Dr. Jeffrey Goldberg: How to Improve Your Eye Health & Offset Vision Loss
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
Today my guest is Dr. Geoffrey Goldberg.
今天我的嘉宾是杰弗里·戈德堡博士。
Dr. Geoffrey Goldberg is the chair of the Department of Ophthalmology at Stanford University School of Medicine.
杰弗里·戈德堡博士是斯坦福大学医学院眼科系主任。
He is a clinician, an MD or medical doctor who sees patients every week, as well as a PhD, meaning a laboratory scientist who directs his own laboratory focused on understanding the mechanisms and cures for diseases of the eye and vision, such as glaucoma, retinitis pigmentosa, and macular degeneration.
他是一名临床医生、医学博士或每周看诊患者的医生，同时也是一名博士学位，即领导自己实验室的实验室科学家，专注于了解眼睛和视力疾病（如青光眼、色素性视网膜炎和黄斑变性）的机制和治疗方法。
Indeed, Dr. Goldberg is one of the world leaders in developing methods to cure blindness.
事实上，戈德堡博士是开发治疗失明方法的世界领先者之一。
He is also intensely knowledgeable about all things related to vision.
他对与视觉相关的所有事物也非常了解。
So during today's discussion, we indeed cover most all of visual and eye health.
因此，在今天的讨论中，我们确实涵盖了大部分视觉和眼睛健康问题。
You will learn, for instance, about the benefits as well as drawbacks of wearing corrective lenses, such as contact lenses or eyeglasses for reading.
例如，您将了解佩戴矫正镜片（例如隐形眼镜或阅读眼镜）的优点和缺点。
You will learn about the benefits and detriments of sunlight, meaning how it can help your vision, in fact, how it can help reverse or prevent myopia, nearsightedness, as well as the things to be cautious about with respect to sunlight in terms of development of cataracts, which are occlusions that prevent vision.
您将了解阳光的好处和坏处，即它如何帮助您的视力，事实上，它如何帮助扭转或预防近视、近视，以及在白内障发展方面应注意的事项，白内障是阻碍视力的遮挡物。
We also discuss many tools for maintaining and improving vision across the lifespan, ranging from behavioral tools, so specific vision tasks and exercises for the eye that you can do that are known to improve or maintain your vision, as well as specific surgical procedures such as LASIK surgery.
我们还讨论了许多在整个生命周期中维持和改善视力的工具，包括行为工具、已知可以改善或维持视力的特定视力任务和眼睛锻炼，以及特定的外科手术，例如 LASIK 手术。
We get into all the details of, for instance, how often to do these various eye exercises, how long the benefits are maintained, as well as age-related considerations for things like LASIK eye surgery.
我们详细介绍了所有细节，例如，多久做一次这些不同的眼保健操、效果能维持多久，以及 LASIK 眼科手术等与年龄相关的考虑因素。
We even get into how to best clean your contact lenses, whether or not to use disposable contact lenses or other forms of contact lenses.
我们甚至讨论如何最好地清洁您的隐形眼镜，无论是否使用一次性隐形眼镜或其他形式的隐形眼镜。
We also discuss things like dry eye and the best remedies for dry eye.
我们还讨论干眼症和干眼症的最佳治疗方法等问题。
And we talk about the scientific and clinical data around nutritional approaches and supplementation-based approaches for maintaining and improving vision.
我们讨论有关维持和改善视力的营养方法和基于补充剂的方法的科学和临床数据。
So whether or not you suffer from floaters or dry eye, or you're considering changing your eye prescription, or you have concerns about whether or not relying on corrective lenses is impairing your vision and you want to enhance your vision, or if you're somebody who has perfect vision, today's episode is going to include science and protocols that will be highly relevant to you.
因此，无论您是否患有飞蚊症或干眼症，或者您正在考虑改变您的眼科处方，或者您担心依赖矫正镜片是否会损害您的视力而您想要增强您的视力，或者您是一个拥有完美视力的人，今天的节目都将包括与您高度相关的科学和方案。
I should also add that if you are somebody who suffers from or who has family members who suffer from diseases of the eye that can impact vision, such as glaucoma, retinitis pigmentosa, and macular degeneration, we also delve deep into the discussion about the most advanced technologies for preventing and offsetting vision loss due to those diseases as well.
我还应该补充一点，如果您患有或您的家人患有影响视力的眼部疾病，例如青光眼、色素性视网膜炎和黄斑变性，我们也会深入讨论预防和抵消这些疾病引起的视力丧失的最先进技术。
Thanks to Dr. Goldberg's incredible knowledge, his clarity of communication, and his generosity with that knowledge, by the end of today's episode, you'll be armed with all of the modern information you need in order to best maintain and improve your eye and vision health.
感谢戈德堡博士令人难以置信的知识、他清晰的沟通以及他对这些知识的慷慨，在今天的节目结束时，您将掌握所需的所有现代信息，以便最好地维持和改善您的眼睛和视力健康。
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
And now for my discussion with Dr. Geoffrey Goldberg.
