Transcript

[music]: [00:00:00] Knock, knock,

Kristin: knock, knock. Hi.

Will: Hello everybody. Welcome to another edition of Knock Knock. I with me, your host, Dr. Glaucomflecken. This of course, is your one-stop shop for all things eyeball related and today. Our eyeball topic is gonna be all things presbyopia. Now I know that that doesn’t sound exciting, but when you consider that presbyopia affects 100% of people, if you live long enough, it’s an important topic and there’s a new medication that’s out, and I’ve got some thoughts about how we are trying to.

Treat this thing. So anyway, I’ll get to that after the first break. Uh, but first, just a few [00:01:00] like random thoughts. Just this is random things. Okay. First of all, I, I made the, um, Maha crowd angry again. I keep doing this. Uh, the Make America healthy again, the RFK Junior Acolytes. I, it is, it’s no surprise, like I’m not a fan.

Not a fan. Uh, and the, the most recent thing is I, I’ve been a little bit more vocal in my, um, criticism of this idea of, uh, that, that doctors are not interested in finding the root cause of disease. Not just doctors, but just the healthcare system in general. We are not interested in looking for and uncovering.

The mythical root cause. Of disease. So I made a, I made a video where I, you know, I, I just, I’m, it’s all satire and I’m making jokes. I’m trying to find a rooter cause [00:02:00] for, for the disease. Uh, and uh, it, it, you know, you know, and things are setting me off, like, you know, seeing root beer at the store and seeing a, a weed that has roots in it on, uh, outside, on the, on the gravel, uh, yeah, I, stupid stuff.

Anyway, people didn’t like it. I mean, people loved it. It was a very popular video, but, uh, the people that I guess I was, uh, pointing my criticism toward, did not like it. And, you know, I don’t really care. I, you know, sometimes I put a video out and some of the negative, like the, the, um, the, the, the criticism, sometimes it gets to me.

Sometimes I do feel bad if I like put a video out there. It’s been a while since this has happened, but if I put a video out in. A, a people, a group of people or just in, in general? Just people, uh, take issue with it or I said something incorrect or I offended somebody. I wasn’t trying to offend. If I’m, if I’m trying to offend [00:03:00] you, then there’s probably a good reason why I’m trying to do that, but sometimes I don’t, I’m not trying to offend certain people and they get offended by it.

Um, that sometimes that affects me. Like I, I do feel sad. I, I have a conscience. I, I, like, I don’t want, I want the right people to get upset at my, at my content. That’s important. Um, it’s okay to wanna make some people upset as long as it’s the right people. But in this case, I, I is, you know, I’m fine with it, uh, at the root cause.

It drives me crazy. I’m seeing it all the time. And it, it’s, it’s just like, it’s so disrespectful to like, the number of years of, of education that, that we, um, that we undergo. And honestly, the, the whole, like the, the quote treating the root cause, it’s just, it’s a trope that’s used in alternative medicine.

Integrative functional wellness [00:04:00] influencers, chiropractic manipulation in every respect, uh, it, it’s used by those areas to, to so distrust in mainstream medicine. That’s, that’s the bottom, that’s, that’s what it is. And that’s what RFK is using it as. It’s like, I don’t even know if he knows what he’s talking about.

Asking for people to, to uncover the root cause of disease. Like what do you think we’ve been trying to do? Like, and it is like, is this, is, is there, do you think there’s a chemical that’s like, that’s gonna be. That, that’s, that’s that, that’s it. Like if we find this chemical, it is, alt disease is solved.

Like I, I just, I just don’t get it. It’s like, what do, what do you think we’ve been doing what modern medicine has been trying to do. It’s just treat disease. That’s right. And that’s, that’s, that’s the other issue, right? He in particular, and he’s, ’cause he is said this doesn’t think that we are trying to [00:05:00] treat disease, which he thinks, he thinks we’re trying to make people sick and keep people sick because that’s how we make money.

