iriscan
It's said that the eyes are the windows to the soul. And truly, the eyes can communicate a great deal - emotional state, intention, health, attention - we can tell a lot about a person by looking them in the eye. But unless something has gone wrong, we don't tend to think much about our eyes. What should we be doing to maintain the health of our eyes? Are the supplements said to be good for the eyes actually any good? Are glasses good for the eyes? What about contact lenses? Is it possible to correct vision without lenses? Why do some people need glasses and some maintain perfect vision all their lives? How does staring at digital screens affect our eyes?

Join us on this episode of the Health and Wellness Show as we interview Optometrist Reshma Seth, B.Optom (Hons), and we'll explore the many facets of ocular health.

And stay tuned for Zoya's Pet Health Segment, where she explains how animals see in the dark.

Running Time: 01:19:21

Download: OGG, MP3


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Here's the transcript of the show:

Doug: Hello and welcome to the Health and Wellness show on the SOTT radio network. I am your host Doug, and with me today is Tiffany.

Tiffany: Good morning.

Doug: We also have with us a special guest for an interview today, optometrist Reshma Seth. Welcome Reshma!

Reshma: Hello!

Doug: Reshma is an optometrist in Australia, with a passion for alternative and holistic approaches to health and well-being. Having graduated with a degree in optometry with therapeutics, she has also studied and obtained a diploma in fine arts, vibrational medicine, remedial massage, and Feng Shui. That's quite a basket of modalities there that you've got under your belt.

Reshma: Yeah. I think I've always been interested in alternative approaches to health and healing. What drew me to optometry was I was in my final year in school, I had no idea what I wanted to do, I knew I didn't want to do medicine or law or anything like that, and I went to the open days at the universities and went up to the optometry clinic and the fourth year students there had contact lenses bubbling away in an eye exhibit and pictures of the back of the eye where you could actually see you know systemic eye diseases and I thought, this might be me. I've always liked looking into eyes, you know, eyes being the windows of the soul, and I thought that's me. I don't mind working with eyes. I'd rather be working with eyes than teeth or feet or anything else.

But, when I graduated, I still had an interest in alternative therapies, in just a more holistic approach, because I sort of don't want to just look at eyes as just eyes. Eyes are part of the whole body, so I was interested in further study, and the diploma in fine arts, where that comes from is my whole schooling life I'd done really academic subjects, and I'd never really had the chance to explore my more artistic side and so I thought, well you know, so I applied for a spot in a fine arts diploma and I don't even know how I got in, I was meant to submit a portfolio and I didn't have any drawings to my name, but I put together something and managed to get in, and spent the year doing some photography, and drawing, sculpting, painting.

Doug: Very cool.

Reshma: Yeah. It was really good.

Doug: And was that before or after you went for optometry?

Reshma: No. So I'd finished and graduated optometry, I was working, I did some travelling and backpacking and came back, thought, I need to keep doing something else. I did the fine arts, thoroughly enjoyed doing that, and then I saw an ad for a naturopathic diploma, and so I did that for a year. Part of that first year I studied iridology, herbal medicine, homeopathy, nutrition. It was really, really interesting, and at the end of that first year I got my diploma in remedial massage, I didn't get my clinic hours up enough to qualify to get my diploma of iridology, but it's something that I tend to kind of use in the background with my optometry practice, I don't actually have an iridology practice.

Doug: Right. Well, maybe we can talk about iridology later, because I kind of wanted to start with more of the conventional optometry stuff. Well I guess first of all, optometry in Australia, is being an optometrist pretty much the same anywhere you go?

Reshma: No.

Tiffany: Yeah, and can you tell us what the difference is between optometry and ophthalmology because I think many people get that mixed up.

Reshma: Yeah. So, optometry in Australia, basically means it's somebody you go to for primary eye care. You go there to check your vision, get a script if you need glasses or contact lenses, and also get your ocular health checked out so. If there's any eye diseases, we're trained to pick that up, we can either monitor, and we can refer, to an ophthalmologist. An ophthalmologist is basically an eye surgeon. So they are people that have actually gone and done 6 or 7 years of medicine, and then worked as a registrar in a hospital, and then done another 4 years of ophthalmology where they specialize in the eyes. So that's general ophthalmology. Within ophthalmology itself, you have specialists that just work on one part of the eye like the retina, or a corneal specialist, or a glaucoma specialist. You can get specialists within specialists.

Doug: That sounds intense.

Reshma: Yeah.

Doug: So is an optometrist all basically geared towards glasses? Like people who have vision problems and need contact lenses?

Reshma: Pretty much, glasses and an eye check. So you wouldn't necessarily go to an ophthalmologist because specialists are quite expensive. Generally in Australia they don't tend to bulk bill, so they're more secondary care. Primary care is the people you go to say, if you felt like you had eye fatigue, or having some eye problems, you'd book in to the optometrist first, and then we check all of that out and we also check on your ocular health to check if there's anything there. It's good to have baseline data anyway so even though there mightn't be anything pertinent happening right now, two years down the track, four years down the track you come back and see us and all of a sudden we're see that your pressures are a lot higher, than they were four years ago. What's going on?

So optometry, I will say in the States, appears to be slightly different, in that they're more optometry doctors. They're still not ophthalmologist but they have more territory to use pharmacological agents. They can inject people in the eyes for things like macular degeneration so they seem to have more scope to do that. From what I can see in the UK and the EU it's pretty much the same as Australia.

Doug: Right. Interesting. A lot of people have probably had an eye exam before but from your perspective, what do you do when somebody comes in and are getting checked out"

Reshma: So, usually the first thing I like to find out is, why are they there? If it's just a general check up, do they have specific problems, because one thing we got taught at uni is address their problem. So if they come in for reading glasses, and sure. you might detect that they've got something that needs urgent referral, you'd better make sure that you've taken care of their need for reading glasses or they're going to tell everybody you're a terrible optometrist! History-taking is important, so I like to know, you know what they use their eyes for, what systemic medications they might be taking, genetic family history, that sort of thing. Then we check your vision on a Snellen chart which basically the term 20:20 or 6:6 just means the size of the print that you can read at either 20 feet or 6 meters away.

Doug: Ah, okay.

Reshma: A lot of optometry rooms are not 6 meters long, so we have a smaller room, say usually about 3 meters but we double up using a mirror system where the chart is reflected a further three meters in the mirror.

Doug: Interesting.

Reshma: Then we check your prescription to see what's going on with the eyes, if there's a refractive error, and then we do an ocular health check where we check what's the pressure in the eyes, and the anterior segments and the front of the eye and then we use either some kind of, you know, an ophthalmoscope or a camera to view the back of the eye, which has the retina, the optic nerve. That's how you can see blood vessels, those sorts of things, and record it all, and go from there. So that's generally a routine eye exam.

Doug: Right, and do you get people asking you why you're taking their family history and medications and all that kind of stuff?

Reshma: Oh, yeah, yeah. I get weird looks like, why do you need to know that, and quite often I'll explain to them there are some systemic medications like corticosteroids and prednisone that can actually have ocular side effects. So if someone's on prednisone for a very long time, we need to monitor their pressures because it can cause glaucoma. We need to check their lens because it can cause cataracts so there's a reason why we're asking those questions.

Doug: Yeah, sure.

Tiffany: So, are people born with perfect eyesight. That's probably not the case because I've seen a lot of little babies that wear glasses. But what are the things that can make people's eyesight not be 20:20?