现在我与杰弗里·戈德堡博士进行讨论。
Dr. Geoffrey Goldberg, welcome.
杰弗里·戈德堡博士，欢迎光临。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Thanks.
谢谢。
It's great to be here.
很高兴来到这里。
Andrew Huberman:
安德鲁·休伯曼：
You and I go way back.
你和我可以追溯到很久以前。
We will spare people the discussion about all of that, but I'm really excited for today's discussion because I get a tremendous number of questions about vision and eye health, and of course, as a neuroscientist who has worked on the visual system, I sometimes have answers or partial answers, but more often than not, I don't have the answers, and yet I'm confident that you do, or that if you don't, you can direct us to the proper place to get those answers.
我们不会让人们讨论所有这些，但我对今天的讨论感到非常兴奋，因为我收到了大量有关视力和眼睛健康的问题，当然，作为一名研究视觉系统的神经科学家，我有时会得到答案或部分答案，但更多时候，我没有答案，但我相信你知道，或者如果你没有，你可以引导我们到正确的地方来获得这些答案。
So to kick things off, I want to ask you what was one of the most commonly asked questions when I solicited for questions in anticipation of this episode, which is, how early should one do an eye exam on their child, and how regularly should we all be doing eye exams?
首先，我想问一下，当我在预期这一集时征求问题时，最常见的问题之一是什么，即，一个人应该多久给孩子做一次眼科检查，以及我们应该多久进行一次眼科检查？
Also, is the fact that I think I can see normally confirmation that I can see as well as I think I can?
另外，我认为我能正常看到这一事实是否证实了我能看到的和我认为我能看到的一样好？
So that's really three questions, but baby comes out, do they check their eyes right away?
所以这确实是三个问题，但是宝宝出生后，他们会立即检查眼睛吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And if so, how?
如果是这样，怎么办？
And how often should they check, and what kind of information is there?
他们应该多久检查一次，有哪些类型的信息？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's a great question.
这是一个很好的问题。
It's obviously something that touches us all.
这显然是触动我们所有人的事情。
So the answer to that really differs a little bit at the different stages of life.
因此，在人生的不同阶段，这个问题的答案确实略有不同。
First of all, every baby gets an eye exam or should be getting an eye exam.
首先，每个婴儿都会接受或应该接受眼科检查。
And one of the main things that you really just are screening for right when that baby is born, right in the nursery, right in those first few days, is to just look for a red reflex.
当婴儿出生时，在托儿所里，在最初的几天里，你真正要筛查的主要事情之一就是寻找红色反射。
You know when you take a camera picture, a flash picture, and sometimes you get red eye?
你知道当你用相机拍照、用闪光灯拍照时，有时你会出现红眼吗？
That's actually the light from the flash, as you know, reflecting against the retina and coming back out of your eye.
正如您所知，这实际上是闪光灯发出的光，反射到视网膜并从您的眼睛返回。
It looks red.
看起来是红色的。
And a red reflex is actually very normal.
红色反射实际上是非常正常的。
That's great.
那太棒了。
And if you have one of a number of diseases in the eye that can present e- even in babies, even in newborn babies, including most concerning, but thankfully least common, retinoblastoma, which is the most common pediatric eye cancer, which again, thankfully is quite rare, those babies won't have a red reflex in that eye.
如果您患有多种眼部疾病中的一种，即使在婴儿中，甚至在新生儿中也可能出现这种情况，包括最令人担忧但最不常见的视网膜母细胞瘤，这是最常见的儿科眼癌，值得庆幸的是这种癌症相当罕见，那么这些婴儿的眼睛不会出现红色反射。
It'll be kind of a whitish or gray reflex.
它会是一种白色或灰色的反射。
And so even just that first little doctor's taking the little penlight and even just flashing it in the baby's eyes, so that's our first eye exam, and hopefully we've all had that, and hopefully every baby being born today is getting that first eye exam, is really just looking for that red reflex.
所以，即使是第一个小医生拿着小笔电筒，甚至只是在婴儿的眼睛里闪烁，这就是我们的第一次眼科检查，希望我们都做过这样的检查，希望今天出生的每个婴儿都能接受第一次眼科检查，真的只是在寻找红色反射。
It's not typical, as long as that's looking good, to worry about getting an eye exam from there through childhood, maybe early elementary school, unless your baby is presenting with one of a number of features that parents often pick up on.
只要看起来不错，就不会担心从童年时期（也许是小学早期）进行眼科检查，除非您的宝宝表现出父母经常注意到的众多特征之一。
For example, as the baby's aging through those first couple of years.
例如，随着婴儿在最初几年的衰老。
Through the first couple of years, babies actually don't have great visual acuity.
在最初的几年里，婴儿的视力实际上并不好。
And so as they're aging over those first couple of years, it's normal for them to have roving eye movements, for example, be searching their environment.
