different prescription for glasses at night. but it's not necessarily something we can like strengthening work on. not like muscle or doing push ups. but I think that Probably just making sure that you're in the most updated, correct refraction that you can at all times. I think that's probably the best thing you could do for yourself

Erin: 24:31

So we won't send you any selfies where we're sitting in the dark for hours going, look, we're doing it

John: 24:36

Yeah,

Erin: 24:36

we're staring at it

John: 24:38

it. So going back for a second to artificial tears and stuff, I've noticed that, in the news recently, there's been a whole bunch of discussion about eye drops and some of the dangers of eye drops. Certain eyedrops have come out on the market that you should or shouldn't use. And that can be very confusing I do agree with you that our eyes are very dry and it really depends on where you live to, And so I'm sure those can affect that. Trying to make sure that we don't buy the wrong product for our eyes is there a few brands that you strongly recommend that we should all be using or?

Dr. Knight: 25:13

I really don't have one brand in particular that I like endorse or say is superior to the others, but I think a lot of the concern and something easy to overlook, but any drop that comes in. You know, 10 milliliter bottle. It has to have the right amount of preservatives to avoid bacteria growing And, I think in the news we heard when that's not controlled. it actually becomes a great place to grow bacteria and then putting that in your eyes, giving yourself an infection. and that can migrate. So I definitely understand the fear across the public. I think that a lot of the brands that are out there. of course, not saying it the best, but refresh or sustain, like those have been around for a long time and have not really had. that I know of reports of these infections. So I think using these kind of brands that are well known is probably one way to avoid that risk. And I think another category that I would consider is preservative free drops are meant to be used, single use, throw them out, right? when we keep bottles for a long time, I've had patients pull out a bottle and the label's etched off cause it's probably been there for six months. that's not how they're intended to be used. even beyond just expiration date, usually that bottle will give you an idea when you're supposed to throw it out and get a new one. I understand that these drops, these. Costs add up, but, you still want to try to function safely. And I think following the guidelines that are on those models is key.

John: 26:50

Another thing that I was curious about, is I noticed that as I've gotten older, the whites in my eyes have become a little bit darker. Sometimes maybe they look a little bit more tan or whatever. And I've actually seen drops out there called bright eyes or different things that brighten that white. are those safe to utilize or should you not utilize those? Is it just a natural progression?

Dr. Knight: 27:19

Some of it's a natural progression. When we see the whites of our eyes, it's important to know that's the sclera, and there's a layer on top of that, the conjunctiva, and those blood vessels that are within that or between those, often are why we say an eye looks injected or really red and irritated, angry. So a lot of those drops might help constrict those vessels. usually they're not intended to be used chronically. But I think a lot of people might say, Well, I'm just need them to look white tonight, want them to look good today. And I think that's fine. And it's safe. But, of course, we don't want to go beyond what their label indicates.

John: 27:55

How about for people that, maybe they're going through some vanity issues and maybe they decide to go have some eye surgery done, upper and lower lid surgery or whatever. How does that affect your, your eyes ability to continue to work the way it's supposed to work, with keeping your eyes moist and taking care of it is that okay to do? I mean.

Erin: 28:19

so you're saying that if anyone has an eye surgery, whether it's an eyelid lift or some, something that an injury or whatnot, does that affect their eyes?

John: 28:27

Yeah. How, you know, their tear ducts and stuff like that. And the moisture, do you have any recommendations to or against that?

Dr. Knight: 28:37

Yeah, I guess the first thing is I would advise that, anyone who's interested in plastic surgery, you just go to someone who has lots of experience with the procedure, because they'll make sure to make those decisions that will protect your eye. So our eyelids, Every blink we're right. We want to like have a really nice tight closure, moisturizing the eye. So of course, if it's not done well, creates an increased risk of drying the eyes out or not having a normal blink or I think people are concerned they might lose vision. But with lots of experience, they do steps to protect the eyes during those procedures, they'll often actually have a cover over the eye. itself, the eyeball, while they're working on those lids, just to protect them. so I think it's totally safe to do those procedures. you just, it, I think. When professionals are doing it, they're going to make sure to protect your eyes for you.

