How to actually take care of your eye health with Rupa Wong (Senses Miniseries #3)

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3:09This week, I'm excited to share another episode of this month's special series on the five senses and what science can teach us about the mysterious and extraordinary ways our brains interpret the world around us. Today, we're taking a close look at eye health. When I first started out in medical school, ophthalmology was not a specialty that I loved. The concept of vision felt deceptively simple. Light comes in and signals go to the back of the brain. But I quickly learned there's so much astonishing complexity to the human eye. This tiny organ, about the size of a ping pong ball, contains layers of specialized cells, delicate muscles, and neural circuitry that allow us to read, drive, recognize faces, and navigate the world.

3:57For most people, the ability to see is a vital part of the human experience. Vision affects how kids learn in school, how adults work and age, and how we maintain independence throughout our lives. But at the same time, eye health is surrounded by a surprising amount of confusion. Screens are ruining our eyesight. Carrots will fix your vision. Blue light glasses are essential, or maybe they're a scam. As a generalist physician, I get questions like this all the time from worried patients who don't know if supplements, special glasses, or online vision tests actually do anything. So today I want to focus on the truth, practical solutions and tips grounded in science.

4:42I called up Dr. Rupa Wong to help me see the realities of eye health a little more clearly. Dr. Wong is an Ivy League trained, board certified pediatric ophthalmologist and adult strabismus surgeon. That's a condition where your eyes aren't properly aligned and point in different directions. She's the managing partner of Honolulu Eye Clinic, where she's been caring for patients for more than 15 years. She's also an educator, a textbook author, and a spokesperson for the American Academy of Ophthalmology. In the past few years, she's built a large following on social media by explaining eye health in ways that actually make sense to everyday people.

5:21But what I appreciate most about Dr. Wong's work is that she doesn't just talk about eye diseases or about rare, obscure cases. Instead, she talks about how our daily habits, our environment, and even the way we use technology shape our vision over time. Those are the same ideas we're exploring in this conversation, where Dr. Wong shares what caring for your vision across an entire lifetime actually looks like.

5:48Dr. Rupa Wong, welcome to TED Health. Thank you so much for having me today. Eye health is extremely important. It's directly tied to vision after all. But unless there's something out of the ordinary going on with someone's eyesight, I don't know if most people are thinking about it that often. And in your experience, what are some of the more common misconceptions or knowledge gaps that people have about eye health? I'm sure you have many. There are so many, as you prefaced. I think the first one is there are so many people that have had LASIK and they think that LASIK corrects the eye. So they were nearsighted before and then they feel like, oh, I've had LASIK.

6:32My vision's fine. I don't need to continue seeing an eye doctor. And that's incorrect because especially for people who are nearsighted or myopic, there's an increased risk of a lot of ocular health problems that they're not getting checked for if they completely neglect that annual eye exam. So number one, if you've had LASIK, please keep seeing your eye doctor. We need to check your retina. We need to check for retinal detachments or breaks or even cataracts and glaucoma are at an increased risk in people that are nearsighted. So if you've had LASIK, this is your wake-up call to get into the eye doctor's office.

7:07Yeah, I think starting with that misconception really helps ground the conversation because so many people have had LASIK eye surgery. Because understanding I think what people get wrong often reveals what really matters most. And so how have people's perceptions of eye health changed over time? Have there been moments when people's concerns about eye health have spiked compared to before? I really think now is the time that there's a lot more awareness about preventative eye care. And then also just really, I think there's a growing understanding that just because your vision is 20-20, which is another misconception, doesn't mean your eyes are necessarily healthy because something like glaucoma affects your peripheral vision.

7:52And you can have perfect 20-20 vision and have truly advanced glaucoma, which is irreversible. It causes tunnel vision. It causes loss of your field of vision. And I think there's this growing understanding that your eyes need to be protected just like your heart does, just like your brain does, just like your kidneys do. So Rupa, it's interesting how those perceptions evolve, especially as medicine and technology and certainly awareness shift. And it makes me curious about your own path into this field. You're a physician, a practice owner, an educator. You're a mom of three. You're also very active on social media, which is not something most ophthalmologists probably imagined doing 20 years ago when they were training.