I’ve talked about this recently, so I’m not gonna go into it. But anyway, the it, I, I just like, I find myself getting very, very irritated every time, like the root cause that that is, that is this, this, this dog whistle thing that, that’s like, that’s just like all the wellness influences just latch onto and now that’s all they’re talking about.

So, um, anyway. I’m gonna keep trying to find the root cause you guys, I just, I, someday I’ll find it. I don’t know. I don’t know where. Um, dentists, they deal with roots. They do root canals. Maybe they have an idea and ask a dentist. I’m getting a cleaning not too long from now, so actually it’s gonna be a podcast laughing my gas off.

I don’t know if you guys have heard of that podcast. I’m gonna be on it. Uh, so anyway, I’m excited about that, considering I hate the dentist. All right, other things, random [00:06:00] thoughts? Uh, just on the same, in the same vein as this, uh, root cause stuff. Uh, I’m just gonna say it again. Uh, chiropractors must be stopped.

There. I just, I just, right before I started recording this, I was scrolling on TikTok, which I try not to do too often, um, because sometimes it’s hard to stop scrolling. And I found a chiropractor who was, who was cracking, like toddler spines, honest to God, toddlers, they could barely walk. And then another one, there’s like babies.

There’s just like manipulating pieces of baby spines. How is this legal? How that’s, that’s my question. How is that legal and my, and regardless, uh, like, I mean, just putting it on social media, it, it’s like you’re just, you’re filming child abuse. That’s what it looks like. Is like what in, [00:07:00] in. In what world is like a normal, healthy kid need, like spinal manipulation.

Why does anybody ever need spinal manipulation? Well, they really don’t. They don’t. It just, it makes me sick. It’s gross. It’s gross. To see that and to think that like I. The, the chiropractors, they, they, their message reaches people and they, it can, can brainwash people into thinking that their kids need this, that they need this, and then they end up with carotid artery dissections, Horner syndrome, and, and, and terrible things can happen from there.

So anyway, chiropractors, they must be stopped. Not sure how to stop ’em. But legislate the hell out of him. I don’t know, but I at least Can we stop like, seeing it on social media? Like I, I honestly like it should be a, a rules and, what do you call ’em? Rules and regulation violation. Community guidelines.

That’s what it is. It, it, it feels, it [00:08:00] feels like a community guidelines violation when you see a chiropractor. Uh uh, cracking baby spines. Let’s not do that. Let’s not do that. You know, if you’re a grown adult and you can do research for yourself, and you can like, think that you need spinal manipulation by a chiropractor, you are a grown adult, you have a fully functioning frontal lobe, go for it.

You do you, you do the thing that you think you need, that’s fine. All right. But it’s kids like, come on. Like they don’t know. I don’t know what, what’s going on it. It’s gross. I don’t like it. I don’t like it. Um, another video I saw right before this is in the front of my mind is, uh, uh, somebody just to, to lift up the mood a little bit, is I saw a video of somebody receiving their MCAT score and they were very happy about it.

And like, it brought me back to when I found my score. Uh, I remember this vividly, so right after my [00:09:00] mcap. By the way, I took the very last paper in pencil mcat, so that’s something. Anyway, uh, so I was in a big auditorium with like 200 people. We were all taking this paper and pencil test, and it was so hard.

Even to this day, the hardest test. Beyond Step one, step two, step three, board certification, exams, oral, written, all this, the mcat, still the hardest test I have ever taken in my life. And uh, I remember afterwards I went into my dorm room and I just laid down in the dark in the middle of the day. Uh, until the next day I was, I was like, I wasn’t, I would never say I was clinically depressed.

I’ve never been clinically depressed, but that is in my life. That’s as close as I can imagine [00:10:00] Being, like satisfying the clinical criteria of clinical depression like that is as close as I have ever. Gotten in my life. Uh, it was, I was in a dark place, uh, there for like 24 hours. Uh, and then Kristin, uh, lady Glaucomflecken, she pulled me out of it.

