The 30-Second Exercise That Could End Reading Glasses Forever. (Top Vision Expert Explains)

[00:00:00]What if the reason your aging parent or spouse is struggling with memory, focus, and daily tasks has nothing to do with their brain and everything to do with their eyes? What if nearly 20% of all dementia cases are directly linked to untreated vision problems?

[00:00:16]And does a standard eye exam completely miss all of this? Today's guest has spent his career answering that question. So, I'm really excited to bring him here. Dr. Bryce Applebomb is a brainbased eye doctor who has worked with NFL players, Olympic athletes, and thousands of everyday people who were told their vision was fine, but it was not. Eyesight is a symptom, vision is the brain. What most of us call a vision problem is actually a brain problem.

[00:00:44]When you fix it at the source, the results can be life-changing. That's Dr. Abomb's philosophy. If you've ever been handed a glasses prescription and told that everything looks fine, this episode was made just for you. I'm Neil Kesha, a Johns Hopkins and NIH funded caregiving researcher and a caregiver myself. I help many people with dementia care and this topic is really near and dear to me. So, Dr. Oppam, so glad you're here.

[00:01:08]Welcome to the show.

[00:01:09]>> Such an honor to be here. Thank you for having me today.

[00:01:12]>> Awesome. So, yeah, let's kick it off. We have some great questions for the audience. So, so I recently learned that up to 19% of dementia cases can be linked to untreated vision problems. And I mean, that just seems like a really bad and damning number. So why is this why isn't this the first thing that every doctor brings up when a family comes in worried about you know their aging parent or spouse's you know cognitive decline?

[00:01:33]>> It absolutely should be and hopefully after this conversation it starts to become uh top of mind for more people.

[00:01:39]You know vision like you said is it's it's brain function and it's a direct reflection of brain function and when we start to see uh cognitive decline or vision decline a lot of times we just assume that that's co that's that's normal. It's not normal. It's just really common. And when we stop using our dominant sensory system, vision, the way that's intended to, we start adapting and using our brain differently, and that leads to significant changes in function. And specifically, in your line of work, having problems navigating your space, it's one of the earliest signs of of Alzheimer's and of dementia.

[00:02:17]>> Yeah. No, that that I think that that's that's a really interesting kind of way to think about it at the root. And then you have this line that you use a lot that's interesting that eyesight is a symptom and vision is brain, you know. I think many of us think like if you have 2020 vision, you know, our eyes are fine, you know, but I guess yeah, what are we missing about, you know, kind of that that philosophy that you have?

[00:02:38]>> Yeah. And and I'm going to correct you and say if you have 2020 eyesight that things are fine. So eyesight is just a symptom. It is our ability to focus light clearly. It's what glasses or contacts are for. And that's usually where most eye exams end. Is are the eyes healthy? And can you see the tiny letters on the chart? But vision is so much more complex. And and vision is how our brain filters, organizes, processes everything coming in through the eyes to be able to make sense of it, derive meaning, and then direct the appropriate action.

[00:03:08]>> Okay. And functional vision problems are tracking and focusing and converging and depth perception and peripheral awareness and reaction time and really how we engage with our world. That is what we should be testing for from a proactive approach. But very often we're taking this reactive approach and just saying we can't see stuff. Here's a device that's going to help you. And although that's important, that's just one small piece of the puzzle.

[00:03:33]>> Yep. Okay. That's interesting. And and I think that that that brings me to kind of like your own story, you know, like your your personal story I thought was really cool. You know, you came to this work overcoming your own vision challenges, you know, uh through vision therapy as a kid. And what did that experience teach you about what vision really is and how did it impact like your own career and deciding, you know, what line of work you want to go into?

[00:03:55]>> Yeah, I I was an absolute mess as a kid.

[00:03:57]I had an alternating eye turn. I had essentially no depth perception. My eyes had a really hard time focusing and I was lost in space. And what that meant was on the soccer field. I was just terrified in the classroom. I had no idea what was going on. And fortunately was born to the perfect parents. My father was a developmental optometrist.

[00:04:16]My mother a sensory integration based occupational therapist. Wow.

[00:04:19]>> They facilitated the the necessary development for me that didn't take place on its own to allow me to soar in life. And I really went from being a reluctant reader to an avid reader. I went from the last one picked on sports teams to a stud with athletics, especially ball sports. And I went from being this insecure, scared kid to this confident person by really using my eyes to rewire my brain to change how I was using vision, but to turn a disability really into a strength.

[00:04:51]>> Wow. Wow. That's that's awesome. And congratulations for sharing your story and I hope that inspires people out there, you know, who might be worried about their own limitations, you know, that a lot of these things are fixable and solvable, you know, and and in in in going through kind of like more detail around like your thoughts on, you know, the eye exam and just kind of understanding the difference between what is in a standard eye exam test and what does a functional vision exam test do? And I think many people didn't even, you know, may not even understand that these are two completely different things. And why do so few doctors test for the functional side?

[00:05:23]>> Great question and and there's a lot to unpack there. I would say in general, you know, eye exams, like many medical exams and primary care exams, you're in and out quickly. The doctors are dealing with a lot of politics and insurance reimbursement and a packed schedule and it really takes away from the quality of care that really people deserve. And for those listening who've been to the eye doctor, it's can you see those tiny letters on that small chart on that far away dark exam room lane where you know that's just one skill and that's that's looking how well you can discriminate far away. But it's not looking at does your brain have the capacity to use the inside and outside muscles of the eyes together as a team. Do you have depth perception? Can you understand not just where you are in space but where other things are in relation to you in a dynamic fashion? Do you have the ability to attend to what's in front of you and around you simultaneously? Can you process information fluidly and have the visual memory to be able to spell words, to think of pictorial images, to remember somebody's name when you're when they're saying it out loud when you first meet them for the first time? and really to make sure you have the ability for the eyes, brain, and body to fluidly work together as a team, which is needed for reading and learning and sports and driving and navigating through space.