8:38So what made you decide to start sharing eye health information online? So it's interesting. This was back in 2008, and there really weren't a lot of us, a lot of physicians on any of these platforms at that time. Now there's so many, which is amazing. I followed, I don't know if you remember, it was one of these old reality shows and it was some celebrity reality star contestant. And she was on Instagram saying, oh, everybody should give their baby goat milk. That is awful. That's not what you're supposed to do. I mean, I'm not a pediatrician, but I know that at least. And it got me to thinking, all right, if people that are established in their careers, that really know the science and the evidence, if we are not on these platforms because we feel like, oh, I'm too above that.

9:24I'm a Harvard-trained surgeon. I shouldn't be on these social media platforms. Then people are getting their information from sources that should not be doling out medical advice. So that was kind of my first inclination. All right, well, I can decry this. I can say this is terrible, but what am I doing about it? So that was when I turned my social media from private to public and started talking about eye health because there's a lot of misconceptions, especially in my particular subspecialty of pediatric ophthalmology and adult strabismus. And strabismus is misaligned eyes. So if the eyes are crossing in or wandering out, it's a lot of misconceptions about why you need to have surgery or vision health in terms of what the insurance is going to cover.

10:11And I thought this would be a great way to reach more than just my small island of patients here on Oahu, but the broader community at large. And that's been one of the most amazing things about being on social media. I'm not there to become an influencer or to get all sorts of crazy contracts. But when I get those personal DMs that say, I saw your post on adult strabismus, and they ask for a strabismus surgeon, and I refer them to our American Association of Pediatric Ophthalmology and Strabismus, where they can find a doctor, and they tell me I had surgery, you know, I don't see double anymore, or my kid doesn't get teased anymore, their self-confidence has skyrocketed.

10:50And that's what really keeps me going. I think that ability to communicate clearly at scale feels more important than ever. And that's why I do this show. And I don't post as often as you on social, but I think it's so important. And it connects directly to the patients and the families that you see every day. And you mentioned this. So you specialize in pediatric ophthalmology, which means that you're often seeing kids when their visual systems are still developing. What surprises parents most about how vision develops in early childhood? I think there is this thought that eyes and teeth are the same, or eyes and ears are the same.

11:31So that there is not this understanding that actually there's a critical period of neurodevelopment for children for developing good vision. And if we don't give them the ability to see clearly when they're young, that critical period we've studied now probably ends around age 13. It's not hard and fast at age 13, but about that age. So we've got to do everything we can at these younger years to ensure that they've got good vision as an adult. And so sometimes I think people, parents think, oh, well, it's fine if they don't wear their glasses. And sometimes it can be, but if it's a certain prescription, you really have to get your kid to wear the glasses because that's going to influence the ultimate vision they have when they're an adult.

12:15So I have these conversations with parents and actually with the kids, even the three and the four-year-old kids in my office. All right, we're wearing your glasses to make your vision stronger because whatever we do now is going to impact you when you're older. And you're not going to thank me that I didn't force you to wear this patch when you're 25 and can't see well out of that eye. Because I see those adults in my practice too. Oh, my parents didn't make me wear the eye patch. And so now they are legally blind in one eye. And that happens. So I think that awareness of this has long lasting implications.

12:51It's not just wearing the glasses or wearing the eye patch or getting the surgery to fix the here and now. It actually is going to impact them later because of that occipital lobe development and the radiations from the eyes to the brain. And then there's nothing that can be done past that critical age. Rupa, I think a lot of parents assume that if their child can see something across the room, their vision must be just fine. But vision screening and eye exams often pick up issues long before a kid might notice them. What are some of the most common problems that you are able to detect early in kids when the parents bring them in?

13:29So there's so many really subtle things that we can't uncover just with the nurses screening at school, because what they're checking for is just the distance vision that you can read the eye chart, 2020, perfect, fine, check, check, check. But there are a lot of eye muscle things that can go on. We can have kids that are really farsighted. We've been talking a lot about nearsightedness. Farsightedness doesn't really mean you can only see far and not up close, but it means more that everything can be blurry. But kids, their lens is so elastic and so malleable. So what happens if they're farsighted is that they can just dial in the focus, the accommodation, and that can tire their eye muscles out.

14:09They can start to cross in with that. They might even get double vision that can take a toll on their reading ability. So those are the things that we can look at when we are examining them in the office to make sure they don't have any muscular imbalance or insufficiency of those focusing muscles. That's not to say that every single child needs a full comprehensive eye exam, but the pediatrician should be able to pick some of these things up when they're doing their vision screens. They will come up with a measurement in terms of a glasses prescription, and they will even check the alignment of the eyes, so that strabismus that we can uncover.

