The following is transcript of this episode. It has been edited for clarity.
Intro: At some point after age 40, all of us will experience presbyopia, or trouble focusing on nearby objects. We may also suffer from dry eye and other age- and hormone-related conditions. On this episode, optometrist Dr. Surveen Singh tells us about all the current treatments, medicines and surgeries that can help with these issues, as well as the best preventative measures you can take to help keep your eyes healthy. We also discuss computer use and how that’s affecting not only our eyes, but our kids eyes; the eye symptoms that should be viewed as an emergency; the beauty product that may inadvertently protect our vision; and the nasty habit that some of us had back in the ’90s that hopefully we’ve all broken by now….
Welcome to More Beautiful, the podcast for women rewriting the midlife playbook. I’m Maryann LoRusso, and I invite you to join me and a guest each week, as we strive for a life that’s more adventurous, more fulfilling, and more beautiful than ever before.
Maryann: Welcome back! Today we are talking about eye health in midlife and how we can treat and prevent some of the most common conditions that might affect us during this life stage. Good morning, Dr. Singh, and welcome to the show!
Dr. Singh: Good morning. So nice to be here.
Maryann: There’s so much to cover. And I’d love to start with perhaps the most common thing that happens to so many of us somewhere after age 40: near vision deterioration, aka the need for reading glasses. As many of our listeners know, sometime around age 40, 45, even 50, we suddenly find ourselves in a dimly lit restaurant and for the first time, we can’t read the menu. For me, I was in Sephora on my 48th birthday. And I couldn’t make out the name and number on the bottom of a lipstick tube. Dr. Singh, why does this happen to us? And is there anything we can do about it except to scatter reading glasses all over the house?
Dr. Singh: That’s one solution! But you know, what’s happening actually is normal. And it happens to everyone at some point, usually between 40 and 50, sometimes as young as 38, sometimes as late as 60. But I usually tell my patients, between 40 and 50, expect that it’s just going to get harder and harder to see up close. And the process is…When we are looking at things far away, that is when our eyes are relaxed. When we go to look at something up close, that is when the muscles in your eyes and the lens in your eye flexes, in order to keep that image in focus. What happens as we age is that that lens becomes a little bit harder and stiffer. So it is harder to make those muscles can’t flex that lens in order to focus up close. So that’s the mechanism behind it. And there’s really aren’t prevention strategies. It’s just the normal aging process. But there are so many ways to remedy it. As you know, there’s the over-the-counter reading glasses, there’s bifocals, there’s multifocal contacts, increasing the light, you know, things like that can all help.
Maryann: Just to be clear, this type of age-related [far-sightedness] is not the same as [far-sightedness] that we could have when we’re younger, right?
Dr. Singh: When you’re younger, you can be nearsighted, you can be farsighted. Those are based on the length of your eyeball. And astigmatism, which is based on the curvature of the front of your eye. This is a different mechanism. It’s the lens inside the eye that’s just not able to flex anymore.
Maryann: So would laser laser surgery work for this type of age-related vision loss?
Dr. Singh: No, no, you can’t do laser surgery to correct for this. There are ways to do laser surgery that can allow you to see up-close a little better. But it’s a complicated way to do that. And it’s generally for this problem alone. Now, there are other procedures that were approved years ago, but none of them stuck because they weren’t long lasting or efficient enough.
Maryann: Someone really needs to invent this surgery.
Dr. Singh: I know. That’d be so great.
Maryann: Is there anything we can do about this? Or do we just need to accept it?
Dr. Singh: There are some treatments on the horizon. There’s was a drop that was approved in October 2021, I believe, called vacuity. I mean, people if they did a good big advertising campaign…It has limited scope. It does work, but it is a drug that you have to put in every day. Minor side effects are redness, headaches, and a very small risk of retinal detachment, which is a serious condition, but it’s very rare. And it only is lasts about five to seven hours. A small subset of people can use that. And not a lot of people want to use it every day. There’s another drug in the pipeline that softens the lens; I think is in phase two or three of trials…
Maryann: That that sounds exciting.
Dr. Singh: Yes, it softens [the lens] so that it’s more flexible. I don’t know, if that’s gonna ever come to fruition, but there are people trying to solve the problem.