Erin: 29:28

So just do really good research, read the reviews, ask people that may be of use on that,

Dr. Knight: 29:33

I don't think anyone who's doing those surgeries will mind if you, usually a lot of them will have some before and after, like some pictures, just so that you know exactly what you're getting and what you're looking for. because they are going to try to get you to the goals that you give them. and sometimes you might want that guidance too. And I don't think they'll mind wanting you to do that.

John: 29:55

Okay. Now, is there an age, where we've heard of Lasix, you know, that came as this craze of, a chunk of years back and people were saying, Oh my gosh, I'm going to save up the money, get this Lasix and then I won't have to wear glasses. And I'm super excited now I can really see well, is there a certain age that you advise? Against that, that procedure and how long does that procedure and how helpful is it?

Dr. Knight: 30:20

Yeah, so there's no age where I say you're not necessarily a candidate for LASIK. There's just different age points where it may not get you to your goals. LASIK, they're using a laser, and the cornea, remember that surface of the eye people put contact lenses on. The laser and different techniques is creating the glasses prescription on your cornea. if you have a very straightforward need for glasses, you're nearsighted, sometimes they can. Use the laser to give you that. You no longer need glasses. You still have the eyes you ultimately started with, and other changes can still develop. for example, as you age, you might develop cataracts. The light's coming through into the eye, through the cornea, it still will have to get through that cataract. The LASIK will not address that. So if someone also has cataracts, they probably won't get the full effect of LASIK. for that reason, as people are older, sometimes, They might go and get assessed and they'll say, I don't really recommend LASIK for you because it's, it's not going to treat the problem. And when they treat the cataracts often, nowadays, they're putting a lens that will give you some of those same effects. They're giving you glasses inside of the eye. So again, it may not be the right procedure for you. Another thing is that often what we're complaining of as we age is we lose our ability to adjust from far to reading up close. A lot of people need reading glasses. That is something different that we lose, and it's called presbyopia, older eyes. And our lens can no longer adjust as much as it once did. We all are gradually losing that. But once it becomes significant, again, LASIK is just giving you the glasses in the front of the eye. If we aim in close, you won't feel quite so happy at a distance, or vice versa. So LASIK may not be the best option for someone with presbyopia. And there are options, sometimes they'll offset the eyes between one side, make it your reading eye, one at a distance. There are a lot of options you can walk with, but there comes a tipping point where maybe cataract surgery is a better option, or LASIK might just not get you the goals, especially if you're bothered by your loss of reading up close.

Erin: 32:26

Are there some myths out there that you might want to debunk? If someone's like, Oh, I heard this surgery or Oh, I heard this, I think causes this. And you're like, Whoa, hold on.

Dr. Knight: 32:38

Yeah, I think that, One of the hardest things that I deal with as a retina specialist is in the treatments have evolved over time, and, people know someone who had that procedure for their diabetes and they lost all of their vision. And, it's important to understand that sometimes we're trying to treat blinding conditions, and sometimes those treatments don't succeed, and people lose vision anyway. It doesn't necessarily mean that treatment's not appropriate, and might have a different result in you as an individual. So, I think it's important to definitely go online, do your research, read up on the procedures. I encourage my patients to do so. I send them, if you want to watch a video of the surgery, go look at it on YouTube. I don't mind. I think bring that information in. but also understand that I think We can serve as your guide to work through that information because, all information is accessible now. and sorting through it is, I think, why you go see your professional.

Erin: 33:38

Is there any technology coming in the future that you're super excited about? Oh my gosh, this is going to change the way you see things. Cause before we used to have to cut this and open this part and get in there and laser, but now we're just going to go pop and you're done.

