Speaker 1: Hello, everyone, This is Martha Stewart. William Shakespeare said that
Speaker 1: the eyes are the window to your soul, and in
Speaker 1: the medical world, it's true that I say a lot
Speaker 1: about your health. My guest today is an expert in
Speaker 1: I care. Doctor Christina Prescott is an ophthalmologist at NYU Langone,
Speaker 1: where she is also Vice chair for Education and director
Speaker 1: of the Corneus Service. As an ophthalmologist, she treats patients
Speaker 1: for cataracts and other vision disorders. Welcome to my podcast,
Speaker 1: doctor Prescott.
Speaker 2: Thank you so much. It's such an honor to be here.
Speaker 1: Well, it's so nice to have you here. May I
Speaker 1: call you Christina? Okay, now I have to report that
Speaker 1: doctor Prescott, Christina has actually treated my eyes for kind
Speaker 1: of pre cataract conditions and inserted trifocal lenses a lens
Speaker 1: in each of my eyes. And I I have been
Speaker 1: so happy for the last year. I think we just
Speaker 1: passed my year's anniversary. I have been so happy. I
Speaker 1: have no contexts, I have no eyeglasses, and I have
Speaker 1: twenty twenty vision as of last week.
Speaker 3: Yes, I was so excited, and I have to admit
Speaker 3: I was a little nervous when Martha came in and
Speaker 3: we talked a little bit about possibly doing cataract surgery,
Speaker 3: and I asked what you wanted to see and she said,
Speaker 3: I'd like to see everything perfectly at every distance. And
Speaker 3: the bar was a little high, but luckily, I think
Speaker 3: we got there.
Speaker 1: You did it. You did it, and really I'm very happy.
Speaker 1: And I think that my age to have vision like
Speaker 1: I have, which I can drive and see every single
Speaker 1: road sign night and day. I can read in bed,
Speaker 1: I can watch movies far away. I can do pretty
Speaker 1: much everything with my eyes that eyes were meant to do.
Speaker 1: And really and truly it's those little lenses. Can you
Speaker 1: describe that operation right off the bat, because I think
Speaker 1: it's not magic, it's good science, and I think people
Speaker 1: would like to know about that.
Speaker 2: It's so exciting. So I am. I think I have
Speaker 2: the best job. Well maybe martha job's a little bit, but.
Speaker 3: Other than Martha's Stewart, I think I have the best
Speaker 3: job there is because cautaract surgery, which is the probably
Speaker 3: the majority of what I do, is such an amazing surgery.
Speaker 3: So literally the surgery is done through about a two
Speaker 3: millimeter incision, takes about ten to fifteen minutes, and it
Speaker 3: involves removing the cataract, which is the natural lens of
Speaker 3: the eye that's become cloudy over time, usually just as
Speaker 3: part of the natural maturing process. And then we have
Speaker 3: so many different options. Now A basically implantable replacement lens
Speaker 3: is and depending on the type of lens that I
Speaker 3: implant to replace the cataract will determine the vision afterwards.
Speaker 3: And it's been since twenty nineteen that the trifocal lens,
Speaker 3: it's called the panoptics came out. And actually it's a
Speaker 3: funny story because I've been doing catactort about ten years
Speaker 3: at that time, and I was in India doing some
Speaker 3: outreach programs and I just gotten the trifocal lens approved there.
Speaker 3: But we were waiting in the US in twenty nineteen
Speaker 3: and everyone's just going crazy and talking about it, and
Speaker 3: I said, there's no way, there's no way it can
Speaker 3: be this good. People don't need glasses for anything. They're
Speaker 3: happy with the quality of vision. And then I get
Speaker 3: back to the US in twenty nineteen and it just
Speaker 3: gets have to approved. I just started using it, and
Speaker 3: then COVID hits and all of a sudden, we have
Speaker 3: to stop doing all surgery for three months.
Speaker 1: Wow. Right, gosh, it was so terrible. Yeah, for everything.
Speaker 1: It was for the entire medical community and for all
Speaker 1: of us because you were in danger of getting the disease. Yeah,
Speaker 1: but it is an incredible progress report to be able
Speaker 1: to say that you can actually give back the vision
Speaker 1: that we were born with.
Speaker 3: Right, And some people it's even better than the vision
Speaker 3: they were born because you were very fortunate in terms
Speaker 3: of even before you had the cataracts developing, you didn't
Speaker 3: wear glasses for anything, so you had very healthy eyes
Speaker 3: to start with. But some people come in and they
Speaker 3: say they've worn glasses since age five.
Speaker 1: Oh, I know, I got classes when I was twelve.
Speaker 1: No I had I was near sighted. Oh okay, and
Speaker 1: I could I was. I had very good vision, but
Speaker 1: I couldn't see far enough to get my driver's license.
Speaker 1: So I did wear eyeglasses, and then I got contact lenses.
Speaker 1: And then when I got your lenses, Oh my gosh.
Speaker 3: So this is the first time you haven't needed anything
Speaker 3: then never. No, That's what I'm so happy about.
Speaker 1: Yeah. Yeah, So it's a very extraordinary thing that doctor
Speaker 1: Prescott does. She is also a young mother. She is
Speaker 1: extremely well educated. Can you describe your education please for us.
Speaker 3: So I went to Columbia in New York, so right
Speaker 3: around the corner here for undergraduate, and I was a
Speaker 3: biophysics major. I just always really liked biology, physics, optics.
Speaker 3: And then I worked at Regeneron, which is a company
Speaker 3: that now some of you who are interested in eyes
Speaker 3: may be familiar with because they make a product called
Speaker 3: Iliyah which has been very successful for macular degeneration. But
Speaker 3: I started working there when I was in college, and
Speaker 3: I just thought the medical research was so exciting. So
Speaker 3: I decided to do an NIH funded program it's called
Speaker 3: an mdphd, or the Medical Scientist Training program, where I
Speaker 3: did both an MD and then a PhD in neuroscience
Speaker 3: out in Colorado. And then during my medical training, I
Speaker 3: just fortunately spent a day seeing eye surgery and I
Speaker 3: just thought it was the most beautiful thing I'd ever seen.