Maryann: Yeah, I mean, who wants to put drops in every day? That’s a lot of work…Well, fingers crossed, there’ll be something hopefully. Other than needing reading glasses, do our eyes require more TLC as we begin to get older? Are there other eye conditions and diseases that are more common after midlife and particularly with women during and after menopause?
Dr. Singh: Yes, there are. One of the big things that happens to us, especially to women, is dryness. And dry eye is something that sounds benign, but can actually affect quality of life for a lot of different people. And it does tend to affect women more than men, especially after age 40. I don’t know the percentages, but I remember reading in a few articles, something like 50 percent to 60 percent of women. Sometime around menopause age, women tend to experience symptoms from mild or moderate to severe, depending on their overall health, and how they’re using their eyes. But dry eye is condition that we can treat in so many different ways. One of the ways that you can do it easily is just make sure you’re hydrated; drink your water, that helps a lot. People who tend to look at screens, which is all of us, probably tend to not do what we call it visual hygiene. What does that mean? That means that when you’re looking at your screen, after every 20 minutes try to look 20 feet away fro 20 seconds…It’s something we call the 20/20 rule. The moment you look away, your eyes relax—because remember, when you’re looking far away, they’re relaxed. So your blink rate comes back to normal. They’ve done studies where people who look at screens blink half as much as they should. So if you’re already kind of dry and not making enough tears, and you’re staring at a screen, you’re just gonna get super dry. There are other treatments that have been proven, but they’re not immediate gratification. One is omega-3s or fish oils, just popping a vitamin. There are some early studies that vitamin B12 might help. But that’s months and months of doing that. Then there are artificial tears, lubricants that can help, that are a temporary but useful way to help yourself feel better. And one thing that really really does help this is the regimen I suggest for people who have consistent dry: At night before you get go to bed, a hot compress, and then an artificial tear, and then another artificial tear when you wake up.
Maryann: Oh, that’s interesting. A hot compress. You introduced these great eye drops to me; they have flaxseed oil in them. They are excellent and have helped my dry eye significantly.
Dr. Singh: Yeah, they’re amazing. They’re my favorite. When you go to the store, there’s like 5,000 drops, so it’s really hard to know which ones to choose. So yeah, I usually give my patients a couple that I have tried and tested on myself.
Maryann: We’ll put some of those in the show notes…So, Dr. Singh, do we know for a fact that fluctuating hormones actually come into play to cause dry?
Dr. Singh: [Evidence indicates] that it does; it’s the reduction of estrogen and progesterone. There is a connection, although no one has made like the direct connection. Like, if you increase your estrogen and progesterone with HRT, or whatever treatments, does it actually improve dry? There are a lot of studies that say yes, and some that say no, so I don’t think we know enough. But I think there is a connection.
Maryann: Yeah, there are so many vague studies or just inconclusive evidence with this whole menopause thing. It’s kind of frustrating, but we’re making progress right?
Dr. Singh: Yes, but I don’t think there’s enough research being done. I don’t think there are enough people funding it, possibly.
Maryann: We need to change that!
Dr. Singh: Yes, yes of course.
Maryann: So how does your doctor screen you for dry eye and what does dry eye actually look like to your doctor?
Dr. Singh: I pretty much look for dry eye in every patient, because it’s actually pretty easy to do a quick assessment. First I ask questions. I always ask patients how they feel. Do they have dry eyes? Are they tired? Do they feel dry? There are a lot of different symptoms, and one is that your eyes actually feel dry. Another symptom is fatigue. Fatigue can be caused by a lot of things, but dry eye can contribute to fatigue. Another symptom is that your eyes tear a lot. Tearing is actually a sign of dryness, because if the baseline tears aren’t enough, your eye reacts by creating extra tears to compensate. Then there’s intermittent blur, when sometimes things are clear, sometimes they’re not. So there’s a lot of things I can determine just by asking questions. But when I take a look at the patient with a slit lamp—that microscope where you put your head inside and I shine bright lights in—I put a drop in that has a yellow dye in there. That yellow dye actually helps me visualize the tear layer. And it helps me visualize the integrity of the front of the eye, the cornea, which the tears are protecting. And I can see how thick the tears are, I can see if the cornea is healthy. If it’s not healthy, instead of being smooth and clean, like a piece of glass, it might be sort of like sandpaper rubbed on it. So there’s different ways that I can see what’s going on.