She’s like, stop it. She literally said that, stop it. Let’s go eat some pizza or something. So anyway, um, and then it, it was like four weeks or so, six weeks before the, the scores came back. I got, I remember getting the email, um. In class. I was, it was in the middle of class and I had to, I just left, I was like, in the middle of the row.

I had to step over people. I had to, I, I, I could not wait another 20 minutes before the class ended. I was like, I have to find this out now. I cannot concentrate on anything else my score is in. And I went and I, I looked at it and I got a 31. Which in the old scoring [00:11:00] system, I don’t know what that correlates to, but it was a good score.

It was like I was, I was comfortably able to get into a lot of schools with a, a score of 31 and uh, and so I was very happy, but man, oh, the feeling walking out of the mcat. Oh, just like a gut punch. It’s like, what the hell did I just take? I was convinced I did horrible. But one thing I’ve learned is that.

Most of the time. All the time. Most of the time it’s not as bad as you think it is. It’s not as, and I tell myself that, and Kristin, even to this day, she still tells me this. It’s like, it’s not as bad as you think it is, uh, because your mind just wants to go to the worst case scenario for everything. And, uh, and I do this, I do this with, with, with, uh, surgical complications too.

Like, uh, even to this day, like I don’t have complications very often, but they happen because when you’re a surgeon, if, if you operate, you’re gonna have [00:12:00] complications. Um, I still tell myself this is like, well, you know what? I did the best I could. The complication happened. It’s not as bad as I think it’s gonna be in almost a hundred percent of the time.

It’s true. It’s not as bad. The patient will do just fine. Human body is resilient. All right, let’s take a break.

Hey, Kristin. Yeah. I almost did not get outta bed this morning to record. 

Kristin: Why is that? Were you tired? The the Cozy Earth Sheets. Oh, they’re incredible. They really are. 

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Kristin: They’re probably the best sheets we’ve ever had. 

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[music]: That’s right. 

Will: I, I, I want Cozy Earth to, to cover my skin at all times. Oh, wow. Like clothes, blankets. 

Kristin: Yeah. 

Will: Uh, the sheets, everything. 

Kristin: They make it possible, I guess, to just drape yourself in cozy earth and why wouldn’t you? 

Will: I would love that. Yeah. And I want our audience to feel that too. 

Kristin: Okay. 

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Okay, guys, this is your, this is your, your eyeball topic. Stay with me on this one, okay? Because it’s important, it affects every one of you. If you are listening to this, you will someday, if not already, be affected by presbyopia. So presbyopia, let’s just, let’s just, I’ll just physiologically, let’s tell you what this is.

So. When you’re, let’s say you have perfect vision, all right? If you’re myopic, you know, you put your glasses on, well then you have perfect vision. Okay? So let’s go from that baseline, your baseline of the best vision you could possibly [00:14:00] get when you’re in your twenties and thirties, uh, even teens. Like, uh, basically up until the age of 40, you have this remarkable ability to look in the distance and then.

Focus your eyes up close and when you’re like 20 years old, you can focus up to your nose. You can, you can you, you can do this all day. You can look at something three inches in front of your face. You can read a textbook, you can read anything. You can look at your phone all day, no issues. And the way, the way you’re doing that, like physiologically, what happens is you are contracting little muscles.

The ciliary body inside your eye. All right, so the ciliary body, it sits kind of right behind your iris, kinda right next to the lens inside the eye. It’s this little plump of tissue that has muscle in it, [00:15:00] smooth muscle, and whenever you focus, you are contracting those, that muscle and what that does. It releases tension on the lens inside your eye allows that lens to change shape.

It becomes more spherical. And what that does is it, it is, it moves your focal point forward. So you contract your muscle releases tension on the lens, the lens changes shape, and your focal point where, where what you, where you see things in focus goes from distance 20 feet away. Up to titrate it, whatever you want.