14:44And especially if there's a family history that you wore a patch or an uncle wore a patch, then those are the kids that I do want to see in my office. That's a special case. If there's a risk of eye cancers, if glasses before the age of two, eye surgery, all of those things put your kids at increased risk. And sometimes they're not really visible and your kid's not going to complain. And the reason is kids don't know what they should be seeing. They don't know that they should be seeing the individual leaves on a tree. I still remember my college roommate said when she first got her glasses at 10, that's when she realized, oh, it's not a Monet painting.

15:19So they're not going to complain because they kind of, they figure out a way to get by. They're so adaptable and they want to please their teachers and their doctors and their parents. So those are the kinds of things that will come up in my office. Fascinating. So when you start thinking about vision as something that develops and not just something that you have, it naturally leads to bigger questions about other things that are changing today. We're hearing more about the global rise in myopia or nearsightedness, particularly in children. Some researchers are even calling this an epidemic. What is happening?

15:56Is that real? That is real. So for viewers or listeners that might not know, so nearsightedness is those minus prescriptions. If you wear glasses, you look at your prescription or your contact lens. So it's when it's got a minus number in the sphere. And it means that you need glasses to see far away. But for the most part, unless it's a very high number, up close, it might need to be really up close, you can see just fine. And what we've been seeing is this increasing trend of nearsightedness in children. So it's predicted by 2050, half of the world's population is going to be nearsighted, which that for some people might seem like, who cares if you just need to wear glasses?

16:35What's the big deal? Again, it links back to the fact that individuals that are nearsighted are at an increased risk of ocular health and vision problems, even potential blindness. So especially if you're in the range of minus three to minus six, that's called moderate myopia. And that carries with it an increased risk. But above a minus six, that has a tremendously, like an 850 times increased risk of myopic maculopathy, and increased risk of retinal detachments and retinal breaks. Retinal detachments are terrible. They are an emergency. You have to be face down for 20 hours a day. You have to sleep like that for three weeks at a time if you have to rent a special bed, almost like a massage bed.

17:17So I don't think people understand how serious. Plus, you go blind from them. If it's not caught early, if it involves the macula, which is the center part of the retina, people go blind from myopic retina problems all the time. And so that's what we're really trying to prevent. And there's some countries in Asia where 80 % of the high school seniors are nearsighted. It's a staggering statistic worldwide. So I'm loving that there's so much more growing awareness about this. It's what I try to educate on too, just so that people go to their eye doctors and ask them, okay, what should I be doing for my child or even for my teenager?

17:56Well, this raises the question of what's driving this and what, if anything, we could do about it. So when you talk about myopia progression, one of the things that comes up is time outdoors. And that always surprises people, right? So what does being outside actually do for the eyes? And then, of course, are there other things we can talk about? You mentioned screen distance, but tell us all the things. I found an article from 1930 in the Journal of Pediatrics, and it actually has a little blurb about the rising incidence, even back then, 100 years ago, of the rising incidence of nearsightedness in kids.

18:35And this author says, we need to get our kids out, and he says, in the fresh outdoor sunshine. So they even knew about this back then, which is amazing. But what's driving this is our lifestyle. The genetics have obviously not changed in such a short period of time. In 1983, I think, the average age of a kid being diagnosed with nearsightedness was 11 years old. 20 years later, it was eight years old. So I don't even know what that number is now, but it's dropping. The genetics haven't changed in that 20, 25 year time span. It's what our kids are doing. So what are they doing? They are inside, they are on screens.

19:14It's not yet 100 % shown in real definitive studies that the screens themselves are the culprit, but we do know that near work, anything up close, so whether it's reading or writing or screens, and that's also what they've shown in a lot of studies is it's that intensity of the near work. And so that's what I try to talk about with parents in the room because that's something that's so important. But getting outdoors, They've shown in a lot of different studies across the world from, you know, Australia to China to Singapore, even in Alaska, that two hours a day of outdoor time has been shown to decrease nearsightedness and maybe even prevent it in at-risk kids.