Maryann: And if people are suffering from this, they should really go and see their doctor, right, because it can be very painful for some people?
Dr. Singh: It can be painful. In very, very dry eyes, I will see a cornea that is—I don’t want to say scarred, but it could lead to scarring. With mild mild dry, we can reverse that irritation. But sometimes in very severe dry eye, we have to prescribe actual prescription drugs, I’m sure you’ve seen ads for Restasis or Xiidra that in certain cases are very helpful.
Maryann: Can dry eye be associated with other medical conditions or be a symptom of them?
Dr. Singh: They can be. Some autoimmune diseases can create dry eye: sjogrens syndrome, different types of arthritis…Those are the main ones that will see dry eye associated with,
Maryann: I can’t tell you how many friends I have that are in this age range that are suffering from dry eye.
Dr. Singh: It’s so common; about 50 to 60 percent of women. That’s a lot of people.
Maryann: Well, thank you for those tips. We’re all gonna go get our eye drops. So what other conditions may strike us as we get older? Besides those two common ones?
Dr. Singh: Well, you know, there’s what I call the big three that we’re always looking at looking for when we examine a patient. One is, of course, the dry eye which is very common, and then the three: cataracts, glaucoma and macular degeneration. They are all very different. And cataracts is more of an aging process. I wouldn’t really call it a disease because it’s something that everyone will eventually get if they live long enough. People get it at different ages, depending on their environment, their diet, their general health—but eventually everyone will get it. Glaucoma is more of a disease process. We don’t know why people get it…Let’s backtrack to cataracts…Cataracts are the aging of that lens that was flexing to focus; that lens almost becomes like a dirty window. It’s no longer clear, so it’s harder to see, you get glare, you get blurred vision. The great thing about cataracts is that it is—I don’t know if I want to say curable, but it’s fixable. During surgery, they take out that dirty lens, and they put in a brand new one and it’s probably the quickest, most immediately gratifying surgery you can have. It’s very safe and and very immediately effective—so cataracts are curable, I guess you could say. Glaucoma, on the other hand, is something that you want to catch early. And you do want to treat it right away if it’s discovered, because it is what I call the silent disease; you won’t know you have it because there really are no symptoms until the damage is already done. That’s why we will check the eye pressure of everyone who comes into my practice. Not everyone with glaucoma will have high pressure, but if someone’s pressure is high, we’re automatically gonna do the screening to figure out if [glaucoma is] what’s causing it. Why do people get it? We don’t know. But if it’s in your family, you have higher risk. It doesn’t mean you’re going to get it, but you should definitely be checked. And it’s often treatable in the beginning. We treat it with specific prescription eyedrops…and sometimes surgery.
Maryann: Going back to cataracts for a second, is it my imagination are young more younger people—and by younger, I mean in their 40s and 50s—getting this surgery?
Dr. Sigh: When I see cataracts in someone that young, there’s probably some other link. Cataracts are shown to be connected to heavy steroid use. Not the type of steroids someone takes to get muscles, but steroids used for skin conditions or for other conditions…or if someone has uncontrolled diabetes or really extreme exposure to UV tanning beds or something like that. Maybe because UV light is linked to cataracts.
Maryann: Have you heard of Latisse? It’s used to grow eyelashes long and lush, but I think it was originally designed to treat cataracts or glaucoma?
Dr. Singh: Glaucoma. Yeah, it was and it was a side effect of a glaucoma drop that a lot of these patients had. They kept getting these beautiful lashes, so someone tapped into that [market] and [thought], I can make money off this in a different way. And as far as I know, it’s safe to use. I’ve never prescribed it, but it’s pretty benign.
Maryann: So, I confess I’ve been using it and it’s amazing. Now I’m wondering is this protecting me from glaucoma. Is it?
Dr. Singh: It can’t hurt and it might help if you were gonna get [glaucoma]. But glaucoma is not that common.
Maryann: Right. So as you said, there are no real glaucoma symptoms to watch out for…So do you just have to get your eyes checked every year?
Dr. Singh: Yes. Especially if you have family history. You definitely want to go get your checkups. Getting your eyes checked, and especially dilated, is one of the best preventative measures for any eye disease. Just like your general health. You don’t want to wait until something happens…Preventative Medicine is always better medicine.
