Eyesight And Overall Health With Dr. Kevin Hong

Glen talks with optometrist Dr. Kevin Hong about how eye health connects to overall wellbeing. They cover why a yearly eye exam is worth having, how screens and close-up work strain the eyes, and simple habits such as the 20-20-20 rule, conscious blinking and where to place your screen. Dr. Hong also explains what to look for in sunglasses to protect your eyes from UVA and UVB light. This content is educational and is not a substitute for one to one professional care.

Transcript

Please help me welcome my guest, Dr. Kevin Hong. Dr. Kevin Hong is an optometrist and clinical programs lead at VisionWorks who helps people better understand the connection between eye health, Healthy aging, And overall wellness. With experience spanning private practice, Telehealth, And clinical leadership, He is passionate about preventive eye care, Helping people build simple daily habits that support long-term vision and quality of life, And how healthy vision is an important part of overall well-being. Thank you, Glenn. That was a wonderful introduction. I appreciate that. You are very welcome. Thank you for your work and for making time to be here. And when I read your profile about your work in vision, I said we have to connect because that is an under discussed topic for me. So before we get into the meat of things, Just give us an overview of what led you to this work. Well, Again, Thank you. It's a pleasure to be here to join you and speak to you and your audience. But I've been doing, As you mentioned before, I've been in different roles in the eye care world. But yeah, Where I started was when I was eight years old. My first pair of glasses, As I'm sure many of us have had that experience of just not seeing clearly and not knowing. And then all of a sudden, You go to this doctor and he fixes everything for you. So that moment of clarity was really my first wow moment. Okay, Excellent, Excellent. And how long have you been an optometrist? Oh boy. At this point, I've been in practice for about 13 years now. Yeah. Wow. Okay. Okay, Very good. Very good. Now there's a lot to cover. And I'll do my best to pace myself so it makes sense to me and the audience. Tell us why. Eyesight and vision health is important for overall health. Well, I mean, Like I said, The first thing you think about when you think about eyesight is clarity of vision, Right? That's what gets us going into the office. But it is kind of a window into your overall health as well, Too. So the biggest thing there is looking at the back of the eye. We take a look at different parts there, And there are about 270 different systemic conditions that are kind of connected to that back of the eye. So we can tell a lot, And we like to partner with different either primary care specialist or a number of different specialists out there if additional care is required. Wow, I had no idea, 270? Different conditions can be detected in the eye. Yeah, I mean, Some of the big ones would be like hypertension, Diabetes, Certain types of cancers. But yeah, A lot of systemic conditions do connect with signs that we can see in the eye. Okay, Okay. And so you recommend an annual exam. Just for maintenance or more frequent exams? Typically, That baseline is that annual eye examination, Right? There's a lot of, I guess, More silent conditions that can be detected in that way. But yeah, Typically, Annually. Now, If we do find certain conditions there, That follow-up schedule may be a little bit more frequent. Okay, Okay. Well, We'll talk to Talk to me about, Talk to us about. Of the impact that technology has on eyesight. Well, I mean, We use our eyes completely differently than even several decades ago now. With technology, The primary way we're interacting with it is screens. And that proximity is kind of the biggest piece there. And we can get into it a little bit later, But there's a lot of different parts of the physiology where we are focusing a lot more, Putting a lot more effort into using our eyes in that way. Well, Let's get into it now. What are those parts? Well, When we're looking at something that's far away, That's when our eyes are most relaxed. The closer we bring something, Whether it's reading on a phone, Whether it's reading even on paper, Right? The closer we bring something, The more those accommodative muscles have to squeeze together. So like this. Is there a problem? Exactly. And I'm stealing this from another optometrist colleague of mine, But anytime a patient would come in with their smartphone into the exam lane, She would look down at their, Right here, She would say, What's that? And the patient would be like, Oh, That's my elbow. And she's like, That's right. It's an elbow. Keep it an L. Don't make it a V. Make sure those screens are a little bit further away from you. And that's kind of stuck with me. But yeah, The closer we bring them, Those devices, The harder it is on our eyes. Muscles are the accommodative muscles are squeezing together and again when we look far away that's how we relax our eyes a little bit more. OK, Very interesting. Wow. Okay, And so what is computer vision syndrome? Sure. It's a combination of different things. And it's not just at the computer. It's a number of different symptoms like dryness, Like tiredness, Like fatigue. And these can all be exacerbated by kind of our work conditions if we're adults or even like study conditions. If we're our patients are a little bit younger, If we're thinking about our kids, Right, That proximity, The screens, They can kind of cause some of that fatigue, The symptoms of fatigue a little bit earlier for us. So we do see this clinically in the exam lane. More frequently nowadays. Is there another factor in how vision is impacted by technology? In addition to the closeness of it, Is there something about the lighting? Of a device or the. You know, The binary codes, Things like that. How does that impact the eye as well? Well, I mean, Just that illumination that we get from screens that can be kind of taxing on the eyes. That's why a lot of times we do recommend to our patients, Hey, If you're using your iPhone or your Android or your computer, There