19:57So when they did the study in China and they put these little light meters and they attached them to the students and actually observed how many hours a day. And it doesn't need to be that they're doing something active. They don't need to be in a basketball game or playing soccer. You can literally just be sitting outside or even walking in indirect sunlight is fine, too. That is all fine. But the key is just getting that outdoor time. And yes, parents should still continue to put their kids in sunglasses. That's a common follow-up question. Again, still protect them from the sun with their hats and their sunglasses.

20:30The beneficial effects of the outdoor time are still even with the sunglasses. And it doesn't matter if it's a gray overcast day, that still has more lux light than anything indoors. So even a gray day during the winter, try to get your kid outside as much as possible. That is one of the easy things that we can do that's free to help slow down or even prevent nearsightedness. Does it go the same for adults, though? If I'm sitting in bed watching my iPad for an hour at night fairly close up, does it matter? For you and I or our teens or kids that are binge watching or on their screens at night, there is some data about the blue light and circadian rhythms, especially for teens and adults as well.

21:20That blue light late at night can cause more morning grogginess. It interferes with how deep your sleep is and it leads to more fatigue. So I mean, that all kind of makes sense. Then there's also the beneficial effect, which is hard for me because I tend to be a Netflix binge watcher, to stop your screen time an hour before going to bed. You're just going to get more restful sleep. If you don't, then make sure you turn it on dark mode and do all of those things to just limit the amount of blue light. And then the same thing for the morning. It's just like a real common easy biohack for anybody, adults and kids, is don't reach for your phone first thing in the morning.

22:00we have these really old cells they're kind of the oldest cells in our retina which process blue light and they set the circadian rhythm so if you just get outside or get some outdoor time for even 10 minutes the first 30 minutes that you're awake and if you live in somewhere where you're waking up at 5 30 and it's dark doing it with one of those blue lights for seasonal affective disorder, those kinds of light displays will really help you feel just so much more adjusted and get your morning start off better. So that is something I also try not to do is answer emails. It's hard for me because in Hawaii, I'm six hours behind the East Coast and I have a couple companies where I have partners on the mainland.

22:42So they're already up and running for a long time, but I protect that first 30 minutes of the day with no scrolling and no emails and just drink my water, drink my coffee, get some morning sunlight. But I do think it's a great thing for you and I, for anybody to do. This episode is sponsored by Kohler Smart Toilets. The objects we interact with most are often the ones we notice least. Kohler Smart Toilet challenges that assumption. What if the most overlooked space in your home could become the most considered? Their Veil Smart Toilet is a sculptural silhouette that isn't just intentional, it's a philosophy that design changes everything.

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24:46So I want to come back to screens because it's so important and such a part of our lives. This certainly comes up constantly in conversations about eye health. Phones, tablets, laptops, many people, I think, feel like we're conducting a giant experiment on our eyes and then on our brains. What does the evidence actually tell us about how screen use affects vision, especially for kids? I mean, there is some data that shows screen use in and of itself has been linked to nearsightedness. But for the most part, it's hard to tease it apart from near work in general. That's the key. I will still make recommendations.

25:23So if someone is just a big reader, but they like to read on their iPad or on their tablet, get a Kindle Paperwhite as the app, as opposed to just reading with the regular Kindle, because the focus is a little bit more flat and more simulates a book. as opposed to just kind of that depth of focus that you're doing when you're on a laptop or on a tablet or on a phone, your eyes are constantly going in and out. So that's certainly been shown. And again, it's just the length of time that we're all on these devices. I mean, check out your screen time for the day, for the week. We're on them constantly and we're not taking the breaks that we should, both kids and adults alike.

26:03And that's really crucial at just maintaining eye health for young kids, limiting that amount of near work. I'm not saying you can't do screens at all, but I think just being aware and being intentional, look at the cumulative hours, look at how often they're taking breaks, look at how close are they holding their devices. That's another thing because I'm constantly correcting my kids and myself. We tend to hold our phones very close and it really should be more elbow distance at least for holding a phone. okay so that's a little further than most of us do and for your laptop arm's length that's just going to prevent you from constantly needing to focus and accommodate and give those focusing muscles a break especially in young kids where that's been linked to worsening nearsightedness and when you say take a break what do you mean by every hour every 20 minutes what does that look like?