因此，随着他们在最初几年的衰老，他们的眼球运动是正常的，例如，搜索他们的环境。
But over those first couple of years, if parents start noticing the baby isn't making eye contact or looking where a sound is, certainly if they have what's called nystagmus, like these rapid flickering, alternating eye movements, anything like that, of course, you're going to trigger an eye exam.
但在最初的几年里，如果父母开始注意到婴儿没有目光接触或看有声音的地方，当然，如果他们有所谓的眼球震颤，比如快速闪烁、交替的眼球运动，类似的事情，当然，你会触发眼科检查。
But otherwise, most babies, other than their pediatrician doing that red reflex check when they're in for their regular well-child checks, that's really all that's needed through that.
但除此之外，大多数婴儿，除了儿科医生在定期进行儿童健康检查时进行红色反射检查之外，这确实是所需要的全部。
When most kids get to elementary school age, they're often done at the schools an amblyopia screening exam.
当大多数孩子到了小学年龄时，他们通常会在学校进行弱视筛查检查。
If kids' eyes, either if one eye doesn't see that well, like maybe you're very nearsighted or farsighted in one eye and pretty normal sighted in the other, or the two refractive errors are quite different from each other, that can lead to a condition you've talked about on the podcast before called amblyopia, which is probably one of the more common or most common eye diseases of children.
如果孩子的眼睛，或者一只眼睛看得不太清楚，比如你的一只眼睛近视或远视，而另一只眼睛视力正常，或者两种屈光不正彼此差异很大，这可能会导致你之前在播客上谈到的称为弱视的情况，这可能是儿童更常见或最常见的眼病之一。
Or if the eyes aren't aligned, our eye muscles and the brain behind them are really responsible for keeping the two eyes looking straight ahead.
或者，如果眼睛没有对齐，我们的眼部肌肉和眼睛后面的大脑实际上负责保持两只眼睛直视前方。
And if that's not working properly and one eye is off-kilter, and therefore the image of what we're looking at is falling on different spots of the retina, it's not syncing up right in the brain, that can lead to this disease condition called amblyopia, where that eye is no longer talking to the brain properly.
如果它不能正常工作，一只眼睛失去平衡，因此我们所看到的图像落在视网膜的不同位置，它就不会在大脑中同步，这可能会导致这种称为弱视的疾病，即眼睛不再与大脑正常对话。
And there's a pretty easy screening exam that can be done for strabismus, the misalignment of the eyes that kids will do in elementary school.
有一个非常简单的筛查检查可以针对斜视（孩子们在小学时就会出现的眼睛错位）进行。
The other main presenting symptom of kids in elementary school is when they admit to their parents, "I can't see the board," or, "I can't see the teacher up front." And then they might be quite nearsighted, and so that will also trigger an exam.
小学孩子的另一个主要表现是，他们向父母承认，“我看不到黑板”，或者“我看不到前面的老师”。然后他们可能是近视眼，所以这也会引发检查。
And so those are usually the parts for babies, for toddlers, for school-aged children that might reasonably trigger an exam.
因此，这些通常是针对婴儿、幼儿、学龄儿童的部分，可能会合理地引发考试。
Andrew Huberman:
安德鲁·休伯曼：
A couple of questions about early eye exams, and we'll get onto eye exams in older individuals in a second.
关于早期眼科检查的几个问题，我们稍后将讨论老年人的眼科检查。
But I want to interrupt you with this question.
但我想用这个问题打断你。
So you mentioned that there can be a misalignment of the eyes.
所以你提到眼睛可能存在错位。
I've seen many people's babies where there is one eyeball that seems to be drifting around, and then it might correct, but sometimes they'll have a-- We don't want to get technical here.
我见过很多人的婴儿，其中一只眼球似乎在四处游移，然后它可能会纠正，但有时他们会出现——我们不想在这里讨论技术问题。
For our listeners, we'll keep it general, but either convergent eyes or one eye converging, cross-eyes, or wall-eyed, again, using that non-technical language here.
对于我们的听众，我们将保持笼统，但要么会聚眼睛，要么一只眼睛会聚，斗鸡眼，或者斜眼，再次使用这里的非技术语言。
And my understanding is that the brain is taking that information in and is very plastic.
我的理解是，大脑正在吸收这些信息，并且具有很强的可塑性。
It's changing at these early stages of development, and that it's fairly critical to get that stuff corrected early on, because if you wait too long, the brain can essentially become blind to the...
它在发展的早期阶段正在发生变化，尽早纠正这些问题是相当重要的，因为如果你等待太久，大脑基本上就会对……视而不见。
Or rather, the brain cannot learn to handle the proper alignment.
或者更确切地说，大脑无法学会处理正确的排列。
So in other words, if a kid has crossed eyes, and they're not corrected until their 20s, it's possible that they will never recover normal vision.
换句话说，如果孩子有斗鸡眼，到20多岁才矫正，他们可能永远无法恢复正常视力。
Whereas if you align the eyes properly early in development, they can indeed recover vision.
