Ophthalmology (EYES) with Reid Wainess

Imagine the place where you can escape for a day, get immerged in a world of rooms, inspiration and expertise, where you can lay in luxury, accommodation and kids cam fees from ninety five sets. Tickets are free to everyone and include all the attractions you've just imagined a day out at Ikia Ikia the Wonderful.

Every day your flat out and your to do list is grown by the minute, but unfortunately, so is your headache, and now you've gone from flat out to flattened. Luckily, Panodal extra film coated tablets are boosted by caffeine and they get to work in as little as ten minutes for powerful relief. That's more than just paracetamol. That's one for panadal speed based on absorption data contains paracetamol. Always read the label or leaflet.

Oh hey, it's your uncle's corduroy jacket that smells like pipe smoke and breakfast sausage. Ali Ward back with another episode of ologies. Okay, so this one's special because your ears are about to get a real mouthful about your eyes. So it's a very multisensory affair, like, hey, ears, will you pass this highly informative binder paper note to Eyes and Ears is like ooh, hell yeah, but I'm gonna read it first and it better not talk shit on me.

Okay.

Back to optthalmology, which is a word that is like a letter party where someone invited too many h's, Like, oh damn, why can I not spell this word? Just keep adding hus. That's the secret and the etymology. If you guessed Russian, you are not correct because it's Greek. It's just Greek guys. Ophthalmolos means I. Okay, but what

Let's do this. I haven't I listened, Like I said, I listen to podcasts every day. I probably listened to an how I have the podcasts almost every day?

Oh my god, I listening to.

A podcast when you walk out to the door.

Oh my god.

Okay, I just have to get read in here like friend, like ptend like I'm on the radio now.

Yeah, it's great, look at this, we're rolling all right? Yeah? Okay, doctor Reid Wayness, you are an ophthalmologist. Yes, I know you get this question. I feel like everywhere like rental car counters, cocktail parties, whatever. What's the difference between and ophthalmologists and optometrists. I'm sorry, I have to ask you that.

It's the question everybody asks, so it's a good one to start with. So optometrists and optthalmologists do a lot of there's a lot of overlaps, so they do a lot of the same things, which is examinize and treat eye conditions.

Okay.

Optometry school focuses on diagnostic pathways, so learning to diagnose certain eye diseases, learning to do refractions, which you check patients for glasses and get them seeing well, do vision therapy like contact lenses and low vision specialties where they really focus on your vision.

Okay.

Ophthalmology is more of a disease focused specialty. Yeah, and you go through medical school, so you're focusing on the diseases and treating the diseases, whether that's medically or surgically. So it is definitely overlap. But optthalmology is more of the medical side of things, but that's blurred a little bit more in recent years. So optometrists are doing nice pun right intended aphalmology pun.

So refractions is what you call it. When they're just checking to see if you can read the idea.

Yeah, the torturous number one or number two, which is more clear that everybody hates.

I just did that. I just had an eye appointment on.

Tuesday, which I and you didn't see me.

I did not see you, can you? But do you do refractions? To you?

Do I do?

Okay? I didn't know that you only cut eyeballs open.

No, I mean I can. I don't do it as my mainstay of my work, but usually for friends and family and people I know, I do that.

I had no idea, okay, I thought that I thought you were the big guns. Like you go to you and you're like, I think I have cancer in my eye.

Well sure, I mean for that, you'd probably go to an oncologist specialist, which you know, you could see me first, and if I see cancer in your eye, we'd refer you out to one of those, thankfully. But you know that's pretty rare. You don't have cancer.

I didn't realize until I said that that I have been told I do have an eye tumor.

You have a trigium. I know, yeah, I remember.

So a side note, I forgot that i'd made read look at my gross eyeball like seven years ago. Also, a trigium takes its name from the word putter, meaning wing, and it's this webby wing shaped film that grows in your eyeballs if you move somewhere with bleached bright light and you don't wear sunglasses for a few years. The

Well, they don't just go away? Yeah, God, I have So.

I have a benign tumor in my eye.

Right, a tumor. It's more of a degeneration of the membrane covering your eye. Terygium is the medical term for it. But it's just a uv damage to the white part of your eye that causes it to get a little It loses the elastic portion, so it kind of swells up a little bit and grows a little differently than it normally would.

And so can I use I have eye tumors as an excuse to not go to things.

You can do whatever you want, whether you know, if there's an ophthalmologist or an optometrist at the party. They'll know you're full of something, but you know you can pull it off.

I'm full of it. Tumors can't go to your birthday. So how did old doctor Waynis who I'm let's be honest, I'm just gonna keep calling Reid because we're like bros in real life. How did he decide to go to medical school for ophthalmology?

I went to medical school not knowing that I wanted to be an ophthalmologist, but just knowing that I wanted to be a physician.

Really, so what convinced you? At what point during medical school were you cutting into a cadaver and you're like, you know what, eyeballs?

So definitely not when cutting into the cadavers, although that was some fun times as a first year medical student. A few people lost their lunch that first day. I'll never forget that really pretty kine. Oh yeah, actually reserved.

So in his third year of medical school, Read came to a fork in the road, will he take medical path or the surgical path? That was me being like a witchy oracle deciding his future. If you're like medical surgical, Like, what's the difference? Okay? One involves the phrase.

So for me, early on, I knew I wanted to do something on the surgical side. I always loved doing model cars and building stuff, so I knew I wanted to do something like that with my medical.

Training, but with live bodies.

Yeah, but with live people exactly.

There's something to me. I'm like the leap between, Like I like working on like model ships, and like I'll cut into an eyeball. There's a very large, canyon size leap that one makes. How did you do that?

So I don't think it feels that distinct when you're doing it, Like it just feels kind of like a natural progression of life, or like I want to be a physician, and I always liked working with my hands, so it's like a natural next step for me, and for me, all the surgical specialties just were much more fun. I just enjoyed those things more. I enjoyed doing things physically to help people be better. Oh thank god, Yeah.

Thank god there are people like you that exist.

Yeah, thank you.

I'm like, I can't cut a raw chicken, and so thank god that there's someone that's like, yeah, I'll hop in there and do that, who would fix people's eyeballs.

Yeah, that's what I'm here for.

Like no one, so you were, was it kind of the altruism of it, like knowing that they're going to come out of this surgery it provided you're not drunk, that you're they're going to come out of it better sort of.

I mean, I don't think I've ever thought about it from that perspective. It's an interesting way to think about it. I mean, I think I just it felt normal to want to do something to make a difference in people's lives. But I never thought about, like, oh, the reason I'm doing this is altruism. It's more about just seem normal. I want to do something where I can help people, and it just fit. So for me, it was kind

You know what, I just realized, you have glasses.

I do.

How long have you had your glasses?

So I've worn glasses pretty much since high school?

Why is it so common? This is my biggest question. So many people have bad vision. If you put me in the wild or like on Survivor, and you took out my contacts, I would die in the first like twenty four hours, Like I have no chance. I can't see anything without them. So why have we evolved to have such shitty vision?