[00:06:43]>> Yeah.

[00:06:44]>> And I think the last part of that of of why do doctors not test for this, >> you know, I think there's many reasons, but in school, I mean, we're taught how to manage vision decline, right? We're taught how to when there's problems in place, how to slow down the problem, sometimes stop them. But very little is shared with avoiding these problems altogether and taking a proactive approach and recognizing that vision is a skill set and it's something that we don't see with our eyes, we see with our brain.

[00:07:14]>> Yeah.

[00:07:14]>> And yet we're just looking at eyes as as if they're separate from the brain, separate from the body. And it allows for a lot of misdiagnoses, missed opportunities, and really just kind of going down a path of adapting to lenses, adapting to the stress from our world without actually addressing the root cause for why these changes are even occurring.

[00:07:37]>> Yeah. Yeah. Thanks for the detailed explanation. Actually, while you were talking, I was just thinking about scenarios in my head of like several people that I've helped, you know, who are caregiving for parents and stuff, you know, that you mentioned like why people fall, you know, and why things happen in their lives. Often times it's like just a standard eye exam may not catch some of the things you mentioned like depth perception. And we hear this a lot of time in helping caregivers that after the fact people realize like something has changed, but you know, my guess is it probably wasn't caught on the standard eye test, you know, um but something did change in like the broader vision, you know, which is why somebody had a harder time, you know, kind of getting around and then had an accident.

[00:08:15]So that's that's fascinating. Yeah.

[00:08:16]Thanks for sharing.

[00:08:17]>> Absolutely. And those kind of visual spatial and visual memory challenges, those are functional vision challenges or functional vision skill sets because >> getting lost or getting confused in in new spaces or trouble identifying objects and people or >> misperceptions kind of not processing information and assigning the right label or language to what we're seeing.

[00:08:41]Those are really common with people as they age. And that difficulty with kind of spatial reasoning and navigation, being unsure of our surroundings, that's really warning signs and neon lights around the fact that we're not trusting what we're seeing.

[00:08:56]>> Yeah.

[00:08:57]>> And we're not using all of the areas of our brain in an integrated fashion. So something needs to be done to figure out what's going on, but then how to change the outcomes that come with that.

[00:09:08]>> Yep. Yep. No, agree. I think I think this is a great reframe. You know, I think another thing that I written down that might be surprising to a lot of our listeners, you know, you mentioned like undiagnosed vision problems can actually mimic ADHD and even learning disabilities and potentially even early cognitive decline. You know, how often do you see people that are potentially misdiagnosed possibly for several years when the real issue might have been vision related all along?

[00:09:33]>> I love that you're bringing this up.

[00:09:34]Literally every day and multiple times a day. So to really simplify this, if you have a hard time controlling your eyes and their ability to focus, >> you're gonna have a hard time controlling your mind and its ability to focus.

[00:09:47]>> Yeah.

[00:09:47]>> Any change in eye movement is a change in attention, whether it's voluntary, involuntary. And again, if you can't control your eyes and ability to focus, you can't control your mind and disability to focus. And so many of the symptoms of ADHD, dyslexia, yeah, >> autism spectrum disorders, even learning disabilities are so similar to those of hidden functional vision problems.

[00:10:10]>> And so they're incomplete diagnoses without addressing vision first.

[00:10:14]>> Yeah.

[00:10:14]>> And we see so often people who can focus really well in certain tasks, but then when they're doing sustained near concentration tasks, their focus is terrible. or somebody who can read with their ears but not with their eyes.

[00:10:29]Meaning, if it's auditory input, it's easier to process than visual input.

[00:10:33]Those are clear signs of a hidden functional vision problem that hopefully is no longer hidden now that we're talking about this. But again, it's not like there's this blood test that says, "Oh, you have ADHD." It's based off of behaviors and symptoms. And 15 of the 18 most commonly associated symptoms of ADHD are also symptoms of certain functional vision problems.

[00:10:57]>> Wow. Wow. That I think that's what's fascinating about that whole thing is just like people might be unnecessarily then at the end point getting medication when like the root cause could be, you know, fixable or modifiable through correcting vision, you know, or addressing that. So that's that's really interesting, you know. Thanks. There there was a uh a recent study that came out, a metaanalysis of tens of thousands of of participants that revealed that children labeled as having ADHD >> have a three times higher likelihood of devel of having convergence insufficiency. So trouble converging the eyes together, pointing them at the same place.

[00:11:34]>> Two times a higher likelihood of having strabismas or an eye turn. And two times a higher likelihood of having a stigmatism or hyperopia.

[00:11:42]>> Wow. Which means very often those diagnoses are also confounded by other labels or other challenges.

