hello my name is lisa aereo and i am the director of the belmont health collaborative thank you for tuning in for another show of focus on health today i am delighted to be joined by dr linda bennett and dr rebecca ma of the bennett family i care we're going to talk today about issues relating to i help us so thank you both so much for joining me let's start with some brief introductions tell us a little bit about yourselves and your practice here in belmont so thank you for having us i've been in a comic strip from belmont now for nearly thirty years on the practice started in question square and it's currently located in belmont saint when we say family i care we really mean  regarding i health and one of the main questions that people are concerned with is screens we're looking at our cellphones we're looking at our computer screens we have our i pads with us tell us a little bit about how detrimental that is to our eyes and then is there anything that we can do to mitigate the strain are or you tell us what happens when we are staring at screens for so many hours a day so this is a really common question we get it at the office all the time because you're right everybody spending a lot of time on computers today our eyes really were invented so we would see the wolf on the prairie before the wolf saw us so we're right it's looking clothes is is the problem for the most part of looking at our screens we we look near for so many hours a day when in the past we've used their eyes to look far away so we do recommend a few things that might make it a little bit more comfortable and one of them is something called the two hundred and two thousand and twenty role that means that when you're working on your computer or on a screen that you should look at your computer for twenty minutes and then look up and  something that's twenty feet away for twenty seconds ok so by refocusing your eyes over and over again you mitigate some of the effects of looking at a screen for many many hours there's other things too that are that are affected by looking at screens such as dry eyes can be worsened by looking at the screen because we tend to blink glass when we're actually looking at a screen and so those that already have dry eyes that the dry eyes get worse so i drops both artificial tears and some prescription eyedrops and other dry things can help with those symptoms the other thing that's a more new or problem that's still being studied is blue light so we all know that u v light is a problem for the eyes and that's one reason that we need to wear sunglasses but they found that blue light that is emitted off of the lights is very close to the the wavelength of u v light and they think that it's going to cause a lot of problems going forward because we're staring at these computer screens some people might have seen when they got a device that says don't use within an hour of bed time and that has to do with changing people's rhythms throughout the day and one of the reasons is because of this blue light so they've come out with some coatings for the glasses that actually block some of this blue light the studies are still going forward right now so it's unclear how much needs to be blocked is this really going to be a problem so that's kind of up in the air right now but what i hear you saying is that the blues that we are exposing our eyes to when we're looking at screens is similar to that's what i think so that's what they think and they think that that's going to cause a lot of back in generation early cataracts in all of us that are staring at all these now so that's one of the things they're they're studying right now see how problematic that's going to be and you know that we've all changed our lights in our houses and now we're using those every day lights which emit more blue light so this is a very lively discussion happening now in the i care field something twenty feet away for about twenty seconds and that'll give your eyes a break the other thing that helps too is conscious blinking thinking about blinking and you can put a little post a note on your computer screen that says blink every time you look at it if you make a full  closed blink that will help as well ok as we said earlier we probably could spend a whole program about this because this is this is something that just so important not everybody's eyes are equipped to look at mir for so much time remember that i said that we are that's not what our eyes were intended for and so when you come in for your routine i examine what we end up doing is looking to see how your eyes work together because sometimes people's eyes just were not designed st for doing that extended amount in your work even for twenty minutes right right in it is a concern i mean i think people are aware that there is risk involved but so much of you know so much of our lives some of the jobs are on screen based so that's good that it's good to hear some tips for for mitigating the strain and stress dr maybe you mentioned blue light from sunlight so that's a good segue into the other question that we hear a lot is about sunglasses how important are sunglasses should our infant spi wearing sunglasses what are sunglasses protecting us from i mean when i st started wearing them it was just because it was more comfortable to not have the bright light  but it's more than you so tell us about sunglasses so we think sun glasses are very important and look at this this is a sunglass that's for really little children the fact is is that that studies have already shown that we're exposed to more ultraviolet light in the st eighteen years of our life busy than we are in the rest of all the years the follow so you can't start to young having protection sunlight and if we definitely had of course would be helpful yes ultraviolet light really important we we recommend that all children should have their eyes examined starting at six months of age  it's never too early to think about eye health and and what