Reshma: A whole host of reasons. Sometimes it can be genetic. Sometimes it can be congenital. With things like cataracts, it's usually something that happens later in life, but there are congenital cataracts that people can get born with. It's a bit hard to say. Most kids are born slightly long-sighted, which is actually what we expect to see.

And then as they sort of grow and the eyes grow as part of their bodies and they get to, say, anywhere from 10 to 12, progressively that long-sightedness should slowly be decreasing, so it's actually normal for us to see that there is a refractive error, with children.

Doug: Just to cover that, because I don't know if everyone is familiar with the terms. So if somebody is long-sighted, it means they can see far distances okay, but they have trouble seeing things up close.

Reshma: Yes.

Doug: And then near-sightedness would be the opposite, where you can see up close pretty well but distances are where you start to have problems. And that's called myopia?

Reshma: For short-sightedness.

Doug: And is it hyperopia, the other one?

Reshma: Yeah.

Doug: Okay.

Reshma: And then there's another one called astigmatism which just means that the shape of the eyeball isn't perfectly spherical. So the way I explain it to my patients if they say "Well what's a stigma?" is what they often say and I say it's an astigmatism and what it means is that instead of your eyes being perfectly round like a basketball, it's shaped more like a football and where it's elongated is where you need extra power to correct it. If you think about a protractor, that could be anywhere from 0° to a 180°. So you could have vertical astigmatism, or vertical, or horizontal, it just means that when we prescribe glasses to correct your eyesight and give you clarity, the lens needs extra power ground in that particular direction.

Doug: Oh, I see, okay.

Reshma: Yeah.

Doug: So going back to Tiff's question there are all kinds of myths about what's going to ruin your vision. I remember my mom used to always make me sit back from the TV because she was like, it's going to wreck your vision, and people would say things like, you know, being on a computer too often can...

Tiffany: And stop trying to read in low light.

Doug: Yeah! Reading in low light, all these kinds of things that may cause eye fatigue, is that really doing damage?

Reshma: I wouldn't say that it's necessarily doing damage but it's certainly causing eye strain. Well, one of the big problems, say in life in the modern day is our exposure to a lot of screen time, whether it's TVs, smart phones, gadgets, devices, iPads, that sort of thing. And what the current research is showing is that blue light exposure from LED devices can be very, very harmful over a period of time, particularly to the lens and to the macula. So. I don't know if I've digressed from your question.

Doug: No, no, no, that's interesting because you know we've actually talked about blue light on the show before and how screens are particularly high in blue light. We've talked about it a lot in terms of the effects on sleep and melatonin.

Reshma: Yeah.

Doug: But, I don't know that we've talked about the mechanism of the eye exactly. So it's actually damaging to those things as well.

Reshma: Basically because it's a shorter wavelength, it has more energy and so it tends to cause photo-oxidation and stress to the cells of the nerve cells of the retina. Repeated exposure over a long period of time basically causes the retina to degrade over time and that's how you get macular degeneration coming on. I can certainly say from when I first started practicing optometry, macular degeneration used to be something that you'd see in older people, let's say 70 plus, and now we're seeing it in younger people. Sometimes in their mid-40s, you start seeing early signs of something happening at the macular.

So, I think there's definitely something to it It's not always possible to limit your screen time and so much of what we do is computer-based. But if you had to stare at a screen, there are things that you can do. I think there are programs like we were talking about the other day, with f.lux and with iPads there's night mode, and you can get orange-tinted glasses. A lot of prescription glasses, well certainly in Australia, I don't know about here, but there is a product called Blue-Guard which blocks a certain part of that blue wavelength, not completely, because in order to do it completely you'd need orange or red glasses, but it certainly does block out a fair bit of the blue wavelength.

Doug: Right. That's probably a good idea. A lot of people you know in the paleo community and stuff who use the software, or wearing the glasses and stuff or something like that at night, because you know you're trying to stay within the circadian rhythm, the natural circadian rhythm. But from what you're saying it sounds like maybe it's something you would want to do all the time.

Reshma: I wouldn't wear the orange glasses all the time because I think a certain amount of blue light is necessary. Depending on how much screen time, you'd probably get more of a dose from sunlight, but I think, within context it's okay. I think wearing orange glasses all the time would probably be counterproductive because you do need some degree of blue light exposure, but I think if you're spending a lot of time on screen-based work, I think having a Blue-Guard sort of a situation or even something that you can put an overlay, or even one of those programs like f.lux for example would be a good idea.

Doug: I'll tell a bit of my story here. I needed glasses when I was a kid. I guess it was probably around when I was going through puberty that my vision started to go off and I got prescribed glasses but I hated them.

Reshma: Yeah.

Doug: So I very rarely if ever, wore them. If I was at a movie or at class and I had to read the board then I'd put them on, but just walking around normally I wouldn't have them. So anyway, at one point much later in years I actually lost my glasses. See, I had read quite a bit about natural vision correction and I had come across this information which said that lenses are actually not so good for your eyes, because your eyes become dependent on them, and that your prescription will get kind of progressively worse as you go along and you'll always need to get stronger and stronger glasses. It's like walking around with a crutch all the time.

So I had these ideas in my head and when I lost my glasses and I thought, forget it, I'm not going to bother replacing them. And that brings us to today and I still don't have any glasses, and I think that my vision is not perfect by any means, but I think it's pretty good. So this is a roundabout way of asking, are glasses good for our eyes?

Reshma: It kind of depends. I was actually going to ask you, do you know what your prescription was?

Doug: It wasn't strong. It was like -1.5 or something like that.

Reshma: Yeah.

Doug: Yeah.

Reshma: I think scripts that are in the range of 0 to plus or minus 2, you can kind of get away without glasses. It's a bit hard to generalize, but a few years ago when I was living in Sydney and I had a practice in Sydney, I was part of a group of optometrists called the Holistic Optometry Group. They were really interesting because they would convene, say once a month and have guest speakers, like a chiropractor, come out and talk to the group about how certain manipulations to the back and the neck would increase blood flow to the orbit, and could effect a slight change or improve vision or what have you, which kind of makes sense if your neck's out of whack and you've got lots of shoulder tension and things like that.

So, that was really interesting and there was a lady by the name of Janet Goodrich who wrote a book called Natural Vision Improvement and we had someone from her camp come out and talk to us about different eye exercises that you could do, things such as palming, where you rub your hands together and you kind of rest the palms of your hands and overlap them over your eyes. What we now know about things like Reiki where there are healing centers from the palms of your hand, you're probably you know giving yourself Reiki as part of sort of that palming process for all we know.

Some of the other things they had were sunning, where you look to the sun through closed eyes or you could do circles with your eyes, clockwise and counter-clockwise. Jack Kruse has a lot of stuff about getting natural sunlight to the eyes, so there's probably something in that, systemically anyway for the whole body. Then they had things like looking at a pen and bringing that in close, so that's convergence exercises. So you stare at a pen say about 40 or 50 centimeters away, bring it in till it's about 10 centimeters away and repeat that a couple of times. Then you hold a pen or something with a bit of detail at about 40 centimeters, stare at that, and then swing your glance to something in the distance with a bit of detail and swing your focus backwards and forwards and that tends to focus the muscles inside the eyes that are responsible for accommodation of focusing up close. And then there are other exercises you can do where you do big circles, diagonals and things like that. Those exercises stretch the extraocular muscles that move the eye around.