然而，如果您在发育早期正确调整眼睛，它们确实可以恢复视力。
How early can and should one consider getting those eye realignments done?
人们可以并且应该多久考虑完成这些眼睛调整？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Pretty much right on.
差不多就对了。
What they'll do is if they detect any eye misalignment, and sometimes parents are good at noticing that.
他们会做的是，如果他们发现任何眼睛错位，有时父母很善于注意到这一点。
Sometimes you take a picture and one eye got the red eye reflex and the other one didn't.
有时你拍一张照片，一只眼睛出现红眼反射，而另一只眼睛却没有。
And sometimes people notice that their kid's eyes are turning in, it seems like too much.
有时人们会注意到他们的孩子的眼睛向内翻，这似乎太多了。
Sometimes there's what's called pseudostrabismus, which is where actually, depending on your anatomy, if you have a little extra skin on the inside corners of your eyes, it makes your eyes look turned in when actually they're straight.
有时会出现所谓的假性斜视，实际上，根据您的解剖结构，如果您的内眼角有一点额外的皮肤，它会让您的眼睛看起来内翻，而实际上它们是直的。
Andrew Huberman:
安德鲁·休伯曼：
Mm.
嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
But if your eyes are actually turned in or slightly less common in children, more common in adults, misalignment turned out, it's really important to correct that early.
但是，如果您的眼睛实际上是内翻的，或者在儿童中不太常见，而在成人中更常见，则证明是错位，那么尽早纠正就非常重要。
And the reason is, as you were saying, the brain starts ignoring.
原因是，正如你所说，大脑开始忽视。
It fails to fully develop the strong connections for the data coming in from one of those two eyes into the brain.
它未能充分发展从两只眼睛中的一只到大脑的数据的紧密联系。
And if you pass certain thresholds during development, during childhood, without correcting that connectivity, getting those two eyes to work together properly, you can permanently lose that.
如果你在发育过程中、在童年时期超过了某些阈值，而没有纠正这种连通性，让两只眼睛正常地协同工作，你可能会永久失去这种连通性。
And so we used to use very gross numbers, like it's fully correctable if you can intervene before age three.
所以我们过去常常使用非常粗略的数字，就像如果你能在三岁之前进行干预的话，它是完全可以纠正的。
It's partly correctable if you can intervene before age six.
如果你能在六岁之前进行干预，这种情况是可以部分纠正的。
You got a chance before age nine.
你在九岁之前就有机会。
But it turns out in follow-on studies that even kids into their young teens have a shot at correcting that eye-brain connection, that amblyopia, that loss of vision that can occur during early development.
但后续研究表明，即使是十几岁的孩子也有机会纠正眼脑连接、弱视、早期发育过程中可能发生的视力丧失。
So even if you're only unfortunately detecting that later on in childhood or even the tween years or early teen years, it's still worth a try to really push to retrain the weaker eye and then also realign the muscles so that they can work together to keep the eyes focused.
因此，即使您只是在童年后期，甚至是青少年时期才不幸发现这一点，仍然值得尝试真正努力重新训练较弱的眼睛，然后重新调整肌肉，以便它们可以共同努力保持眼睛聚焦。
I'll tell you, it's interesting, and there's a lot more to learn about brain plasticity and probably a lot of really cool new ...
我告诉你，这很有趣，关于大脑可塑性还有很多东西需要了解，可能还有很多非常酷的新东西......
therapies yet to discover that could reopen what's called critical period plasticity, this plasticity that we have during development that kind of goes away as we age.
尚未发现可以重新开启所谓的关键期可塑性的疗法，这种可塑性是我们在发育过程中拥有的，随着年龄的增长而消失。
And that critical period plasticity, as you know, has been the best studied actually in the visual system, and the idea that we could reopen that is really fantastic.
正如你所知，关键时期的可塑性实际上在视觉系统中得到了最好的研究，我们可以重新打开它的想法真是太棒了。
But for different parts of that eye-brain connection, there's different periods for critical period plasticity.
但对于眼脑连接的不同部分，可塑性关键期也有不同的时期。
For example, even if you get the amblyopic eye to see well again, and then you realign the eyes and now they're working together, a lot of kids will never recover full depth perception, stereopsis, the use of two eyes to see depth, for example.
例如，即使你让弱视眼再次恢复视力，然后重新调整眼睛，现在它们可以一起工作，很多孩子也永远无法恢复完整的深度知觉、立体视觉，例如使用两只眼睛看到深度。
So why that part of the brain doesn't correct as well as the visual acuity or central vision part of the brain, I'm not sure if we understand that yet.
那么，为什么大脑的这一部分不能像大脑的视敏度或中央视觉部分那样纠正，我不确定我们是否理解这一点。
Andrew Huberman:
安德鲁·休伯曼：
I'm going to ask for a curbside consult, as it's sometimes called, right now by telling you a story.