26:58So we've all said, optometrists and ophthalmologists alike, we've all been talking about this 20-20-20 rule, which is every 20 minutes, you take a 20-second break where you look at something 20 feet away. But there's actually not a lot of great evidence for this. So when they studied it a couple years ago and looked at different breaks and altering the time, they didn't find a lot of great data for it. But we still recommend it because it's an easy intervention to do. They found that for some people, taking breaks every 10 minutes might be better, or for others, taking kind of a self-guided break might be the best and offer relief of symptoms and eye fatigue and eye strain and dry eyes.

27:38But taking a break, I think that's the most important. So we don't necessarily know what's the ideal amount of time, but 2020-20 is kind of easy to remember. I also will tell people, because sometimes taking a break every 20 minutes is not reasonable. If anyone's familiar with the Pomodoro clock and if you have ADHD, then if you're doing those 25-minute work sessions, then it's perfect. It's perfectly timed. Stick in your break where you're not scrolling on social media. That's the key, especially for the teens like, oh, I'll take a break. And then they're right from my homework. And then they're right on their phones.

28:10Go get a snack. Go do something where you are up, active, and looking in the distance. Or sometimes I'll just say every two hours, take a 15 or 20 minute break if that seems more reasonable. But I think the bottom line is really to take those breaks just to really allow your eyes to reset. I suspect many adults listening probably spend eight or 10 hours a day looking at screens and dry eyes, eye strain, headaches happen. What is actually going on physiologically when our eyes start to feel tired or even irritated from digital work? So there's a few things that's happening. First, it is kind of those focusing muscles, those muscles of accommodation.

28:51So depending on the age of the person, so I'm going to be 50, I need reading glasses to see up close. And sometimes I don't wear them. And I get a lot of that eye fatigue and eye strain because I'm really trying hard to focus without them. And then the most important thing, I think really a lot of this digital, they call it digital eye strain or digital eye fatigue, a lot of that's actually linked to dry eyes. When you're on a device, your blink rate can decrease up to 60%. So people might think, well, who cares? What does it matter if your blink rate decreases? Well, the tears in your eyes are made up of three components and you have about 30 to 40 meibomian glands.

29:32They make the oil. They're all on your top and the bottom of your eyelids. And when you blink, that releases the oil into your tear film so it doesn't evaporate so quickly. When you're on a device, you can even time yourself versus if you're in a conversation with someone else, your blink rate drastically decreases. So then the oil for your tears decreases. Therefore, your eyes get more dry because your tears are evaporating. So that's one thing to incorporate in those breaks is that's actually might be the most beneficial thing is to really practice a good blink closure because we tend to blink even when we're on the devices, but it's an incomplete blink.

30:09So you want to do like a good, complete, forceful closure. So I had sent back during the pandemic when the kids were all on their devices and doing distance learning. And I saw like all the kids wearing their blue light glasses, which we can get to in a minute. But what I sent to the teachers was, I would love for you to encourage the kids to take breaks. And I laid out some of the data and then just to practice blinking. And I watched my daughter, she was in first grade, she was six at the time. And so she's like doing her little zoom. And then I see her almost look like she has is having a seizure, like an absence.

30:42So you're just staring off in the distance. Like, what are you doing? It's like, oh, the teacher says, this is our break time. And we're supposed to be blinking our eyes. So I loved it. It was awesome. Oh, my gosh. That's incredible. I think once you understand what's happening in the body, it opens the door to simple ways to reduce that strain. So we've talked about a few things. But if somebody works on a computer all day, what are some other simple habits, in addition to taking breaks that can make a meaningful difference for eye comfort? So first is just the ergonomics. And this was huge for me is making sure if you're on a laptop, if you are using a desktop, that it is appropriately positioned.

31:22So you're not straining your neck, you're not hunched over, your eye gaze is not too high or too low, really making sure that you are at eye level. I think that's really key. Paying attention to where the windows are so you're not creating unnecessary glare when you're on your screens, I think is super helpful as well. Having a bottle of artificial tears in your desk drawer, that's easy because your eyes are going to get dry, especially if you just have to work eight to 10 hours and you don't get to take your breaks or you just don't remember to blink, especially for those of us that are perimenopausal women, we increase risk of dry eyes.