Three feet, two feet, one foot, one inch. All right? So that’s, that’s the normal mechanism. Now, as you get older, and this really starts in your thirties, but it usually doesn’t hit you until like your forties, fifties, that muscle atrophies, that ciliary muscle that you’re contracting, that [00:16:00] sets this whole plan in motion to be able to focus up close that muscle atrophies.

The atrophy so much that you, all of a sudden it’ll just hit you one day and you just, wow, I can’t, why is this blurry up close? That’s usually the complaint I get, uh, from people. It’s like, whoa, I, it just like last week I was like, all of a sudden I can’t like see up close. I mean, it doesn’t always say people like immediately like that, but it can.

But that’s what’s happening is that muscle atrophies and eventually you reach this threshold where, oh, all of a sudden, like where I usually hold my phone to to read. I can’t do that comfortably anymore. You find yourself straining. You get this brow ache, you’re right above your eyebrows. That’s where you just like this headache from trying to look up close at something all day.

And this starts, this is called, that’s, that’s the process called presbyopia. It affects everybody. There are things that are certain in life, like paying taxes, [00:17:00] death, and presbyopia. There’s a third one that nobody ever remembers. Yeah. Death and taxes, but like presbyopia is the third one. Why don’t people include this?

I do. No one seems to care, but, uh, it’s a, it’s a problem. And it’s like there’s a couple of holy grail things in every specialty, right? These are like. Either procedures or diseases or, uh, something that you’re constantly trying, trying so hard to treat or fix? I can think of two in ophthalmology. Alright.

Holy grail conditions. One is opt is optic nerve damage. So whole eye transplants, you know. Uh, trying to recover optic nerve function from a variety of different problems. Ischemic optic neuropathy is basically you torch the optic nerve. I mean, this is not just the optic nerve, it’s, it’s the central nervous system, right?

We can’t yet, like, put nerves [00:18:00] back together and have them function normally, like that hasn’t been done yet, at least, you know, central nerves. Same thing with the optic nerve. All right? We can’t transplant a whole eye because we can’t get the optic nerve to function again. People are working on it. It’s the holy grail.

It’s like the, we’re just trying to eventually get there. Well, I would say the other one that’s, that’s more attainable but not quite is presbyopia, because this is something that bothers people and, and it, and it affects everyone, as already mentioned. Right. I am almost 40. It’s gonna hit me like a, like a ton of bricks.

I have never had glasses. I see. Perfect. I remind my family that I see perfect all the time. All right. My wife who’s a minus three and a half, she loves it. She loves it so much that I always tell her, well, I don’t know. I have perfect vision. I can see that just great. Um, but even for me, see, I, yeah, I have [00:19:00] great vision in my youth.

But once I hit that presbyopic age, where tho that muscle atrophy so much where I can’t read up close, I am, I’m gonna have, I am gonna have the biggest crash out meltdown you’ve ever seen in your life. Even though I know it’s coming, it’s gonna be really hard for me because my whole life, I have never had to wear glasses.

I could see anything just fine, but it’s coming for me. It’s coming for me. Like grim death. It’s coming. And grin Grim Death has already had me once, so you’d think I’d be okay with this, but I’m already, I’m already semi crashing out about it right now. You can tell I’m pressed, I’m anxious, I don’t wanna wear reading glasses, and that’s how a lot of my patients feel.

Right? And so there’s been a, a ton of resources in the world of ophthalmology on trying to fix this. How do we basically, if I could sum it up. How do we give people [00:20:00] 20-year-old eyes again, and this is something I always caution people when they get cataract surgery. I was like, I cannot give you 20-year-old year, year old eyes like, we’re not there.

I cannot give you something. I cannot do a cataract surgery. Put a lens in the eye that’ll give you an entire range of vision up to your nose. Like that does not exist. Right now. All right. Maybe it will someday, but it doesn’t right now. But my God, are we trying? We are. Let me tell you how we’ve tried.