[00:11:49]>> Yeah. Wow. Wow. No, thanks for sharing that. I think that's it's a fascinating reframe. You know, then I think in thinking through like >> you know my team and I had the chance to try out screen fit, you know, this past week and you know it's great. So I think one would love for you to kind of elaborate on it and you know you founded it specifically around you know kind of like this concept that the damage that digital devices are doing you know to our visual system uh which is also I think applicable just for generally anyone of any age and you know I think you highlighted that humans were not designed to stare at you know flat glowing rectangles all day. Um so yeah what is excessive screen time actually doing to the brain? Is any of that damage reversible? And I guess yeah, can you give us an overview on screen fit?

[00:12:33]>> Yeah, so screen time is the new pandemic. That's there's no question. We know what it does to cognitive development, emotional development, social development, but we're now learning and seeing what it does to vision development.

[00:12:45]>> And we're as humans not meant to be staring at these >> boxes two inches from our face blasting high energy light at us for hours on end. We're meant to be scanning the horizon for dinner and danger and exploring through nature. We're now having to make those same eye movements in this with this near visual stress of up close and there's very different eye movements required for screens. Our focusing system, the inside muscles of the eyes responsible for clarity become locked up. Our convergence is at a higher demand. There's more eye movements. They're more sporadic.

[00:13:16]They're all over the place. And then there's all this light that we have to contend with. And so it's causing significant problems. One of the most common of which is myopia or nearsightedness which is far away getting blurry often because of a near problem.

[00:13:32]>> And we know the three biggest risk factors for myopia progressing not enough time outdoors and it's proven that two hours a day is protective for the development and progression of nearsightedness.

[00:13:43]Too much near work especially with poor lighting and too much screen time. And so we created screen fit as a way to have this work be more accessible for the masses because I recognize not everybody has the opportunity to fly to us in Maryland and go through our treatment. And so this is kind of a a do-it-yourself program that's very intentionally sequenced in terms of the learning and it's designed to teach the specific visual skills and abilities needed for for life, for reading, for learning, for driving. And it's not more screen time to treat screen time. It's it's uh two different courses. Each course has 30 lessons. Each lesson is a video of describing a specific vision exercise. You then put the phone or tablet down and you do the exercise. And really without equipment so that it's kind of like body weight work instead of going to the gym. Like it's sit-ups, air, squats, and push-ups, but for the eyebrain connection. And of course, if you go to the gym, if you work with somebody one-on-one with all the tech, all the equipment, you're going to get better results faster. But again, not everybody has access to that. So, >> this has been uh an absolute monster.

[00:14:51]We've had as young as five, as old as 89 go through it successfully.

[00:14:55]>> And listen to this. We've had 100% of people who finish the first course see a reduction in symptoms. And that's out of thousands of people.

[00:15:03]>> Wow.

[00:15:04]>> But you got to do the work. So people that say vision exercises don't work, >> that's the same people saying normal exercise doesn't work. You got you got to do it. You got to know what to do and you got to do the right stuff.

[00:15:13]>> Yeah. No, that's awesome. And I I like that. I like that range. Age five to age 89. That's that's really awesome, you know. And I think that that that actually leads me to kind of my next topic was like this idea or this assumption that most people, you know, think that eyesight will just get worse as they age. You know, that's like seems to be like a generally accepted and you have thoughtful push back on that, you know. So you know what what do you mean you know when you say vision does not have to decline with age and what kind of habits can make a difference there?

[00:15:42]>> Yeah. So let's separate that into kind of two different camps.

[00:15:45]>> Yeah.

[00:15:46]>> Distance and near.

[00:15:47]>> So distance eyesight should not get worse as we age. And if you're getting stronger glasses every year or different glasses or contacts, that means you're adapting to the lens you're in and needing something stronger to maintain that same clarity because of the visual stress of life and not having the foundational tools or skills in place to meet those demands. So, as an adult, a distance prescription only changes when there's a functional vision problem. M >> when we then think about near that's a little bit of a different scenario but also with some of the similar conversation there's age related changes that happen for most people in their 40s or so you and I will be there in in another few decades hopefully uh where we have to the lens inside of our eye becomes hardened the muscles and fibers controlling it become more rigid less flexible we have to start holding things farther away from us until our arms aren't long enough and then you know the drill you're grabbing readers >> but just like We don't jump into a wheelchair when our knee hurts and stop using it. We figure out what happened. We develop and we work our way back to functionality.

[00:16:51]>> The same goes with the eyes. And in the 40s when you start to notice up close getting a little blurry instead of reaching for the overthec counter readers the first chance you get, you can train the focusing system and the eye coordination systems to hold clarity to close distance for two seconds and then 3 seconds, then 5 seconds. And if done right with specific vision performance training exercises, we can actually slow down those changes. We can even stop them and in some cases even reverse them. But it requires knowing what to do and the right type of work.

[00:17:21]But I would say I mean we have patients in their 70s and 80s who are doing work every day but not wearing reading glasses.

[00:17:27]>> Wow, that's awesome. I I I've never heard it explained that way and I I love the analogy of like don't get in the wheelchair as soon as your knee hurts, you know? And I think that's yeah, most people are like absolutely avoiding canes, wheelchairs, whatever, and trying to kind of like adapt. And I think that you're right, like why not do the same thing with your eyes, you know, and I think that's like most people just don't think about it that way. So I think that's that's a great reframe.

[00:17:47]>> Absolutely. And just to give you a little bit of perspective here, I've been in practice for 17 years. For the first decade of my career, >> Yeah.

[00:17:53]>> I would have said this conversation we're talking about is impossible. Like this that's we didn't learn this was possible in school. What are we talking about?

[00:18:00]>> Yeah. But then we start to see all the changes occur around COVID times.

[00:18:05]>> Yeah.