I haven't actually seen any evidence-based literature about glasses being a crutch. I think the natural vision improvement exercises work for the low prescription ranges. It's kind of like we were talking earlier, it's like having a gym membership. You've got to do those exercises on a fairly regular basis to see the difference. If you just do it once a week, it's not really going to effect much of a change. I personally wear glasses. I've started to need them for reading up close. It's more anecdotal that I've had patients tell me that, "Ever since I've started wearing glasses I feel like I rely on them more and more." That may be true for a condition known as presbyopia where the lens starts becoming rigid from about the mid-40s and continues to get worse through to your mid-60s. I do not know why the human body's designed that way. I don't know that not wearing glasses for correcting presbyopia is going to make the presbyopia go away. I've got people in their 50s and how they get around it is they just stretch their arms and eventually they come to see me because their arms are just not long enough, you know.

Doug: Right!

Reshma: I think if you're prescribed something and it's let's say, just for reading, I think it's a problem if people tend to leave them perched on the end of their nose and get up and go make themselves a cup of tea or wander around the house doing other things because then their eyes gets progressively used to distances other than what it's prescribed for. So if I prescribe an anti-fatigue lens which is basically a type of lens to take the strain off the eyes, it may have a refractive error sort of fix in it, or it may just be what we call plano, I'll say to them, "Look, I'm prescribing this to you for class work and close work. I don't want you wearing it any other time. It's literally for you when you're taking notes down in class. You don't need it for lunch or recess or sport, because, you want your eye muscles to do some of the work, some of the time." Mind you, I haven't done a search in a while, but I haven't seen any studies on PubMed that says, "Oh, don't wear your glasses. Your eyes will get worse!" It's more empirical evidence where people have say, "The more I wear it, the more that I feel I need to rely on it."

Doug: Yeah, and that's got to do with their eyes are degrading, and it's got nothing to do with the glasses, it's just kind of what's going on.

Reshma: Could be, yeah.

Tiffany: Or it could be dietary.

Reshma: Well there's lots of factors, really, once you think about it because like I was saying earlier, your eyes are part of your body. you don't just look at it in isolation., I'm sure diet would impact it, what you're actually using your eyes for. I was saying to you earlier before the show started that refractive errors were not recorded until the advent of literacy when things started to be recorded and written down and books came about, which I find fascinating.

Doug: Yeah. That's interesting. I wonder if maybe the way humans evolved, they weren't really doing much really up close work.

Reshma: Exactly.

Doug: It was kind of like that was something that came along with reading.

Reshma: Yeah. You look at how society has changed even in the last 50 years. With my kid's school, my kids were in year six, but you know I was quite heavily involved with the community and the P&C and the principals and staff, they were bringing in iPads for kindergarten kids to teach them how to write. Can you believe that?! There was an app that showed them that you start the 'A' down the bottom and so on and so forth. So these kids were being exposed to technology at such a young age. WiFi hotspots were another thing they decided in their infinite wisdom to bring into the schools, so there's multiple impacts to the eyes as there are to our body in general.

Doug: Sure. Yeah, I often wonder about that and maybe we can talk about this actually. Nutrition for the eyes. I think what it is, that eyes are part of the body, in total, so, if your eyes are failing in some way, it might indicate there is some kind of nutritional deficiency, or something along those lines. Is there stuff that we can do specifically for the eyes?

Reshma: General antioxidants are good anyway, but there are some vitamins. It's more things like your antioxidants like beta carotene and things like lutein and zeaxanthin which are pigments and components of brightly colored fruits and vegetables, leafy greens and those sorts of things, are particularly protective to the macula.

Doug: Right.

Reshma: I actually read some interesting research about saffron being protective to the macula and I'm kind of keeping my eyes out to see if more research comes through. I know it's very expensive and what have you, but if they can actually make that in a tablet form. I would assume that turmeric also would be good because again, we're going for the brightly colored pigments in those particular spices.

I know my health food shop sells something with the lutein and zeaxanthin and also saffron. It's starting to actually become available at our local health food shop. I know people sort of talk about bilberry and I know that's also available at our health food shop. This is something I remember coming across that World War II, RAF pilots were eating bilberry jam. I think it's a cousin of the blueberry, to help with their night vision. When I looked it up, just in preparation for the show, the evidence seems to be a bit conflicting as to whether it does or doesn't.

Doug: Ah.

Reshma: Eyebright is another one we were talking about and that's a herb that's good for, for soothing tired, inflamed, sore eyes, can be used for conjunctivitis. So mild kind of inflammatory conditions where the eyes are irritated more so than anything else. One thing that I came across when studying naturopathy was chamomile tea. So if you brew chamomile team, and you obviously let it cool, do not put scalding chamomile tea over your eyes. But yeah, even just the teabags, once if you were going to drink the tea, if you kept the teabags aside and put them in the fridge, and put them over your eyes, very soothing for dry, tired, sore, itchy eyes.

Doug: I used to know a guy who worked in a health food store and there was one guy there who was kind of kooky. He was always doing pretty crazy things for his health. We used to sell these little eye cups, so you could do an eye wash, and he would do it with cold chamomile tea. But he also one time - and this is just insane - but he took a cayenne tincture, and added cayenne and did an eyewash with cayenne.

Reshma: Why?!?

Doug: Well he was talking about how cayenne was supposed to be really good for circulation. So he was saying that it was really good for eye circulation and to his credit, he was an older guy, and he didn't need glasses. Actually wait a second. Maybe he needed them for reading, but on a day to day basis and stuff like that he didn't were glasses.

Reshma: Yeah.

Doug: But I don't know that that necessarily is an endorsement of using cayenne on your eyes.

Reshma: No!

Tiffany: So apparently the cayenne didn't bother his eye?

Doug: He said it was painful. I said "That must have hurt", and he said yes. But, I don't know He used to bathe in turmeric too.

Tiffany: Wow!

Reshma: Wow! So going back to supplements, what else did I have? Oh yeah. We talked about blueberries and grapes, even goji berries have antioxidant and anti-inflammatory properties because of a compound called anthocyanin. And then you have your fish oils, your DHA. Fatty acids, can provide support to the cell membranes to boost our health.

One of the interesting things is that, I'm kind of bound by my association and in terms of what dietary recommendations, if I give any at all, is the traditional food pyramid, which is the low fat, especially not much saturated fat, at all, and high-carb. And it's interesting that there was a huge study done in the Blue Mountains, which is not far from Sydney and it followed these people over quite a period of time and it conclusively showed that the lutein and zeaxanthin was really protective of the eyes. It's funny because prior to the study being done, ophthalmology just completely disregarded diet. If you talked about diet, they'd go like, "Ppppffftt, it doesn't affect the eyes at all." And then when that study came out, all of a sudden they were like, "Oh well, there's not much we can do for dry macula so take these tablets", or, "eat your spinach". I find that really interesting and I lost my train of thought. What was I talking about?

Doug: You were talking about fats, I think.

Reshma: Oh, yeah, yeah, yeah. So it's interesting that despite that advice, and it's been, you know, about 10 years about eating your leafy greens and what have you, we're still seeing a spiraling increase in incidence of macula, and I personally feel that it's because of this food pyramid, and not enough fats in the diet.

Doug: Yeah, well, it affects so much. It just it wouldn't surprise me at all. You need those, omega-3s for keeping membranes flexible, which I'm assuming is important to eye structure.

Reshma: Yeah, sorry, I was just reading some questions on the chatroom, trying to multitask!