is what does the ultraviolet light do to our eyes if we are exposed to it for long durations if we're not wearing sunglasses they cause cataracts earlier everybody gets cataracts if they live to be old enough to read but more the studies have shown that people that are closer to the equator for example in exposed to more altered by the light they develop cataracts earlier degeneration something that everybody here is very concerned about also is made worse by ultraviolet light and finally even something as simple as a pain killer which doesn't sound very simple but it's like  which is cumulative in other words the sunlight you're exposed to when you're young come backs to haunt you later in life because you have yellow or calluses on your eyes but don't go away ok wow and are there any are are fair people are lighter eyes more vulnerable or should we all brown eyed should we all be wearing sunglasses and everybody should be wearing sunglasses so they're just because you have less pigment doesn't mean that you don't need some glasses but what what a blue eyed person is different is that they have less pigment in their iris which usually corresponds to less pigment in their retina as well blue eyed people can sometimes feel more sensitive to light because when the light comes back because there's less pigment within the retina back here the light ends up bouncing around the eye and causing more of a glare feeling ok so while there is less pigment and sunglasses are important to protect the one everybody is sensitive to light sensitivity as a whole different question too because there are plenty of blue light blue eyed people that feel like they don't need some guy says that they're ok with the bright light and pretty plenty of darker  people that are very sensitive so and if one wanders into target and picks up a pair of sunglasses st six hundred and ninety nine will that help with the ultraviolet exposure or do we need to be getting high quality sunglasses so the most important part about sunglasses is they have to protect against uva and u v b rays so that is what actually is protecting you bought it's also how it fits on you as well because if you fit something that's further away from the eye you still get the sun from around the edges to the right that is helpful information thank you the next question that we hear about and i think it is we all encounter is what happens around middle of nowhere and in order to see the menu or you know where we're pushing something away from us tell us about that phenomenon that seems like it is this lens focuses the light on the on the back of the retina that woman's is about the size of an eminem and just like an m and m it has the candy outside the chocolate inside well our lens has the capsule which stays about one size throughout our life and it where the chocolate is those are selves so think of it like a pillow when you're young it's very soft and very flexible so that we can focus the light very very close and very very far but as we grow those cells grow also and around forty to forty five depending on other things depending on how long your arms are among other things that's why it had feathers ladies earlier the lens becomes less flexible and we're able to make it get into the rann don't curve that it needs to focus very very close and over time that continues until becomes hard like a rock so that is why in your forty's you feel like you must move things farther away or need to get some reading glasses or the prescription of your glasses needs to be changed so that the bottom part makes it so that you can see close and f ok again can we wander into c v s and pick up a pair or should should we get something that's that's more professional more under you know the care of your optometrist or certainly over the counter reading glasses work it's only been about thirty years that they've been on the market here in massachusetts and there was a big concern that because people had emerging presby opiah in their forty's they would go to their eye doctor and have their eyes examined and then they would get reading glasses that was before they were available in the stores and the concern was that after people were able to go to the store and pick up those reading glasses which don't hurt your eyes they would not come for a regular eye exam and then certain diseases like glaucoma cataracts manipulated generation wouldn't be picked up as early as they might be if you had to get your eyes examined because you couldn't breathe ok so it's a good way to to treat the tickler exactly so and not over the counter glasses don't work for every person one of the things that we look for in a regular eye exam is what does each i need the lens each i need to see clear but then how do they work together as a team going back to the original question some people's eyes don't work well as a team for multiple different reasons and so you might put on a pair of over the counter reading glasses maybe each lens is the quote unquote right number but they don't feel right and they cause more eyestrain because of how your eyes are working together there are certain things that we can write in a prescription pair of glasses that can help with that and to make it more comfortable ok that makes a lot of sense and a good segue into the next question dr bennett mentioned cataracts and glaucoma tell us st about cataracts help us understand what is happening and what the treatment is sure so we're going back to that same that same area the lens the same part that is the culprit of why we end up not being able to see a los as that lens let's go back to that pillow idea gets more and more stiff it's actually the cells change color there's lots of different types of cataracts but for for the most part let's just talk about the common type which is that lands end up turning yellow and it turns yellow over very usually very slowly over time and so then decreases and even with the best possible lens it can also change your