Sure, so that's a good question. I think a lot of it comes back to what you just said, which is it's evolved. So we didn't necessarily evolve to have that bad of vision. You know, if you go back hundreds of years ago, we probably didn't have people who had minus ten prescriptions and these super strong glasses and contacts. That wasn't as common. We've seen a big boom in myopia, which is nearsightedness of having strong, strong need for glasses.

So wait, what you're saying is wearing glasses really does mean you're a nerd because that means you were staying indoors, like not getting any sunlight, probably reading. Then you're wearing glasses. Thus you're a nerd.

So a chicken or the egg, right, I don't know, but yeah, probably works that way a little bit. If you're spending more time indoors, you know, playing games and doing things up close, you're probably more likely to wear glasses.

You know.

One of the treatments they recommend for kids to reduce myopia is to spend more time outside. Really yeah, absolutely, Oh damn.

That's the one thing I feel like we're getting worse and worse probably.

Probably yeah, And we're just going the exact opposite direction of that.

I guess like your kid reading an iPad outside doesn't cut in, right.

Probably not? Probably not.

So do you think that like dogs and apes and giraffes and stuff have shitty vision and they're just like, man, I would I can't read that sign?

Uh?

Some do? I mean yeah? I mean you've can tell though, if an animal can't function because of their vision, then they're gonna be walking into stuff. So you know, again, evolution, I think hits those kind of animals a lot harder than they do us at this point, since we're pretty domesticated. But you know, a dog that can't see. We all see dogs with cataracts as they get older, and you can see the cloudiness in their eye and they're bumping

Do that dog would rule?

Yeah, I mean Garfield probably would mean glasses eventually, but other than that, most pets are good to go.

Quick aside, I needed to see photos of animals and glasses, so I googled animals and glasses and it did not disappoint. I soon found myself on a website called doggles dot com, which, as you may have guessed, sells goggles for dogs, just dope as hell, prescription lenses, sunglasses for pups. And for a second, I forgot all about the world's troubles. Also, one study found that gorillas, are you ready for this

Okay?

The muscles in our eyes, they make it harder to squish our lenses to change focal length. So it's kind of like your hand getting too tired to work a zoom lens. But I feel like instead of reading glasses for gorillas, they would technically be like lice picking glasses. Okay, how much do you notice eye problems and other people? Like, for example, my eyes are garbage. My eyes are tiny balls of garbage, Like I have turigium, which are I'm sorry, there are tumors in the eye. I'm telling everyone. I

Not that much? Surprisingly, I'm not just talking to people out in the street and really like looking, Oh do they have a red eye? Do they have a contact in their eye? Do they have trigium? Do they have a cataract?

Now with the influx or rather now with a change in policy toward wacky tobacci. Do you notice a lot of stony eyeballs in Los Angeles and California and also Denver?

So?

I think it's hard to tell, because you know, you don't. I think I just assume at this point everyone in Los Angeles is stone. So I can't tell who's just got red eyes from dryness out there and who's actually stone.

Why do people's eyes get bread when they're stone? I can't believe that. I didn't realize that. I meant to ask.

Sure, So we have blood vessels on our eyes, and when they're dilated the blood vessels, they look more red, and when they're shrunken they look less red.

So heads up. It's the THHC levels in the wacky tobacci that lower the blood pressure and then cause blood vessels to just bloom and dilate into something beautifully bloodshot. But that very decrease in the intraocular pressure is what helps the glaucoma patients. So if you're somewhere it's legal and you want the other medicinal benefits of cannabinoids but do not wish to look like mugshot, you can go for lower TAC products instead of just like buying vizine by the leader jug.

You know, if you take vizine, it just a vasoconstrictor. It shrinks the blood vessels on your eye so they don't look as red. That's what vizin is doing to people's eyes are clear eyes. Any of that stuff I.

Hear that stuff is garbage. It's so bad, terrible is it?

So it hides the redness, but it doesn't actually treat the problem, and then what ends up happening is your eye gets addicted to it. So once you stop taking it, the blood vessels aren't trunking down anymore. They kind of dilate up really really big, and then your eyes look super red, and then you put more in because you're stuck using it, and then you're just in a cycle where anytime you don't use it, your eyes get super super red and you feel like you have to use

It.

Don't use it every day because it's you know, your guy's gonna get hooked on it, and you don't use it for dry eyes. Use it for occasional redness relief.

That's totally cool, okay, But in general, treat it like a special occasion type of vasoconstrictor exactly. I hear you can use it on zis though, and it makes them less red.

I haven't heard that. I mean, I will try it. I've got some samples.

I mean, you're also talking to someone who's put hemorrhid cream on their face, So don't listen to anything I say. So let's back up and say, let's just back up and look at how does vision work? Like in a nutshell, because it's kind of crazy that we have these eyeballs in our faces. What are they mostly made of? Are they mostly empty? Okay? So this in a nutshell in one paragraph explains like the miracle a vision and it'll change the way you think about your own eyeballs forever.

Yeah, so the inside of it, it's mostly just an empty gel. It's kind of like a watery, guey fingelly almost okay. But yeah, your eye's like a camera. I mean, we know how cameras work, and well people don't even worcaus are all digital. But we used to know how cameras work with you know, film and all that fun stuff.

Okay, I'm just gonna repeat that just in case you spaced or like someone in the park was walking a cat on a leash and you got distracted, Because this is real life, that shit happens. Okay. So the cornea is the clear dome covering the iris, which is the colored part which lets light into the lens below, and the lens is a biconvex aka that just means eminem shaped jelly blob that works like a camera lens, so light enters, gets bent and then goes through your eyeball.

So you know, you've got a lot of cool stuff going on. But it's basically just a poor man's camera or cameras, a poor man's eyeball, I guess are the way around?

I guess you don't. You don't need much money to have eyeballs. Which is kind of good. Does the light go through the cornea, through the lens, through the jelly, and then hit the retina type of film in the back and now it rods cones. What's happened?

So, rods and cones are the sensors inside the eye. The rods are sensing the amount of light that are hitting the retin or flying into the eye there, and the cones measure the amount of the wavelength of the color essentially coming into the eye. So you know, you think of ROIDGBIV like you know, the rainbow, red, orange, yellow, and whatnot. That each of those colors has a different wavelength, and so the cones in your eye are sensing what wavelength that light ray is coming into your eye at,

Do you ever just space out and think like it's so weird that we can see anything at all, and what if I'm seeing everything in a totally different color? Spectrum than other people, and like what's reality?

I think half the second half, yes, I think that what's reality? Like consciousness throws me for a total loop. But just the fact that we all have consciousness and thoughts and all those things. Yeah, I you know, in my head, I assume we all see things mostly the same. But you know, obviously we all have different color palettes because there's people with color blindness. I don't know if what I see as red as what you see as red. Who knows?

Right now? Are you colorblind? One and twelve?

Dude's right, Yeah, it's a pretty big number. I don't know if it's exactly one and twelve, but it's something like that.

I think it's one in twelve for men and one in two hundred for women.

Yeah, it's pretty common. But again, most people don't know that they have a problem. The just that's how they experience the world.