Doug: There was another one actually, speaking about nutrients for eye structure. It's hyaluronic acid. Do you know much about that one.

Reshma: No, you asked me about that today. The only time I've come across hyaluronic acid has been in dry eye formulations. Dry eye is something that tends to affect people as they get older, sometimes with women they can suffer from dry eyes and dry mouth, and it sometimes can be so bad that it's a syndrome, it's called Sjögren's syndrome, that then can lead to other autoimmune problems. So the dry eye industry is big, and the only time I've seen mention of hyaluronic acid is with formulations so that they actually stay on the eye, and give some longer lasting relief.

Doug: Well one of the reasons it interested me is because I know that that's something you can get from animal products, like meats and things like that and one really good source of it is actually bone broth. Bone broth is so good like on a systemic level for so many different things that it wouldn't surprise me at all that it was also something that was very good for the eyes.

Reshma: It would make sense. It keeps coming back to that the eyes or not separate for the body, so what's good for the body systemically and in general, one would think, would be beneficial to the eyes as well.

Doug: Maybe you could even try bone broth eye wash.

Reshma: Certainly not cayenne!

Doug: I was not suggesting that listeners, please don't do that! So maybe we can start talking about some things that can go wrong with the eyes, like eye diseases and things like that.

Reshma: Sure. So cataracts is probably the most common one, and whenever I'm talking to my patients about cataracts, I'll say to them, "Look, I'm starting to see early signs of it, do you know what a cataract is?". Nine times out of 10, they'll tell me "Oh isn't that that bit of skin that grows and covers your eye?", and that is a very, very common misconception. It is not actually a bit of skin that grows over the eye. It's the human lens inside the eye, kind of sits about a third of the way anteriorly into the eye, and initially it's transparent. Just like when you crack an egg open it's transparent. Once you cook that egg it changes color and becomes progressively more opaque. It becomes a thick milky white. That's what a cataract in it's end stage looks like.

The human lens kind of cooks over a period of time, and it's actually interesting because medically it's one of the few conditions where you don't have to rush out at the first sign of it. Ophthalmologists will not operate, on a cataract in it's early stages. And I kind of like the egg analogy because it's kind of like when you've got a runny egg out of a pan, it's a messy job, it's the same thing with the human lens; they actually wait for it to literally cook because then they get it all out in one go.

Doug: They actually take it out?

Reshma: They actually take it out.

Doug: The whole lens or just the cataract?

Reshma: The lens sits in a capsule. So they leave the capsule. They use a machine that kind of emulsifies it, and then they kind of, suck it out, for want of a better word.

Doug: Oh god!

Reshma: And then they place a clear plastic lens in it's place, an intraocular lens and that sits inside the capsule. One of the side-effects, as it were, from that kind of surgery is that glare becomes a problem, because obviously a plastic lens doesn't quite function the same way as a human lens. And then you've got again, that exposure to blue light. I did see some research about some pharmaceutical companies trying to put a blue filter in some of the newer intraocular lenses that they put in, but I think that's a work in progress.

Doug: Right, and if you actually do need blue light for some things then it wouldn't be the best idea.

Reshma: Exactly. Yeah.

Tiffany: Yeah.

Doug: Well, do they know what causes cataracts?

Reshma: The general literature suggests UVA and B exposure. That seems to be the thing. I again, think it's a combination of things. I think it's what you use your eyes for. I think if you're fair in your coloring, you've got light colored irises and you're somewhere in Australia in the outback and it's 50 degree heat, and you don't necessarily have the pigmentation in your skin and your iris to deal with it, genetically I think you're not in a climate that is not amenable to your predisposition. When I was doing naturopathy, one of the things I remember was doing orthomolecular nutrition. In particular, high doses of vitamin C can slow down the progression of cataracts.

Doug: Yeah.

Reshma: And you know, even though there's a treatment for it down the track, any surgery has risks, so you really want to prolong that, as long as you possibly can. And vitamin C is a good thing to experiment with because it's water-soluble. There's no toxicity. Your body will use what it needs and you shed the rest, so.

Doug: And it would make sense too. It's an antioxidant, so if it is oxidative damage that is causing the cataract, then it would make sense that an antioxidant like vitamin C would work.

Reshma: Yeah. Yeah. The other one that's talked about a fair bit now, didn't used to be, is macular degeneration as we talked about before. So the macula is a specific part of the retina. The retina is kind of like the inside lining of the back of the eyeball and, it's got all your nerves. Your nerves all inhabit the back of the eyeball, and it all comes together as an optic cable, literally, which is your optic nerve, which then goes up to the brain, and tells the brain what it is you're seeing out there in the world. And the macula has a very high concentration of cones.

So cones are really good for very specific, very high resolution acuity. Out towards the periphery you have more rods. In the retina itself, there's about nine different layers of nerve cells, if you kind of think of it as a BLT or a sandwich, with different layers. With macular degeneration what happens is, the layers, instead of staying in nice neat little array, they get into disarray. They're all mushed up together and what have you, and you start to see degenerative changes. Early signs of it would probably be that you see pigment clumping, or you might see drusen which is like a fatty lipid kind of deposit, and that's the dry form.

Most people usually start with the dry form. You can get the wet form, which just basically means there's a bleed at the back of the eye which they then treat with injections. And the injections are basically designed to stem the flow of bleeding, because the problem with bleeding is that it leads to scarring, which leads to new blood vessels, which leads to more bleeding, and it's a bit of a nightmare.

Doug: So it's the dry and the wet form of macular degeneration. And so, just to clarify, the cones are for detailed seeing,

Reshma: Or for night vision.

Doug: For night vision. And the rods are more for, is it movement or?

Reshma: Yeah. And more in the periphery as well, and that's why at night time when you try and stare at a star directly using your macula, you don't see it as well. If you look slightly off, to the side, using your rods, you'll see it better then.

Doug: You'll see it better. Interesting!

Tiffany: What about the glaucoma?

Reshma: Yeah. I was coming to that. I was talking to Doug earlier today. It's one of those things that I don't think is very well understood; the mechanism by which damage occurs to the optic nerve, and the ensuing optic neuropathy as it's called. Traditionally it has been called raised intraocular pressure that damages the nerves at the back of the eyes. So, people say to me "Is that related to blood pressure or something like that?". What it is, is, that there is an intraocular fluid that gets pumped into the eyeball, in through the front, nourishes various structures, and then it kind of drains out. Sometimes it could be that you're producing it faster than it can get out so that causes a build up of pressure which literally squeezes the life out of the nerves at the back of the eye and causes the neuropathy. Sometimes it can be that the channels through which the fluid needs to drain out, either the structure is physically so narrow that it ain't getting out fast enough, or there's blockages, and once again it's impeding outflow.

Having said that though, probably the most common form would be primary open angle glaucoma, which means that the angle out through which the, you know, intraocular fluid flows out, is open. There are things like, normal tension glaucoma where the pressures are normal, but we still tend to see glaucoma that does damage at the back of the eye. And then there's low tension glaucoma, where pressures are low, and we are still seeing damage at the back of the eye. So there are other mechanisms at play that I don't think are fully understood; whether it's a balance of the capillary perfusion, to the axonal sort of fluid, mitochondrial issues with oxidative damage. I don't think anyone really knows this. If you look at the literature, there seems to be a range of different theories, but nothing that's concrete, proof, 'this is what causes this'.