Maryann: How is glaucoma treated if you are diagnosed with it?
Dr. Singh: With special prescription eyedrops and surgery. So, there’s a fluid in your eye that’s circulating, and when that flow is not right, the pressure will build up. And as the pressure builds up, it can start causing the nerve to atrophy, to die. So you want to reduce the pressure so that it doesn’t push against the nerve and cause atrophy, which can then cause a reduction in your vision. Usually, it’s your peripheral vision that goes first. So you want to you want to catch it early, because once the damage is done that’s irreversible.
Maryann: Speaking of peripheral vision, does that naturally change as you get older?
Dr. Singh: I don’t think it necessarily changes that much. It’s all the other things that come into play that may make it feel like your peripheral vision is changing. Glaucoma will definitely reduce it. Cataracts will, in a sense, because you just have less light coming in. So you have less visual stimuli. But otherwise, I don’t think so.
Maryann: Alright, so now the big one. This is the one that scares me personally. Macular Degeneration. Can you tell us about what that is?
Dr. Singh: Yeah, so that’s also very common, more so as we get older, like in our 70s, 80s and 90s. It can be seen in 60-year-olds too, but not as often. Macular degeneration is when the macula, [the center of your retina, the thin layer at the back of your eye that’s the region of the keenest vision], for somewhat reasons unknown [becomes damaged]. Its surface starts to change, and it creates a reduction in your central vision. So it can lead to “blindness”—I hate to use the term blindness, but it can reduce your quality of life. And again, it’s one of those things where we don’t know why some people get it and some do not. However, if it’s in your family, especially in your immediate family—parents, siblings—you’re just at a higher risk. You may be symptomatic [for instance, you may start to experience vision changes], but we do want to catch it early…There are somewhat preventative measures that you might be able to [take] that could possibly delay the onset, if you are destined to have that. One is, what you eat matters. The three super foods I recommend—I know everyone wants to say carrots, and yes carrots are good, but there are three other great superfoods—are kale (or spinach or other leafy greens), blueberries and salmon. We’ve kind of narrowed it down to those three, but from those you can expand to similar healthy foods. [Another preventative measure is] UV protection. Always wear a hat or sunglasses when you’re outside. And don’t smoke. That’s the other big one.
Maryann: I love all three of those foods. That’s great. So salmon, blueberries and kale. And wear your SPF.
Dr. Singh: Yes, wear your ocular SPF.
Maryann: It’s funny you mentioned carrots. My dad used to say, “Have you ever seen a rabbit with glasses? Eat your carrots.”
Dr. Singh: [Laughs] I love that.
Maryann: So, you know, so many of us have worn contacts for years too. And I think I told you, Dr. Singh that I, you know, when I was much younger, in my 20s, they were advocating those disposable contacts that you keep you would sleep in. And so I wore those for a while, as did a lot of people I know. Does long term contact usage increase your chances of getting any of these diseases or conditions we mentioned?
Dr. Singh: I would say yes and no, but more likely no. Yes, but only if you abused the system…So back in the day, I want to say the ’90s, lot of companies approved what were called extended wear contacts, or contacts that you can sleep in safely for up to a week, or for as long as a month. Anytime you sleep in a contact lens, you always increase your risk of an infection, or reduction of oxygen to the cornea. They were approved, but I personally never ever recommended that anyone sleep in their lenses even from day one, because I knew that your eyes needed oxygen, and by wearing lenses for [extended periods], you’re blocking some of that oxygen. So the long term use of extended wear contacts? I don’t know if anyone’s done a study to see if that could possibly cause macular degeneration, glaucoma, cataracts, none of those things. But…maybe you’ll have dry eyes when you’re older. Or maybe you can’t wear contacts as long now; i.e., if you took your contacts out every night, like you were supposed to and cleaned them properly, maybe you can then wear contacts until your 60s. But if you slept in them, maybe you’ll have to stop when you’re 50 because your corneas are decompensating from over-wearing them.
Maryann: I know. It’s like anything else you did in your youth that probably wasn’t good for you. You’re paying the price later. I wish you had been my doctor back then. I wouldn’t have done it.