我现在要向您讲述一个故事，要求进行路边咨询（有时也这样称呼）。
When I was a kid, I went swimming without goggles and I had one eye closed and the other eye open and closing as it went in and out of the water because I'm a deficient swimmer and I only breathe to one side, unless I really consciously force myself to breathe to both sides in a freestyle swim.
当我还是个孩子的时候，我去游泳时不戴护目镜，当它进出水时，我闭上一只眼睛，另一只眼睛睁开又闭上，因为我是一个有缺陷的游泳者，我只向一侧呼吸，除非我真的有意识地强迫自己在自由泳中向两侧呼吸。
Got out of the pool, and I was seeing double.
从泳池出来，我看到了重影。
It was pretty eerie, and then it became downright scary because I didn't recover my double vision until they patched one of the eyes, forcing me to use the other eye that had been closed the entire time.
这非常怪异，然后变得非常可怕，因为直到他们遮住一只眼睛，迫使我使用一直闭着的另一只眼睛时，我才恢复了复视。
And fortunately, this was done early enough and I was young enough that within, I think it was about a day or so, I restored normal vision.
幸运的是，这件事做得足够早，而且我还很年轻，我想大约一天左右的时间，我就恢复了正常视力。
However, my depth perception is terrible.
然而，我的深度感知很糟糕。
I'm the kid that fly ball always hits me in the outfield, and it's coming, and then it hit me.
我是那种总是在外场飞球击中我的孩子，它来了，然后它击中了我。
This is why I've generally focused on foot sports throughout my entire life as opposed to precise hand-eye coordination.
这就是为什么我一生都专注于足部运动，而不是精确的手眼协调。
I'm better at throwing darts and things with one eye closed than I ever would be with both eyes.
我闭上一只眼睛比用两只眼睛投掷飞镖和其他东西更擅长。
Maybe that's true for most people.
也许对大多数人来说都是如此。
Question I have is, is it true that even just a few hours of misalignment of information to the two eyes early in development can permanently rewire the brain unless there are some corrective measures-
我的问题是，即使在发育早期两只眼睛的信息不一致几个小时，是否真的可以永久地重新连接大脑，除非有一些纠正措施——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
such as patching up one eye?
比如修补一只眼睛？
And the example I gave is just one, but for instance, if someone gets a scratch on their cornea and they patch the eye and the person happens to be 10 years old, is it important to then patch the other healthy eye after the scratched eye is feeling better?
我举的例子只是一个，但举例来说，如果有人的角膜被划伤，他们戴上眼罩，而这个人恰好是 10 岁，那么在划伤的眼睛感觉好一点后，再戴上另一只健康的眼睛是否重要？
In other words, how critical is it to ensure the balance of information coming into the two eyes, even on the order of hours or days?
换句话说，确保进入两只眼睛的信息平衡有多重要，即使是几小时或几天的数量级？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Your story has some features of totally usual how we think about misaligned eyes leading to amblyopia, where one eye is weaker, patching the strong eye so the weak eye can recover, but not necessarily fully regaining depth perception.
你的故事有一些完全常见的特征，我们如何看待导致弱视的眼睛错位，其中一只眼睛较弱，遮盖强眼，以便弱眼可以恢复，但不一定完全恢复深度知觉。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And so that part of it is quite stereotypical.
所以这部分是相当刻板的。
The part of your story that's atypical is that for most kids, an hour or two, let alone minutes, an hour or two, even an hour or two a day, I don't know, if you were a young kid and you just really were training up on throwing darts, and you were just keeping one eye closed to throw the darts, really practicing for an hour a day, it'd be very unusual for that to trigger this kind of either strabismus misalignment of the eyes, let alone amblyopia.
你的故事中非典型的部分是，对于大多数孩子来说，一两个小时，更不用说几分钟，一两个小时，甚至每天一两个小时，我不知道，如果你还是个小孩子，你真的在训练扔飞镖，你只是闭着一只眼睛扔飞镖，每天练习一个小时，触发这种斜视眼睛错位是很不寻常的，更不用说弱视。
And the strabismus is what's giving you the double vision because they're misaligned, let alone the amblyopia of one eye turning out weaker.
斜视是导致复视的原因，因为它们没有对准，更不用说一只眼睛的弱视了。
If I had to guess, of course, not having done your exam before that fateful day in the swimming pool, if I had to guess, I would guess that you may have had some intermittent strabismus, and your brain was already getting kind of hit, and neither you nor your parents may have even noticed it.
当然，如果我不得不猜测，在那个决定性的一天之前，你在游泳池里没有做检查，如果我不得不猜测，我猜你可能患有间歇性斜视，你的大脑已经受到了某种打击，而你和你的父母可能都没有注意到。
It could be happening at other times of day, or you're not really paying attention.
它可能发生在一天中的其他时间，或者你没有真正注意。
It doesn't stand out in the way that that day that you got out of the swimming pool, you really noticed it.
它并不像那天你走出游泳池时那样引人注目，你真的注意到了它。
And it may not have been that strong.
而且可能没有那么强。
It may have been quite intermittent.