We’ll start with cataract surgery because that was really the first, the first time that we, once we started to innovate cataract surgery, to the point to the place where it is today, where we have. Plastic lenses we can put in the eye. Well, different companies have worked really hard on trying to do different designs that can actually give people, you know, vision in multiple focal ranges.

So we have what are called [00:21:00] multifocal intraocular lenses, little plastic lenses. They go in the eye, they have little concentric rings. In the, honestly, the optics of which I’m still kind of puzzled to how this works, but it does, and it gives people kind of like a, a range. There’s different forms of this that have varying degrees of success, but they can give people distance, vision and arms length and then reading, but there’s limits to it.

All right, fine. Print medication bottles, little tiny things. You’re not gonna get that. Hence the me telling people, you’re not gonna get 20-year-old ice. Can’t do it. All right. We can kind of treat presbyopia with these types of lenses, but it’s just not perfect. And more and more, as more time goes by, people are expecting perfection With cataract surgery.

It’s actually the why I miss Iowa so much. ’cause those farmers, they just want to have two eyeballs after surgery. If they have two eyeballs, they’re [00:22:00] great. They’re, they’re, they’re perfect. All right. Here on the West Coast, expectations are a bit higher. Most places around the country, you gotta have perfect vision.

All distances. See everything without glasses, that’s remarkably hard to achieve. But we’re trying, that brings me to the reason I even brought this topic up in the first place, because there’s a new medication. So after we’ve, we’ve had, for years, we’ve had these, these, these IOLs. That are trying to accomplish this to varying degrees of success.

I’m kind of, I, I go back and forth on these IOLs by the way. They’re like, sometimes I really like them, sometimes I don’t. It really depends on, uh, whether or not I have a patient that’s struggling with them or not. When the patients come back after getting these premium lenses, by the way, they cost like three to 4,000 per eye.

These are very expensive lenses, but when they get ’em and it works great, which I will say most of the time works great. Then I’m like, [00:23:00] yeah, I wanna put these in everybody. Let’s do it. But then I have one patient where it doesn’t work so great. And usually when it doesn’t work, they have lots of halos, they have side effects to the lenses.

Maybe it didn’t quite get the target Correct. And they, they’re so, they’re a little bit subnormal vision picking knits a little bit. But I mean, it happens and, you know, people pay this much money, expectation is gonna be through the roof. Right. So I, I, I struggle. With that, given my Iowa upbringing in the world of ophthalmology, I was like, the, the, the, the high expectations are, are sometimes a bit too high.

Um, so, so we’ve had the lenses for a while now. Uh, but more recently people have, uh, companies have been trying to make eye drops that will, that will incr, that will move your focus, that will treat presbyopia, presbyopia, treating eye drops. We had ity. This was a few years back, [00:24:00] and this is a drop that basically just constricted your pupil a little bit.

It was like a little bit of pilocarpine. Pilocarpine is an, is a, uh, sympathetic, um, agonist, which, sorry, not a sympathetic, a parasympathetic agonist. Gotta gotta get my adrenergic. Receptors and things. Autonomic nervous system. Correct? Um, it’s a parasympathetic agonist. What it does is it helps to constrict people, right?

Flight or fight or flight response. Sympathetic. Your, your eyes are gonna dilate. Alright? Parasympathetic. They’re gonna constrict. And so what the first iteration of these types of. Treatments did was they helped cons, they constricted the pupil a little bit. And when you constrict the pupil, what it does is it helps to move your focal point a little bit forward when you accommodate.

That’s what we’re talking about is when you move your focal point in the distance, so to near, when you focus up close, that focusing the fancy term for it is accommodation. So when you accommodate, you’re [00:25:00] moving that focal point forward. And, uh, you’re, you’re, you’re looking at something up close. All right, so what this drop did ity is it just constricted the pupil slightly, moved the focal point forward, um, and allowed people to have a little bit better reading vision, but it wore off after four hours.