prescription a little bit but even with the best possible  cataracts develop it will change what you can see and everybody gets cataracts if they live long enough i always tell my patients not only one everybody's going to get them but two is everybody feels differently about them so  i kind of discuss that like white or gray hair some people get one gray hair and they're running to dye it right away and some people have a whole head of gray and it doesn't bother them and the same thing is true with cataracts so some patients come in and they say i can't i can't read the bottom line and the n missing like two letters on that two thousand and twenty line and they're like it's affecting my life i can't see this is causing too much glare there really bothered by it and they're ready to get their cataracts removed at that point and some patients can't even read the chart and they're saying i'm doing fine no problem because when cataracts are removed is very subjective it's when it's ok patient is feels it's affecting their daily life so what exactly i understand that's great metaphor about a strand of gray hair verses salt and pepper head but as we progress what exactly would it be just impaired vision are we seeing is this the i would be seeing floaters i mean what are we this was not this is like looking through a dirty window that gets dirty or dirty or ok that's all that cataracts are other things like floaters that is and that's a different process entirely so this is just vision that some paired cannot clear not as chris as it once was yet people will find that they don't want to drive at night and more that might be a beginning fun and so if you can live with not driving at night anymore you wait so it has to do with busy effecting you exactly how you live your life and cataract surgery is one of the most commonly perform surgeries in the united states and in the hands of a good surgeon you're in the operating room for fifteen minutes or less it's very quick so it's treatable it's treatable the completely treatable and the biggest aggravation i would say for most patients is all the drops they have to take after the cataract surgery just to make sure that the results taken ok so it sounds like it's inevitable but it is treatable correct and that's good and it's one of the less serious things that we see as far as affecting people  i mean people have many other problems with their eyes but cataracts are something we know that we can't cure ok well that's good news how about glaucoma tell us about that and that's a more complicated disease and that is a disease so not where we said everyone gets cataracts not everyone gets the national institute for health says about two percent of the population gets glaucoma but it's a more common i mean that doesn't sound like very much but it's a more common disease than then you think the blind there's various types of blindness is everybody thinks that when they close their eyes and they don't see anything that that's what blindness is but in fact there are a lots of different kinds of pla blindness from glaucoma is more close to that close your eyes and you can't see anything you gradually lose your peripheral vision and you can't see what you can't see so when i close this eye and i wave my hand over here i can see it with this eye and that's the st vision that we lose in glaucoma coma truly is an eye disease that is diagnosed by your eye doctor you don't generally know there are a few exceptions but you don't generally come in  saying i'm seeing something that thinks that makes me think i have glaucoma so it is your you're a regular your due diligence to get your eyes examined it is related to age so there are very few cases  under age forty and they progressed from age forty and onward the older you get the more incidents there is of glaucoma ok so it it sounds like it's something that would be detected by through an eye exam that these signs are not super perceptible that's right if you were noticing a sign of glaucoma it means you're closer to the end stage than the beginning and once you've lost the vision it does not come back ok and it's treatable that's the important thing there are drops we have multiple different types of medications today surgical and drops that can treat and control glaucoma it's a progressive disease but the earlier the did the sooner treatment started the more likely you are to preserve your vision so i always say it's our job to make sure your vision last as long as you do so you just have to tell us how long you're going to be here and then we can figure out what to do got it ok other com issues i had noted detached retina macular degeneration but if there's something that's more common than those we just want to spend a few minutes on other things that people should be aware of ok so let's talk about detach off there's no pain receptors inside the retina so you don't feel this just doesn't hurt but what you might notice would be flashes of light sick fireworks in your vision when the photoreceptors are stimulated from the t floaters black things red things clear things floating by or if it gets down far enough shadows in your vision so this is why if anybody has any other symptoms we look at it like an  normal yeah so there's a jelly within the main cavity of the eye here called the vitreous and it is made up of this clear material and when we're younger think of it almost like a basket we have everything's perfectly aligned and as we get older as our eye grows as a whole bunch of things change it comes out of alignment and those can be the normal floaters that we all say but there's no way to tell if they're normal or abnormal without looking we can even just you know talk to you and decide whether they are based on what you say we have to learn have to do an exam so if people say i'm just calling because i want to get an exit i'm right stop the office will not perceive that as an emergency no one including us can tell you whether it's serious or not