[00:18:06]>> We then like got in the lab and and we we're blessed to have to learn from hundreds and thousands of of patients and we developed protocols that can actually train that eyebrain connection just like we train the rest of our body.

[00:18:21]>> Yeah.

[00:18:22]>> But >> to actually develop more flexibility and stamina especially with the focusing system.

[00:18:28]>> Yeah. And my colleagues who say that's not possible. My my response is well have you ever tried because if you haven't tried and if you haven't gone through these these protocols, you can't say it it doesn't work. And we have found that those who take an an intensive approach meaning a lot of work in a short period of time. It is better results faster. And the more opportunity the brain has for learning with the least amount of time between the learning, the faster learning takes place.

[00:18:55]>> Yeah. And so we see people every week who fly in from all around the world for intensive boot camp treatments, but with a 100% accuracy. We've had adults either slow down, stop, or reverse their age related changes at near, but it's also fine-tuning our protocols by the day.

[00:19:13]>> Yeah. Yeah. No, that's amazing. I mean first of all I mean that's amazing in terms of both the protocols and I think it's amazing philosophically in terms of hope you know that I think if people realize it's possible for other people then they'll change their own mind about what could be possible for them and I think sometimes that that itself is like a very valuable starting point. So, it's awesome.

[00:19:32]>> And I will say for for somebody who's got a really high prescription.

[00:19:36]>> Yeah.

[00:19:36]>> You've got a lot farther to to backtrack, but especially when the changes are early, that's the the prime time to to jump on it and take a proactive approach.

[00:19:46]>> Yeah. No, that's I think that's awesome.

[00:19:48]You know, and I think that, you know, shifting a little bit to kind of just the mechanisms of aging, you know, I think as we age, you know, the visual system might change in ways that a lot of people aren't familiar with or hear about. you know, um I think you know, you've talked about like the lens yellows, contrast sensitivity will drop, depth perception, you know, we talked about a little bit. How does it this cascade into sometimes things that families would attribute to either normal aging or even potentially dementia or cognitive decline when the root cause might actually be the eyes?

[00:20:17]You know, have you seen situations like that?

[00:20:19]>> Yeah. Well, actually, can I can I ask you a quick question? So, I've I've been saying that cognitive decline does not have to happen. and you as like the dementia expert and guru in this space, do you agree with that?

[00:20:32]>> I yeah, I agree with that too.

[00:20:34]>> Okay.

[00:20:34]>> I I completely agree with that. I mean, I think I think in a small subset of people it it may just be heavily genetically predetermined, but even even I'm changing my mind on that in recent years, you know, but I think yes, I've generally seen people do a lot to change cognitive decline trajectory, including people who were on the early side of the journey and dramatically change their lives. So, but again, it's hard to pro, you know, it's hard to prove that, but I think just intuitively, you know, from working with so many people, I I think it's not a um it's not a sentence, you know, >> right? And it's well documented that when our hearing declines, right, that that we're not tapping into the same areas of the brain and that exacerbates >> cognitive decline. Well, >> the same should follow for vision as our dominant sensory system, >> right? Like if you're not tapping into all areas of of processing and visual processing, >> you're not going to have the same outcomes than if you did. And I always talk about how there are more areas of our brain dedicated to processing vision than all of the other senses combined.

[00:21:38]>> Wow.

[00:21:38]>> And more than half of our brain is dedicated it the real estate of half of our brain is dedicated to vision and processing vision.

[00:21:46]So I I look at the type of work we do as using the eyes almost as like joysticks to tap into the brain to rewire the software to allow for communication to take place that we're either bypassing or >> where there's roadblocks in place and we're literally >> rewiring the brain to eliminate the roadblocks so that we can allow for more fluid and accurate communication between the propriceptive centers and the language processing centers and the balance centers and uh uh different communication centers that allow for us to confidently navigate and process our world.

[00:22:22]>> Yeah. And actually, so this so actually thank you for going in that tangent because I I didn't have this question on my on my list, but it made me think a lot of times in in the earlier stages or even kind of modern stages of dementia and cognitive decline, we notice a lot of people's daily life patterns turn into watching more and more TV, you know, and I guess in the theory where you are kind of like going through, which I think is an interesting thread to pull like that might actually worsen significant ificantly, you know, the trajectory. So, you know, any thought? I mean, I realize, you know, not to put on his spot, but I'm curious about that because I just see it so much and I just know deep down that isn't what, you know, they should be doing, but people default into that mode, but is it making it worse?

[00:23:07]>> I mean, the whole uh if you don't use it, you lose it saying. I mean, that that applies for >> cognition. It it applies for vision. And I have loved ones in my family who >> uh have a lot less stimulation in their lives. They're on watching TV a lot more. They're reading, they're >> watching the news, and yeah, >> they're less aroused and less aware and less alert. And >> it our brain is so plastic. Yeah.

[00:23:36]>> Which is a good thing, but it's also a bad thing. If you stop allowing vision to guide movement and if you stop get out getting out and walking and allowing for blood flow and and heart rate to regulate the areas of the brain that are should be fluidly pumped with oxygen and blood and allow for the right nutrients to get to the right place and >> just like uh you know toxicity from our environment can impact our brain screens are toxicity for our visual system and our nervous system.

[00:24:06]>> Yep. and we adapt to the stress that we're in or we avoid it. But the these maladaptations, that's really where we start to see vision decline take place and then not trusting what we're seeing and then all of a sudden as we get older, you know, changes in elevation we're less secure on and we're not seeing the the tree route that comes out of the sidewalk or going downstairs when we're hesitant.

