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Intro: It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we are talking about wellness within reach, the importance of healthy eyes, not something that we all think about. But those eye exams, those annual exams are so important, whether you have little kiddos or adults, and we're going to talk about those today with Dr. Julia Sein. She's a board-certified ophthalmologist and retina specialist on the medical staff at Henry Mayo Newhall Hospital and the CEO of Evergreen Retina in Santa Clarita and Palmdale.

Dr. Sein, thank you so much for joining us today. I'd like you to start by expanding on what I just said, the importance of regular eye exams and a little bit about age-specific recommendations that exist for screenings. Because of course, when our kids are little, they get those little eye exams at school, but an eye exam with someone like you is completely different. Tell us about those through the ages.

Dr. Julia Sein: Yeah. Thank you so much, Melanie, for having me. I'm very excited to kind of share my tidbits about eye health. so most people think that if they're seeing clearly, their eyes must be healthy, but that's not always true. There's some serious eye conditions like glaucoma, macular degeneration to name a few where you don't have any symptoms early on. There's no way to detect it unless you go to an eye doctor. So, for example, I recommend for kids they get their first eye exam by the age of four to five. If they're complaining of having difficulty seeing, or something just doesn't seem right, please tell your pediatrician, please get a referral to an ophthalmologist, optometrist, you know, to get their eyes checked out earlier on.

For adults, if they're completely healthy, no real medical problems, I would recommend every one to two years starting at the age of 40. If they have, for example, any autoimmune diseases, a lot of medical issues, then definitely on a yearly basis. And for seniors, after the age of 65, I recommend annual exams. That's not just your glasses exam. It's a full on dilation, everything, so we can figure out what's going on with your nerves and your retina. So, it's kind of like going to the dentist. Don't wait for a problem. Regular checkups are better to kind of catch the damage before it happens.

Melanie Cole, MS: Well, that is certainly great advice. And what about genetics? What role does that play in eye health, Dr. Sein? Are there specific conditions? Because I've been told my grandfather had macular degeneration and glaucoma, but he was also like 90. So, I am wondering the role of genetics in our eye health and is there a certain kind of cutoff age like there are for cancers where those things are not considered a genetic predisposition?

Dr. Julia Sein: So, as you had alluded to, age-related macular degeneration does happen in age 65 and over, and that doesn't necessarily mean that you need to have a family history of it. However, patients who do have a strong family history tend to develop it more aggressively and earlier. So if you have siblings or parents who've had relatives who've had vision loss, it's important to tell your eye care providers so we can monitor you more closely.

Again, the same thing with glaucoma. Definitely the older we get, the more predisposed we are. However, if you have a strong genetic history of glaucoma that runs in the family, then it can occur earlier. Diabetic eye disease, same thing. And there's some rare conditions such as retinitis pigmentosa, pattern dystrophy, that can tend to run in families as well. And luckily, at Evergreen Retina, we do offer genetic testing for free for patients who are curious or have a strong family history of any inherited retinal conditions.

Melanie Cole, MS: Wow. That's really cool that you do that. Thank you for letting everybody know that. Now, are there current guidelines, Dr. Sein, for prevention and early detection of those eye diseases like glaucoma and macular degeneration? Are there some guidelines that you adhere to for looking at these things?

Dr. Julia Sein: Yeah, definitely. If you have a strong family history, it's important to screen early. So for patients who have a family history of glaucoma, I would recommend screening at the age of like 40, 50 years old. And if, for example, if they have macular degeneration history, the same thing, I would screen a little bit earlier than the most frequent onset age, which is age 65 and older.

And at Evergreen Retina, we actually screen for both of these conditions. We've invested in the highest sort of diagnostic tools. So, we'll actually take very, very detailed images of your retina, of your nerves so we can detect anything early on. I always say that early detection means early treatment, which means to give the best chance for your eyes.

Melanie Cole, MS: Dr. Sein, I'd like to do a little question and answer quick round here, because there are so many myths, especially in this age of screen time, and we're sitting there in front of our screens all day. Our kids are sitting there in front of their screens all day. So, let's do a little quick round here. So first of all, blue light glasses. Do they actually work?

Dr. Julia Sein: Yeah. So, my answer is a little bit more nuanced for that. So, they're very, very popular these days. And of course, I feel like kids are always on their tablets, screens, and there's a lot of remote workers these days. So, blue light itself from the screens isn't actually strong enough to cause retinal damage. So, wearing these glasses won't prevent serious conditions like macular degeneration or other retinal diseases. So that's a very common misconception. However, they might help in reducing some digital eye strain. So if you have a lot of dry eyes or headaches and fatigue from staring at screens, the studies kind of show the effect is minimal and probably patients do feel better about it because they feel like it reminds them to be conscious of their screen time. So if it helps you to wear these glasses, to be conscious of the fact that you're on your screens and take frequent breaks, then it might be beneficial.

But the easiest thing you can do also to protect your eyes is to protect your eyes from UV light. So, that means wearing sunglasses when you're going out in the California sun. And another thing that I'd like to add, which helps me kind of remember and to tell my patients, this is the 20/20/20 rule. So, that is basically every 20 minutes, you look 20 feet away. Sometimes it's so hard to tell what 20 feet away. So, just look out to an object in the distance for about 20 seconds. It just kind of lets your eye muscles relax. So, it prevents eye strain. It makes you blink more, takes a break, so you can take a break and, basically, just, you know, get back to work once your eyes are more relaxed. So, definitely taking frequent breaks when you're on the computer for a long time does help kind of reset things.