Speaker 3: It was just it's so different from most surgeries where
Speaker 3: you'd maybe see on the TV where there's blood and messy,
Speaker 3: but eye surgery is nothing like that. There's no blood,
Speaker 3: it's all done under a microscope. It's just very beautiful
Speaker 3: and elegant. It's so so precise, and then afterwards the
Speaker 3: outcomes the patients are so happy, and it was such
Speaker 3: an uplifting field, whereas some of medicine I liked, but
Speaker 3: I found a little bit sad and it got a
Speaker 3: little bit motional to me if the patients were sick
Speaker 3: or didn't do so well. So I just the day
Speaker 3: I sawp theomology, I decided that was my fit. And
Speaker 3: then I came out to Yale for residency, and then
Speaker 3: did a fellowship in Corny and refractive surgery and at Harvard.
Speaker 3: Then I went to Hopkins for nine years, which I loved,
Speaker 3: and then one of my dear friends became chair it
Speaker 3: NYU and recruited me back to New York.
Speaker 2: I've been all over.
Speaker 1: Yeah, you have, You've been. And in the meantime you
Speaker 1: also have time to get married and have two children.
Speaker 2: Three children.
Speaker 1: Oh, three children, Oh my gosh. How old are they?
Speaker 2: Oh my goodness, they're getting old.
Speaker 3: Seventeen year old who actually had as an intern, which
Speaker 3: is I wouldn't necessarily recommend, but it worked out well.
Speaker 2: He's a great kid.
Speaker 3: And then a fifteen year old who I was as
Speaker 3: a resident, and then an eight year old, so there's
Speaker 3: a bit of a gap, but it's fun.
Speaker 1: Wow. Well, it's so incredible, and you are just the
Speaker 1: master of your craft, really and truly, I have been
Speaker 1: so thrilled, and I thought maybe we should talk about
Speaker 1: besides the lenses which you've been planted in my eyes,
Speaker 1: we should really talk about general guidelines for taking care
Speaker 1: of one's eyes, because so many of us just don't
Speaker 1: have any idea. We know that they're precious, we know
Speaker 1: that we need our eyes. If there was one of
Speaker 1: the five senses that I could not live without, I
Speaker 1: would say it's my eyes. I would be a very
Speaker 1: bad blind person. I could do without I could do
Speaker 1: without smell, but I couldn't do without eyes. And it's
Speaker 1: so incredible to know how to take care of them.
Speaker 1: So give us some guidelines for taking care of your eyes.
Speaker 3: Well, the good thing is it's actually pretty simple. I
Speaker 3: think overall we've talked about this a little bit. Is
Speaker 3: a lot of the things, and as you mentioned so
Speaker 3: eloquently earlier, you know, the eyes are really the window
Speaker 3: to the solar and the self, and also really most
Speaker 3: of the things that affect the eyes are things that
Speaker 3: affect the rest of the body. It's just that we
Speaker 3: can see them in the eyes. So we have the
Speaker 3: epidemic of diabetes and high blood pressure in this country.
Speaker 3: And it's amazing because you can actually see the blood
Speaker 3: vessels in the back of the eye when you go
Speaker 3: in for your eye exam, so your doctor may be
Speaker 3: able to tell you, oh, your diabetes control is worse,
Speaker 3: or how's that blood pressure doing. I've actually even diagnosed
Speaker 3: a patient once with a leukemia because they had these
Speaker 3: very unusual bleeding in the back of their eye and
Speaker 3: no other systemic symptoms. So you can really see the
Speaker 3: see a lot of the pathology that's happening in the
Speaker 3: rest of the body, but you.
Speaker 2: Can see it in the eye.
Speaker 1: Your eyes great.
Speaker 2: And the other thing is avoiding smoking.
Speaker 3: I'm sure that's a common theme, but that's the one
Speaker 3: thing that makes macro degeneration, which is such a common problem.
Speaker 2: That's the one thing we know we can do to.
Speaker 1: Is that really common?
Speaker 3: It is, It's very common, especially among people as they
Speaker 3: become older. It's an unfortunately there's not a cure. We
Speaker 3: have better treatments nowadays, but there's still not a cure.
Speaker 3: So things you can do to reduce your risk, which
Speaker 3: is the main one is smoking, and then there is
Speaker 3: some evidence that a Mediterranean diet and a high dose
Speaker 3: antioxidan vitamin also help.
Speaker 1: And what are the signs of a healthy eye?
Speaker 3: One thing that's fortunate is most of the time, not
Speaker 3: all the time, if you're seeing clearly, that's obvious a
Speaker 3: very good sign. Now, sometimes, like with diabetes, sometimes it's
Speaker 3: pretty advanced before you actually can get visual loss. Also,
Speaker 3: something called glaucoma can develop without you realizing it because
Speaker 3: it affects your peripheral vision.
Speaker 2: So even though your vision.
Speaker 3: Is good, it is still good important to get your
Speaker 3: eyes checked, especially as we get more mature, so.
Speaker 1: They really do reflect your general health very much. So
Speaker 1: vision and eye pressure tend to get worse with age.
Speaker 1: I've read. Are there any signs of symptoms people shouldn't
Speaker 1: ignore or assume that are part of aging.
Speaker 3: Well, the vision really shouldn't drop dramatically at any or
Speaker 3: suddenly at any point. So the sort of normal things
Speaker 3: that happen with aging, you know, the kadarct slowly developing,
Speaker 3: the eyes getting a little dry, or even the slow
Speaker 3: form of macular degeneration are all very slow. So there
Speaker 3: should never be a sudden drop in vision, because if
Speaker 3: there is, that could be a sign that it's something
Speaker 3: more significant, sometimes a bleed or a stroke in the eye,
Speaker 3: So if you have a sudden change in vision, that's
Speaker 3: never good.
Speaker 1: And is there an age where you need to start
Speaker 1: annual exams?
Speaker 3: So it really depends on the person in your family history,
Speaker 3: but in general, it is good to get a screening
Speaker 3: exam when as a child before you start school, definitely,
Speaker 3: because a lot of times children don't necessarily show that
Speaker 3: they can't see until they get.