[00:24:27]>> Yeah. And vision can be enhanced and optimized for any brain at any age. But again, you have to treat it as this fluid dynamic process where learning takes place from our life experiences.

[00:24:43]But if we're not learning from our life experiences and if our life experiences are becoming more sedentary and static, we're not learning, we're not adapting, we're not applying uh these judgments to space.

[00:24:55]>> Yep. Yep. No, I think I think that's totally agree and I think that's is really interesting. Hadn't thought about it, you know, in that way. You know, I think then thinking about other things with older adults that we help falls, you know, obviously, you know, we all know it's one of the leading causes of deaths and even just disability and older adults. You know, can you talk about the visual component of the fall risk that many even doctors or family caregivers may not be, you know, fully thinking about?

[00:25:20]>> Yeah, and I think it goes back to to not trusting what we're seeing. I mean often times our visual midline becomes unstable as our eye coordination or eye teaming becomes unstable and then our visual midline and our body midline are sending conflicting signals on how where we are in space >> and you know falls be being able to prevent a preventable fall can allow for so much more longevity and happiness.

[00:25:46]>> Yes.

[00:25:47]>> And especially when you know head injuries are in are in play. Like we know that if you've had one head injury, you're more likely to have additional ones.

[00:25:54]>> That that's only if you're not rehabbing the brain to get back to a place where you have a a confident sense of central and peripheral processing. And especially with these two pathways, like the central and peripheral processing pathways should be like a seessaw that's balanced. But when we're under stress, >> yeah, >> regardless of the stress, how that shows up visually is that our pupils widen and we get stuck with this tunnel vision.

[00:26:22]And so when we get stuck with this tunnel vision, this central processing, it means we're not aware of what's around us. We're not able to prevent things from coming into our field and reacting appropriately, whether that's we're in a car, whether it's >> we're on the road and somebody and somebody or something is coming past us.

[00:26:39]And a lot of falls are preventable, especially when vision is giving us accurate feedback in real time in real space on how to prepare ourselves for um what's coming.

[00:26:54]>> Yeah. Yeah. No, I think I think that's I think that's something really important that you know people should be thinking about you know in terms of like fall risk and how to address it through vision you know. So thanks for sharing that. I think, you know, then then if somebody has a, you know, is watching this right now and might have a parent in assisted living or even like memory care, you know, are there things that like signs they should look for, like maybe two or three signs that might suggest they have a hidden vision problem or that a vision problem might be making things worse, you know, for their lives.

[00:27:25]>> Definitely. And I think some of what we touched on initially, but kind of the getting lost or, you know, not remembering where they parked their car.

[00:27:35]>> Yeah.

[00:27:35]>> Or being confused in a new environment or even in a familiar environment or trouble identifying an object or a person and assigning >> the right label or language or understanding what they're seeing. I mean, those are clear signs that something has changed. And often times with early signs of of dementia or Alzheimer's, we'll see somebody who like sees a dark rug but perceives that maybe as a hole in the ground or >> there's and that can often be a sign of damage to the occipital lobe to the back of the brain that was responsible for for eyesight.

[00:28:14]>> Yeah. Yeah, >> but it's also these kind of misperceptions of what's around them >> or where they are in space.

[00:28:22]>> And then I think the navigation piece. I mean, certain people are rely heavily on on maps or ways or they're in a new environment and they can't orient or locate themselves in terms of where everything is around them. I think to me I look at that as a functional vision problem along with like knocking over a glass of water, bumping into the wall.

[00:28:45]We have a uh gentleman here this week with us for treatment who says that he always when he turns to the left trips over his left foot.

[00:28:56]>> And we see this all the time that our ability to have vision guide movement improves but also it's almost as if we're not fluidly processing space. And then our ability to direct our body becomes compromised. And then it can be as simple as not relating to where you are in in space.

[00:29:14]>> Yeah.

[00:29:15]>> Compared to another object is or like in a new hotel room, you're always bumping in the corner of the bed and your shins are all all messed up. Or >> um you know, often times as we get older and we get progressive lenses where the top of the lens is for distance and the bottom is for near.

[00:29:30]>> Yeah. that can really disrupt going up and down stairs and without adjusting our whole body. You know, the world is literally >> perceived differently and almost like it's warped >> and that can just be from being in the wrong glasses setup for that person.

[00:29:47]>> Yeah. So that visual spatial processing and visual spatial function, I look at that as like the clear signs of early stages of cognitive decline which can lead to other more advanced stages.

[00:30:00]>> Yeah. Yeah. No, that that that's super helpful, you know, and and then and then you talk a lot about vision performance training, you know, just as a way to kind of rewire the eyebrain connection, I guess. You know, is it ever too late to start? you know, can a 70, 80 year old benefit, you know, actually from this?

[00:30:18]>> Old brains can be taught new tricks. Uh, we have a 92 year old in treatment with us developing depth perception for the first time.

[00:30:26]>> Wow.

[00:30:27]>> And one of the for anyone medically who's listening, we're all taught in school that there's this critical period of vision development and after age eight, you blow out the candles and all of a sudden what you see is what you get. That is for vision lost, not for vision gained.

[00:30:44]>> Yeah.

[00:30:44]>> Meaning, if you or I were to wear an eye patch for 6 months and take off the eye patch, we'd be a little sensitive to light, but we wouldn't have lost the ability to see.