它可能是断断续续的。
But if you had had some years of intermittent esotropia, or turning in of the eyes, or exotropia, turning out of the eyes, that just happened here and there, but was accumulating sort of damage or failure to connect over years leading up to that day in the swimming pool, and that day just tipped you over the edge, and you got double vision.
但是，如果你有几年的间歇性内斜视，或者眼睛向内翻，或者外斜视，眼睛向外翻，这种情况只是到处发生，但多年来积累了某种损害或无法连接，直到那天在游泳池里，那天刚刚把你推向边缘，你就得到了复视。
You really noticed it.
你真的注意到了。
That led to an eye exam at an eye care provider, and they said, "Wait a second.
这导致了眼科护理人员的眼科检查，他们说：“等一下。
This eye's stronger, this eye's weaker.
这只眼睛更强，这只眼睛更弱。
You've got a little amblyopia.
你有一点弱视。
We're going to start patching your strong eye so you can get your weak eye back." So for 99.9% of the kids who like, yeah, they get a little corneal scratch, or they're patching one eye closed, or anything that's sort of a rare event like that, nothing to worry about.
我们将开始修补你的强眼，以便你恢复弱眼。”因此，对于 99.9% 的孩子来说，是的，他们的角膜有一点划痕，或者他们闭上一只眼睛，或者任何类似的罕见事件，没有什么可担心的。
Parents don't have to worry.
家长们不用担心。
Kids can be kids.
孩子就可以是孩子。
They can play.
他们可以玩。
They can do that kind of thing and not have to worry.
他们可以做那种事情，而不必担心。
And it's unfortunate that we can't tell in advance which kid's been having the intermittent amblyopia because we don't do a standard eye exam on every five-year-old who's not complaining of anything.
不幸的是，我们无法提前判断哪个孩子患有间歇性弱视，因为我们没有对每个没有任何抱怨的五岁孩子进行标准眼科检查。
But yeah.
但是是的。
So that's an unusual case in yours, and if I had to guess, I would bet that you were having some sort of subclinical, untracked, uncharted, unnoticed, maybe strabismus leading up to that point.
所以这对你来说是一个不寻常的情况，如果我不得不猜测，我敢打赌你患有某种亚临床的、未被追踪的、未知的、未被注意到的、可能是斜视导致的这一点。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Great.
伟大的。
Thank you.
谢谢。
You can send me a bill at the end.
最后你可以给我寄一份账单。
Along those lines, I'm 47 years old, so I was part of the generation that grew up with some computers in the classroom, but not a lot.
沿着这些思路，我今年 47 岁了，所以我属于在教室里伴随着一些电脑长大的一代，但不是很多。
Nowadays, kids from a very young age are looking at iPads, and phones, and screens, and things very close up.
如今，孩子们从很小的时候就开始观看 iPad、手机、屏幕以及非常近距离的东西。
And there is a wealth of experimental animal data showing that if you limit vision to just close range ...
大量的实验动物数据表明，如果你将视力限制在近距离......
that the eyeball lengthens, and therefore the visual image falls in front of and not directly onto the neural retina, essentially the light-sensing portion of the eye, and those animals become myopic or nearsighted.
眼球变长，因此视觉图像落在神经视网膜（本质上是眼睛的感光部分）前面而不是直接落在神经视网膜上，这些动物就会变得近视或近视。
What can we say about the environmental conditions in which kids are seeing from the time they're born through, let's say, adolescence and their teen years in terms of how their visual system wires up?
对于孩子们从出生到青春期和青少年时期所看到的环境条件，我们能说些什么呢？
And are there any recommendations that are coming from the scientific literature, clinical studies, clinical trials, excuse me, or otherwise, that indicate what a healthy visual environment consists of?
对不起，是否有来自科学文献、临床研究、临床试验或其他方面的建议表明健康的视觉环境包括什么？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's a great question, and actually, it's really relevant these days because myopia is so common.
这是一个很好的问题，实际上，它在当今非常重要，因为近视非常常见。
It's more common in Asian populations.
这在亚洲人群中更为常见。
It's called an epidemic in China.
这在中国被称为流行病。
In California, we have a lot of Asian heritage or Asian Americans, and so we see a lot, like at Stanford, we see a lot of myopia in kids and adults, and really starting to get thoughtful on the science of myopia control.
在加州，我们有很多亚洲血统或亚裔美国人，所以我们看到了很多，就像在斯坦福大学一样，我们看到很多儿童和成人近视，并真正开始思考近视控制的科学。
How do we provide the right environments?
我们如何提供合适的环境？
Now, what's interesting is that for decades, the assumption, some of the data, really led us to the path of thinking like, gosh, the more you spend at near activities, and these are mouse model experiments like you described, but also well-designed human cohort studies figuring out, asking kids and families, "How long is your kid reading or in front of the computer?