Speaker 2: To school, so it's good to do that mostly for
Speaker 2: their learning.
Speaker 3: And then when you get a little bit older, you'll
Speaker 3: notice you'll start eating reading glasses, usually in the forties,
Speaker 3: so it's probably good to make sure that's all it is.
Speaker 3: And then once you get into your fifties, it's good
Speaker 3: to go more often.
Speaker 2: But if you have a very.
Speaker 3: Normal healthy exams that you go in at forty hor
Speaker 3: eyes perfectly healthy of no family risk factors, you don't
Speaker 3: necessarily need to go annually. For a lot of people,
Speaker 3: every three years would be okay, but you want to
Speaker 3: make sure that you don't have many risk factors.
Speaker 1: And I've been noticing lots of little kids with eyeglasses
Speaker 1: these days. I think more than when I was in
Speaker 1: school as a child. Absolutely so is that because there
Speaker 1: is better detection?
Speaker 3: Actually, that's such a huge thing, and I'm so glad
Speaker 3: you mentioned that because we actually have and some people
Speaker 3: literally are calling this a myopia epidemic, and myopia just.
Speaker 2: Means being nearsighted.
Speaker 3: But actually it's likely due to the increase in screen times,
Speaker 3: especially being held very close, the children spending so much
Speaker 3: time looking at these screens inside that actually, over the
Speaker 3: last ten to twenty years there's been worldwide and worse
Speaker 3: in some areas of Asia, but worldwide there's been a
Speaker 3: huge increase really, so that now about fifty percent of
Speaker 3: children are actually myopic, and it's predicted to get worse
Speaker 3: and worse over the next decades.
Speaker 1: And if kids are looking at screens, should they be
Speaker 1: looking at screens in a dark room? Is that worse
Speaker 1: than looking at screens in a light room? Because I've
Speaker 1: been having arguments with my grandchildren. The boy is it's
Speaker 1: on his screen a lot. He watches sports, and so
Speaker 1: it's a small screen and he's in one hand he
Speaker 1: has a book where he's reading, and the other hand
Speaker 1: he has the screen watching a soccer game. What's the
Speaker 1: best way to watch a small screen if you're going
Speaker 1: to right.
Speaker 3: So it's a combination of the size of the screen,
Speaker 3: so the smaller and closer or worse, and then also
Speaker 3: the lighting. So actually, if you can make them make
Speaker 3: him go outside and watch it outside, it actually is better.
Speaker 2: Because then that's what I say, it's actually true. There's
Speaker 2: some data.
Speaker 3: I know it sounds like a weird not scientific, was
Speaker 3: actually some great scientific data showing that spending time outside
Speaker 3: during the time that I was developing, so from birth
Speaker 3: up until about age seven to thirteen, you actually can
Speaker 3: reduce the amount of nearsightedness with more time spent outside.
Speaker 3: There are actually some public health interventions that are geared
Speaker 3: towards that.
Speaker 1: So I was trying to wonder why I was myopic
Speaker 1: as a young child. But we didn't have screens. We
Speaker 1: didn't have screens, we didn't even have a television. So
Speaker 1: I read all the time, and I read in the
Speaker 1: semi dark because I was turn out your lights, and
Speaker 1: so I would read with a flashlight and probably very
Speaker 1: close hours and hours reading all the time with a
Speaker 1: flashlight in bed, yes, and I think that might have
Speaker 1: contributed to it. But I think also I think my
Speaker 1: mother was also my out.
Speaker 2: There's a combination.
Speaker 3: There's definitely a genetic tendency, and again this is part
Speaker 3: of the reason why Asian countries are such an increased incidence,
Speaker 3: but it also is related to near work. And then
Speaker 3: the other interesting thing. In some of the different countries
Speaker 3: where they have a lot of near sighted children, they've
Speaker 3: done studies looking at urban versus rural areas and it's amazing.
Speaker 3: There are some urban cities where about ninety percent of
Speaker 3: the troldern are nearsighted, and in the same country about
Speaker 3: ten percent of children in the rural areas are nearsighted.
Speaker 3: So even with similar genetics, there's a huge environmental effect
Speaker 3: I see wo So it's a really a big public
Speaker 3: health issue right now.
Speaker 2: In ophthalmology, I see.
Speaker 1: So many kids with glasses and it's hard to see them.
Speaker 1: They look like little old people in glasses.
Speaker 3: And it's not just the glasses, because I think sometimes
Speaker 3: we think of that just cosmetic, and that's true. If
Speaker 3: it's a mild prescription like yours, it's a very mild prescription,
Speaker 3: so then it's perfectly healthy of a perfectly healthy eye.
Speaker 3: But when you get this would call pathologic myopia or
Speaker 3: these really near sighted strong prescriptions. It's actually not healthy
Speaker 3: for the eye because basically the eye've grown too long,
Speaker 3: is why that happens, and so you get thin areas
Speaker 3: and they're much more prone to retinal detachment and other
Speaker 3: problems as they get older.
Speaker 2: So it's not just a cosmetic thing.
Speaker 1: So suggest to parents to reduce the amount of screen time, right.
Speaker 2: I try, Yeah, I do try.
Speaker 3: No, it's really yeah, it is, and for adults as well,
Speaker 3: for it doesn't affect your being nearsighted's so much once
Speaker 3: you're adult. But actually dry eye, which is such a
Speaker 3: huge problem. I think it's actually the most commonly diagnosed
Speaker 3: eye problem in the US, and I think probably worldwide.
Speaker 3: And actually screen time is directly contributes to dry eye
Speaker 3: symptoms as well, especially to periods. So do take breaks
Speaker 3: when you're spending time on the screen. I know it's
Speaker 3: easier said than done, but it's an important thing.
Speaker 1: So people pay attention to your kids and pay attention
Speaker 1: to screen time and be diligent about it because it
Speaker 1: really will have long term effects.
Speaker 2: Yep.
Speaker 1: And go outside and go outside. Yeah. Well, luckily, my
Speaker 1: grandchildren go outside all the time. They're out there all
Speaker 1: the time, and they don't mind either of being outside
Speaker 1: with their screens or inside. They just they're adaptable, but
Speaker 1: they have to watch out. Now, people get confused, what's
Speaker 1: the difference between an optometrist, an ophthalmologist, and an oculist.