When I was looking up some alternative things, because I know there was a thread about glaucoma on our forum, other than antioxidants, we were looking at an I article today which mentioned a herb called Goldenroot.

Doug: Also known as Baikal Skullcap.

Reshma: That's it, yeah. Which seemed to show some promise in lowering pressure. I know that there's been things about medicinal marijuana that can lower pressure and that's used. I don't know if it's used in Australia, because they're funny about that sort of stuff. I think it's might be more in the States. Glaucoma is not well understood. But from the landmark glaucoma trials - this is again evidence-based literature - the one thing they found that slows down the optic neuropathy, which if you leave it go, people tend to lose the nerves responsible for their peripheral vision. Eventually they end up with just tunnel vision, and if still nothing's done, any intervention is instituted, they end up going completely blind. So it's kind of the opposite of macula. In macular degeneration you tend to have a round black spot right at where you want to look at but you've still got your peripheral vision. So macular won't send you blind, put it that way. It will kind of just destroy your central vision. But with glaucoma it's the opposite, and with the landmark trials, the one thing they found that seems to help, is lowering the pressure.

Doug: Right.

Reshma: It's the one thing that they found stops the progression of the optic neuropathy and the damage.

Doug: And that's even if it's normal pressure or low pressure glaucoma? Even lowering the pressure further will help?

Reshma: Yep.

Doug: Interesting.

Reshma: Very.

Doug: Yeah, that's weird, I wonder why that is?

Reshma: I don't know. We'd need to have a glaucoma specialist or an ophthalmologist here to have a really good chat about that because a few years ago, with optometry now, it was four years, it was a degree over four years. Now in Sydney anyway, at the University of New South Wales, it's five years, and the optometrists are graduating being able to prescribe some pharmacological agents. When I graduated, I didn't have the therapeutics qualification, so, a few years ago, I decided to go back to uni and do my postgraduate certificate in graduate therapeutics. There were a lot of case studies, because glaucoma cone is one of those things.

Now the laws won't let us diagnose glaucoma ourselves. Australia is funny. The AMA which is the Australian Medical Association and RANZCO which is the Royal College of Ophthalmologists are very territorial. The only time I found them not to be so territorial is if you're in the middle of nowhere, of you're in the outback. So a few years ago I did some relief work in the northwestern part of Australia in a place called Broome. And over there, aside from us, we were the only optometrist, eight hours either direction, eight hours drive, and there's a visiting ophthalmologist that comes once every three months, and a general practitioner's clinic had just closed. So there was only one doctors' clinic there. And so they were actually sending people my way. Normally GPs are very possessive of their patients.

Doug: Right.

Reshma: And what have you, but they were sending people my way, with foreign bodies and minor abrasions that I had to treat. So that seems the only reason when they tend to be more relaxed about it. But I digress, I'm chucking a Jordan Peterson here. So when I was back doing postgrad studies, part of it was glaucoma management, and I had to write a case report and I chose to write mine on primary open angle glaucoma. I still, looking through all the literature, cannot for the life of me understand what the mechanism is behind optic neuropathy.

Doug: Wow!

Reshma: Don't know it.

Doug: It's a mystery, I guess.

Reshma: It is, to me anyway.

Doug: And how do they lower the pressure?

Reshma: So they either work on outflow. They either work on the production of intraocular pressure and slowing that down, or they work on the outflow by helping them drain out faster.

Doug: Ah. Okay.

Reshma: And there's other things that they've come out with. So there's a type of laser that the ophthalmologist can use. It's an argon laser where they kind of create little tiny burns around the ciliary body to basically open up the channels and get rid of any obstructions.

Doug: Jeez.

Reshma: It seems to work for about a year or two and then the pressure starts to escape and people then need to be put on treatments again. And then for really recalcitrant glaucoma cases there's things like microfiltration where they install something surgically to keep the fluid drain faster.

Doug: Wow!

Reshma: And keeping the pressures down.

Doug: Geez.

Reshma: That's well and truly not my realm of expertise!

Tiffany: Is marijuana as effective as the stoners would like you to think, for glaucoma? Or is it just, used to make people feel better?

Reshma: It's one thing that I haven't really looked into. I can't really answer that because I don't know!

Doug: Well you were speaking about lasers.

Tiffany: Yeah, that was what I was going to say, speaking of lasers. LASIK eye surgery is really popular now, and I remember when it first came out. I've never worn glasses. I don't think I've ever even been to an optometrist, but I was always scared, if I did wear glasses, whether I would have this LASIK eye surgery. So can you go into a bit of that and what the risks are and what the benefits might be?

Reshma: Yeah. So LASIK eye surgery has come a long way. Way back when it was kind of experimental, I was really hesitant to refer anybody, but now, in my practice, I've actually referred quite a few people to the closest laser refractive surgery clinic, which is 2 hours away from me, but anyway with really, really good success. I think there was one person I had that had an epithelial defect, where the cornea just did not want to heal and we had to put what they call a bandage contact lens. But basically for prescripts that are moderate to high, say, above, upwards of +/- 3, +/- 4, I really don't know that natural vision improvements are going to give you much relief, even if you did that religiously. A -4, even if you got that down to a -3, your still talking probably needing glasses to be safe on the road for example, and to keep, you know, whatever your roads and traffic authority, equivalent, would be.

Laser basically what it does is it, is it kind of molds the cornea, and reshapes the cornea. The cornea is a sort of front part of the eye, and is actually responsible for most of your focusing, and with say, myopia or short-sightedness, it tends to be quite pointy. It tends to create a sort of longer axial length, and so what they thought they can do is make what they call an ablation, and create a bit of a flap, so they get the top part of the cornea off to the side, and use laser to shave down the cornea and remold it, and they sit the flap back on. So it doesn't require any stitches or anything like that. Dryness probably seems to be the biggest issue my patients report, maybe in the first three months or so, a bit of glare and distortion and halos at night time, but truly within about six months, they're all good.

Doug: Well it sounds like it's actually come a long way, because I knew people who, when it was new, people who hated their glasses, that they had to depend on glasses, and ran for the laser eye surgery as soon as it kind of came out.

Reshma: Yeah.

Doug: And, some of those people, one of those people that I'm talking about, had red eyes chronically after that. You can read the horror stories on the internet, I'm sure, but it seems like now it's kind of come a long way, where things are better.

Reshma: It definitely has, but having said that, if you're thinking of doing it, research and pick your practitioner, really well.

Doug: Right.

Reshma: So I'm very careful about who I refer my patients to because that chain of care is important to me. So I won't send them to someone that I'm not entirely sure they'd get the results that I'd want for my patients. But then again, you'll find people who self diagnose or look for it on the cheap, because with the clinic that I send my patients to, to have both eyes done, treated, you're probably looking at about 5,500 Australian Dollars.

Doug: Wow.

Reshma: So it's not cheap.

Doug: Right.

Reshma: There are some people in say Melbourne, and some in Sydney, who will probably do it for half that, and they would just take themselves off to that particular person, but the thing I like about these guys that I refer to is, you send them along, a patient, and if they can't deliver a good visual prognosis, they'll tell you up front.

Doug: Hmm.

Reshma: "Look, the chances are," or "we can't do LASIK, we need to do PRK," which is a slightly different technique. Or, you know "Look, we can see that your script has been changing. You're better off to wait because your going to pay 5000 dollars. You're not going to get the mileage out of it." Generally, the advice that I've been given from them as a referring practitioner is, it's really good to wait for your script to be stable for at least 12 months before you think about getting refractive surgery, because if your script is still in the process of changing, you might find that you get maybe one or two years and then you're slowly, progressively becoming short sighted for whatever reason/

Doug: Yeah, yeah, right. I do know...