现在，有趣的是，几十年来，这个假设和一些数据确实引导我们思考，天哪，你在近距离活动上花费的时间越多，这些是像你所描述的小鼠模型实验，但也是精心设计的人类队列研究，询问孩子和家庭，“你的孩子阅读或在电脑前多长时间？
How myopic are they?
他们有多近视？
How nearsighted are they?" Versus, "How much time is your kid in front of the computer doing near work?
他们的近视程度如何？”与“你的孩子在电脑前做近乎工作的时间有多少时间？
How myopic or nearsighted are they?" And these well-designed cohort studies did point towards this concept that if you do too much near work as a kid, that you're more likely to develop nearsightedness as you get through those pre-teen and even into the teen years, which is when most of that myopia progression or eyeball elongation is actually happening to cause nearsightedness.
他们的近视程度如何？”这些精心设计的队列研究确实指出了这样一个概念：如果你小时候在近距离工作太多，那么当你进入青春期前甚至进入青少年时期时，你就更有可能患上近视，而在青少年时期，大多数近视进展或眼球伸长实际上是导致近视的原因。
It's only been in the last few years that some really exciting studies have actually pointed in a slightly different direction, and that's that maybe it's not all, not to say it's not about near activity, but maybe it's not all about near activity.
直到最近几年，一些真正令人兴奋的研究实际上指出了一个稍微不同的方向，那就是，也许这不是全部，并不是说这与近距离活动无关，但也许这并不完全与近距离活动有关。
Maybe it's actually a little more about the kind of light we're getting into our eyes.
也许实际上更多的是关于我们进入眼睛的光线类型。
And I think you've talked about this before, and it's really important.
我想你之前已经谈到过这一点，这非常重要。
When they've now studied and asked the kids, instead of just how much near and how much far are you doing, how much time are you spending indoors in indoor lighting, which doesn't have full-spectrum light in a typical indoor environment, versus how much time are you spending outdoors playing in the yard?
现在，当他们研究并询问孩子们时，不再只是问你在做什么近多远，而是问你在室内照明（典型的室内环境中没有全光谱光）下花费了多少时间，以及你在户外院子里玩耍的时间有多少？
You could be reading outside, but what kind of time are you spending outside?
你可以在外面读书，但是你在外面度过了什么样的时间呢？
And of course, when you're outside in sunlight, even it's in direct sunlight, you're getting a different spectrum of full-spectrum lighting from the sun.
当然，当您在室外阳光下时，即使是在阳光直射下，您也会获得与太阳不同光谱的全光谱照明。
And it looks like it's pretty clear now actually that it has maybe more to do with outdoor lighting time than just near work.
现在看起来很清楚，实际上，这可能与户外照明时间有关，而不仅仅是与工作附近有关。
And so I think that we've actually already seen the first couple randomized controlled trials where they're having kids intentionally spending time outdoors versus standard life, which is going to be often much more indoor time, and seeing some effects.
所以我认为我们实际上已经看到了第一批随机对照试验，他们让孩子们有意识地在户外度过时间，而不是在标准生活中，而标准生活通常会更多地在室内，并且看到了一些效果。
You follow those kids over a couple of years, and the kids who spend time outdoors are progressing in their nearsightedness less, like their nearsighted prescription is not getting as strong as the kids who are spending more time indoors.
你对这些孩子进行了几年的跟踪，发现那些花时间在户外的孩子近视度数进展得更慢，就像他们的近视度数没有那些花更多时间在室内的孩子那么强。
And there's some pretty good biology that's getting worked out going back to animal models, more about how that might be working in the retina inside the eye.
一些非常好的生物学原理正在通过动物模型得到解决，更多地涉及到它们如何在眼睛内的视网膜中发挥作用。
But it's pretty compelling concept.
但这是一个非常引人注目的概念。
And so as a parent, you may want to be telling your kid, "Okay.
因此，作为父母，您可能想告诉您的孩子：“好吧。
Yeah, I want you to read that book," or if your kid's playing on the phone or something like that, or the iPad or something like that, they're allowed that time.
是的，我希望你读那本书，”或者如果你的孩子正在玩手机或类似的东西，或者 iPad 或类似的东西，他们可以在那个时间玩。
"Okay, you can have that time, but I want you to spend some of the time that you're doing that outdoors."
“好吧，你可以有这个时间，但我希望你花一些时间在户外做这件事。”
Andrew Huberman:
安德鲁·休伯曼：
Are there any thresholds for the amount of time that one would suggest their child be outdoors to get that full-spectrum light?
人们建议孩子在户外获得全光谱光的时间是否有任何阈值？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
It's a great question.
这是一个很好的问题。
We talk about cohort studies where we just ask people what are they doing, and there seems to be a little bit of what we would call a dose-dependent response.
我们谈论队列研究，我们只是询问人们他们在做什么，似乎有一点我们所说的剂量依赖性反应。
Maybe the more time outdoors might be better.
也许在户外的时间越多越好。
We don't know if there's an upper limit, like, gosh, if you go over two or three hours, there's no additional benefit.