Melanie Cole, MS: What about the dark lighting on computers? You know, they have dark mode. Is that better for our eyes?

Dr. Julia Sein: I think it does help in the fact that, it prevents the brightness from drying out the eyes. I think, when you have very, very bright screens, sometimes it's difficult. It causes more eye sensitivity because there's more light kind of penetrating your pupils. So, I do think that sometimes if you can kind of lower the settings to just where you can work comfortably but not super bright. I think it helps. And the American Academy of Ophthalmology actually recommends that you have your screens far enough away at arm's length, about 25 inches away from you.

Melanie Cole, MS: Ooh. I'm just testing that now. Also, I looked away from my screen for 20 seconds to give my eyes a break, so that's such good advice. Reading glasses, Dr. Sein, when do we know that we need them and does wearing them-- this is a big myth that people think-- does wearing them make it so you have to keep wearing them and that it gets worse because your eyes don't have to work that hard, so they get lazy as it were.

Dr. Julia Sein: That is definitely a myth. So, reading glasses happen because as we get older, our lenses, our natural lenses lose their ability to accommodate. So when we're really young, we can really, really push through everything. But when we get a little bit older, we need a little bit of assistance.

So, starting from the age of usually 40 to 45, we'll start noticing that things are blurry up close. And so, you might want to go to your eyecare provider to get a prescription for glasses. I feel like overtaxing your eyes and not using appropriate readers when you need them will actually cause more headaches and more eye strain. And wearing them will not make your prescription worse. It's just a natural course of events that will happen as we get older. So there's nothing really to kind of prevent it. Nowadays, you know, if you end up developing being cataracts or as we get older, there's actually a lot of different technologies in terms of the different types of lenses that can be placed in your eyes that prevent you from having to, necessarily wear glasses all the time. So, it's not like it's going to be a burden forever.

Melanie Cole, MS: This is such an interesting episode and you and I could do lots of these and certainly one on cataracts just by themselves. Now, what about sports and eye protection? You mentioned the sun, so you mentioned sunglasses, which is so important. But what about sports and eye protection? While our little kiddos are playing different sports, they're out in the sun, but also things fly around and the grass and the turf and all this stuff.

Dr. Julia Sein: I definitely recommend sunglasses. And if you are engaging in contact sports, I would recommend using glasses that wrap around even the sides, and especially that kind of also makes me think about like, if you do like a lot of metal work or if you're in construction, you know, it's important to wear those safety glasses as well.

But kind of going back to the sports, that's why it's important to get the eyes checked even as a kid, because if you have areas of your retina, which show thinning or anything like that, your doctor may recommend that you cut down on a lot of contact sports, or at least wear eye protection at all times to kind of prevent more insidious conditions such as like retinal tears or detachments.

Melanie Cole, MS: Wow. We're just learning so much from you. And as we get ready to wrap up, I'd like you to speak about what a comprehensive eye exam includes. Tell us what you do when someone comes in for that exam and what you tell them every day about lifestyle choices, diet, exercise. People don't think about their eyes being involved so much with diet, exercise, overall eye health. So, I'd like you to kind of tie that all together for us with a comprehensive eye exam, what's involved in that, and why you recommend good lifestyle choices.

Dr. Julia Sein: So when the patient comes in, we've kind of made our practice very stress-free and for the patient experience. So when they come in, our staff is there to take care of them. We basically check their vision, their pressure. We make sure their pupils are good. We kind of check for their eye muscle movements. We do a very thorough front of the eye exam, back of the eye exam. We also take some images of the back of the eye, some photos of the nerve as well. And then, you know, I kind of go in there and try to figure out like what's going on. If they're having any blurry vision, try to address the issue.

So, it's a full on front to back of the eye. So, we kind of do everything. So, it's quite comprehensive. And depending on your medical condition, we may look for certain things as well. So, I do believe in the saying we are what we eat. So, nutrition is very important. So, I especially recommend as a retina specialist to eat a lot of leafy greens like spinach, kale, berries, oranges, some fatty fish like salmon. And particularly if you have macular degeneration, then there's actually special supplement that you can get over-the-counter called AREDS 2 vitamins. Some brand names include PreserVision or Ocuvite. So, that actually is a studied ingredients that prevents the progression, and to slow down the progression of macular degeneration patients. So, these ingredients include vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin. So, essentially, these are vitamins to help patients slow down their progression. But again, these are expensive vitamins, so I wouldn't recommend taking them if you don't have the condition. That's why it's important to ask your eye doctor if you do need them. And, if you smoke, then definitely quit smoking, because that's one of the biggest risk factors in terms of macular degeneration, glaucoma, and other ocular eye diseases.

And in terms of exercise, it's not only good for your heart, it's good for every part of your body. So, it really helps to control blood pressure, to lower blood sugars and cholesterol. And all of these things can damage the back of your eye or your retinas over time. So, just walking 30 minutes a day can really, really make a difference.

Melanie Cole, MS: What great advice. Thank you so much, Dr. Sein. You are just a wealth of information. I hope you'll join us again and share some more of that with us. Thank you again. And to learn more or to schedule a consultation with Dr. Sein, you can visit evergreenretinamd.com. You can also visit the free Henry Mayo Newhall Hospital online health information library at library.henrymayo.com.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please always remember to subscribe, rate, and review. It's Your Health Radio on Apple Podcast, Spotify, iHeart, and Pandora, and share these shows with your friends and family on your social channels because we are learning from the experts at Henry Mayo Newhall Hospital together, and there's a lot of learning going on, so these are great episodes. Thank you so much for joining us. I'm Melanie Cole.