Dr. Singh: I would have been like, no. And I tell people who do it, You know what, you’re just putting your eyes at risk. You might not be able to work contacts when you’re 50. But when you’re 25, you’re like, “50? That’s old! That’s [so far off].”
Maryann: Yeah, I feel like it was a sales pitch.
Dr. Singh: Yes. But I was never a fan, because I also saw a lot more eye infections during that time. It was like, this is not good.
Maryann: What are some other symptoms we should look out for with our eyes as we get older?
Dr. Singh: Well, I think the best thing that you can do for yourself, like I said, it’s diet, UV protection, get your eyes checked every year or two. Because there are a lot of things that you may not know you have; glaucoma is one of them. [During an eye exam I look in the back of a patient’s eye and] I can sometimes tell if someone has uncontrolled high blood pressure just by looking at their blood vessels, or sometimes diabetes, but usually by the time it affects an eye, they’ve had it for a while and they’re probably symptomatic, but not necessarily so with blood pressure. So those are the three: Diet. UV protection. See your eye doctor. And know your family history. I think all those things make a difference. Bottom line, eat well and know your family history. And also, just take a break from your screens—and get your kids off the screens.
Maryann: How do we do that? Please tell me because that is my biggest challenge in life.
Dr. Singh: Yeah, kids…and husbands.
Maryann: But the kids are so young, and they’re getting so much more exposure than we ever did.
Dr. Singh: Yes, and the [mental side effects of screen time], that’s a whole other podcast. But they’re finding a link between screen time and increasing myopia, which is nearsightedness. So, but again, we don’t have that many years of data, when you think about it, and it’s not so much…like TV is totally benign—remember when TV was the evil thing?
Maryann: Yes! [Laughs}
Dr. Singh: Now I’d much rather have my kids watched a TV, because at least the TV screen is across the room I know than their phone. Because we don’t know the long-term really ramifications, visually, except the nearsightedness and nearsightedness has its own risks. The more nearsighted you get, the more risk you have for detached retina. So there’s other things that we may see more of, based on [increased screen time]. We might see more of based on this. But I tell my kids, who don’t really listen to me…
Maryann: Join the club.
Dr. Singh: I tell them to do the 20-minute break. And how do you do that? Just set your set a timer on your watch or your phone and after 20 minutes, it forces you to get up and walk away. Also, don’t look at your phone before you go to bed. Because it really affects sleep patterns, and it affects your melatonin. And that’s been proven. Just don’t do it, if you can avoid it,
Maryann: Do blue light lenses actually work?
Dr. Singh: OK, I knew that was going to be the next question. I was prepared for that one. Because I get that I get asked that every day. So the jury’s still out. Basically, again, it’s it’s the amount of data that we have. So there’s two different aspects to [the answer to], do blue light lenses work? Are you using them to make yourself feel better? Or are you using them to prevent damage down the line. Preventing damage down the line is: Is blue light affecting us so that it’s affecting the health of our eyes long-term? We don’t have enough data to know [for sure], but we think it might. Blue light filters maybe reduce the amount that’s coming toward you, so that you’re not getting as much exposure. As far as blue light lenses making you feel more comfortable at the screen, all that data is anecdotal. Some people are like, Oh, I put them on and they I feel great. What has been shown with blue light glasses is that they do help sleep patterns. So by reducing the amount of blue light coming at you, you are going to help yourself sleep better. The other thing about blue light glasses is, like, if you’re gonna go buy them on Amazon, there is no regulation, so you don’t know what you’re getting, I don’t know what percentage of blue light is being blocked. I don’t even know if there is a blue light filter on those lenses. Nobody’s regulating it. But when you have glasses made with prescription, there are certain standards that labs have to follow with the amount of blue light that can penetrate. There’s a new contact lens that just came out at that block 60 percent (when most others block about 30 percent). That’s brand new, that’s literally the last few months. But then again, do we know it’s really doing anything?
Maryann: You bring up an interesting point. In terms of reading glasses, is there a difference between prescription lenses and the readers you can buy for 10 bucks in the drugstore?
Dr. Singh: Yes and no. When you get the $10 ones, the quality of the plastic, the optical integrity and the clarity are going to be a little bit different. They may be warped, they might not be consistent from power to power, that sort of thing. Also, if you’re gonna wear glasses for a long time, when you have classes made, the centers of the lenses are placed where your pupils are, and everybody has a different distance. So the over-the-counter ones just have some random public average that may or may not match what yours are. And will that cause long-term damage? No, nothing bad is gonna happen. You just might fatigue faster, and the [over-the-counter glasses] might not be as comfortable to wear because they’re not made for you.