Speaker 2: So that's a great question.
Speaker 3: So I think sometimes people do get confused with optalmalists
Speaker 3: versus optomics, and I work with both. I'm an ophthalmologist
Speaker 3: and I mostly do surgery. I don't do regular routine
Speaker 3: exams or glass or contacts myself. But the way I
Speaker 3: think of it is an ophalmologist is a medical doctor.
Speaker 3: So I went to medical school, did a residency just
Speaker 3: focused mostly on surgery. So after college you do fourias
Speaker 3: of medical school, and then four y is of themology
Speaker 3: four years after four years, and then if you want to,
Speaker 3: you can do an extra year or two of fellowship,
Speaker 3: which I did in corneon refractive surgery. So it's a
Speaker 3: pretty long program that's to become an optimalogist, so you're
Speaker 3: really focused on more problem eyes. Is how I think
Speaker 3: of it, as ict of see sick eyes, so people
Speaker 3: who need surgery or need some kind of serious medical intervention.
Speaker 3: Whereasn optometry is also actually an advanced degree. I think
Speaker 3: some people don't realize that, so they actually do four
Speaker 3: years after college an optometry school, which is focused a
Speaker 3: lot on glasses, contacts and more healthy eye exits, they're no,
Speaker 3: so they're what's called an od a doctor of optometry.
Speaker 3: So they're not medical doctors. So but if you have
Speaker 3: a healthy eye, and especially if need glasses or contacts,
Speaker 3: then that's most likely to be your primary eye care provider.
Speaker 3: And again I have a lot of people that I
Speaker 3: work with in both. But for sick guys or if
Speaker 3: you need surgery, then you need an ophthalmologist.
Speaker 1: What's an oculist? Is that a doctor? So no, that's
Speaker 1: I think an is that somebody who make cyeglasses.
Speaker 3: I was gonna say, so optician is you? I think
Speaker 3: ocus is the old fashioned term for optician.
Speaker 1: So the optician, remember hearing that from childhood, the oculus.
Speaker 3: The oculus, So I think that's what they used to
Speaker 3: call an optician. Who is the person who actually makes
Speaker 3: class and that's a lost art. Now there are some
Speaker 3: really elegant crafts people who can really fine tune lenses.
Speaker 3: Now a lot of the lenses are made mechanically, not
Speaker 3: by hand, necessarily.
Speaker 1: So so you just you describe the training that Aphalmologies
Speaker 1: goes through. That's a long training program.
Speaker 3: Yeah, it's actually gotten quite competitive to I'm the program
Speaker 3: director at NYU and we have six lots and we
Speaker 3: get over seven hundred applicants every year, so it's become
Speaker 3: quite popular.
Speaker 1: Wow wow, But so what is the whole industry of
Speaker 1: eye care? It's a vast industry. I was trying to
Speaker 1: remember since the time I was twelve when I got
Speaker 1: my first little pair of pink rimmed glasses. I remember
Speaker 1: they were little cat eyes and I wore those and
Speaker 1: I kind of liked I like having I have them.
Speaker 1: I's still oh my gosh, But I remember then I
Speaker 1: got a pair of blue ones. It was expensive to
Speaker 1: get a new pair of glasses, and my mother every
Speaker 1: time I grew a pair, and she told me how
Speaker 1: I had to take care of them and wash them
Speaker 1: and everything. And I remember being proud that I had
Speaker 1: glasses and happy that I had them so that I
Speaker 1: could see perfectly for school. But children who don't have
Speaker 1: the opportunity to get the glasses that are appropriate for them,
Speaker 1: is there anything they can do?
Speaker 3: Actually, I'm so glad you mentioned that because it's such
Speaker 3: a huge problem, and worldwide there are millions of children
Speaker 3: who basically would see perfectly if they had glasses. So
Speaker 3: luckily there are some good outreach programs here.
Speaker 2: There's one that I.
Speaker 3: Recently met the founder called ReSpectacle, which I thought was
Speaker 3: a really neat concept. And basically what you can do
Speaker 3: is you can donate your old glasses. You send them
Speaker 3: into this website and they keep a database of all
Speaker 3: the prescriptions and the type of glasses, and then anyone
Speaker 3: who wants to who needs glasses can go on there
Speaker 3: just type in their prescription and they'll make recommendations of
Speaker 3: similar ones that they have in sock and send them
Speaker 3: the strat yep.
Speaker 1: Oh, just remember that everyone ReSpectacle. It's like hearing aids
Speaker 1: and now taking hearing aids. And I remember donating my
Speaker 1: mother's hearings when she passed away.
Speaker 3: Because it's people's person changes, even the frames change. And
Speaker 3: then some of the different optical shops I know, Warby
Speaker 3: Parker is one of the ones that kind of pioneered this,
Speaker 3: but some other optical shops have started doing this as well,
Speaker 3: where when you buy a pair of glasses, they'll donate
Speaker 3: a pair as well to a child in need, which
Speaker 3: is there's some great programs out there.
Speaker 1: Are very important, and oh gosh, that is such good news.
Speaker 1: So let's talk about these trifocal lenses again. Back to
Speaker 1: my eyes and the ability for me to have this
Speaker 1: wonderful vision that I have now or is that something
Speaker 1: that everyone could have?
Speaker 3: So I'm so glad you asked that, because I love
Speaker 3: the trifocal lenses that I tell people, like if I
Speaker 3: was getting catac starch brow, that's what I would get.
Speaker 1: My assistant, by the way, Matt, he just told me
Speaker 1: today that his eyeglasses are trifocal eyeglasses and they drive
Speaker 1: him crazy. They're eyeglasses and he can't read, he can't
Speaker 1: see distance, he can't drive at night, all the things
Speaker 1: that he's suffering. But he's wearing this one pair of
Speaker 1: glasses that supposedly does everything. Does that really work well?
Speaker 3: So it's a lot harder with glasses. And I was
Speaker 3: also talking to one of your other colleagues about progressives,
Speaker 3: where a lot of times it's hard to actually progressive
Speaker 3: eyeglasses where you have far, medium, and close all in
Speaker 3: one frame and it basically gradually transitions. And that's actually
Speaker 3: probably the most popular type of lens now among people
Speaker 3: once they get into their forties or fifties or older.