is that night shift feature that kind of moves things a little bit more from that blue light into something a little bit warmer, A little bit more comfortable for the eyes. And I do recommend that in addition to your audience, Or you may have heard of some of those blue light lenses as well, Too. And they do kind of the same thing. Or similar things, Yeah. Okay, That's doesn't sound like it would be your first choice, Though, To have a blue light lenses. Um, No, I, I do advocate for them again, Especially if a patient is symptomatic. Um, If it does make them more comfortable, A lot of times a patient may have, If the, If you wear glasses all the time, Right. And you come into my office and say, Hey, I am noticing that fatigue. We may optimize that prescription a little bit more for that distance. And then that blue light, Um, Filtering part of it does make things subjectively a little bit more comfortable. You can work a little bit longer, Work a little bit more without feeling that fatigue as easily. Okay, Okay. And is, Are some of the symptoms of the computer vision syndrome related to digital drain? Or is that a little deeper into problems with technology? I mean, What I can say about that is that What we were speaking to, Kind of some of the techniques of reducing that blue light with glasses, With software settings, Right? That's about half of the equation. The other half is kind of trying to change our habits as well, Too. Earlier in our conversation, I said, Looking far away, That's how we relax our eyes. So the other thing that I tell my patients is try to exercise the 20, 20, 20 rule. Every 20 minutes, Take about 20 seconds to take a look at something that's 20 feet or further away. It'll help you catch up on blinks and relax your eyes a little bit more too. Okay, Yeah, I was going to ask you about the 2020 rule, Because in my research, I came across that. And I'm wondering how I can implement that in teletherapy. It might be a little rude to away from the client. Periodically, Right? To be honest, I mean, That's not something that we can probably do consistently all the time, Right? But whenever we can, Implementing any amount of relaxing those eye muscles, Letting them just stretch a little bit instead of holding on to that tightness all the time is good, Right? So whenever you can implement it, Whenever you're not in direct clinical care, Whenever you're not in like a long session in front of the computer, Highly recommended. OK, OK, And what is? Tell us about conscious blinking. Yeah, Whenever we are focusing on something, And again, I don't want to say that it's just in the computer, But that holds our attention so well. Things that we're scrolling through on a feed holds our attention so well that our blink rate tends to go down just a little bit more. So we start to experience some of those symptoms of dryness. Okay. Okay. Another tip I came across was about the placement of your screen. It said four to five inches below eye level. Yes. That's going to be just a little bit more ergonomic in terms of Computer is one thing. Yes, That's going to be ideal. But if we're at our laptop, We're going to be kind of craning our neck down just a little bit more. The most extreme example would be. The smartphone. If you're holding it way down low, Again, It's just not going to be as comfortable. And it's not a big deal if it's just for a few minutes here and there, But these are positions that we're adopting for eight plus hours a day if we're in an office environment. Okay, So is it recommended that is say if I have my device. Four to five inches below my eye level and I look down rather than bend my neck. Is that feasible? That is highly recommended. And even in, Particularly in my field, As we get into glasses that have multiple prescriptions in there, That's how we recommend our patients use those as well too. Because the prescription, If we're talking about like a multifocal lens, That prescription's graduated. We want our patients to use their eye motions to kind of follow down instead of like turning your head down, You know. Yeah, I had a pair of progressive glasses once and I couldn't do it. I couldn't do it. That's not the only technology. You know, We have multifocal contact lenses that patients love and they swear by because there's not as much of that, Hey, Where's my sweet spot, Right? That whole lens just kind of works automatically. There is a little bit of a learning curve, Absolutely. And that's why Comtrist is there to help you through it. But yeah, There's different solutions for everyone. Oh, Wow. That's interesting. How long has that been around, The multifocal contact lenses? Um, It's been around for as long as I've been practicing. I know, Uh, Before, Before, Uh, Before multifocals came out, The, The way of correcting was, Hey, We can either correct your, Your distance vision with contact lenses. And then you put on a pair of reading glasses when you need to, Um, Or there were some, Uh, Individuals that did mono vision. Um, And some people still do it nowadays. It's one eye for distance and then one eye for, For near intermediate distances. Yeah. Okay. I'm thinking of how confused I would be. And again, We work through it with patience. We always go through like a test run to kind of fine tune things until we find that perfect solution. Okay, Okay. Now, You talked about how the eyes can rebuild 270 systemic conditions in the body. Is that. Related to iridology? Erendology, I am not. Nearly as familiar with that particular field. So I can't speak specifically to that. Okay. Yeah. I just came across that years ago where, You know, Non-medical people would look at your eyes and tell you what was wrong. So I didn't really give it much credibility. I can't speculate as to that. There are conditions that involve the iris, But I think that would be more kind of localized to that particular tissue. I mean, Speaking to that, There are inflammatory conditions that can be connected to the iris. But I'm not sure. If that's what they were to specifically. Okay, Thank you. Thank you for for giving it a shot. Now, For me, A little more technical information is is nagging at me. So for example, What? How