Maryann: I have a lot of Peepers. If I am going to buy an over-the-counter brand, they tend to be a little higher quality. Is there a brand you like?
Dr. Singh: There are a few brands…one that’s called Caddis.
Maryann: Yes, I have a pair of those too. They’re amazing. But expensive.
Dr. Singh: I think it’s worth paying a little more for them, because the optical quality of the plastic is going to be a little bit better. And they won’t scratch as easily.
Maryann: A little while ago, you spoke about retinal separation. And told me a while back that people who have bad distance vision are more at risk of this happening. What are the signs to look out for, for this potentially serious condition? Are there symptoms?
Dr. Singh: Sometimes, yes. So for people who are highly nearsighted—that means that your eyeball is longer than an average eyeball—the retina, the back lining, can get sort of stretched and at the very edges is more commonly where you may develop tears or holes in the retina. Symptoms that people might have include flashes of light, or floaters That being said, floaters are very common, and an occasional flash of light, I don’t worry about it. But if you have a consistent flash that you see every day or see a few times a day and it doesn’t go away, I would want to look into it. A lot of people have floaters, a little things that you see like flies moving in your vision, I don’t worry about them if they’re stable, and they’ve been checked already. But if you have a few, like three or four, and then suddenly you have 20, you should get that checked out. And with anyone who is nearsighted, I always always dilate their eyes, because when I dilate the pupil, I can see far into the periphery. I can see if there is there’s a lot of thinning or if I see a tear, [I can get to it] before it becomes something serious, If I’m concerned I will send that person to an ophthalmologist to have them take a look. And sometimes they preventatively will treat it with laser, and laser is kind of like glue, which kind of sticks it down so it doesn’t tear off. So preventatively you want someone to take a look at your retinas, that’s the bottom line.
Maryann: And isn’t there some new imaging technology that can see better behind the eye?
Dr. Singh: There are all kinds of imaging. There’s a basic photo, which just has the central area, and then there’s another one called an a map, which can get pretty far peripherally and document that. Neither of those can take the place of dilation, yet. I think it’s the combination of the two that’s the best. If you can get both, then you’re covering all your bases.
Maryann: One thing I love about you as a doctor is that you are very patient and you like to experiment with different ways you can help your patients. You know that I have really complicated eyes, because my distance vision is so bad—you can confirm how bad it is—and now on top of that, I can’t read anything up close. So you’re always trying to tweak my prescription to get me just the right balance for the near and far vision. A lot of people I know are playing around with different types of [corrective lenses, experimenting with] bifocals or whatnot. What are some of the options to ask your doctor about at this stage of life?
Dr. Singh: It depends if you’re a glasses wearer or a contact lens wearer. If you’re a glasses wearer, then it all depends on your prescription. But, you know, [check out] progressive lenses, or no-line bifocals. It takes time to adapt to them. But I would say 90 percent of people can adapt and 10 percent probably never can. The odds are in your favor, so it’s worth trying. Give it a good week or two to adapt. It takes most people about a week. If you’re a contact lens wearer, there’s all different ways to try it. Like I have experimented with you, there’s multifocal contacts. They are great, but they’re not a perfect system; it’s really hard to put all those prescriptions in a teeny, tiny lens. And you can’t do that with every prescription…And reading glasses over your contacts, as annoying as that is, sometimes that helps.
Maryan: Yeah, I have to do that. I’m doing it right now. [Laughs}
Dr. Singh: Yeah, I can see that. [Laughs]
Maryann: But the things that you’ve tried on me…Like, you’ve told me, you need to go a little bit easy on the distance correction in order to get back the ability to read up close…You [need to play around with the formula] to find a balance that works for you, right?