31:59That's just been shown over and over. So have those artificial tears, especially also if you work in environments with a lot of heat or AC units, those also dry your eyes out. Fans, so like all these things that make you comfortable to work out, like a fan is also going to dry your eyes out more than anything else. And then the question always arises about blue light blocking glasses. And like I mentioned before, during the pandemic, when everybody was on screens all the time, I saw all of a sudden there was so much marketing. Everybody was in blue light blocking glasses. And my kids wanted blue light blocking glasses as well because they saw all their friends with them.

32:35There is not any real good data that this helps with eye fatigue or eye strain. It does not decrease your risk of macular degeneration or cataracts. cataracts. I think sometimes there's a little bit of confusion between blue light and UV light. Ultra light is going to increase your risk of cataracts and macular degeneration. But the sun has 100 to 1000 times more blue light than anything emitted from your screen. So what I say is this, you yourself or your kid has no complaints. You don't have eye fatigue or eye strain from the device. There is no reason to rush out and go buy some blue light blocking glasses.

33:12it's not been proven in the one double-blinded randomized placebo-controlled trial you know our gold standard it showed no benefit that being said it only looked at two hours a day of screen time and most of us are on devices for a lot longer than that so i think there just needs to be more studies about it if you have blue light blocking glasses and you love them and you feel like they help you continue to wear them i'm fine with that i just don't want people to feel like they have to buy them. Hi, this is Becca Moore from For The Girls and this podcast is sponsored by Aerie, where you can find the right bra in 59 sizes, soft fabrics and good fits.

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34:59This is why I have to have my Zeevo flying insect trap. You plug it in and you let it do all the work. It's specially designed blue and UV light attracts the bugs you didn't know you had. And wow, did we have a lot. Like house flies, fruit flies, gnats. And then with Zeevo, bam. Next thing you know, the pests are caught in the sticky cartridge and away from your yummy treats without any mess or strong odors. The best part is the design is actually sleek and curved. so it hides the bugs it catches, keeping them out of sight, and when the cartridge is full, you just grab the no mess tab, throw it in the trash, pop in a new cartridge, and then you're done.

35:36No mess, no stress. So whether you're hosting a dinner party or spending an afternoon baking treats with all your friends, and you want to focus on hosting and not constantly swatting at bugs, Zivo has you covered with 24-7 bug protection. Plug in a Zivo flying insect trap so you can work smarter, not harder, and actually enjoy your time at home.

35:59You spend a lot of time online addressing eye health misinformation. And when you see a viral claim about natural vision cures or exercises that promise to eliminate the need for glasses, how should people approach those claims? And what should they look into or ask themselves before buying into it? I think they should look at it cautiously. There's something called sun gazing that people will do or they look directly at the sun in the morning and the evening hours. That's dangerous. Please don't do that. I don't recommend that. Or there are these exercises. I get sent these all the time. All these eye exercises you can do, you don't need to rely on your glasses.

36:39The eye exercises are geared towards adults and your eyes are set. They're not going to shrink at 40 or 35 or anything like that. If you're nearsighted, it's because your eyeball is too long and the light is focusing in front of the retina instead of on the retina. So you're not changing those focusing muscles. I will say in the past, there was really nothing that we could do as an alternative. They've got to be able to see. They need to see the board. They need to be able to function. Now there actually are options in terms of special glasses, special contact lenses that can combat that elongation of the eye.

37:14So with these, they've actually shown it's preventing the worsening by the anatomic changes on the eye. But I think there is some neuroadaptation going on with some of those exercises. But I just say, before you plop down thousands of dollars for some kind of program, just be wary. If it's something that's free that you would just want to try at home, it's likely not going to hurt other than sun gazing. Don't recommend that. I want to talk about eye exams. So many adults only see an eye doctor when something feels wrong. We talked about that earlier. From a prevention standpoint, how often should people actually be getting their eyes checked?

37:50So if they've had LASIK, if they're nearsighted, I want them into the office every year. That's just the standard. Typically, we need to be able to check the retina. We have to put those dilating drops in. I know everybody hates it, but that's what we want to do. Now, if you are someone like me who never needed glasses, no family history of anything, then they really do recommend the American Academy of Ophthalmology about the age of 40 to start with your eye exams. And it really can be every couple of years up until 50, unless something is found. And then 50, they do recommend once your eye exams.