Tiffany: Is LASIK something that can be done more than once?

Reshma: Depends on the thickness of the cornea. We're talking about nanometers. You've only got so much room to move before you run out of something to work with.

Doug: Right, right, right.

Reshma: I'm not a LASIK expert but that's what I've heard. There are some times where people might be changed from, say a -5, but there's still is a residual -1 or a -0.75, and they're not entirely happy with that because at night time they tend to notice it more and they want to be completely glasses-free, so within six months these guys will go back in and do it. I don't know if it's a sort of procedure that you would repetitively go and have done.

Doug: Right, and you were saying before that people usually get about 8 to 10 years out of it, if it's a good one?

Reshma: Yeah, yeah.

Doug: So what do they do at the end of that 8 to 10 years? Do they get it again, or do they start wearing glasses again?

Reshma: Well, it depends how old they were when they had it done, because the other problem is, if they get it done in their mid-20s or 30s or whatever, if they get towards their early 40s they're probably starting to get presbyopic which means they are starting to need reading glasses. So then they need to go back to glasses, or contact lenses. Some of the newer techniques with laser are trying to correct people for presbyopia, where they might leave the dominant eye for long distance vision. and the non-dominant eye they might give a little insert or something for clarity for close up. I haven't seen too much research into that and I don't know how long lasting that is.

Doug: Right.

Reshma: But, yeah, in terms of what they can do, the other things is, in your 40s or 50s or 60s, and if that's how old you are when you're thinking about laser correction, another alternative or another option would be to see your ophthalmologist and have the cataracts surgery brought forward. So if you in theory don't have cataracts, it's actually called a clear lens exchange. But it's actually the same procedure. So what they do is they remove your human lens. They put a clear plastic lens, but they calibrate the optics of that lens, so much so that you don't need glasses or they do the monocular vision thing, where your dominant eye is set for distance and your non-dominant eye is set for reading so you can kind of be glasses-free, because that's what everyone wants these days, so.

Doug: That sounds weird, though. To have one eye that can focus on one area and on eye that focuses on another?

Reshma: You know, it's not for everyone. I have got a few contact lens patients who I fit with monocular vision. It's not for everyone and if you were going to experiment with that surgically, quite often what they'll do is put contact lenses in your eyes, and see how you fare, and if your brain cannot cope with, the disparity in having one eye for distance, one eye for reading, then they know not go ahead with that kind of surgery for you.

Doug: Right, right, right. It all seems kind of strange too. I had no idea that they could actually just replace human lenses with plastic essentially.

Reshma: Yeah, it's kind of weird.

Doug: Yeah, it is kind of weird, yeah.

Reshma: It is. When you look enough into people's eyes, you can kind of tell, because of the reflection, if you look into their pupil...

Doug: Really?

Reshma: You actually see the reflection of the intraocular lenses. Yeah.

Doug: Yeah, that's weird.

Reshma: If you know what you're looking for.

Tiffany: That's weird.

Doug: That is kind of bizarre.

Reshma: Hmm.

Tiffany: I don't know if using an animal lens would be even more bizarre.

Doug: Yeah.

Tiffany: Or if it's even possible. Would it be rejected?

Doug: Monkey lenses.

Tiffany: Like a pig lens.

Doug: Pig lens, yeah.

Reshma: Can't say I've seen any literature about it, but it just sounds weird to me.

Doug: Plastic is less weird.

Reshma: Yeah.

Doug: So, I do want to ask you about diagnosing things with they eye. But there were a couple of comments and things in the chat which I wanted to bring up. So one person in the chat said that she had trouble with dry, burning eyes and she used MCT oil, by putting that in the eye for a couple of days, and it really lubricated things and actually made them a lot better.

Reshma: Yeah.

Doug: You ever heard of that?

Reshma: No, certainly not in evidence-based stuff. Dry eyes is a really big problem, and in my practice it's mainly an older demographic. So average age of my patients would be about 73.

Doug: Hmm.

Reshma: And drops are kind of okay, but the problem with drops, regardless of the formulation, is that they're so watery, that by the time you've managed to get some of it in your eye, half of it is running down your face. I actually like a gel, which is kind of halfway between an eye-drop and an ointment. Ointments you usually only apply at night because it's so gooey you can't see anything out of it.

Doug: Mm hmm.

Reshma: But the gel, it's easy to apply, you can stand in front of a mirror and apply it to the inside of your lower lid, and it stays there like a protective film. But MCT oil, is that kind of like a coconut oil?

Doug: Yeah, it's like one of the fats that is found it coconut oil, a couple of the medium chain fats.

Reshma: I'd be curious. Would it blur the vision though? Because sometimes I use coconut oil as a moisturizer and I get it in my eyes and I'm like "Oh my god, I can't see!"

Doug: It might, I don't know. I experimented for a while because I was having a similar problem with dry eyes. I had read that castor oil in the eyes was pretty good...

Reshma: Did you put cayenne in it?

Doug: No, no I did not! No cayenne is going in my eyes.

Reshma: Just kidding, just kidding.

Doug: I have cut peppers before and accidentally rubbed my eye though and that was pretty painful.

Reshma: Yeah.

Doug: It was weird though, just like you described it. You couldn't do it and it kind of goes out because you did have kind of blurry vision.

Reshma: A little bit, yeah.

Doug: For a while, and I don't know whether or not it helped., Maybe it did. It was a while ago so I can't really remember.

Reshma: There's actually new things coming out now for dry eyes, and I haven't had the time of late to look into the research. But intense pulse lights, the IPL.

Doug: Yeah, one of the questions on that chat was about that also.

Reshma: Yeah, so, I know, with some optometrists, they're getting IPL units, and they're using it to basically stimulate the meibomian gland, which is the sebaceous or oil-producing glands in your eyelids, to get the flow happening. And it seems to be working quite well because it's springing up in more and more practices. Because it really is a problem. It's usually that you start out with drops or gels, or ointments. You can try some fairly heavy duty anti-inflammatory kind of eye drops like Cyclosporin or Restasis.

I was talking with someone else earlier about autologous serum. So that's where they draw blood, your own blood, and then they take out the white cell component, and centrifuge that, and create a serum from that, which seems to be quite beneficial. I don't know much about that because ophthalmology mainly deals with that sort of thing. But those are sort of the things in the line of treatment, but of late, I've been seeing a lot more about IPL for dry eyes.

Doug: Interesting.

Reshma: Very.

Doug: So that method where they take out the white blood cells, they then use that as drops, kind of thing?

Reshma: Yeah.

Doug: Oh.

Reshma: They make it into a serum and they use that as eye drops.

Doug: Wow. Very interesting. Oh the person responded in the chat, saying it was briefly blurry, after using the MCT oil.

Reshma: Yeah. Okay. Interesting.

Doug: Yeah. We was talking about something before, how it's actually possible to diagnose things by looking in the eye, like looking at the blood vessels.

Reshma: Ah, you mean systemic conditions?

Doug: Yeah.

Reshma: Yeah. So looking through the pupils through to the back of the eye is one of the only ways that you can observe blood vessels in a human being without cutting them open, and I find that absolutely fascinating.

Doug: Yeah.