So real quick. Those rods in the retina are for low light vision, and the cones detect color. So we have three cones. They each pick up different ranges of light and color. Vision deficiency tends to happen when one of those cones isn't working right. So the story goes about a decade or so ago. While making protective eyewear for surgeons who worked with lasers, there was a California scientist named Don McPherson, and he accidentally stumbled upon some greatness.

I feel him, dude. It's weird.

He seems to almost struggle to keep his balance. He's just like washed over in this orange glow of a Virginia sunset, like the first sunset he's ever seen in full color?

Can do? Is it very noticeable difference?

Oh?

I'm shaking.

Ten out of ten would weep to anytime. I honestly just watched no fewer than twenty of these videos. My eyes are so swollen. I just kept watching it, just kept crying. I knew what I was doing. I loved it. You just see all the it's so yeah crying, It's like, oh God, it's wrenching.

Yeah.

So, what kinds of things do you have to treat? Like, what's a typical day for you? How often are you like scrubbed in Gray's Anatomy style and in the O R.

So I'm in surgery one to two days a week, depending on the week. Okay, I was in surgery today, but mostly I'm doing cataract surgery, so, you know, helping people see who can't see anymore because their cataracts have developed from aging. I'd see a lot of cataract patients, glocoma patients, people with dry eyes, macular degeneration, diabetes, all sorts of stuff that you affects their eyes. But I spend three or four days in the office seeing patients and.

How many of your patients are stone cold awake when you're operating on them, and how many are just knocked the fuck out?

So probably fifty to fifty honestly. Yeah. So we give people anesthetic to you know, relax them and ivy you know that fun stuff, and everybody just responds differently to it. And I always tell people like, we're gonna give you just enough sedation that you're comfortable, because you know, the more you give the risk. Here it is, and there's no need to do that with eye surgery because it's pretty quick, Like cataract surgeries take like eight minutes. What, Yeah, it's crazy so fast?

How is that possible? I've waited for smoothies longer than that. How is it? How can you do cataract surgery both eyes or one.

I just want eye. Oh yeah, yeah, per ee. So most people do one at a time. The surgery is eight minutes, but the whole process is like an hour and a half. So, but the surgery is quick. You just go in and you make a little incision that's like two and a half millimeters. You go in and kind of vacuum out the cataract and you put a new lens implant to replace it, and you're done quick.

I don't get that though, because the cataract, So do you take out the lens that's there or do you put another lens on top of the lens?

We take out the lens, so yeah, the cataract is the lens itself getting cloudy. Oh so I always tell people, like, think of your camera. If you get an old camera with a cloudy lens, you need to replace it with a new lens. That's what cataract surgery is. It's just a lens replacement. So we take out the old one and put in a new plastic artificial one that's clear so people can see better. Again.

My dad had that surgery done one at a time, not by me, not by you. I'm so sorry, we had no idea. I should have been like, dad, come down here. But in low light, he has the most like shimmery cartoon unicorn eyes. They just like they're like, why is that?

Yeah? So the lenses plastic, so you're catching a reflection off of it when you see it. So what happens in the low light is as pupil gets big, so it's pupil dilates, so you can see more of the artificial lens, so you get more reflections off of it.

Oh my gosh. So next time you know someone with cataract surgery, just like like take a gander, you'll.

See a twinkle, Like you'll see like it'll be a light off in the distance and you'll catch that twinkle off someone's eye, and yep, you know they have implants from cataract surgery.

Yeah, you're like, what are you Santa Claus? Like, where did that covered? Just like exactly, so different color eyes now the iris is the colored part, correct, Okay, so what's the function of that? And also I heard that everyone who has blue eyes is related to each other somewhere down the line by one person who just had crazy eyes.

Well, technically we're all related. If you go by far enough, so probably true, yes, But the different color eyes. So if you evolutionarily wise, if you grew up somewhere your ancestry that was Nordic and there wasn't as much sun, you're more likely to have light colored eyes because it doesn't matter if too much light's coming in the eyes because there's not a lot of light. If it's just like having darker skin or lighter skin, it's melanin deposits in the eye. It's the same thing as why we

And melanin can be the blue.

So it's not that the melanin is blue, it's the amount of melanin in your eye changes what it looks like. So if you have a really light colored eye, you don't have as much melanin in your eye.

So then why are eyes blue or green? Like? What's causing those colors all again?

It goes back to the wavelengths coming out of your eye. It's like why is the sky blue? It's that same age old question. It's not because the sky is blue. It's because the light that bounces off the sky is coming at the wavelength that is blue.

I'm glad someone explained that to me, because I still sometimes struggle with that concept. So side note. The physics of the blue sky is called Rayleigh scattering, and that has to do with the size of the particulates. But in the eye, in the iris, it's called the Tindal effect. So it's not that like Frank Sinatra or your neighbor's cool husky has blue pigment up in their all peepers, but really a lack of pigment that lets the shorter wavelengths in blues scatter and reflect back. So it's called

Yeah, I mean, thankfully for me, I had to experience that too much because they were around long before my time. But eye lasers in some capacity have been around for decades. People use lasers for laser and treating diabetes in the eyes and all sorts of other things, which is that's been around for you know, many US thirty years. But you know, there's newer technologies and newer types of lasers all the time, and people always trying to figure out new uses for that stuff.

When you did your first surgery and you're like, I'm about to work on a live, a living person's eyeball, were you nervous as hell?

So probably I don't remember it too well. Now it's been a few years. You have somebody sitting with you. It's not like you're just out in the wilderness operating on somebody, and you know, if you're doing something wrong, they're going to say, okay, step aside, let me take over, and they'll get things back on course for you. It's not like all of a sudden you're just out on your own trying to operate on somebody and you just hope for the best.

Sounds that I picture I picture someone. It's just like there's like maybe a nurse and an antesthesiologist in the room, and everyone's like, all right, doctor, go for it, and you're just like shit out of luck. You can't look anything up, like if you screw up or you sweat on someone, like it's your own I just picture you being totally on your own.

No, so thankfully, unless you went to some terrible training program. By the time you graduate and you go out to the real world where you do have to be on your own, you feel pretty confident. But it is still a weird feeling that first time you operate out in

All right, I'm about to spill like a thimbles worth of tea about my personal life here, but so Reed and I are like bro buddies now. But before he met his amazing, smart, super badass hot wife Aaron, years and years ago friends tried to set up me and read I remember because full disclosure, we've been on a couple of dates. True, sorry, And I remember like eight years ago. I remember me being like, how how was your day at work? And you said the words ruptured

So you know, when I was in training, I trained at a county hospital, so you saw a lot of crazy stuff, Like I have some crazy stories. Tell me crazy I will, I'll get to that. But my wife, you know I'm in I'm boring private practice now, so I don't come home with crazy ruptured globe stories too often. But you know I come home my wife's like how

So what's a story? Then you can tell me that I won't throw up in a garbage can right now?

So should I get a garbage can ready? Like? Do I need to be prepared?

I'll throw down my shirt.

It's okay.

So the craziest story I've had is I'll tell the story the way I like to tell it because I think you save what it actually is till the end and it makes the you know, had some drama.