You had to keep taking it. It was expensive. It caused redness. People got allergic reactions to it. Also, people would just get headaches. Because again, you’re just, you’re, you’re, you’re, you’re constricting muscles in the eye that that can cause you to have some strain. So people got headaches with it and it kind of just flamed out.

People didn’t like, I mean, it just, you know, they didn’t like the cost. That was a big one. Some people really liked the drop, but it was like 80 bucks every month and it wore off quickly. Right. So you had to keep using it, and so it just wasn’t. It just, it just, it just petered out and [00:26:00] people, uh, people stopped.

I, I haven’t prescribed it in like two years probably. Well, I was just informed by my wonderful wife, Hey, look, there’s another medication out. This is called this. So we had ity and now we got FDA approves presbyopia treatment and a medication called Viz, which is the, uh, VIZZ. The, uh, the generic term is, um, AIC Aine Aine, A-C-E-C-L-I-D-I-N-E.

Uh. I’m not sure, I’m not familiar with this. Uh, it’s, it looks like it’s just a parasympathetic, mimetic, miotic agent, just like ity was. And so the, the, the point here is that this new medication, it’s like the same thing. It’s the same thing as ity. It’s like, it’s acting [00:27:00] as doing the same thing and it’s, has reading about it, uh, the, the, the trial, these, these, uh, phase three studies, clarity trials.

People, the, the adverse effects were the same thing. 20% irritation, 16% dim vision. People also, that’s another reason people don’t like these types of medications. These drops that treat presbyopia. It constricts your pupil. Well, what is that? What happens? I mean, you need. A larger people in a dim environment because it allows more light to come in.

So if you’re like in kind of a dim, dim lighting and you use the, like, say you’re at a restaurant and you do, you wanna try to read the menu, but you’re embarrassed, you don’t wanna, uh, take out your reading glasses. By the way, don’t ever be, feel embarrassed for pulling out glasses. Glasses are beautiful.

You’re beautiful. Your eyes are beautiful. Uh. That’s my uplifting message to you for the day. En enjoy your eyes. All right. And if you need glasses, just, it’s just a disability accommodation. That’s it. It’s okay to say you have disability. Disabilities are okay. [00:28:00] All right. That’s what we have. This wonderful thing called glasses that will fix your disability.

And so, um, but dim vision, if you’re in a restaurant, dim light, trying to read a menu, you put in a drop that constricts your pupil, it’s gonna make it even harder to read. ’cause you need a larger pupil in dim light. Right. Makes sense. Also, headaches, redness to the eye, all these same problems. And so like, I, I don’t know, what are we doing the, it just, I, I have a, it’s kinda like a philosophical problem and I know I just finished like ranting.

Uh, you know what, let’s take, let’s take a break. Let’s take a break and I’ll finish this up. I’ll wrap this up with my thoughts on, on just this class of treatment options in general.

Hey, Kristin. Hmm. I know I like to talk to you about the little dex mites. Mm-hmm. And little tiny guys. Mm-hmm. Thought we could give that a break [00:29:00] and just talk about the, the eyelid disease that they cause when there’s an overgrowth of dex. 

Kristin: I like that idea. No mite talk. 

Will: So Dedex blepharitis it, it gets missed, it gets misdiagnosed.

Because a lot of the symptoms overlap with other eye conditions. 

Kristin: Okay. So what are the top symptoms that people should be looking out for? 

Will: Itching, swelling, irritation of the eyelid margin, redness. 

Kristin: Yeah. That kind of sounds like it could be allergies or something else. Exactly. 

Will: It could be several different things, but the key is if your doctor spots.

Little crusties that’s, they’re called collarettes, but you know, they’re like little crusty technical term. Exactly. Uh, then, um, uh, that’s Dex Blepharitis. You just know it. 