[00:30:52]>> Okay.

[00:30:53]>> But if you take a six-year-old and give them an eye patch for 6 months and take it off, >> there literally will be eyesight lost because that's a rapidly developing brain that's still allowing new firing and wiring. But in terms of what can be taught with the right work, right motivation, and right compliance, we can tap into stereopsis, which is the medical term for depth perception as long as there's eyes connected to the brain. And no one is born with the ability to see in 3D. It's all developed through our life experiences. is we develop cells in our visual cortex that only respond to two-eyed learning and learning from our life experience to be able to understand where things are in relation to us and then we develop these cortical pathways. So eyesight develops through biology, the eyes develop through biology, but vision develops really from experience and learning from our experience. And so putting yourself in a learning experience in novel environments where we're regulating and and adapting in real time, I mean, that's how we can really tap into a lot of our brain function that often we bypass or stop using because our brain often takes that path of least resistance and does what's easiest.

[00:32:07]>> Yeah. No, that's that's that's fascinating. I think that's fascinating.

[00:32:10]So, you know, thanks thanks for sharing the insights and then now turning into rapid fire. You know, I think some rapid fire round of questions, you know, ready.

[00:32:18]>> Let's do it.

[00:32:18]>> Okay, so 2020 eyesight overrated or, you know, uh, is it a most dangerous number in medicine?

[00:32:26]>> Oh, most dangerous number in medicine.

[00:32:28]Definitely. I love that. So, I always preach 20 happy, >> meaning not everybody has to see the the HD small letters, right? And for some people, myself included, I'm around 2030 >> because for me that allows me to have this kind of comfort where I'm not overfocusing at any distance, but I'm also there's a little bit of kind of wiggle room everywhere. But no two people see the same. So we don't need to make everybody see the same. And I'm always a big believer of if we're in glasses or contacts, it should be the weakest lenses possible that give the most improvement that are the most balanced between each eye. But that improve performance.

[00:33:10]>> So if you're going to the eye doctor and they're saying you need new glasses and here's what the prescription is, >> there better be an improvement in performance or reason why you're doing that rather than just because the tests say that you need something stronger.

[00:33:22]>> What does that mean in terms of quality of life and activities of daily living?

[00:33:26]>> And if there's a benefit, by all means, then let's go down that path. But if there's not, >> we don't just need to respond to test results. We need to interpret them and understand what that means.

[00:33:36]>> Yeah. Yeah. No, that that that's helpful and very practical advice. Then what is the single worst thing we do um daily for the visual brain?

[00:33:45]>> Screens. Screen time is terrible.

[00:33:49]>> Uh it is we're not meant to be doing this and it is directly causing challenges with eyesight, eye health, visual function, and even mental health and happiness. And you know, it's crazy.

[00:34:05]I have three young kids and seeing what was happening when COVID first hit when they're on screens too much.

[00:34:11]>> I mean, it was clear as day. And so, all three of my kids have been through vision performance training.

[00:34:17]>> All three of my kids didn't have a choice, but also >> I don't worry about screen time as much with them because I know they've trained their brain to have the visual foundation to thrive.

[00:34:28]>> Yeah.

[00:34:28]>> But then also, I have them in protective what we call digital performance lenses.

[00:34:33]>> Okay. which are glasses specifically for screens that have a a high quality blue light filter, but they're way more than just a blue light filter. They have a specific prescription that decreases the visual stress associated with near and gives their brain a better opportunity for the inside and outside muscles of the eyes to work together.

[00:34:52]>> Yeah.

[00:34:52]>> In unison. And so that's something that >> um really when when you know better, you can do better. That those are so protective especially for kids. But there's also a level of digital performance lens that every adult can be in as well. It just requires the right uh mindset and approach to be able to know how can we develop uh a support system there to to handle screen time.

[00:35:17]>> Yeah. Yeah. Great. No, thanks awesome insights. you know, is there a vision exercise that someone can do like right now after they finish watching the episode that actually works and can benefit them?

[00:35:31]>> There's there's so many. So, I would say the most bang for your buck would be something that I call eye push-ups.

[00:35:40]>> Okay?

[00:35:41]>> And so, let's all do this together and then I'll explain what this does. So, eye push-ups, cover up an eye with a hand, >> okay?

[00:35:46]>> And then stick a thumb up with your other hand and look at the the nail portion of your thumb. And then you're going to slowly bring your thumb towards you, keeping it clear the whole time.

[00:35:54]And then stop as soon as it gets a little blurry. And then when it gets a little blurry, you want to stop. Try and make it clear. Look really hard at your fingernail. Think about stimulating your focusing system.

[00:36:03]>> Visualize your pupil getting small.

[00:36:05]Think about locking in looking hard at this. You're going to hold it for 5 seconds.

[00:36:09]>> Then you look into the distance for 5 seconds and relax your focus.

[00:36:13]>> Okay?

[00:36:13]>> And then look, think about looking soft, kind of diverging your eyes, panoramic viewing. and back at your thumb for five, back in the distance for five. So, this is a stimulation, relaxation, stimulation, relaxation. So, everyone listening, you want to do this same amount of time, right eye as you do left eye. And most people will notice that you can probably hold your thumb a little closer with one eye than the other, which means under two eye conditions, you're actually focusing your eyes at slightly different planes, likely because it's too hard to focus them at the same plane, and your brain is adapted to use one a little more for near and the other a little bit more for far so that it doesn't have to avoid the task.