38:22And that's because we can see the changes, diabetes, high blood pressure in the back of the eye, oftentimes before your primary care doctor might even diagnose you. So I have been the first to diagnose someone with diabetes because I dilate their eyes and I see bleeding and diabetic retinopathy, or I might see a cataract. That makes me think, okay, you're 40, 45. Why do you have a cataract at this age? So it can be a clue as to what's going on systemically, which is the real thing. And also by that age, most of us need reading glasses. So you're probably into CS anyway. Yep. Yep. And Rupa, before we wrap up, what simple, hopefully sustainable daily habit would you want people to adopt to best protect their long-term eye health?

39:08For kids, get them outside. Get them outside. one to two hours a day. And if you can't do the two hours, 90 minutes is better than one hour. Whatever you can get done, I think is super helpful. And for adults, it really is to just be really cognizant about your eye fatigue and your eye strain and taking those steps because most of us are on these devices, whether it's breaks you can incorporate into your schedule, throwing the artificial tears in your drawer, super simple things that can just help your eyes feel a little less strained and a little less fatigued and keep up with your eye exams when needed.

39:48Yes. Dr. Rupa Wong, thank you so much for being here. This has been such a practical and eye-opening conversation. I learned a lot, so I really appreciate you sharing your expertise. Thank you so much for having me. It's been a real pleasure.

40:06And that's it for today's episode. Thank you so much for listening. TED Health is a podcast from TED. Stay tuned for next week's episode in our mini-series on the senses as we turn our attention to smell. And I'd love to hear your thoughts about this episode. Send me a message on Instagram at ShoshanaMD. This episode was produced by me, Shoshana Ungerleiter, and Jess Shane. Edited by Alejandra Salazar and fact-checked by Vanessa Garcia-Woodworth. Special thanks to Maria Lages, Farah Degrange, Daniela Balarezo, Constanza Gallardo, Tansika Sangmarniwang, and Roxanne Highlash.

40:53This episode is sponsored by Kohler Smart Toilets. The objects we interact with most are often the ones we notice least. Kohler's Smart Toilet challenges that assumption. What if the most overlooked space in your home could become the most considered? Their Veil Smart Toilet is a sculptural silhouette that isn't just intentional, it's a philosophy. That design changes everything. The Kohler Veil Smart Toilet is sleek, with a rounded shape that's more like architecture than just plumbing. And it goes beyond looks. The touchscreen controls and customizable cleansing features offer a level of comfort and cleanliness that exceed expectations.

41:30It's all about elevating those ordinary daily rituals into something extraordinary through thoughtful design. Kohler has been pushing these boundaries for over 150 years, mastering that balance of stunning form and high-performance function. That's a long time to get it right, and it shows in every detail. Experience the difference of Kohler smart toilets. Find out more at Kohler.com.

41:57This episode is sponsored by Toyota. There's something powerful about momentum, that feeling when things are moving forward, when you're not stuck, you're not waiting, you're just going. That's true in life, and it's true in how we move through the world. Toyota's new all-electric vehicles are built to support that kind of momentum, whether it's the quick acceleration of the CHR, the versatility of the BZ, or the capability of the BZ Woodland. And with access to a growing network of chargers, including Tesla superchargers, it's designed to keep you moving, not slowing you down. Because capability isn't just about power.

42:30It's about removing friction. Learn more at Toyota.com. The new all-electric family. Toyota. Let's go places. Hey guys, it's Paige from Giggly Squad. Okay, can we all agree that hosting is so much fun? And I really do love it. Every weekend, it's come over for snacks, let's make dinner together, and somehow the second you put out a fruit platter, it seems that bugs show up before your friends do. This is why I have to have my Zeevo flying insect trap. You plug it in and you let it do all the work. It's specially designed blue and UV light attracts the bugs you didn't know you had. And wow, did we have a lot.

43:07Like houseflies, fruit flies, gnats. And then with Zeevo, bam. Next thing you know, the pests are caught in the sticky cartridge and away from your yummy treats without any mess or strong odors. The best part is the design is actually sleek and curved. so it hides the bugs it catches, keeping them out of sight, and when the cartridge is full, you just grab the no mess tab, throw it in the trash, pop in a new cartridge, and then you're done. No mess, no stress. So whether you're hosting a dinner party or spending an afternoon baking treats with all your friends, and you want to focus on hosting and not constantly swatting at bugs, Zivo has you covered with 24-7 bug protection.

43:46Plug in a Zivo flying insect trap so you can work smarter, not harder, and actually enjoy your time at home.