Dr. Singh: You do. There’s a lot of trial and error. And you know, if somebody told me they were a truck driver, I would make sure that their distance vision was really great. I would err on that side. But if someone says, you know, I hardly the drive, I mostly spend time in front of my screen or at home, I would err on the side of their [close-up] vision. It’s based on their lifestyle more than anything else. It’s a lot of listening to what the patient needs, and then sort of going from there but discussing with them…
Maryann: I’m so glad you brought up the truck driver, because that’s something I needed to ask you. Night driving gets so much harder when you’re older. Right now realizing I can’t even drive on the highway at night because of my my prescription and the fact that the refraction of the oncoming cars is so bad. So so many people are dealing with this now. Are there additional things we can do to help with night driving?
Dr. Singh: It all depends, again, on your visual system: Are you wearing glasses or are you wearing contacts? If you’re wearing multifocal contacts, that is when the system kind of falls apart. It’s night driving and a tiny font on the back of a medicine bottle…Like, those two extremes are really hard to fix with those lenses. So if people did a lot of driving, sometimes I prescribe glasses over contacts for driving. Sometimes that works. Sometimes I just tell patients to just have a driving prescription. But as we age, things change. Our lens in the eye is aging from the moment we’re born. So it’s not that crystal clear lens it was when you were a baby. When you’re 40, when you’re 50, it’s constantly changing. So, when that’s changing, less light is coming in and you’re getting a lot more glare just as a process of natural aging. And if you do wear glasses, always, always always get the anti-glare coating on the lens. That really reduces headlight glare, it makes a big difference.
Maryann: It really does. The other day I was in a restaurant; there were four of us, two couples, and like clockwork, the menus come and we all whip out our reading glasses, except for my husband who always forgets his [laughs] and he asked to borrow mine, so then I can’t menu. So he’s getting in his [Christmas] stocking this year a pair of small reading glasses. You can fold them up and put them into your pocket, so they’re perfect. He’d better not lose them.
Dr. Singh: My husband has this too. The other thing people do is whip out their iPhone flashlights. Technology works.
Maryann: It does. Good times [laughs].
Dr. Singh: The thing people need to know is that it’s normal. It’s OK. And we’re finding ways to work around it that we didn’t even have 10 or 15 years ago,
Maryann: And you have to laugh about it too. I find I have to laugh about everything.
Dr. Singh: Definitely.
Maryann: Is there anything else we should know about taking care of our eye health in midlife and beyond?
Dr. Singh: There’s so much more we could talk about, but I think we covered the basics: the dry eye, cataracts, glaucoma, macular degeneration, seeing your eye doctor. In a nutshell, see your eye doctor annually. Have your eyes dilated. You know, a lot of people tell me [during their checkup], “Oh, I can’t do it today. I have things that I need to do.” You know, it’s it’s one day a year. It’s worth just doing it if you can.
Maryann: Oh, you know what? I just remembered one other thing I wanted to ask you: Are you ever too old for LASIK surgery?
Dr. Singh: Yes and no. So with LASIK, the assumption is that your prescription is stable, and that your eye health is good. So as we get older, what happens is you’re eventually gonna get cataracts. Once you have cataracts, you don’t you won’t don’t want to get LASIK because cataract surgery is almost kind of like a blessing in disguise. When they do the cataract procedure, they put that new lens into your eye, and they can incorporate your prescription into that. So you can actually get rid of your classes to some degree. When you have cataract surgery, you can tell the surgeon hey, I want to have great distance vision. So they will put a lens in that will correct for your distance prescription, your standard reading glasses. Or you can tell them, I want the opposite. I want to be able to read and I don’t mind having glasses for distance. You can’t have both, so those are the two options. The third option is now we can also do multifocal lenses in the lens that they put in with the cataract surgery. They work, but there are are limitations, just as there are similar limitations to multifocal contact lenses. But for people who don’t want to wear glasses 80 to 90 percent of the time, that’s an option. So cataract surgery is not a bad thing, because it’s almost like the LASIK as you get older.
Maryann: But we can’t just say like, “Oh, I’m gonna wait wait till I get cataracts because we may never get cataracts.”
Dr. Singh: Everyone will get them eventually.
Maryann: Wow, so much to digest. And we will put all the stuff we talked about in the show notes. Thank you so much!
Dr. Singh: Thank you, Maryann. This was really fun!
Outro: Thank you so much for tuning into More Beautiful. Please visit Morebeautiful.com for show notes and bonus content. And it would mean so much if you could subscribe, rate and leave a review on Apple Podcasts or wherever you’re listening. See you next week for another great conversation!