But so I'm on call. I'm at the hospital and I get a call from the emergency room downstairs, and it's getting kind of late in the day. So they call me and they say, we got a guy down in the emergency room. He fell off his bike four days ago and his eyes swollen and red and he can't see very well. He saw an eye doctor in the community and they told him he needed a cat scan, so they send him here and I said, cool, we'll

All right, just please prepare for this. Also, I was editing this while I was making tea, and I didn't know that the kettle was done because in my headphones, my screams sounded the same as the high pitched tea whistle, screaming. Okay.

I pull up the scan and I see a picture of a nail that's probably five inches long, I swear to God, going through his entire eye and up into his brain and with the front of aelbe of the brain. My God, and I was like, uh, I think I need to run downstairs to the emergency room to see what's going on here.

Oh my God.

So patient had no idea it was in there, and I swear to so it was the real He lied and said he fell off his bike when he came to the emergency room, But the real story was he was working construction and the nail gun he was using backfired. And it hit him in the face so hard that he passed out, So he didn't know what happened, and the nail went I wish the listeners could see your

My fucking gun.

Yeah, So obviously we took him to surgery, took the nail out. He kept his eyeball amazingly, but he's not seeing very much out of that eyecause he had a retten on the attachment and all sorts of other problems. But he stayed at home for four days with that thing in his eye before he came to the hospital.

I'm on the verge of throwing up, but I'm not going to. I'm swallowing a very a lot. Oh my god. Okay, two questions. Sure, did it touch his brain? Did he get to keep the nail? So?

Yes? And no, it did touch his brain, but he didn't get to keep it.

Why didn't he get to keep the nail.

That's a good question. I think that's a question for the neurosurgeon who took it out.

Oh, he should have given him the thing.

I don't remember him getting to keep the nail.

Did he Did it hurt his brain?

No? I mean the front of lobe is kind of a you know, it's hard to quantify, but that hurts the brain or not? You know, if you remember back to the story of Phineas Gage, he had like the nail.

Yes, see the eighteen forty eight accident in Vermont, when a twenty five year old railroad foreman had a three foot metal spike blast through and out of his skull and lived for twelve years after, albeit a little less inhibited. Side note Google image search Phineas Gage, and you will pull up like a dagera type with sultry lighting of a bizarrely honky dude. And he's just holding this railroad spike like a staff. After the fact, he traveled with it.

In the trained spike or whatever. It was, a railroad spike went through his frontal lobe, and it just changed his personality, like you can live a normal life, but it just like disinhibited him. But this was just barely in his brain. I don't think he probably did much.

Oh my god. What if he's just like so good at dancing and Carrie.

Could be yeah, and it's all thanks to that nail gun.

He's just like, yeah, found out I'm an opera.

Say there, he could be painting Picasso's like he could be the best artist in the world.

Now, oh my god, was he Were you there to deliver the news?

Oh yeah, I was there. We were more at this point, just so because he didn't tell us what actually happened that I was. We were like, come on, tell us, what really happened. We know you didn't fall off your bike. There's a nail in your eyeball.

Oh my god. When you told him, was he in shock? Did he laugh? Did he cry?

He was amazed? He was amazed, O my god. Oh, but obviously not surprised because he knew what actually happened.

He's like, yeah, I didn't the face of the nail gun. Oh my god, full face moments from now on with nail guns definitely Okay. So picture an otherwise normal looking X ray film with just a giant nail floating in the middle of the brain. Just astonishing survival. And I googled to see if maybe this particular story like made the news, and you guys, I didn't find it, but I found several other stories of men who had nail gun accidents and didn't know until the X rays came back.

Took two pencils and you can imagine the rest. The pencils did not touch your eyes.

Amazing, right, the good news in this story everyone lived bad news. Not with great vision. Have you ever had any close calls with your own bowles?

Uh?

No, I have not, think.

Okay, yeah, have you ever worn mascara?

I haven't.

Or do you ever see eye makeup or beauty treatments and you're like, that is not good for your eye? Don't do it? Oh?

All the time, really all the time. So there's people, you know, we see a lot of patients for dry eyes. People come in with their eyes are irritated, they burn, they scratch, they are tired, all that kind of normal stuff that we all complain about. Their eyes are teary. And then people come in the office to get examined and I look at their eyes and their tear film has just little black specks of mascara floating all in it because they put so much mascara on that is

Oh no, that makes me want to cry because I think mascara is made of like wood pulp. Alarily, Yeah, like part of what we adhere to our eyelashes to lengthen them is like wood pulp. True story, I mean sort of. So mascara can contain rayon fibers which are processed cellulose derived from wood pulp on your eyeballs? Are we bat shit? I mean, baby? But is mascara is mescara? Well? According to the twenty ten episode of the Kid Rock Look and Rat Trapper show Billy the Exterminator.

Guano's beneficial demand, the number one thing we use backguano for is mass scarra. Yes, ladies, when you use your mass scarra, you're painting back guano on your eyes. It's okay, they killed the diseases. It goes through a process, but that's all it is.

Back Crab checked into this, and mascara does not contain guano, but rather it has this shimmery substance guanine, which, don't worry, this is simply derived from putting dead fish scales in an industrial blender like a fishy milkshake. Who's hungry? Speaking of is sugar rush. How does diabetes affect eyes.

So that's a really important question because diabetes is like one of the leading causes of blindness in the world. Really yeah, absolutely, So what ends up happening in the eye is the retina, which is, you know, where the rods and cones are, like the film in the camera. There's a lot of blood vessels through there, and so the blood's not working properly. The tissues get what we call a schemic when there's not enough blood tissue perfusion.

Blood tissue perfusion just means that blood is getting where it needs to go, like no traffic on the floural five, all is right with the world.

The retina gets damaged from lack of perfusion, of lack of proper blood flow. And then the response is it signal to say, I need more blood vessels. So this isn't working for me. I need better blood. So all that vegaff or vascular endotheld growth factor floods into the eye and it kind of floats in the eye, and the eye starts making all these new little wispy, crappy

So if left unchecked, these issues can lead to blindness. So go to the doctor if you can. Now. One thing they can do to help is use anti cancer drugs for it. Like, really, what in the sam hell how does that work?

We actually inject it into the eye and it turns down that signal, so the blood vessels start to shrink down. So those new little, whispy, crummy blood vessels shrink, disappear, and you can reverse some of that. Some of the damage is permanent, but you can reverse some of it.

Oh, I didn't realize that diabetes and eyesight were so linked. Oh yeah, I had no idea. So I'm sure you're seeing more and more in that.

We see tons of it. Yeah. So you know, one of the really important things if you have family or friends or yourself are diabetic. Yearly eye exams are so crucial because if you catch it early, we can treat it with lasers or injections, different things that stop it from happening. So you know, we can really save people from going blind when we treat it early.

Speaking again of eye lasers, okay, let's talk lasik. Sure, so many people have gotten it. I'm going to let you know so many people I know who have gotten it and had crappy experiences, and I'm scared.

Of it bad.

And I'm sure there are so many people I know that have gotten it and just said nothing. And it's only the vocal people who are like putting on Facebook that their eyes are bleeding or whatever. But what happens with lasik? How safe is it?