Dr. Knight: 33:54

Oh, yeah. so on so many levels. So from a medication perspective, I treat a lot of retinal diseases, macular degeneration in particular. And we have, in the past few years, there's been tons of new treatments. Then on top of that, there are biosimilars, which are like, I guess the equivalent of a generic, but for these injections where these things are going to be much more accessible. hopefully it would better cost for patients as well. and that's just from the medication perspective, as far as, detection of disease, I'm, I'm really excited for where AI takes us, ophthalmology, there's so many, So much imaging. And the reality is that if we were to be able to train it well, it might be an incredible assistive tool for us, where they're taking pictures remotely and we're giving people advice hundreds of miles away on what they need to do for their eyes. I think it'll help us be better at delivering care to those who need it most. And I'm excited to see where that goes. I think it'll be ultimately like a great assistive tool for us.

Erin: 34:53

It'd be like getting one of those little nanobytes and you stick it in your eye and it just goes in and goes, wouldn't that be cool?

John: 34:58

so interesting. You know, I, I really believe we have a, an amazingly forgiving God to that helps our eyesight. get worse as we age in order that we don't see ourselves as getting older because I've noticed with myself, when I look in the mirror, I don't see all the wrinkles that are really there until I throw on my glasses and I look in and I go, what happened? Who's, you know, it really looks when I don't have my glasses on, everything looks softer and I'm much happier because

Erin: 35:26

I

John: 35:26

see that. But,

Erin: 35:27

Oh my goodness.

Dr. Knight: 35:29

Love that.

Erin: 35:30

one thing, my advice, I'm wondering if you could give is any of your patients or people that might be dealing with eye loss, do you have any advice for them to help calm or ease their world and their understanding of what they may be going through?

Dr. Knight: 35:45

Yeah, I occasionally have patients who are truly completely blind or legally blind and I think one of the biggest steps is to get them started on the process of Accepting it and getting into the hands of there are professionals who deal with patients who are low vision or no vision. That's what they do every day. There are so many assistive tools, devices, approaches that I am not aware of. That is not my expertise. you know, at least Where I am, I'll often send patients to the Braille Institute or some of the, Southern California College of Optometry has low vision exams and support for patients. And I have been most impressed by how much function people are able to get. I think earlier you had mentioned, a lot of losing your eyes. Like, how could I do anything? Even small things like imagine pushing the buttons on the microwave, right? but just small things like putting kind of print that you could get the texture on those numbers so that those patients can learn how to heat up their food themselves, cook and prepare food for themselves. Like they do learn how to do these things again. I'm not saying it's easy by any means. but I think that with a lot of support, a lot of. Life can be restored for these patients. I understand there's a lot of fear, but there are a lot of resources out there.

Erin: 37:16

That's great to know because some people may not know that that's available, go to the Braille Institute and people can help you with your microwave numbers on the microwave and just helping you set up your room so you can adapt to how you walk in your room and different things.

John: 37:32

How important is sleep when it comes to eye health?

Dr. Knight: 37:38

getting good sleep, is very restorative for our brains, for our eyes. It is a natural process that we all need. as far as our eyes themselves and vision, I think just ties into you want your brain functioning at its best. It's got to get enough sleep. easy to say hard to do. I know sometimes his life gets busy, but, that's getting through those sleep cycles is really critical, at having us at our best function. So, doesn't directly help your eyes in that way. Right. I mean, I guess. Closing them, in that sense, will give it time to moisturize people who have very severe dry eye. I do have patients, occasionally, where they might benefit from actually, like a sleep mask. Just to help keep the eyes moist, because sometimes there's an element of myopotomus where their eyelids don't shut quite as tightly as they should. But that's not as common. I would tell everyone you need to wear a sleep mask or anything like that.

John: 38:31

Perfect. All right.

Erin: 38:33

So one of my favorite things to do and John's as well as we love to travel. And so I'm always curious where people have been or where they would like to go. So it can expand my knowledge of, Oh, I got to go check this place out or do this thing. What do you guys have on your list?