[00:36:47]>> Yeah, >> this eye push-ups, this is is crazy to think about, Neil, but if you do this every day, >> you literally will not need stronger reading glasses. You may be may a be able to even get by with weaker lenses and for some people even avoid lenses.

[00:37:04]And this is a gross activity. It's it's turn on turn off and it is not the most exciting activity. And obviously there's way more dialed in treatment that we can use with lenses and prism and tech and filters and things like that. But this is the type of thing that if you could do this, let's say you did this every day for a week and your thumb is 2 millimeters closer.

[00:37:23]>> Yeah.

[00:37:24]>> Millimeters add up to centimeters.

[00:37:25]centimeters add up to inches and then that extends.

[00:37:29]>> Um, that is probably the single biggest >> bang for your buck exercise in terms of the lift that it does.

[00:37:36]>> Yeah.

[00:37:36]>> But then there's certain exercises to help engage periphery that we could talk about or certain ones that help your visual and vestibular systems communicate more effectively so that maybe motion sickness is less often or certain ones that can help with convergence or with tracking. And so it's really a matter of knowing what system we're trying to target and what the outcome should be.

[00:37:58]>> Yeah.

[00:37:58]>> Um but even like something as simple as like eye stretches, which is almost like yoga for the eyes. It's going to help >> calm the nervous system and allow for better flexibility with the outside muscles controlling the eyes.

[00:38:12]>> Yeah, that >> we could knock a lot of these out if we wanted.

[00:38:15]>> I I I really appreciate you sharing it.

[00:38:17]I'm glad you did the exercise real time because when we did that I now realized your earlier point that when I brought it over here it was kind of like blurry and fuzzy and then by just like trying eventually it focused and I was like okay that's like super interesting you know and like >> yeah I think so yeah thanks everyone watching try that you know >> and and something like the the eye push-ups we're doing there.

[00:38:39]>> Yeah, >> think of that as like it can also be done with let's say you're doing bicep curls. You start with a 5B dumbbell, then you go to a 10 and then a 15.

[00:38:47]>> In our clinic, we have lens powers that would ask you use one side of the lens and it turns on your focus a little bit and we use the other side and it relaxes a little bit and then those powers can extend and we're al honestly putting in work to build the flexibility and stamina of that system. And that's just one system, but that is the system that gets impacted >> from age and the age related changes.

[00:39:10]And then for many people, >> when you stop having the rapport with your focusing system that you used to have, >> then the outside muscles try and take over what the inside muscles couldn't do as well as they did previously.

[00:39:22]>> And then we often see >> fragile eye teeming and that can cause the words to move when you're reading or sometimes in a more advanced stage go to double vision.

[00:39:31]>> Yeah.

[00:39:32]>> And really that just is a spatial mismatch of aligning your eyes in a different position than where you perceive something to be.

[00:39:38]>> Yeah. And if we can eliminate that mismatch and you can align point and focus where target is, then you have more single clear comfortable vision and and the eyes working better together as a unit.

[00:39:49]>> Yeah, that's awesome. Thanks for sharing. That was that was great. Um, what's one piece of advice that conventional eye doctors should stop giving out?

[00:40:02]I would say I mean there's so many but probably the one that I often hear is that glasses or contacts don't make your eyesight worse and I would say that is accurate that the glasses or contacts do not make your eyes worse but your your adaptation to that lens and still having the same visual stress but not the tools in place to be able to meet the demands or support that stress That's what causes the changes because you're still trying to make sense of this unstable world. And so it's really if you were to take a ton of breaks from screen time, then you're going to develop better stamina over time and you're not going to adapt as likely. Or if you're going to get outside more and not be stuck behind a screen and indoors all day. I mean, that's going to allow for more distance engagement and panoramic viewing. So again, it's not the lens, it's your your adaptation to that lens by having the same visual stress of life.

[00:41:03]>> Yeah. Yep. Okay, great.

[00:41:04]>> That makes sense.

[00:41:05]>> Yeah. Yeah, it does. And that's a good one. Um, you know, and then and then last one. What did you change in your own daily life after everything that you've learned?

[00:41:13]>> So, I've done more vision performance training than I would confidently say anybody has because I just I live, breathe, and sleep this stuff. But >> um I I would say taking frequent and often vision breaks.

[00:41:27]>> Okay.

[00:41:27]>> So even on this uh recording now, I mean there's times where I'm relaxing my eyes looking through the screen >> and actually diverging my eyes and softening my gaze and then I come back.

[00:41:41]And so it's almost like if you were to stay with your bicep flexed >> for an hour, your arm's going to get tired. But if you were to flex and let go and flex and let go, you can do it for much longer.

[00:41:51]>> Yeah.

[00:41:51]>> So, I think the 20 2020 rule, I I hope most people have heard this by now, but really what that means is at least every 20 minutes, taking a break for at least 20 seconds and looking something at least 20 feet away, but that's kind of the maximum. We should be taking breaks, vision breaks, even every five minutes >> and coming back because it's going to allow you to perform at a higher level for longer. And that, you know, that's going to make it so that screen time is providing less toxicity to the nervous system and you're going to be able to have better critical decision- making, energy, focus, and productivity throughout the workday when you are on screens if you are allowing for more flexibility and and not just staring at one plane for 8 to 10 hours straight.

[00:42:36]>> Yeah. No, that's helpful. AJ, do you mind clarifying actually explaining maybe to the audience even for myself?

