<p class="p1"><span class="s1"><a href="https://peterattiamd.com/stevendell/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220307-pod-stevendell&utm_content=220307-pod-stevendell-podfeed"> View the Show Notes Page for This Episode</a></span></p> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220307-pod-stevendell&utm_content=220307-pod-stevendell-podfeed"> Become a Member to Receive Exclusive Content</a></span></p> <p class="p2"><strong>Episode Description:</strong></p> <p class="p2">Steven Dell is an ophthalmologist, current Medical Director of Dell Laser Consultants, and a leader in refractive eye surgery with over 20 patents to his name. In this episode, Steven explains the anatomy and functional mechanics of the eye and how they relate to common variations in vision. He discusses changes in vision that occur with aging, the fundamentals of different types of vision loss, and provides an in-depth look into the various treatments and procedures available for corrective eye surgery. Additionally, Steven explains how one might protect the eyes and prevent vision loss—a topic particularly important for children in light of the epidemic of myopia. </p> <p class="p2"><strong>We discuss:</strong></p> <ul class="ul1"> <li class="li2">Why Steven chose ophthalmology, and the crossovers to other medical disciplines [3:45];</li> <li class="li2">Anatomy of the eye, common types of vision loss, and age-related vision changes [14:15];</li> <li class="li2">Eye drops that can potentially improve vision [27:30];</li> <li class="li2">The explanation for different eye colors [33:15];</li> <li class="li2">Physiology of the eye and its connections to the brain [34:45];</li> <li class="li2">Understanding human vision through an evolutionary lens [41:00];</li> <li class="li2">Enhancing vision beyond 20/20 [47:00];</li> <li class="li2">Astigmatism: definition, cause, and high prevalence [51:30];</li> <li class="li2">Nearsightedness (myopia): causes, epidemic in children, and prevention strategies [54:15];</li> <li class="li2">Cataracts: impact of aging and how they can be repaired [1:05:00];</li> <li class="li2">Lens implants that can correct and improve vision [1:19:30];</li> <li class="li2">Effects of eye trauma [1:26:45];</li> <li class="li2">Corneal abrasion from 'dry eye': causes, treatment, and prevention strategies [1:29:00];</li> <li class="li2">Sunglasses for eye protection [1:35:00];</li> <li class="li2">Solutions to correct nearsightedness [1:42:00];</li> <li class="li2">Laser eye surgery—photorefractive keratectomy (PRK) [1:45:45];</li> <li class="li2">Laser eye surgery—LASIK [2:02:00];</li> <li class="li2">Laser eye surgery—small incision lenticule extraction (SMILE) [2:11:45];</li> <li class="li2">Glaucoma: definition, causes, symptoms, and care [2:13:45];</li> <li class="li2">Tips for preserving eye health [2:20:00];</li> <li class="li2">Screen time and eye health [2:24:15];</li> <li class="li2">Contact lenses: good hygiene and considerations [2:27:45];</li> <li class="li2">A bonus benefit from repairing cataracts [2:29:00];</li> <li class="li2">Questions about corrective eye surgery [2:31:30];</li> <li class="li2">How an eye exam can be a window into metabolic illness [2:33:45]; and</li> <li class="li2">More.</li> </ul> <p class="p1"><span class="s1"><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220307-pod-stevendell&utm_content=220307-pod-stevendell-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></span></p> <p class="p2">Connect With Peter on <a href="https://twitter.com/PeterAttiaMD"><span class="s3">Twitter</span></a>, <a href="https://www.instagram.com/peterattiamd/"><span class="s3">Instagram</span></a>, <a href="https://www.facebook.com/peterattiamd/"><span class="s3">Facebook</span></a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg"><span class="s3">YouTube</span></a></p>
Actionable Insights
1. Prevent Childhood Nearsightedness
Ensure children spend at least 80 minutes outdoors daily, especially during bright parts of the day, as outdoor light (specifically dopamine release from the retina) inhibits eye growth. Avoid prolonged indoor near-work in dimly lit rooms, which can increase nearsightedness risk 16-fold.
2. Protect Eyes from UV Light
Wear sunglasses consistently when outdoors, even on cloudy days, to protect against UV exposure. This helps reduce the incidence of skin cancer on the lower eyelid, delay cataract onset, and lower the risk of age-related macular degeneration. Focus on UV protection, not just tint, and be aware that car windows do not block all UV light.
Prioritize wearing spectacles (glasses) as the safest option. If using contact lenses, avoid sleeping in them to prevent sight-threatening infections. If extended wear is unavoidable, ensure they are pristine, new pairs and remove them as quickly as possible.
4. Regular Glaucoma Screening
Undergo annual eye exams to screen for glaucoma, especially from age 50 onwards. These screenings check the appearance of the optic nerve and intraocular pressure, which are crucial for early detection and arresting disease progression before significant vision loss occurs.
5. Manage Dry Eye Symptoms
Use artificial tears as needed and consider supplementing with high doses of omega-3 fatty acids (e.g., 3 grams of EPA/DHA) and certain omega-6 fatty acids (e.g., GLA from blackcurrant seed oil) for their anti-inflammatory benefits. Address underlying causes like antihistamine use, hormonal imbalances (lack of testosterone), autoimmune conditions, or thyroid issues.
6. Mitigate Screen Blue Light
While screen blue light isn’t proven to damage eyes or cause macular degeneration, it can disrupt circadian rhythms. Use software like Flux on your devices to automatically reduce blue light emissions as the day progresses, especially in the evening, to support better sleep.
7. Ensure Eye Protection for Kids
Make sure children wear safety goggles when engaging in activities that pose a risk of eye trauma, such as cutting wood or smashing objects. Eye injuries are a leading cause of devastating visual loss in young people.
8. Wear Hats for Eye Protection
Supplement sunglass use with hats, as they provide additional protection by blocking some light that might otherwise bounce off surfaces and enter the eye.
9. Address Adult Nearsightedness Progression
Be aware that prolonged near-work, such as extensive reading for many hours a day (e.g., in graduate school), can contribute to the development or worsening of nearsightedness even in adulthood.
If you have mild age-related macular degeneration, discuss with your doctor whether the AREDS formula (containing vitamins C, E, zinc, copper, lutein, and zeaxanthin) is appropriate, as studies show it can delay or reduce the conversion to severe disease.
If you have diabetes, discuss with your endocrinologist any findings from your ophthalmologist regarding microvascular damage (e.g., fluid exudation, hard exudates, microaneurysms in the retina). These direct observations can indicate that your diabetes is not as well-controlled as blood tests like A1C might suggest, prompting further investigation and treatment.