Dr. Knight: 38:50

Oh, you know, I have very young kids. Big international travel is tough right now. I don't know that we're ready to brave it, but I, Went to Southeast Asia and Bali once and I would love to just go back and just really Island up this time and just go across Indonesia. that's one thing on my list. I also would love to see. I think they were called the salt plants and like Argentina. I just saw pictures and it just looked incredible. I don't know that I'm your resource right now. I don't have anything coming up quite yet. But,

Erin: 39:22

You

John: 39:23

Yeah. Spoke Ugh, yeah.

Dr. Knight: 39:25

and images. I love

John: 39:27

I love that you talked about Indonesia because we spent six weeks in Indonesia this last year and went to six different islands. And so if you ever wanted to call us up and just have another conversation, I mean, we went to some of the most magical places you could imagine. The people there, the food there, the culture, the experience was something that really changed my life. so it was pretty amazing.

Dr. Knight: 39:49

Yeah, no, we'll definitely have to

John: 39:51

Yeah. thank you so much. It's been amazing. I'm excited. I definitely, I think the number one thing I'm going to work on is just keeping my eyes more moist I'm all about health and nutrition and fitness and really trying to live life optimally and, you're one of my favorite guests. guess, because there's so much I personally wanted to learn from somebody like you. And whenever I go see an eye doctor, I don't remember the right questions to ask. Sometimes I'm just going through the paces. So, so I appreciate you for taking the time today to educate me and Erin and

Erin: 40:21

listeners all of

John: 40:22

of our listeners. So thank

Erin: 40:24

you. Well, and as you age too, you know, there's so many different parts. There's parts. You got your eye. You got your brain. You've got your gut. You've got your feet. You've got so many parts and it's hard enough keeping up with life, let alone your body. But we really want our listeners, encourage them. Just take one piece of advice from Dr. Knight today, just one piece of advice and implement it. And if that's, Hey, I'm doing my annual exams and keeping myself in check, then that's what you do. And that's okay.

John: 40:52

Yeah, those are the two things that I'm going to focus on is just keeping my eyes more moist and then making sure that I'm going in annually and getting them checked.

Erin: 41:00

Or like he said, oftentimes they're silent killers, not killers. I shouldn't say that word. There are silent.

Dr. Knight: 41:07

silent diseases, for sure. I think one of the challenges, I didn't touch on it because, you can step on toes, but there are optometrists who go to, go to college, they go to optometry school, they're ophthalmologists or MDs, and then, people can specialize further. And in different points in history, they have not always got along well. Stepping on toes. But I think, ultimately, like there are so many patients, there's more patients than there are doctors of any type. And I think we're all working towards the same goals. And I think that anyone that you're seeing on the spectrum will send you to the right person if they feel like they can't provide what you need. so going to the medical insurance, vision insurance, that divide is actually really challenging for people because a lot of times for optometry, they're coming out of pocket completely. Ophthalmology, typically you can use your medical insurance, but you may not get the prescription for glasses, which is often why people are going and it's what they wanted. So it's a lot to navigate. the system doesn't make that part easy, or cheap,

Erin: 42:09

Agree.

John: 42:10

thank you so much for being here today.

Erin: 42:12

thank you again.

Dr. Knight: 42:13

All right. Thank you guys.

John: 42:16

Thank you for tuning in to another episode of Connect Empower. We want to express our gratitude to you for being part of our community, and we hope today's episode has provided you with valuable insights and inspiration to enhance your life and that of a loved one.

Erin: 42:30

We are more than just a podcast. We are a community dedicated to enhancing the lives of our aging adults and their support system. We encourage you to visit our website now at www. connect empower. com. Explore more information about our guests from today's episode and to access our free resources.

John: 42:52

resources. Our mission doesn't end at the conclusion of this episode. We invite you to take action now by sharing the knowledge you've gained today with someone who may benefit from it. Whether it's a family member, friend, or colleague, your influence can spark positive change.

Erin: 43:06

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John: 43:27

I'm John.

Erin: 43:28

I'm Erin. Until next Wednesday.