So let's start with the number one thing is it's very safe.

Okay.

So you know, like anything, you hear the bad stories. You don't hear the good stories. So everybody who has a bad result is good to talk about it, right. The ninety nine percent of people who have a perfect result just going with their lives and are happy. Right, So you know, the loud people are the people who are unhappy and of anything medical procedures included.

How can you haven't gotten it?

So I don't mind wearing glasses. I have a small prescription, Okay, So I'm happy wearing glasses. I think I look dapper with glasses. I'm happy with them.

It's a good look. And also it's on brand for you exactly there you go exactly, so you might say that for doctor Waynus, the glass is half full.

So lasic is basically reshaping the eye to build your prescription into your eye. Okay, So your glasses work by bending light. So the way your eye works right now is we've talked about this earlier. The cornea and the lens bend the light coming into your eye, and it focuses on the retina. So if you don't need glasses at all, it means that's focusing in the right place. It's focusing right on your Oh okay, if you're near sighted, it means your eyeball is too long, so that focus

No way, So I got long eyeballs.

You've got long eyeballs.

No way. I never realized that's my vision. How did I not ask that earlier?

So that's the more near sighteds you are, probably the more elongated or the longer your eye is. Oh my god, the average eye is like twenty three twenty four milimeters long. I did I have a patient schedule for surgery that has an actual length or a length of their eyeball of thirty one milimeters, so they're really really near sighted.

Wow.

Yeah, so you know, the longer your eye is, the higher your prescription. So anyways, so the way your glasses work or contacts is they bend the light into a different way. So the light coming into your eye is bent, it's hitting a focal point in the wrong spot. So the lenses that you put in front of your eye just change the way that light is bending so that it focuses in the correct place.

Wow.

So lasik is doing the same thing. We're reshaping the cornea to chain the way the light comes into your eyes so it bends and focuses in the right place.

But you're not changing the length of the eyeball, correct, Okay, you can't change that. So with laser they flatten or they steep in the angle of that cornea, that dome that covers your iris, and that changes the way that the light bends before it hits your little jelly lens inside. And so why does it not work for some people? Or can your body grow it back to whatever bad shape it was to begin with?

No, So your eye is not going to change. Your eye does change. So you know, if you laser your cornea to a different shape, it's not going to regress back to the old shape it was in because they actually remove layers of the cornea and they're gone. So that's what the laser does. The lasers ablating are destroying layers of your cornea to flatten it out. Okay, so it's pretty crazy stuff when you actually think about what's

Out and it doesn't hurt.

It doesn't hurt. No, you numb the eye. You put a lit eye drop on there and it numbs it so it'll burn for like five seconds. When you put the numbing drop on, it doesn't hurt at all.

And then when our eyes get worse and worse every year, is it because our eyeballs getting longer or what's happening?

Most of it is the change in the lens inside of your eye, the corny inside the eye.

All right, let's talk about eyes and phones. Okay, I feel like I worry that my phone is making micross eyed or giving me like one wonky eye. Do I have a wonky eye.

You don't have wonky eye?

Are you lying to me?

I'm not lying, okay, And if I was, I wouldn't know which I to look at.

Oh No, I feel like in pictures sometimes I'll look and I'll be like, where are my eyes looking right now?

Yeah? You might have just not been looking at the camera. Okay, that's possible.

Ps. So we took a quick selfie on his porch for Instagram after we recorded, and sure enough, I was just looking at the screen on my phone instead of the actual camera lens, and my eyes looked weird. And he was like, my god, what a dipshit. But our phone's doing terrible things to our eyes.

So yes, and no, I mean they're not doing anything that bad. Our eyes more dry because when ends up happening anytime you stare at something really intently, like your phone, a computer, even a newspaper, you don't blink as much, and so your eyes get drier and drier, and the tears have different layers in them. We have oil that comes from our eyelids, and we know that doing a lot of close up work and using screens makes that oil production not work. Oh Properlately it don't work properly.

How can you tell are their little bumps?

There are those little glands. So if you google my bomian gland, sure you'll see tons of Google images of people's my booming glands, and you'll see those little white dots right at the base of every eyelash pretty much, uh huh. And in somebody with blockages of those, they kind of look big and bulgy. So it's like a pimple. I mean, it looks like, you know, tiny little pimple. It's like a little ball of white goop that's kind of stuck there where the oil is not flowing out properly.

Okay, So I didn't look this up, and oh god, So if you've completely desensitized yourself to doctor pimple popper and are looking for like a stronger barfier fix. Feel free to saunter into the dark underworld. That is a YouTube search for my bomium gland expression, wherein a doctor just gently wedges a metal paddle into your eye and then presses your lid into it, erupting what appears to be butter in a linear fashion like the Bellagio fountain in Vegas, only tiny, oily and out of your eyeballs.

So that's what you're doing your eye when you're staying at your phone and you're making it dry. You're disrupting the oil mechanism of the eye. You're not like causing yourself to go blind. You're not going to cause any permanent problems. But you are just irritating your eye.

Oh god, I had no idea. But it's but it's not going to be something permanent.

No, I mean some of it. You know it's permanent, and that you're not going to give up your phone. So and I don't think we're gonna have a purge and I'll get rid of technology, and I don't know, maybe we will.

I feel like the apocalypse is an I and possible. I mean that in a good way. Just start over. So side note read it also told me that the puff test at the doctor is measuring your intraocular pressure. Like if the air flattens, it not enough pressure, but if it barely budgees you might have a bulge issue, like possibly from glaucoma. So contrary to common beliefs, it's not merely a tool to scare this shit out of

Their tears are different. So I don't know about the emotional component of the tears, but there are definitely different proteins in your tears for different things. So we all have tears that are on our eyes one hundred percent of the time, and when we cry, we make a totally different type of tear. So if you've looked at it under micro's hope, they would look totally different. Really yeah, I think it holds true for different emotional states as well.

So side note. A few years back, photographer Rose Lynn Fisher released a series of dozens of microscopic images of dried tears and tears. Apparently there are three types. There are basal tears, those are the everyday ones that our eyes used just to stain moists. There are psychic tears caused by grief or laughing or frustration. And then there are reflex tiers, which could be caused by like onion,

But people always get really confused because they come to the doctor and they say, my eyes are watering, and I'm like, you have dry eyes and they're like, no, I don't have wet eyes. And it's like, well, no, your eye is crying because the tears that are supposed to be just sitting on the eye all the time, which are different type of tears, aren't there.

That's so that's so funny because if I were at your page, I'd be like, I don't look at how wet my whole face is wet.

Oh, so you're tearing to fix the fact that your eyes are dry with a different type of tear. That's not doing what you really need.

Oh my god. Okay, okay, so quick aside, Reeds started telling me another story about his days in the trenches as an emergency eye doctor and a sixteen year old patient he saw and I'm gonna redact most of it and I'm just gonna let you visualize the rest.

But firework wasn't working. Homemade firework. Of course, it's always a homemade firework. Yep.

Okay, that's all you need. Let's just say he has one glass eye now, or does he there.