Speaker 1: But it's very shard like through the top of the lens.
Speaker 3: One thing exactly distance in the middle in theory computer
Speaker 3: and bottoms in theory reading. But it's very hard to
Speaker 3: find the right spot to look through and when you
Speaker 3: look down it can actually affect your depth perception when
Speaker 3: you're walking up and downstairs, whereas with a lens implant,
Speaker 3: because of the way they're designed, you actually don't have
Speaker 3: to look at a specific diress. It's just based on
Speaker 3: the way your eye naturally looks. But one thing I
Speaker 3: do want to mention is I know you have a
Speaker 3: large follow and I think probably a lot of people
Speaker 3: now are saying I'm going to get the trifle lenses
Speaker 3: that have it as perfect vision, and hopefully that's true.
Speaker 3: But I tell people and the important thing about those
Speaker 3: lenses is you have to have an otherwise healthy eye
Speaker 3: for them to really give you that perfect vision, because
Speaker 3: if you'd had what you know, if you'd had like
Speaker 3: a macro degeneration or gaucoma or something like that, or
Speaker 3: an unusual shape die, that might not have been an option.
Speaker 2: They're not unfortunately not an option. I was every lucky.
Speaker 1: I was just lucky that my eyes were Yeah, my
Speaker 1: eyes were good. I think that if people who have
Speaker 1: healthy eyes but at least investigate that option, it would
Speaker 1: be something. But you told me that insurance doesn't cover them, right.
Speaker 3: Unfortunately, they are more expensive lenses, so they're not an
Speaker 3: option for everyone. But I have had patients tell me, well,
Speaker 3: I did the calculation, and this is how much I
Speaker 3: paid for the specific lens, and then this is how
Speaker 3: much I used to spend on my glasses, and after
Speaker 3: that point I'll come out ahead.
Speaker 2: So right, So obviously it depends on.
Speaker 1: The Really, after one year my eyes, I have a
Speaker 1: little bit of dry eyes and you've taken care of that,
Speaker 1: but generally just so comfortable and no more worrying that
Speaker 1: I fell asleep with my contacts in or that I
Speaker 1: left my glasses somewhere. It's really a great relief to
Speaker 1: be able to have these lenses implanted. Yeah, who is
Speaker 1: the surgery for. It's you've just said for people with
Speaker 1: healthy guys.
Speaker 3: So cataract surgery is really for anyone who has the
Speaker 3: cataractors developing counteracts. But in terms of the trifocal lens
Speaker 3: that you really need a healthy eye. But fortunately, even
Speaker 3: for people who have other eye issues, there are a
Speaker 3: lot of different lens options out there now, and I
Speaker 3: think that's that one really gives you the best chance
Speaker 3: of not needing any glasses and having that full range
Speaker 3: of vision. But even someone who has something like a
Speaker 3: macad degenerator.
Speaker 1: You're in Asia, are you too young for trifocals or
Speaker 1: I usually.
Speaker 3: Don't recommend having counteract surgery until you at least are
Speaker 3: starting to develop the contact and having some visual changes
Speaker 3: from that, because if you have a normal, healthy lens,
Speaker 3: and say you're in your forties, even if you start
Speaker 3: needing reading glasses, that's a pretty big surgery to go
Speaker 3: through if your eyes otherwise healthy and just needing reading glasses.
Speaker 2: So usually it's rare.
Speaker 3: To have that surgery before age fifty athough un certain circumstances, we.
Speaker 1: Do so like all fifty year olds, pay attention.
Speaker 3: Exactly see when you start having your vision travel, at
Speaker 3: least go get checked.
Speaker 1: I would think that it would work for everybody, but
Speaker 1: it doesn't.
Speaker 2: Well if people.
Speaker 3: Have other eye issues, and then the other thing is,
Speaker 3: now your surgery went very well, but that lens Basically,
Speaker 3: the surgery has to go perfectly and you have to,
Speaker 3: as we say, hit the target exactly because it's a
Speaker 3: very specific lens. So if you don't think you're going
Speaker 3: to be able to get a successful surgery, or the
Speaker 3: measurements aren't accurate or reliable, then that might not be well.
Speaker 1: You need an expert like you, you.
Speaker 2: Who does a who does a lot of those surgeries.
Speaker 1: So, and the recovery was very simple. Sure, yeah, two
Speaker 1: days it was fine. You're a very healthy person, so
Speaker 1: I know I'm lucky. So what do you say to
Speaker 1: patients who come to you and have are very fearful
Speaker 1: about operating on their eyes? Because I was, people say, oh,
Speaker 1: did you have lasik? What is lasik surgery?
Speaker 3: So, lasik surgery is a surgery to it's a laser
Speaker 3: eye surgery. I also do that as well, and that's
Speaker 3: designed to reduce the need of glasses for someone who
Speaker 3: doesn't have cataracts. So, say you're in your twenties or
Speaker 3: thirties when you wore glasses all the time, but you
Speaker 3: just want to get rid of the glasses or contacts,
Speaker 3: use a laser to basically reshape the cornea, almost like
Speaker 3: using a laser to etch a permanent.
Speaker 1: Contact you that round perfect eye again exactly, And that's
Speaker 1: that is very delicate and very you have to be
Speaker 1: an expert at that is a surgeon.
Speaker 2: Right, That's awesome, very spaci.
Speaker 1: I know my sister had that and she's thrilled. She's
Speaker 1: thrilled with it.
Speaker 2: Yeah, so that's a great option.
Speaker 3: I tell people when you're in your twenties thirties, lasik
Speaker 3: is a great option, and then when you get into
Speaker 3: your fifty sixties, the counteract surge is great options. We
Speaker 3: still don't have something perfect for that sort of in
Speaker 3: the forties, which actually is where I am in the
Speaker 3: forties range yet.
Speaker 2: But we're working on it so well.
Speaker 1: Could that be?