Kristin: Hmm. I like that there is a clear sign to know. 

Will: Yep. And once you’re diagnosed as a prescription eye drop treatment. Available for Dex Blepharitis.

Whew. 

Kristin: That is good to know. 

Will: To learn about the common symptoms of Demodex blepharitis and more visit mites love lids.com. Again, that’s [00:30:00] M-I-T-E-S-L-O-V-E-L-I-D s.com. To learn more, this ad is brought to you by Tarsus Pharmaceuticals.

All right, so I know I just ranted about the fact that I’m gonna be an absolute mess. When I have presbyopia, but I will understand. I will understand that. It’s just, I’m just aging. I’m getting older. And this works for so many things like just plastic surgery and, and just this, this obsession with not showing your age.

Not saying the wrong thing as it makes you sound old. You know, I don’t know. I maybe it’s, maybe I’m just getting a, becoming a crotchety old man, but like presbyopia is in, is in this, this, this range, this uh, this, this spectrum of, of, of, of aging. It’s aging. That’s what presbyopia, it’s natural aging [00:31:00] and yeah, it’s, it’s a pain in the ass to have to wear reading glasses, but like what we.

Are like doing to ourselves and like paying all this money to try to avoid reading glasses or using these drops that make our eyes red and irritated and difficult to see in dim light and give us headaches. Like why, why can’t I wish we could all just accept aging a little bit more? And I’m, I’m speaking to myself as well.

You guys like, I, it’s scares. I don’t want to have to wear reading glasses. But like, I will get there and I, I understand that it’s, it’s just, it’s the aging process. And so when it comes to your eyes, and I’m not gonna speak about, you know, any, any other aging process because you know this. People are, you know, people have their own stuff they’re dealing with, right?

But, but from, from the eye standpoint, like it’s just, it’s okay to accept it. It’s o put your reading [00:32:00] glasses on. All right? They’re very fashionable. Glasses are in these days, you guys. Uh, and, uh, uh, don’t, don’t start. I would not use these medications. They just, and by the way, this one, this new one, viz Vi, great name by the way.

Viz. I like it. Uh, $79 a month. Which includes 25 doses. 25 doses. So, so you’re, you’re put, you know, and it only lasts probably like four to six hours, right? So, uh, 25 doses, 80 bucks a month, uh, you know, so it’s a little over, uh, you know, it’s basically $3 every, for every drop you put a drop in, that’s three bucks you’re putting in your eye.

You, you, you know that, that adds up over time. $80 is a lot of money for a bottle of eyedrops to do something that glasses will do for you can buy, you know, a 10 pack of, of reading over the counter readers at Costco [00:33:00] for seven bucks. I don’t know how much they cost, but they’re, they’re cheap. You can put ’em in every room in the house.

I don’t know. I just, I, I, the, the whole conversation around presbyopia. And it’s like, it’s at ophthalmology conferences. I know I’m gonna get into the weeds here with this guys, but it’s, it’s, it’s, it’s bother. It bothers me a little bit. We we’re so focused on just, we have to treat presbyopia, but the way we’re doing it, some of these treatments, some of the, and some of the lenses, they’re just not as good.

They’re not as good as a regular old monofocal lens that gives you a good distance vision or good reading vision. And then you wear glasses for everything else. I wanna see a society where we just accept glasses as we age. We’re good at glasses. And it’s, it’s, and it’s, they’re, like I said, one of the most amazing disability accommodations ever invented it.

It’s incredible. Right? [00:34:00] And it’s, and it’s generally accepted, but we just, we just have to accept it as individuals. So that’s, that’s my, I hope, I hope, uh, I hope this reaches the right people. And I’m gonna, I’m gonna do my best. You’re gonna stick with me on this podcast ’cause I’m about to turn four to you guys.