He was like an inspirational kid, you know, just like got him an artificial you know, fake eye and he was happy and look good and how do you live a normal life?

How do those glass eyes work?

And so they're not glass sized? Okay, so glass eyes is like maybe one hundred years ago he wile these glass eyes or I don't know when, but nobody uses glass eyes now. So basically you take out the eye and you put a ball in there. It can be like a silicone implant ball or like a little porous implant, and basically you cover it with the membranes that normally cover the eye. So you actually remove the eyeball itself,

What's that job like?

Is it like.

It's an ocularist.

Reed told me that this job is called an ocularist and case you needs someone, doctor Stephen hadad in La one of the best in the world. And wouldn't you know it, it was Friday night and I just found myself like seventeen photos deep on this ocularist's website. They have a patient gallery, and I'm just I am genuinely thrilled to report that it is extremely unsatisfying. Just a bunch of photos of totally garden variety, nice looking people,

There's just amazing artistic people that do phenomenal work.

So under over the implant is actual your tissue.

Yeah, so if you think about most people don't really understand the anatomy of the eye. But the eye, the weight of your eye is the sclera. But then there's the conjunctiva, which is the membrane that covers it. So you've actually got different layers there. So you can remove

And then how often do you have to put in that kind of covering?

So most people wear it all the time. You can, depending I think on the person's comfort level. It's like a giant, huge contact lens. But they give you like a little plunger so you can pull it out like a contact lens and everything.

And then so some fun celeb trivia, So Sammy Davis Junior and Peter Falk, who played the detective Colombo, both had eye implants. And even cooler than that is that you've probably met a ton of people in real life who have them, but ocularis are such skilled wizards you just never know. It's like no biggie, Okay, onto one more thing that you don't know. Okay, are you ready for rapid fire around?

Let's do it.

Okay, now you've looked at these questions.

I cheated.

Yeah, I saw you became a patron, and I was like, number one, it's fine if you want to become a patron to look at your questions, but you don't have to give me five bucks a month. You could go it for a.

Dollar a month, Okay, I support you.

I was like, you could have gotten in for a lot less.

You asked me to do this podcast, and I started listening, and now I enjoy the ologies, So I'm a patron now.

Okay, all right, but I was like, you didn't have to come in falling so hard.

Oh no, I can handle five dollars.

Okay, Well, if you need to drop it down to one for reason you don't like.

It, yeah, we need to start a college fund or something for the baby.

Drop it down to one.

We'll drop it to one.

Colleen Thompson. I love also that if anyone hears any munching or bowl scraping, that's your well, your pop who has cataracts definitely does.

He's sixteen years old. He's an old little guy.

Do you ever want to do cataracts org you're on your dog?

I don't. I don't know much about operating on dogs. And also people are much easier to anesthetize and keep still than a dog. I can't even brush my dog's teeth because he uses spath, so the thought of the thought of operating on his eyeball does not excite me.

I just love that he's like, he's a good, a living demonstration of what cataracts are. Okay, so rapid fire questions, here we go. We're gonna try and get through as many as we can.

We'll see do it.

But before we take questions from you, our beloved listeners, we're going to take a quick break for sponsors of the show. Sponsors. Why sponsors, You know what they do? They help us give money to different charities every week. So if you want to know where Ologies gives our money, you can go to Aliward dot com and look for the tab Ologies gives back. There's like one hundred and fifty different charities that we've given to already, with more

Imagine the place where you can escape for a day, gets immersed in a world of rooms, creation and expertise, where you can lay in luxury, accommodation and kids cam Fees from ninety five sets. Tickets are free to everyone and include all the attractions you've just imagined. A day out at the Kia Pikia the wonderful.

Every day you're.

On the bus an hour from home and bumper to bumper traffic creeping forward a few inches at a time, someone's kids are screaming, and suddenly your back is too. Luckily, Panadal extra film coated tablets are boosted by caffeine and they get to work in as little as ten minutes for powerful relief. That's more than just paracetamol. That's one for Panadal speed based on absorption data. Contains paracetamol. Always read the label or leaflet.

Okay, your questions. Colleen Thompson asks, can you really get a weed card for glaucoma? Asking for a friend?

It me, Well, thankfully, you can pretty much get a weak card for anything, So you just have to tell them I have anxiety and they'll give you a weak card. So marijuana, it's actually a common question about marijuana and glaucoma. So marijuana does help glaucoma. Glaucoma is a disease where the nerve in your eye gets damage, and the way we treat that is by lowering the eye pressure. And

Got it, but also it gives you feathery, feathery eyelashes, right, the glacoma medical.

Drops you, Yeah, yeah, absolutely do. That's what latis is too, So it's it's the same thing. So if you ever go and buy Latise, you're just buying a glaucoma medication. So the reason they came up with lateise is the glaucoma patients, we're getting thick eyelashes. So people were taking these medications, they noticed their eyelashes were growing and getting thick, and so they were.

Like, well, hot, nagty dog, we can make some real cheddar off this, That's what I'm guessing they said. Also, April far asked, how does latisse work. I thought you just painted it on your eyelid skin to make the hair grow thicker. But a listed side effect is possible darkening of your eye color. Should people be fooling around with this for the sake of spidery lashes?

It can be true. Yeah, So the medication it doesn't done most people, but it can. So the lighter your eye is to be in with, the more likely it is to happen. So the medication has been shown in people with glacoma, same things, So it's a risk if you're taking it as latis because it's the same medication that it does get into the eye. That's how it treats your eye disease. And it can change the melanin in your eyeball, in your iris, and it can darken

I mean, I've looked into it. It's so expensive. It's like one hundred dollars a month.

And then that's why it's nice. I get samples of the glacoma medication, so if my wife wants it, I can just bring her home some samples. Literally. We have lots of people who do that, Like you'll have technicians who in our office who take a bottle home and just put it on a mass kara dropper and then rub it on their eyelashes. Yeah, a lot of the reps do it. All the reps for the glacoma medications do that really absolutely.

And I hear that it's way more expensive when it's latis versus when it's at glaucoma medication.

Well of course it is. But yeah, they obviously when they're selling anything for cosmetic purposes, they're going to jack up the price.

On the topic of this, Susan Kiro wants to know, how about are lash extensions for your eyes professionally done?

So probably fine most of the time. Again, what anything can do that's a foreign body or foreign substance or out the eye is it can cause irritation. So it's not going to cause you to go blind, but you can have an allergic reaction. I've had people come in with laxis lash extensions, with super swollen eyelids and itchy Bernie. Kind of just a leisure reaction. If you've had the multiple times and you've never had a problem, it's not gonna cause any problems.

Okay, it's so weird to be like, oh, we're just gonna glue some human hair on our eyeballs.

Ye.

Most people will do fine, so I wouldn't worry too much about it.

Jessica bomb Gardener and someone named Liz both said, my eyes are green, but sometimes I think they change to blue or gray depending on what I'm wearing. Is that bogus or is it color really bringing out my eyes?