Reshma: Mind you, I wouldn't wait to come to the optometrist to see if you've got diabetes, especially if you've been thrashing yourself and you know there's something majorly wrong, because for it to show at the back of the eye, you need to have been unwell for quite some time. But, we can see systemic things like diabetes, either early - there are certain signs where you might see blood that's leaked out of the blood vessels, because in the back of the eye, aside from the nerves, you need something to nourish the nerves, so you have capillaries and arteries and what have you. Diabetes tends to affect the blood vessels, the lining. They tend to get more permeable to the wrong thing, so you'll find blood leaking out, proteins leaking out. You can see malignant hypertension at the back of the eye where you'll see things like cotton wool spots which is the name for it, where the nerves are actually inflamed. So there are definitely signs that you can see at the back of the eye that alert us to, "Well, there's something going on" and we refer you back to your GP or whatever to get things looked into.

Doug: Right.

Reshma: I know of a colleague of mine who had someone come just off the cuff, for an eye test. I can't remember what the presenting complaint was. I went through the eye test, everything looked sort of normal, at this stage. I think they might have had a mild prescription for glasses, and then they had a look at the back of the eye using one of our digital machines where you can basically see the optic nerve and the whole of the retina, and diagnosed a thing called Roth, R-O-T-H, spots, which is a kind of hemorrhage with a white spot in the middle, and it used to be a characteristic of bacterial endocarditis, but it can also be a significant sign for leukemia, and we said "We'd better get you seen to" and that was how the leukemia was picked up. So people that say to me, "Oh, no my eyes are fine, blah, blah, blah" I think "Well, you never know what could be happening that you have no symptoms or are unaware about".

Doug: And are the GPs open to it? If you refer somebody back to their doctor or something, and they say they found something in an eye exam, are they open?

Reshma: Yeah, for the most part they are. I think they get territorial about things like conjunctivitis because they want to treat it, and then if you start taking over, because now we can prescribe pharmacological agents, anti-inflammatories and antibiotics and stuff like that, they get a bit touchy about that. But if you send somebody there, and you send the diagnostic information and your findings, your clinical details, the images you've taken. I think it's also the kind of relationships you foster, wherever you are, with your practice. It's all about networking. I've got two ophthalmologists practices where I am in my small town, and they're both absolutely brilliant ophthalmologists, and I've got a good relationship with them. So I wouldn't start treating things which are in their territory. So I'll send things off to them and then they'll do the same if it's things like a refraction which means an eye test for glasses that needs to be done, they'll send them back to me.

Doug: Right.

Reshma: It's only if your out in the middle of the outback, or nowhere, where you start to take those things on. So, there's a kind of professional respect that you kind of...

Doug: Sure. I was just wondering if you spotted something in the eye, and you sent them to their doctor, the doctor would be like, "What does an optometrist know about this?"

Reshma: There is a bit of that that goes on and there have been times where I've looked at someone's eyes and I've though, "Oh my god, look at that optic nerve! There's definitely glaucoma going on here," because there's a thing known as cupping, where it looks as if there's pressure literally pushing down on the optic nerve head, and I'll refer to the ophthalmologist and they'll go, "Oh no, no, no, it's within normal findings." And then I'm thinking "Well I'm not really happy with that", and I'll send them over to somewhere else for a second opinion and those guys will institute treatment. So with certain things there is a gray area. You could send someone to three different ophthalmologists and come back with three different, not diagnoses, but forms of treatment some might want to monitor, come back in six months. I might go "No, no, no, let's treat that now."

Doug: Right, yeah. Well speaking of diagnosis, one thing that I find very interesting, and I studied it a little bit, and you told me that you had actually studied it some as well, the idea of iridology.

Reshma: Yeah. Iridology.

Doug: You pronounce it "ear"idology. Ok. Iridology.

Reshma: Yes, so, I'm not a practicing iridologist, but it was always fascinating to me, the concept of iridology. It's almost like a reflexology map of the body, superimposed on top of the iris. And then based on the appearance of the iris, any freckles, or lacunae as they call which are little gaps in the fibers of the iris and other appearances, you can pretty much, make a pretty on point diagnosis about what the person's health is at that point in time.

Doug: Hmm.

Reshma: I studied it for a year, but I didn't actually do enough clinic hours to qualify, and, I think, my association would have a bit of an issue, so I kind of have it running as a kind of background program. So if I see someone with what we call cramp rings or stress rings you can tell if they're quite an anxious, stressed out person, and if I know they've got a lot of pressure, they're doing a lot of computer work, I might prescribe anti-fatigue lenses, I might tell them to take regular breaks, I might prescribe some eye exercises. So it just helps me put together recommendations in my prescription. It kind of helps me refine that.

Doug: Right.

Reshma: It's been a while since I've hit my iridology books, but there's so much that you can tell. So, one of the first things that I was quite impressed about was the fact that if the iris fibers are all fairly straight, and very tightly packed together, it meant the person had a fairly good constitution. They were of good, pretty solid genetic disposition. They would be the ones that could eat anything and do anything to themselves and never get sick. I'm sure we know people like that.

Doug: Yup.

Reshma: And then on the flip-side, people who had very loosely packed iris fibers, these people really needed to look after themselves because they really wouldn't be able to get away with as much. So you can tell someone's constitution and predisposition. You can tell if they are very anxious people, and you can see the nerve rings. You can tell if someone's fairly stressed out, because it tends to cause like a white film or a white overlay. You can tell if they've got issues with cholesterol. This is something that overlaps with optometry because we call it an arcus. You'd actually see a ring of deposit. You can tell if their skin, as the largest organ, isn't detoxing things properly, if they're putting creams and lotions and things that they really shouldn't, because you actually see like a toxic ring around the sort of periphery of the iris. You can tell the gut integrity by looking at the pupil. You can tell if they've got digestive issues, liver issues, kidney issues. And again, there are practitioners that have been doing it for a long while and they are the ones you want to go and see because they have honed their art, so to speak.

Doug: It's pretty fascinating. It sounds very similar to in Chinese medicine where they talk about how all the organ systems in the body get mapped onto different parts So you mentioned reflexology, the idea that the bottom of the foot is actually a map of the entire body where different organ systems are related to particular parts. I think that with the foot, you're not necessarily seeing reflected back, it's just a way of accessing those things through like foot massage or something like that. But with the eye it almost sounds like it's more like a reflection of what's actually going on, in the body.

Reshma: Absolutely.

Doug: Well that's fascinating!

Reshma: And it's really good if you can see someone who can actually take pictures of your eyes because iridology is mainly a diagnostic process. So if you go and see a naturopath, they'll probably use iridology. They might do hair and nail analysis and some other things, just to get a snapshot of what your health is at any given point in time and say they institute dietary changes, or supplements, or exercise, or any of those things, you're bound to see some changes. You and I were having a chat about this earlier because when I went through - and I don't know if this is a more traditionalist approach to iridology - but I was thought there were only two true iris colors, brown, and blue and that, any other overlay, so, to get green you needed a yellow overlay, which, from memory, was issues with liver and gall bladder.

White was too much acidity in the system, so that's how you got grey. So brown eyes, and sort of hazel eyes you've got yellow overlay to give you that hazel look. And I had a textbook. I'm trying to remember who the author of that textbook was, and he had a whole heap of before and after photos of that person's iris. It was quite amazing. You were saying when you did your course, they didn't really talk about that.