Speaker 3: So? There are some surgeons that were developed basically putting
Speaker 3: an implant into the cornea to try to reduce the
Speaker 3: need for reading glasses, but none of them have quite
Speaker 3: panned out because the quality of vision hasn't been there yet.
Speaker 2: But that doesn't mean it won't be. It's just not
Speaker 2: there yet.
Speaker 1: Can you describe the eyeball? I just I went through
Speaker 1: this with my beautiful dog, Crembreulet recently. She had to
Speaker 1: have her eyeball removed because she wounded it. She must
Speaker 1: have run into a tree. And I looked at all
Speaker 1: the photography and all the drawings of the eye to
Speaker 1: see what the doctor was talking about. But can you
Speaker 1: describe it? Here? You have a beautiful eye, it is,
Speaker 1: so what's the dark center?
Speaker 3: So the very dark center is actually the pupil, which
Speaker 3: is not an actual object, it's.
Speaker 2: Just an area where in the space the window.
Speaker 3: Well, so you have the cornea first, which is the
Speaker 3: clear front covering of that. And that's one of my
Speaker 3: areas interestince I transplant that and actually it's interesting. The
Speaker 3: corny was actually the first successful solid organ transplant ever
Speaker 3: performed in nineteen oh six Edward zerm. But it's pretty
Speaker 3: amazing because it's a vascar. There's no blood vest it's
Speaker 3: clear covering of your eye, yep. Because there's no blood vessels.
Speaker 3: It's actually the easiest organ to transplant because the rejection
Speaker 3: risk is incredibly low. Then you have the sort of
Speaker 3: the space we call it the antier chamber, but that's
Speaker 3: basically where you have a fluid and then you have
Speaker 3: your eye res which I think what people always think
Speaker 3: about when they think of the eyes, the colored part.
Speaker 3: So I think about that a lot when they think
Speaker 3: about the eyes, and you know, there's all the people
Speaker 3: prefer one color versus the other, but they're all beautiful.
Speaker 1: And then have you ever operated on an odd colored eye?
Speaker 3: Well, one thing that I should say is the sort
Speaker 3: of public safety thing, and I think this is advertised somewhere,
Speaker 3: especially for people go online to do a lot of
Speaker 3: social media. There was a trend of wild God, I
Speaker 3: think it's hopefully abated, but I'm not one hundred percent
Speaker 3: sure where people were going to other countries and having
Speaker 3: implantable colored irises put in. But unfortunately, it was a
Speaker 3: very crude surgery and the implants were not very safe,
Speaker 3: and so actually I had a few patients who had
Speaker 3: had to have cornial transplants combined with cautaract surgery because
Speaker 3: these implantable irises basically destroyed.
Speaker 1: I saw some of these I saw.
Speaker 3: I Unfortunately, I had two of these patients who went
Speaker 3: overseas for the surge, but then came back to the
Speaker 3: US when they had complications, and very sad.
Speaker 2: Actually, I had a.
Speaker 3: Thirty something year old, beautiful young lady who'd gone overseas
Speaker 3: and had this done.
Speaker 2: I had to do a bilatal corner.
Speaker 1: Was she going from to what color she was engined?
Speaker 3: She was middle Eastern, had dark colored eyes, and she
Speaker 3: went to blue eyes, but it didn't didn't go so well.
Speaker 3: So lucky hair surgeries went well. Her countaract and cornial transplant.
Speaker 3: She did well from a vision point of view, but
Speaker 3: it was sad.
Speaker 2: Back to brown, but a little bit cloudy because of
Speaker 2: all the scarring.
Speaker 1: Gee yes. For Halloween, I always insert colored contact lenses
Speaker 1: that you can buy these every color of contact lens.
Speaker 1: So one year I did yellow, they look so weird
Speaker 1: and beautiful. One year of jagged purple and they look
Speaker 1: really good like the tailor violet eyes, and I've done
Speaker 1: white eyes. The white are the scariest.
Speaker 3: Yeah, some of them are very disturbing looking. Actually, another
Speaker 3: public safety announcement, careful. You'll be careful where you purchase
Speaker 3: those lenses because if you go to an optical shop
Speaker 3: or you have an optomics or an optician who provides
Speaker 3: those for you, there are a lot of beautiful, safe
Speaker 3: ones out there.
Speaker 1: Okay, I've got them from I think Faushion.
Speaker 3: Okay, yeah, that's great because that's a great company. But
Speaker 3: you do have to be careful because especially around Halloween time,
Speaker 3: a lot of drug stores or costume supply stores and.
Speaker 2: The internet will sell it.
Speaker 3: And a lot of them are really not very they're
Speaker 3: not sterile, they're not.
Speaker 2: Safe for the eye.
Speaker 3: And every year we see a lot of really pretty
Speaker 3: significant cornial ulcers and it actually forget it.
Speaker 1: People do not wear you can.
Speaker 3: Get they just get them from a from a legitimate
Speaker 3: optical shop. Don't get them online costume shop. I'd like
Speaker 3: to get dressed up for Halloween, so just be careful
Speaker 3: where you get them.
Speaker 2: There.
Speaker 1: Okay. So then you have your iris, yes.
Speaker 3: And then we have the vitreous, which is the gel
Speaker 3: of the eye that kind of gives you the form
Speaker 3: part of the eye, and that's where people get floaters.
Speaker 3: I know, floaters are something that a lot of people
Speaker 3: probably have and I'm sure some of the people out
Speaker 3: there thinking, oh, she's gonna tell me how to fix
Speaker 3: my floaters and it's going to be great. But unfortunately
Speaker 3: we still don't have a perfect cure for floaters. They
Speaker 3: can be removed surgically if if they're rare, really bothers
Speaker 3: some but the surgical risk of that is still relatively high.
Speaker 3: Then behind the vitreous, you have your retina, which is
Speaker 3: really the film of the camera. It is really the
Speaker 3: most beautiful I think, cause it's if you see the
Speaker 3: photographs of it, you can see these beautiful vessels. You
Speaker 3: can actually see the nerve of the eye, which is
Speaker 3: amazing because the eyes are only part of the body
Speaker 3: where you can actually literally see the optic nerve and
Speaker 3: you can tell so much about the health of the
Speaker 3: eye based on that. And one thing I was talking
Speaker 3: earlier is actually some of those photos there's some evidence
Speaker 3: that maybe looking at retina photos and retina imaging can
Speaker 3: actually give us some predictive value for certain types of dementia.