would the high blood pressure? Show up in the eye versus diabetes, What would be the actual thing you see? So a lot of that is going to be on those, Either the dilated examination or retinal images that we take. And we're specifically looking at blood vessels. We're looking at the overall caliber of blood vessels. We're looking, In the case of diabetes, A lot of times we're looking at potential bleeds in the back of the eye as well, Too. So any of those anomalous findings, You know, Trigger us to say, Hey, We should contact your primary care physician. Or if you don't have one, We can find you. One, Yeah. Okay, Great, Great. Now, A lot of people walk around without sunglasses and it just kind of confuses me, Especially tennis players, Tennis players. Give us some guidance on. Sunglasses. Well, I mean, The biggest things to protect from are going to be the UVA and the UVB. We already know our skin burns, Right? So we try to protect that as much as possible. But we don't think about, A lot of times we forget about those ocular tissues, Right? So the primary way of protecting would be through a pair of Sunglasses that provide protection from UVA and UVB. There are some merits of being outside for maybe 20 minutes or so. Like a lot of times you hear, Like first thing in the morning, Trying to get some natural light, Right? You can get some of that without sunglasses, But under direct sunlight, You could burn that tissue as well too. OK, So should we look for polarized glasses, The prisms, Whatever those different varieties are? So the most important ones, If you're looking for the protective properties, Are going to be the UVA, UVB protection. Polarization is another kind of add-on. That's really more for if you are light sensitive, The way that you perceive light, If you're uncomfortable with it. When light bounces off of different surfaces, You get those polarized lenses. It eliminates that glare for you entirely. And there's different shades as well, Too. How dark or light sunglasses are don't necessarily dictate how much UVA, UVB they block. So again, A lot of that is for comfort or even sometimes for style, Depending on what kind of, What you want to match your outfit with, Yeah. Okay. And what's your take on those, What do they call those glasses that automatically become sunglasses when you get outside? Yeah, The transition lenses. Transition glasses. What's your take on those? The general term for that is photochromic lenses, But they're reactive to light. Most cases, UVA, UVB, Some are reactive to any type of light source. Those are the ones that are a little bit more sensitive for those that are extra light sensitive. I think they're fantastic. They're very versatile. They allow you to have one pair that kind of in quotes, Does everything. But I would say that the choice in frames matters as well, Too. Typically, Sunglasses are a little bit larger and provide more coverage, Whereas regular ophthalmic style lenses or frames are just a little bit smaller. So I would also be mindful of getting full coverage with those as well, Too. Okay. And do the transition glasses, They don't work in all climates, Do they? Because at one point when I was in Vegas, I looked into transition glasses and I was told it's too hot. They're not going to work for them. Good call there. They do work in pretty, It's a pretty wide range of temperatures they work at, But extreme temperatures, Extreme hot, Extreme cold, They can kind of slow down a little bit, Both in the rate that they get darker. And the rate that they return back to being. You know, Clear colored. Okay, Okay, That's fine. I'll say that again. Sorry, The activation time is the big thing there. But that is just specifically the color, Right? If that lens is UVA, UVB protective, It retains all that protective property even when it is completely clear. OK, So UVA and UVB, No matter what. Even if that lens is completely clear, It'll protect you from that. It might not be as comfortable, You know, If you're, You're staring right at the sun or anything. But yeah. Well, Don't do that. Don't do that. Then you'll be coming to see me. Yeah. Now, Other than the tips you gave earlier, The 2020 rule, The conscious blinking, And screen placement, What other lifestyle choices would you like people to make to promote eye health. As it relates with technology, One of the bigger ones is, I've always said that proximity is kind of the culprit here in terms of creating a lot of that eye strain. So, You know, A smartphone is worse for you than a laptop, Which is worse for you than like a dedicated large display, Right? So yeah, Get the biggest display you can if you're working in front of a computer all day, Move that as far from you as you can, And then just take breaks, You know? Make sure that you have some time away from the screen if you're able to kind of break your day up, If you have that flexibility. OK, OK, Great. What about non-technical lifestyle choices? The biggest one would be making sure that we are in for annual eye examinations. I mean, There's, As we talked about before, There are so many different conditions that can be uncovered by that so many things that. We may not necessarily be aware of, Again, Whether they're directly related to the eye or if they are systemic conditions. OK, OK, OK, Excellent, Excellent. OK, Well. Dr. Hong, This has been fascinating. I thank you so much for, Again, Making time and enlightening me. And before we go, What is the one nugget or one takeaway you want the audience to have. Just that, You know, In terms of vision care, We think so much about, Hey, How do I get that 20-20 vision? And that's just the smallest piece of it. That's just the very, Very start of it. And your optometrist can see so much inside of your eye, And that tells us so much about overall systemic health. I think it's very, Very valuable and I hope more people can take advantage of that. Okay, I agree. I absolutely agree. Thank you again for being here. I deeply appreciate it and your work. Well, I appreciate your time and the opportunity to speak with you. I loved your questions. This is very much like the questions that I get on a daily basis when I'm in clinical care.