I am getting, I’m almost there. I’m almost there and I’m going to be going through it all right. But remind me that I had this conversation with you all right. Because I might need to hear it once or twice. It’s okay to get old. It’s okay. Your eyes age, just like every other part of your body. Uh, all right, let’s finish up with maybe a couple of comments here.

Uh, the, the most recent, uh, episode that just was out on our YouTube channel at Glaucomfleckens, by the way, go check it out. I read all these comments, had some good ones. This is an episode called the One Rule I Follow in Medical Comedy, which is basically. Don’t make fun of patients. That’s, that’s the rule.

I have some, a lot of people really appreciated that. Uh, [00:35:00] they agreed. Um, uh, at Simba 6, 5 3, 1 5, golden rule of comedy never punch down. Yep. Because when you punch up, it’s funny. When you punch across, it’s funny. When you punch down, it’s bullying. That’s what it’s, uh, I don’t remember saying this, but, um, at Roberto Guerrero, 8 0 6 3, uh, quoted something that I said in the, in the episode, uh, where I apparently I said, get your Ballis ass outta here.

I love it because I don’t, I don’t see. I don’t read these comments until like, probably two weeks after I record the episode. And so I get reminded of some of the things I say, and that one made me laugh. I was like, I have no idea what the hell I was talking about. But I appreciate Rob Roberto for, uh, for reminding me.

I love it. It’s great. Um, uh, and this episode I also showcased, uh, swim Goggle. Sorry, not swim goggles, onion goggles. You can wear it to protect you from the [00:36:00] harmful chemicals coming from onions. So, um, let’s see, at Lisa, B-M-P-L-S said, how about an urgent care doctor, character part, emergency part family medicine?

I haven’t thought about it that way. I, I, I, you’re right, I haven’t had an urgent care. I had lots of people ask me to do urgent care. Uh, I haven’t thought about doing like a half and half. You have the. The emergency, get up. Maybe just the glasses are skewed. That my, like my, my sunglasses, my, um, Oakley sunglasses are, uh, uh, skew a little bit.

I don’t know. I gotta, I’ll think about that one. It’s a good idea. I love it. Uh, urgent care, uh, this is still a handful of, of doctors. I haven’t, I haven’t represented, and the, the people in those specialties remind me. All right, last one at Gustav Mahler. 3, 2, 2, 8. Dr. Glock great episode. Why do you pronounce it ophthalmology as opposed to ophthalmology?

Uh, I feel [00:37:00] like ophthalmology is too pretentious. I don’t think it matters, honestly, but I feel like if I was like, oh yes, I’m a doctor of ophthalmology. Like, doesn’t, that sounds kind of dumb, doesn’t it? It sounds like I’m trying to like, make it seem more important than it is even though it is the most important thing in the world.

I say ophthalmology because it’s just easier to say ophthalmology. That’s that’s too much that my mouth is doing. What is doing gymnastics. There’s too much going on and trust me, ophthalmology. We have too many things going on with the language of ophthalmology anyway, so I’m just gonna make it as simple as possible.

It just rolls off the tongue better. Ophthalmology. Ophthalmology. I don’t like it. I don’t like it. Ophthalmology is where it’s at. Alright, thank you guys. That was knock, knock eye for today. I am your host Will fan, also known as Dr. Glaucomflecken. Thanks to my executive producers, Aaron Corny, Rob Goldman and Ashanti Brook, editor and engineers.

Jason Portizo. Our music is by Omer. [00:38:00] Ben-Zvi. And, uh, yeah. Oh, send, send comments, questions, concerns, uh, anything eyeball related, even remotely, tangentially, eyeball related. I want to hear about it. Okay. Uh, and gimme some ideas for different, um, uh, diseases. Things you, you, you wanna know about. Uh, and we can even doubt.

Into some non ophthalmology if you want, but I’m always gonna try to bring it back to the world of eyeballs. Alright, that’s it. Thank you all. Thank you for listening. We’ll see you next time.

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