Speaker 3: So that's a really exciting area of study right now.
Speaker 1: But what could you do it?
Speaker 3: Well, I guess there's not necessarily anything you could do
Speaker 3: since we don't have a treatment right now, but at least.
Speaker 1: To be aware, yeah you're going to fit Alzheimer.
Speaker 3: That you're the higher risk maybe and maybe a venture
Speaker 3: we have a treatment.
Speaker 1: Come in and you can look at me and make sure.
Speaker 2: I think there's lots of evidence that you're doing just fine.
Speaker 1: Goodness, So that's it.
Speaker 3: That's the eye, not the Yeah, it's very simple, but
Speaker 3: very beautiful. Where do you transplant from from donor donor.
Speaker 3: It's actually pretty amazing. In the US, we have a
Speaker 3: great I banking system, so for people who are organ donors,
Speaker 3: that's one of the most utilized organs that can be used.
Speaker 1: I never thought of it that way because my sister
Speaker 1: who passed away gave her eyes. So somebody has her eyes. Yes,
Speaker 1: well they have her.
Speaker 3: Right the corny is the only part of the eye
Speaker 3: that can be transmit It's pretty amazing. And sometimes, you know,
Speaker 3: you see the stories about the donors and the recipients,
Speaker 3: and I always ask my patients, I said, do you
Speaker 3: want to know who gave the cornia? Because sometimes it's
Speaker 3: a sad story and they can write letters to the
Speaker 3: family and things saying thank you. And especially when I
Speaker 3: have a child who gets the cornea as the recipient,
Speaker 3: a lot of times I think it's really nice.
Speaker 1: To And so why would you have to have your
Speaker 1: corny replaced? Is it so there are there or something not?
Speaker 3: Usually so there are some congenital reasons for children and
Speaker 3: then an adult. There's something called Fuchs corneal dystrophy, which
Speaker 3: is basically genetic conditions. It's actually pretty common where you
Speaker 3: lose the inner cells of your corny over time as
Speaker 3: you get older.
Speaker 2: But it's really neat.
Speaker 3: Now instead of having to replace the whole cornea for that,
Speaker 3: we can literally just replace the inner layer of cells
Speaker 3: with a donor layer of cells.
Speaker 2: And now there's some new things going on that just.
Speaker 1: Got approved in you inject the cells.
Speaker 3: So actually, it's funny you asked that you're ahead of
Speaker 3: your time and a lot. Yeah. Yeah, Shaguru Kinoshita in
Speaker 3: Japan actually just got approved in Japan a cell injection
Speaker 3: therapy and he's been working on that for decades and
Speaker 3: he finally got approved in Japan and now we'll see
Speaker 3: if if that gets approved in the US.
Speaker 2: But I think we're getting pretty close.
Speaker 1: Wow.
Speaker 2: So it's amazing. It's amazing.
Speaker 1: Our eyes one of the most worked on organs.
Speaker 3: Actually, a cataracts ARET is most common surgery performed in
Speaker 3: the US.
Speaker 1: It is.
Speaker 3: It is probably because it's so successful and as you mentioned,
Speaker 3: people care so much about their vision. That's something that
Speaker 3: people are likely to have operated on eyes you want
Speaker 3: to see and I think our outcomes are just really good.
Speaker 1: It's so amazing. I'm so thrilled about this. So what
Speaker 1: are some of the risks to eye health from weight
Speaker 1: loss drugs. I've been hearing that there are some problems.
Speaker 3: So that's such a good question because it's such a
Speaker 3: hot topic right now. I mean, the drugs have been
Speaker 3: such an incredible thing for so many people. A lot
Speaker 3: of my patients are on it and really have had
Speaker 3: a great result. Initially, there was quite a worry because
Speaker 3: there are a few cases of what's called naion, which
Speaker 3: is almost like a mini stroke to the eye that
Speaker 3: can happen. It usually happens overnight and people notice it
Speaker 3: when they wake up in the morning with basically half
Speaker 3: their visual field is usually missing. And there was a
Speaker 3: few episodes of that reported right surely after people started
Speaker 3: these medications. But it's a little hard to tell because
Speaker 3: the main risk factors for those type of strokes in
Speaker 3: the eye developing are being overweight, having unstable blood pressure,
Speaker 3: being older men, so a lot of the same risk
Speaker 3: factors for people that might be on these medications. So
Speaker 3: it's still being looked at right now. They're not saying
Speaker 3: don't take the medication, but they're saying if you have
Speaker 3: any of these sudden visual loss, especially upon first waking up,
Speaker 3: it's make sure you get seen right away. And then
Speaker 3: the other thing that's happenings interesting is when people I
Speaker 3: talked a lot about diabetes control, when you have a
Speaker 3: really sudden drop in your blood sugar, so you're all
Speaker 3: of a sudden, your control goes from being very poor.
Speaker 2: To being very good.
Speaker 3: That's a great thing overall, but sometimes it can actually
Speaker 3: that that sudden change can actually cause some changes in
Speaker 3: the blood vessels of the eye and actually can make
Speaker 3: the diabetic retinopathy worse if you already have that.
Speaker 2: So that's something you want to be aware.
Speaker 3: If you start those medications, especially if you have diabetes,
Speaker 3: to make sure you have your retin a check before
Speaker 3: you start the medication, that have someone who can follow
Speaker 3: that because's usually treatable, but you want to be aware
Speaker 3: of that.
Speaker 1: The other thing that concerns us is sudden exposure with
Speaker 1: the demise of the protective layers of the atmosphere because
Speaker 1: of global warming and stuff. How important is it to
Speaker 1: wear sunglasses.
Speaker 3: Well, it is, and it is important, and part of
Speaker 3: the reason isn't so much what people think for the
Speaker 3: inside of the eyes, also for the eyelids, because the
Speaker 3: eyelids are actually one of the most common sights of
Speaker 3: skin cancer because that skin is so delicate, and people
Speaker 3: don't always realize that those are the main reasons for that.