As far as bringing out the eye color, your eye is not changing. So your eyes is the same. So if you wear a different colored shirt, it's gonna bring it out because of the contrast between the different colors, or it might be reflecting off something so you catch it in a different light. Things like that, Your eyes can look different and it comes it's not you sense the color based on the light bouncing back to you,

So it's like when I turn the lights off in this room, this table gets darker. Yes, is the table getting darker? No? It's no, Okay, got it. One day we're going to have chromatophores like octopuses and we'll just we're going to be able to change them at will. It'd be pretty cool one day. I'm sure that lilachice people are going to get on that. Anna Thompson wants to note. Do contacts make your eyesight worse over time?

School, people do what's called ortho caratology, where they wear hard contact lenses overnight while they sleep, and it actually flattens your cornea out so when you wake up, you don't need glasses the next day. What Yeah, I swear to God. So it's actually a big thing in the Asian population, especially like in Los Angeles, and we have some offices out in like Roland Heights in St. Gabriel, which are big Chinese and Korean populations, and it's really

Well, it's like a retainer for your eyebones.

I know, yeah, I like that analogy.

It's like a waist trainer. It's like a Kardashian corset. PS. Before you go google these old school corsets that are racking up all kinds of new money, please note that a year or two ago, the ones that Kimmi Kay and the crew endorsed got sued for false claims and for misleading consumers, and they lost the lawsuit. So don't squeeze your organs into an elastic vice because you'll find the way you are. And social media is a lie. Okay, bye,

Sure, so your eyes are white on the sclare, but then, as we talked about, there's atle membranes that cover it, like the kanjin taiva. There's blood vessels that flow through all that. The blood vessels are red. So when the eyes are red, it's those blood vessels getting dilated. And that could be because they're irritated. It can be because you ingested a drug that makes your blood vessels dilate, you know, whatever it may be. If your blood vessels

I can't believe that the yellowness is like fatty deposits. That's gross.

It's not that gross.

It's a little gross. I mean thinking of like just having like chicken fat under there.

Well it's not chicken fat, it's.

Like eye small Yeah, I mean a little bit, a little bit, who knews. Okay, So hydrate, yeah.

Highrate is good. But again, it's not just about Diet plays a big role too, So it's not just about how much water you drink. It's about like what vitamins you're eating. So the American eyes westernized diet is very low in Omega three fatty acids, for example, and we know that having a high dosage of those things can help dry eyes.

Oh, the next question on my list from Julie is what habits or foods can the average human do to extend their eye health.

Thank you Julie for that wonderful segue. But you know, eating healthy, obviously is important for the health of everything in our body. But the eyes work just like everything else does. So you know, vitamin A, for example, is good for the health of the retina. And that's why they say eat your carrots because carrots have vitamin A. Eating things that have green, leafy vegetables which are have high antioxidant levels in them are very important for the

Macular degeneration by the byet tends to affect more folks over sixty and it's when the central portion of the retina. Remember the film in the camera at the back of the eye deteriorates. It kind of looks like the center of your vision blurs. And I started looking up images of simulations, and then I started thinking of grandmas and grandpas not being able to see their own perth daycakes

We know that anti accidents are really important, So whenever somebody comes in and is diagnosed with macaula degeneration, we put them on an anti accident supplement.

Ooh, like, eat more blueberries for God's sake.

Oh, we give them a pill. But that's important too, Okay, So yeah, eat blueberries, eat raspberries, eat green leafy vegetables. All that stuff is really important for the aging health of your eye. Studies have come out that have showed that you're more likely to get a cataract if you have a diet that's low envitamin C. Really all the stuff. Just eat healthy. That's really what it comes down to. There's no magic bullet. Just eat healthy and your eyes

You know, I did have I had a makeup artist I worked with who had really lovely skin, and she was telling me that she she just takes a lot of vitamin C and it helped her skin a lot. And I was like, I never thought about vitamin C being helpful for anything other than colds. Oh yeah, you know what I mean.

Well, I mean think about it. You didn't have vitamin C, people will get scurvy. That's like where scurvy came from. It's so important for the health of your body.

I only think about it when it comes to being like, oh, I got a cold. I'm sorry vitamin C for just booty calling you when I'm sick. Here is Carl asks semi serious question. When will I doctors get equipment that can automatically detect what your vision is so you don't have to go through those nerve wracking questions about which is better.

So number one, good news, Carl, we already have it.

What Yeah, I had to go through this two days ago.

Well, here's the problem. It's not as accurate. So we use that as a starting point and then we fine tune it. Okay, so go on a machine that will spit out your what it thinks is your exact prescription for your glasses. It's going to be pretty close to perfect.

Whoa.

So sometimes you'll do that and you put that in the little machine which call four opter where we do the one and two and you don't have to make any changes and it's right on the money. Wow. But sometimes you do yes.

Okay, So Brianna Fauss wants to know what is happening when you're saying better one, better two? And also for me, and I thought I was the only person bout this way, but every single time, I'm like, what if I'm saying the wrong thing?

And I can tell Yeah, so one or two. What we're doing is we're comparing two lenses, so we're flipping little dials inside that machine. So basically we're just playing hot and cold. That's what we're doing. Yeah, we're going higher and lower with the numbers till we kind of get to where we know you are. And if you think you're wrong, we double check. Oh, you don't have to worry. So yeah, so you're not gonna I mean, if you're like really really bad at it, you could

Oh my god.

Yeah, So if you know, sometimes we'll see what's called going around in circles on the dial, So we'll be spinning the dial and you'll go right past where you started and you'll just keep going, and we know, Okay, this person needs a little more help to figure out where their trupbscription is because they're struggling to tell the difference between these numbers.

So essentially, if you're like a train wreck about it, they'll discreetly keep asking without you knowing.

So you know, we do things to figure all that out so you don't need to stress about it because we know that it's not as easy as as it should be.

Do you ever see a certain temperament that's worse at making that call?

No, not the temperament. I think the older you are, the harder it is. Sometimes.

Oh, it's so scary. Every time I'm like, what if I just was spacing and gave them the wrong answer.

It's the worst case scenario. Your glasses an't right, And there we make them like Okay, I know, I know, it's not the end of the world.

And then sometimes I'm like, am I there's this little part of me. That's like it did I say it wrong? And I'm going to offend them and they're gonna know.

What's worse is when I go one or two and the patient goes yes, which happens all the time, all the time, all the time.

No, you're like, it is a binary question, but it's not a true of all. Yeah, Zach Marta Lucci asks, is it true that your eyeballs are the same size throughout your whole life?

It is not?

Oh my god.

Okay, so your eyes do grow over the first few years of your life. They're pretty much fully grown at some point in your childhood. Okay, but yeah, they definitely grow after your born.

But apparently we are more likely to take care of a baby if it looks like it has big eyes because it's cutter.

That's probable.

I believe that, you know, why are babies with glasses the best?

I think anytime you see something that's out of the norm of like what you're expecting, it's just adorable, Like a dog with glasses would be adorable.

I mean, once again, doggles dot com killing game. Aki wants to know why is looking at the sun a bad idea? Is it worse to look at the sun during a solar eclipse? Are we just looking at the sun more during a solar eclipse?