[00:42:41]What do you mean by like looking through the screen because I suspect I have like sometimes days where I have backtoback Zoom calls or I'm on a screen a lot of people in the audience might depending on their type of work might be in a situation like this where they're like looking at a screen. What do you mean like looking through the screen? Are you like looking at something behind and then focusing the eye on that or how can people practically during like a one-hour Zoom call setting like that look through or you know do something?

[00:43:06]Yeah. So it's really engaging your periphery, your side vision. And periphery is what grounds vision, grounds us in space.

[00:43:14]>> Okay?

[00:43:14]>> And so for a lot of people, it takes active work to get to this place where you can learn how to soften your gaze and look beyond.

[00:43:21]>> One great exercise for that would be something like peripheral pointing, which would mean >> look at something straight ahead. Don't move your eyes away from that, but then notice something off to the side. So I'm going to notice this light switch here.

[00:43:31]I'm pointing to where I think it is without looking there. Yeah.

[00:43:34]>> And then I make the eye movement over and see, all right, was I right on or was I off? And then bring [snorts] it back down. And so you want to kind of like actively paint or open up the periphery. You can do this on a walk >> where you know you're seeing the house to the left, the mailbox to the right, but if you're intentional, you can see them both at the same time.

[00:43:51]>> Y >> and so it opens up your world. And periphery is the key to central localization.

[00:43:58]>> And so even right now I have our window and don't take this the wrong way, but I have it really small.

[00:44:03]>> Yeah. so that I'm just kind of engaging with the whole screen, the whole room rather than directly at you.

[00:44:11]>> And so I can soften and kind of look through the monitor.

[00:44:14]>> Yeah.

[00:44:15]>> But most people would not even know that's possible or even know how to do that.

[00:44:18]>> Thanks for sharing because I'm doing the opposite. I'm staring right at where your face is the entire, you know, thing. And you're right, like that's I do that often on calls and I later wonder, hey, I was spending the one hour staring at almost like a one inch like point on my screen, you know, the entire time. And I think that's really interesting that, you know, >> simple practical advice that anyone can take. Yeah, >> absolutely. And a neat practice to kind of translate this to to the real world.

[00:44:44]>> Yeah.

[00:44:44]>> Often times when you're talking to somebody, you're thinking, do I look at their left eye, their right eye, their nose, their mouth? But if you kind of look at the whole face >> Yeah. and you kind of look at the whole the forest, not just each individual tree.

[00:44:57]>> Yeah.

[00:44:58]>> The more you can take in, >> yeah, >> the more regulated your nervous system is, but then the less you're kind of locked in with that central focal processing and that really can be uh wonderful for allowing performance to stay heightened for longer.

[00:45:13]>> Yeah, this is awesome. Yeah, thank you.

[00:45:15]I think there's so many practical tips.

[00:45:16]I hope everyone watching like it makes you rethink a lot of things you know in your life and also just like helps everyone you know practically I think you know yeah Bryce this has been you know a wonderful conversation it's been a treat you know I think I'm actually going to start thinking about how I do things in my daily life after this I love that >> so you know thanks for that and and I think just the whole concept of like the eyes you know being a direct window to the brain I think is really interesting and I guess yeah if you could share with everyone you know where can they find you know screen fit and you know my vision first and just follow along, you know, where can they follow you, follow your work.

[00:45:49]>> Amazing. Thank you so much. So, myvisionfirst.com is is our practice and that's where we kind of house everything that that we're involved with. Uh screenfit is our online vision training program. That's screenfit.com.

[00:46:01]It's actually in the process of being turned into an app right now. So, it's going to be gamified and allow for better compliance.

[00:46:07]>> Uh and then we're all over social media.

[00:46:09]Instagram's probably our our best one with just the most content and exercises that we're always pumping out. And that's just Dr. Bryce Apple Bomb. But my uh my ancestors wanted to make life really challenging for us. So Apple Bomb is spelled app pel b a m. Not like apple the fruit.

[00:46:26]>> Uh but you'll find us if it you know when you when you type it in. And I'm always just trying to get people to recognize how much vision is related to so many areas of life and and so much struggle that we all just assume as normal. That doesn't have to be that way. And we're now learning that training the eyebrain connection can be the most critical driver of performance, longevity, focus, critical decision- making, energy so much so that when our brain's not on overdrive, just trying to align point and focus our eyes, we can actually utilize and tap into so much more of our capacity.

[00:47:03]>> Yeah. No, that's I think awesome philosophy and I would highly urge everyone to um check out Dr. Apple's work. Um, you know, I think there you have it. You know, and if this hit home for you, you know, do one thing, which is book a functional eye exam or functional vision exam, I guess, and not just a standard eye exam. Um, you know, and I think, uh, and check out screen fit, you know, I think that, uh, this would be awesome things for people to try out. I think there's a broad range of people that could benefit as we learned about, you know, on the episode.

[00:47:31]And we'll be sharing short clips and tips from this conversation across, you know, all of our platforms. And of course, tag you guys on Instagram, Facebook, YouTube, Tik Tok, etc. Keep an eye out. And if this uh watching this makes you think about someone you love that might be, you know, struggling with uh vision issues or a friend or a family member, you know, send it their way.

[00:47:51]And, you know, if you're not subscribed, you know, hit the subscribe button. Dr. Apple, thank you again. I think this was this was an awesome show. I learned a lot. I hope the viewers learned a lot.

[00:48:00]And you know, thanks so much for, you know, spending time with us and, um, yeah, we'll see you in the next one.

[00:48:04]>> Honor to be on here.