Speaker 1: Sunglasses.
Speaker 3: Yeah, and your new fancy lens actually have a UV
Speaker 3: filter built into them.
Speaker 1: A lot of the and you know what, notice that
Speaker 1: you didn't tell me that. Oh sorry, but I noticed
Speaker 1: that because I don't feel like I have to put
Speaker 1: sunglasses on them all the time.
Speaker 2: A lot of the newer, higher end lenses have that.
Speaker 1: Welt into it, So that is brilliant. So if you
Speaker 1: aren't wearing sunglasses, should you wear a hat?
Speaker 3: Do you want to do something to protect again, especially
Speaker 3: the delicate skin around the lids and then the white
Speaker 3: part of the eye.
Speaker 1: And what about you said, smoking is like one of
Speaker 1: the worst things for eyesight, Yes, and for lungs and
Speaker 1: for everything else. It's really damaging to your eyesight.
Speaker 3: Yeah, especially for a mac of the degeneration. And then
Speaker 3: thyroid eye disease, which you may see there's a lot
Speaker 3: of advertising now about five rid eye disease. When you
Speaker 3: see people their eyes come out, they look like it're
Speaker 3: almost like popping out. Smoking is the biggest respector for
Speaker 3: that as well, and that affects younger people.
Speaker 2: A lot of the time.
Speaker 1: So is Lasik less popular now because this is the
Speaker 1: laser treatment for irregular eye shapes right.
Speaker 2: Right, for being nearsight or foresight?
Speaker 1: Is it less popular now?
Speaker 2: Well, it's interesting. I think it's reached a steady state.
Speaker 3: I think what happened is when Lasik first came out,
Speaker 3: so it's FT approved in nineteen ninety nine, there were.
Speaker 1: You know that's very not so long A yeah, I guess.
Speaker 3: FT approved in nineteen ninety nine, And I think what
Speaker 3: happened is so many people were excited, so there's this
Speaker 3: huge boom, right, I mean, everyone who didn't like glasses
Speaker 3: or contact was getting the Lasik surgery, so there was
Speaker 3: that huge wave. And I think now it's happened is
Speaker 3: it's more of a steady state where most people want Lasik.
Speaker 3: I've already had Lasik, but there are still new people
Speaker 3: every year who are getting to the age or just
Speaker 3: aside they're tired of their glasses. So I think it's
Speaker 3: still popper, but it's not as popper as it was
Speaker 3: back in the early two thousands where it was really
Speaker 3: just incredibly popular.
Speaker 1: Now I wanted to talk about diet because people always say, oh,
Speaker 1: eat carrots, they're good for your eyes kerotene? What about foods?
Speaker 1: Which foods are really good for your eyesight?
Speaker 3: So the only evidence we really have is the Mediterranean diet,
Speaker 3: which I'm sure you're much more familiar with the exact
Speaker 3: details than I am. And then one thing that's it's
Speaker 3: concerning about. Actually, this is something that I don't think
Speaker 3: we really think about in this country, is actually a
Speaker 3: vitamin A. So usually and it's only we thought of
Speaker 3: it only as a developing world issue where people have
Speaker 3: a vitamin A deficiency. But recently I've seen a few
Speaker 3: cases in some very severe where people have come in.
Speaker 3: One actually was a child that came in with the
Speaker 3: hole in the cornea because of a severe vitamin A deficiency,
Speaker 3: and because what happened is he had a very restrictive
Speaker 3: diet due to a lot of other behavioral and psychological issues,
Speaker 3: and so he ate no vitamin A.
Speaker 1: At allain A most readily found.
Speaker 3: So you've got your carrot, your leafy greens, so most
Speaker 3: of your vegetables, but even you can take a supplement
Speaker 3: if you're in someone who doesn't get that. But I've
Speaker 3: seen a couple of children now again the one who
Speaker 3: is very severe. Who with these restrictive diets who come
Speaker 3: in with problems?
Speaker 1: Now, who ever restrict vegetables from a child? Yes, it was,
Speaker 1: it happens.
Speaker 2: I don't think they're getting the home cooked meals from you.
Speaker 1: Well, we have covered so much territory in such a
Speaker 1: short period of time, and you were so eloquent about it.
Speaker 1: This is really an amazing amount of information to digest.
Speaker 1: Is there a book? Have you written a book about
Speaker 1: the eye? Yet?
Speaker 3: I've written, have several chapters and articles. I don't have
Speaker 3: my own particular book.
Speaker 1: Can we reference those somewhere?
Speaker 2: Absolutely?
Speaker 1: So where do we look? We look under Christina, doctor
Speaker 1: Christina Prescott.
Speaker 3: I think you just type in my name in n
Speaker 3: YU and then a page will come up with a
Speaker 3: little bit about me, and then have some reference with
Speaker 3: some articles and things that I've written. And also if
Speaker 3: you know you need tripical lenses or are other issues,
Speaker 3: then has a number to call.
Speaker 1: Okay, So this is at NYU Lango and doctor Christina
Speaker 1: Prescott p R. E. S C O T T. We
Speaker 1: do have a lot of research that you have contributed
Speaker 1: to and written, so that's very useful. I am so
Speaker 1: interested in the eye. I am so interested in good eyesight,
Speaker 1: and I am so interested in seeing the world, so
Speaker 1: we have to protect our eyes. And thank you for
Speaker 1: all this information. I'm really happy to have talked to you.
Speaker 1: This is fantastic and thank you, and our listeners will
Speaker 1: really benefit tremendously from this.
Speaker 3: Well, thank you so much. I'm just gonna say that
Speaker 3: I have to ad make I've done so many eyes surcher.
Speaker 3: I don't usually get nervous, but I was a little
Speaker 3: nervous doing Martha's eye surgery.
Speaker 2: But I was so happy it went well.
Speaker 3: I think she's an amazing woman who's been up personal
Speaker 3: hero of mine for a while.
Speaker 1: So thank you, but don't be nervous with that. I
Speaker 1: wasn't nervous. I wasn't that all nervous. I was just
Speaker 1: so happy with the result, and thank you so much.
Speaker 3: Cher,