So it's easier to look at a sun during a solar eclipse because it's not as strong feeling, but the light rays hits you just as hard. So that's the problem with the solar eclipse. Normally, if you try to look at the Sun, it's going to really hurt and you're gonna turn away. So it's really really bad for the eyes. Like looking at the Sun for a few seconds can blind you. Oh and it literally just torches

Oh god, even the president saw it. But in a move that is not a complete surprise. He looked directly at the sun without any glasses. Perhaps the most impressive thing any president's ever done.

So that was a real clip from Shoot what network was it? Where are my notes?

Oh?

Yeah, it was Fox News. Right, he's that strong, strong.

It's impressive. Impressive.

Sterristrated into the sun when told not.

To true, that's true, he showed us. Oh god.

Hillary Maser wants to know why do some newborn's eyes change color in the first few months. Is it always blue to brown or can other things happen?

So it's usually blue to something darker, Okay, But essentially it comes back to the mount of melanin in the in iris. So they just still growing melanin and producing melanin when they're a baby. My son came out with blue eyes and they're they're kind of like a brown and hazel, but still little blue. They've definitely changed eight months old and they've changed oh, crazy.

So they're just you're just read you're populating it with melanin.

As you grow exactly.

Oh, I didn't know that, Ariel Bell wants to know. I always get these painful styes in my eyes. What's about, she.

Asks, Sure, So that's a good question, very common. So we have these little glands in our eyelids called the Mybomian glands, which we talked about earlier a little bit when we talked about dry eyes. But basically oil comes out of those glands and sits on top of your tiers. So your tears have layers, and the oil is the outer layer that kind of protects them from the world, so your tears don't evaporate. So you know, we all

Oh, that'll help it. Cut it a little hole. Correct, Why do they get plugged in the first place.

So again, we think it comes back a lot to some dietary issues as well. But some people are just it just the enzymes that live kind of on your eyelid aren't doing what they're supposed to do. All the proteins on the eyelid aren't doing what they're supposed to. And again we know that it's staring at a screen

Do you ever see mites on people's eyelashes or are they so you see them?

Well, you don't see like the literal bug crawling around okay, but you know what they look like. They look like little giant clumps of dandruff, like in a little cylinder on the base of the eyelash. Really yeah, if you took them and put them under a microscope, you see the little bugs. But we know what it is when we see it, and it's pretty common. It's very common.

I love that we're never alone. Like you have mites just hanging tough out.

Your entire gut is just filled with bacteria that are with you all the time.

I know you're never alone. We've gotten a lot of these, which is awesome. Hillary Blake wants to know. Was there anything in your tree training that stood out for you, like gave you that Yep, this is what I'm here for a moment.

Definitely. I think the best thing about ophthalmology is when you take someone who can't see and you make them see again. The happy feely story here. So I was a second or third year in my training as a resident, and I did cataract surgery on this woman and we have her in the office the day after her surgery to take her patch off. So we sent her home with a patch over her eye, and she had really

Oh my god, yeah right.

And like seriously, I was like, this is the best. This is why I'm doing this, Like nothing felt better than that. And I still have those experiences today. I have people that just like come in so happy because they can see again. And that's the best part about being an eye doctor is you can literally, with a ten minute surgery, take someone from blind to having normal vision.

Oh my god, that's just like I can just already picture the montage of moments that you could put together to just make people ball their faces.

Oh.

Definitely one more question, because I know I'm peppering you with a million, but this is a question that we got from Collette Ayers, Melissa Cowan, Dan Engler, Bob Carlson, Tom Tarmo, twicken On, Kira Lichfield. So many people are like, what are floaters? Why do we get them, should we be concerned about them? Give us the scoop on floaters.

So sometimes you should be concerned about them, but most of the time, no, thankfully. So a floater is just a little piece of the gel inside of your eye causing a shadow. So our eyeball is big, and it has to be filled with something to stay you know, big, but otherwise it would just deflate if it didn't have anything inside of it. Weird, So yeah, like if an I has really really low pressure, it can actually kind

So it's pretty normal unless it's not. So if you start to see like Rando disco lights and you are not in a disco called the doctor.

And so if you see like flashbulbs go off in the corner of your eye and as a giant new sea of floaters, you need to get checked because you may have a tear in your retina which could lead to a full detachment.

Mary m and also Anna M McDavid asked, what's the deal with detached retinas? Why do they happen? Can they be prevented?

Sure? So, a detached retina is think of the retina like wallpaper and wallpaper. If you get water behind it, it's going to detach, right, It's gonna kind of pull off the wall. So inside the eye, the retina's attached to the wall of the eye and it's held in place by that gel, the vitreous gel, And as the vitreous pulls on it, it can cause a tear. And if that tear forms, fluid gets behind it, and just like your wallpaper, with water going behind the wallpaper can

Whoa, God, that's crazy. You can just shoot a laser and be like, all right, I glued it back.

Yep, you're literally just tacking down the retina with lasers.

Yeah, like lasers in your eyeballs. Is like, it's it's crazy that this is the world that we live in.

That's pretty cool.

So I mean, what now, okay, what about your jobs sucks? Like, what is the worst thing about your job?

The overhead dealing with doom, with insurance companies, pharmacies, all of those things that are just not why anybody went into medicine. So it's just such a pain no matter what your political beliefs are affiliations. Even if you think we have the best system in the world, the worst system in the world, it sucks.

So we talked about how shitty the business side of medicine and insurance was for like seventeen more minutes. But you know, episodes can only be so long, and I don't want to make any of you shed any psychic tears. Okay, what is the best thing about being ophthalmologist?

The best thing is just helping people see you again. Honestly, it's amazing when somebody comes into your office and they come back to see you and they're better. I mean, it's like any feel of medicine. When you can make someone better in a tangible way, it's awesome. But the instant gratification of having people come to me every day happy because I made an immediate impact in their lives is awesome.

Well, thank you for fixing so man new people's.

VISI oh, I love to do it. You need to thank me. I thank them.

I hope I am never under your knife, but if I have to be under a knife in my eyeballs, I will let you know.

If you want those trigiums. Remove. You know where to find me?

Can I should I get them cut off?

Oh?

You don't need to get them cut off?

At what point?

Just because they're there, you don't need them remove. You get them removed when they're like causing severe irritation or blurring your vision.

They look bad?

No, they're barely noticeable.

Okay.

I only know they're there because I'm an eye doctor.

Oh God, thank you for being on.

Yeah, I'm a pleasure. It's been It's been a lot of fun.

My favorite ophthalmologist.

Oh I am I the only one you know?

Yes, but you're my favorite. Okay, So to gently stalk your new favorite ophthalmologist. If you're in the LA area, you have an eye ish, you can find him at acuityigroup dot com. I'll put the link in the show notes. You can call if you are you ready for this? Dad, pun? Get this their phone number one eight hundred eight nine eight twenty twenty. I'm literally proud of him for that pun of a phone number, like way to go. You can also google doctor Reid Waynus. His YELP comes right up.

Bye?

Bye? Pacodermatology, hobbiology or doo zoology, lithology and technology, meteorology and paradology, anthology, zeriology, selenology.

Not the first, not the first?

Ah, I love my eyes eyes? Oh no,