until we take a look ok wow so there's a whole host of other things but if you look right here this is the macula that's the best part of your vision and this is where mack of the generation and so the america is very very small region of the i i mean credibly small when you see all the rest of it right when you notice that ninety percent of macular degeneration is dry ten percent is wet so if you were guessing and someone said they had macular degeneration i would guess that there was dry dry macular degeneration affects the vision slowly over time i always say look at your vision as if you were looking at it p v you go into best buy to buy a new television you've got the h d t v that's the most expensive one that's the best picture but over time when you degeneration it's like you losing pixels on the television st you can't really tell but the picture is a little bit grainy and eventually the picture becomes so grainy that you're not sure what the picture is ok wet macular degeneration tends to affect vision more s so that as the liquid fills the macula or swelling people will say oh my goodness something's wrong whereas dr is very very slow over time but this is just a central blindness right what exactly whatever you're looking at it's not like like homa that happens on the periphery slowly toward people can lead a fairly normal life with macular degeneration even though they can be legally blind they can actually see walking around they're not falling down the steps so they can lead a more normal life than for someone who has severe glaucoma really can't walk around because they can't see the floor ok thank you that's  the other question that i wanted to ask was about lasik eye surgery about twenty years ago twenty five years ago it seemed like everybody was jumping to get this done and i will fess up that i considered it but i was concern that there were no long term studies i didn't want to jump into something when they didn't know what would happen two thousand and twenty five years out tell us tell us if it has been a successful endeavor for people and it was for people who are near sighted correct hands of a good surgeon lasik is great however all the normal aging things that we've talked about like needing reading glasses or cataracts those things still happen even if you had lasik surgery so while the  lasik procedure leads you to a stable per script then if something changes on the inside the prescription ok that's that's interesting tell us at work we've got a few minutes left we have about four minutes three or four minutes left tell us about just what we can do to maintain or improve our overall i health i will say that when i was a kid in the seventy's my mom definitely encouraged eating carrots that carrots were rich in vitamin a and that would help keep my eyes healthy is that a myth i mean is there anything we can do exercise water do the foods we eat impact our our i health yes they do ok tell us a little more about pop i knew what he was talking about carrots your mother was was correct in the head at that time they were really pushing carrots and there's nothing wrong with eating carrots but spinach has a lutein in it which is known to so healthy eating is really important and that and the protection like we've talked about wearing your wearing those sunglasses is really important and to get back to eating fish fish oil i always say all of the things that busy are good for your heart are also good for your eyes because as you we showed you there's so many blood there's a very a lot of blood supply to your right and keeping their blood getting there makes all the difference and so keeping your cholesterol down fish oil  multiple ways to good cholesterol and also in in helping in dry ice and there have been studies that show that if you don't drink enough water your eyes are more dry so that i don't think anybody around here doesn't drink water but we have people routinely come in and say they don't they don't drink very much and that certainly can help certainly all those things help with smoking not smoking ok that also is something that helps with i health irritating cause more dryness but that's that now i would think i'm making a deduction here i could be wrong but because of the vascular component part of the eye that exercise would be helpful because as an exercise increase our blood flow would that have a positive impact on my health when you don't usually talk about it the way that it's good for your heart there's nothing wrong with a lot of exercise but there's no direct cause and effect ok all right i just thought i'd ask in our last minute anything else you want to tell our listening audience again we're we've we've had a wonderful show learning so many things but we have about a minute left any final points from from dr bennett or dr made i think that it's important to talk about how often you should have an eye exam i think that that's most people who are show up to the office are like i've never had an eye exam we recommend that children as young as six months between six months and here have their st dykes and no we're not going to give them glasses but it tells us whether there's going to be a problem we know that learning eighty percent or ninety percent of learning is visual so definitely if you miss that six months to a year all children should have an eye exam before they go to school and then depending on what the doctor says those i exam should be on a regular basis we recommend every year whether you think you need it or not ok every you know only way to know there's something wrong is to take go take look and as we pointed out many of the things that affect your eyes are not painful they they don't have any signs so the sooner the regular busy exam start the better great thank you  again i'd like to thank my guests from bennett family i care for joining us today it was a pleasure having you and we leave you with get your eyes exam to get a baseline we found out today all of the