Doug: Well, that was a long time ago, so I don't totally remember. They might have actually said something like that. I think that people would be kind of resistant to that idea though because green eyes are kind of valued, and people want to have green eyes. I don't think anybody would be a big fan of having green eyes because they have liver and gall bladder problems!

Reshma: Yeah, yeah, yeah. I mean, how true it is, I don't know. It's been a long time since I hit my iridology textbooks, so yeah.

Doug: Yeah.

Reshma: But you mentioned traditional Chinese medicine just before. When I studied naturopathy, I think one of the things that turned me off studying it further was, it was fairly eclectic in the way they taught the course. So you had iridology as your primary diagnostic tool, and then they taught you a little bit about herbs. But by then, Big Pharma had gotten their tentacles into herbs, so everything had to be a standardized extract of X amount, and evidence-based literature, and the whole wild-crafting and the more intuitive art of prescribing herbs was kind of gone. Homeopathy was very interesting. If I was to go back, I would just concentrate on homeopathy and refine that.

Doug: I agree, I agree.

Reshma: Because the concept of something being more potent, the more dilute it is, is fascinating. I've got a little dispensary at home, because with the information that I got from that year of studying naturopathy, I basically used it on myself and my family, and my close friends and what have you. But vibrational medicine like flower essences, homeopathy, is just absolutely fascinating. But aside from homeopathy, I think traditional Chinese medicine is something that I find extremely fascinating because, anything to do with the Daoist philosophy - it's like we were talking earlier, it's like a unifying field theory, where they talk about the cosmic chi or energy that comes in from the cosmos, splits of into your yin and yang. From that you've got your five elements, your fire, earth, wood, water, metal.

And the combination of how those elements react with each other, or clash against each other, is what they use for their herbs, prescribing herbs, prescribing acupuncture, meridians, getting the yin and the yang of that, within the five elements into balance. It's what they eat. They eat seasonally as well, so in springtime they eat more salads, because salads and sprouts and things like that relate to spring, and the first shoots, so to speak. In summer it's more yin foods like fruit. In winter, it's like casseroles, things that are cooked for a long period of time because in winter, the environment is so yin, you want to put in more yang into the system.
Incidentally, the eyes are the sense organ for the liver meridian and the liver relates to anger. This is just an aside that I collected along the way.

Maybe the people who have persistent eye issues, the liver meridian might be something to look at. But yeah, traditional Chinese medicine is very, very interesting, and I learnt more of it when I studied Feng Shui, because it's the same principles of those five elements that's used to cast charts, as well as to harmonize a space. And I always thought Feng Shui was moving a sofa here, and moving a bed there, and putting a mirror over there, but that's just the Feng Shui of space. There's also the Feng Shui of time which is a whole other thing, and maybe a whole other show!

Doug: Well Tiff, did you have any other questions at all?

Tiffany: No, I think Reshma pretty much addressed everything I wanted to ask.

Doug: Well that was very fascinating. I think...

Tiffany: It makes me want to go get my eyes checked by Reshma!

Reshma: Come and see me! I'm only thirty hours flying away!

Tiffany: Yeah, we might be able to finagle a deal.

Doug: Well, maybe what we'll do is go to the pet health segment, and then we can come back and wrap up. So here is Zoya with the pet health segment where she's going to be talking about night vision.

Zoya: Hello, and welcome to the pet health segment of the Health and Wellness show! This week's topic is, how do animals see in the dark. To human eyes the world at night is a formless canvas of grey. Many nocturnal animals on the other hand experience a rich and varied world, bursting with details, shapes and colors. What is it then, that separates moths from men? Listen to the following recording to uncover the science behind night vision. Have a great weekend, and goodbye.

To human eyes, the world at night is a formless canvas of grey. Many nocturnal animals on the other hand, experience a rich and varied world, bursting with details, shapes and colors. What is it then, that separates moths from men?

Moths, and many other nocturnal animals, see at night, because their eyes are adapted to compensate for the lack of light. All eyes, whether nocturnal or not, depend on photoreceptors in the retina, to detect light particles known as photons. Photoreceptors then report information about these photons to other cells in the retina and brain. The brain sifts through that information and uses it to build up an image of the environment that the eye perceives. The brighter the light is, the more photons hit the eye. On a sunny day, upwards of 100 million times more photons are available to the eye than on a cloudy, moonless night.

Photons aren't just less numerous in darkness, but they also hit the eye in a less reliable way. This means the information that photoreceptors collect will vary over time, as will the quality of the image. In darkness, trying to detect the sparse scattering of randomly arriving photons is too difficult for the eyes of most daytime animals. But, for night creatures, it's just a matter of adaptation. One of these adaptations is size.

Take the tarsier, whose eyeballs are each as big as it's brain, giving it the biggest eyes, compared to head size, of all mammals. If humans had the same brain-to-eye ratio, our eyes would be the size of grapefruits. The tarsier's enlarged orbs haven't evolved to make it cuter, however. But to gather as much light as possible. Bigger eyes can have larger openings, called pupils, and larger lenses, allowing for more light to be focused on the receptors.

While tarsiers scan the nocturnal scene with their enormous peepers, cats use gleaming eyes to do the same. Cat's eyes get their shine from a structure called the tapetum lucidum that sits behind the photoreceptors. This structure is made from layers of mirror-like cells, containing crystals that send incoming light bouncing back towards the photoreceptors and out of the eye. This results in an eerie glow and it also gives the photoreceptors a second chance to detect photons. In fact, this system has inspired the artificial cat's eyes we use on our roads.

Toads, on the other hand, have adapted to take it slow. They can form an image, even when just a single photon hits each photoreceptor per second. They accomplish this with photoreceptors that are more than 25 times slower than human ones. This means toads can collect photons for up to 4 seconds, allowing them to gather many more than humans do in each visual time interval. The downside, is that this causes toads to react very slowly, because they are only receiving an updated image every 4 seconds. Fortunately they're accustomed to targeting sluggish prey.
Meanwhile, the night is also buzzing with insects, such as hawk moths, which can see their favorite flowers in color, even on a starlit night. They achieve this by a surprising move. Getting rid of details in their visual perception. Information from neighboring photoreceptors is grouped in their brains, so the photon catch of each group is higher, compared to individual receptors. However, grouping photoreceptors loses details in the image, as fine details require a fine grid of photoreceptors, each detecting photons from one small point in space. The trick is to balance the need for photons with the loss of detail to still find their flowers.

Whether eyes are slow, enormous, shiny or coarse, it's the combination of these biological adaptations that gives nocturnal animals their unique visual powers. Imagine what it might be like to witness through their eyes, the world that wakes up when the sun goes down.

Tiffany: Goats with night vision.

Doug: Well thanks for that Zoya. That was very interesting and topical. So I think that is our show for today. Thank you very much Reshma for joining us.

Reshma: My pleasure, it was fun. I was actually crapping myself beforehand! I'm sitting here with my Rescue Remedy across from Doug going "Oh my god!", but it was very enjoyable. So thank you for the invitation, it's been fun.

Doug: No problem, no, it was great information, very, very good.

Reshma: Oh, that's good.

Doug: Okay, so that is our show. Be sure to join us next week, where we will have another show, possibly another interview. Also tune in to the other two radio shows on the SOTT radio network. One is tomorrow and one is on Sunday, and you can tune in by just going to sott.radio.net, and it will give you a countdown there on when it's going to be happening. So, that's it. Thanks for joining us, and we'll see you next time.

Reshma: Bye.

Tiffany: Bye.