我们不知道是否有上限，天哪，如果你超过两三个小时，就没有额外的好处。
We talk about that in cohort studies.
我们在队列研究中讨论这一点。
The real gold standard for answering these kinds of questions are randomized controlled trials, and specifically placebo-controlled or a control group that's not getting the intervention.
回答此类问题的真正黄金标准是随机对照试验，特别是安慰剂对照或未接受干预的对照组。
That's our highest level of evidence for clinical evidence for any of this kind of science when we're talking about humans or preclinical models in the laboratory.
当我们谈论人类或实验室中的临床前模型时，这是任何此类科学的临床证据的最高水平。
And the study that hasn't been done yet to really answer that question is to randomize kids to telling this group of kids, "You just do your normal life," tell this group of kids, "We want you outside an hour," this group of kids, "We want you outside two hours a day," this group of kids, "three hours a day," and see between the groups, is there a big difference?
尚未完成的研究可以真正回答这个问题，就是让孩子们随机告诉这组孩子，“你只需过正常的生活”，告诉这组孩子，“我们希望你每天出去一小时”，这组孩子，“我们希望你每天出去两个小时”，这组孩子“每天三个小时”，看看这组孩子之间有很大的区别吗？
We have pretty good evidence now from the studies that have been done that the difference between zero and one or two hours is clearly there.
我们现在从已经完成的研究中得到了很好的证据，表明零小时和一两个小时之间的差异是明显存在的。
Is five minutes enough?
五分钟够吗？
Is five hours better?
五小时比较好吗？
I don't think we know the answers to those questions yet, like what's the right dose, but there's probably at least some dose dependence to that.
我认为我们还不知道这些问题的答案，比如什么是正确的剂量，但可能至少存在一定的剂量依赖性。
Andrew Huberman:
安德鲁·休伯曼：
And I can imagine it's a little bit hard to tease apart the near/far viewing from the indoor/outdoor, because yes, of course, a child could be outside on an iPad up close But it's hard to imagine that at some point they aren't seeing off into the distance, far viewing-
我可以想象，要区分室内/室外的近/远观看有点困难，因为是的，当然，一个孩子可能会在户外近距离使用 iPad，但很难想象在某些时候他们不会看到远处，远距离观看 -
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
as it's called.
正如它的名字一样。
And the reverse is also true.
反之亦然。
If you're indoors, unless you live in a very, very large home or you're staring off a balcony, far viewing is much harder to achieve.
如果你在室内，除非你住在一个非常非常大的房子里，或者你在阳台上凝视，否则很难实现远视。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And perhaps it isn't important to isolate these variables, although I can see the challenge in developing a really good randomized clinical trial for this.
也许隔离这些变量并不重要，尽管我可以看到为此开发一个真正好的随机临床试验所面临的挑战。
Meanwhile, I'll go into the grave shouting, or saying rather, and suggesting that people get some morning sunlight in their eyes to set their circadian rhythm.
与此同时，我会走进坟墓大喊，或者更确切地说，建议人们让一些早晨的阳光照射到眼睛里，以设定他们的昼夜节律。
But far viewing at least a few minutes and ideally hours per day, or a mixture of near and far viewing by being outdoors just seems like a good thing to do, regardless of age.
但是，无论年龄大小，每天至少几分钟，最好是几个小时的远距离观看，或者在户外混合近距离和远距离观看似乎都是一件好事。
So are there any data in older people, not necessarily elderly, but older people, so people when they're from, say, 25 years of age into their 60s or 70s, that getting outdoors and getting this full-spectrum light is healthy for the eye in ways that are separate from the known healthy effects of doing that on circadian rhythm setting?
那么，是否有针对老年人（不一定是老年人，而是老年人，即从 25 岁到 60 岁或 70 岁的人）的数据表明，到户外接受全光谱光对眼睛有益，其方式与已知的昼夜节律设置健康影响不同？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
The circadian part's pretty clear.
昼夜节律部分非常清楚。
In most people, the development of nearsightedness happens a lot until age 10, little more through age 20, little more than that in through the 20s up to 30, tiny bit in the 30s up to 40.
对于大多数人来说，近视的发展在 10 岁之前经常发生，到 20 岁则稍多一些，稍多于 20 岁到 30 岁，稍稍发生在 30 岁到 40 岁。
But usually by those later ages, your prescription might be changing a quarter of a diopter, that's the measurement that we use when we give you your glasses prescription.
但通常到了后来的年龄，您的处方可能会改变四分之一的屈光度，这是我们为您提供眼镜处方时使用的测量值。
A quarter of a diopter, half a diopter.
四分之一屈光度、半屈光度。
It could get a half diopter more nearsighted or less nearsighted, once you're aging into your 40s, 50s and beyond.
一旦您进入 40 多岁、50 多岁甚至更老的年龄，近视度数可能会增加或减轻半个屈光度。
So most of the action on nearsightedness development is actually really happening in the younger ages.
因此，大多数针对近视发展的行动实际上都发生在年轻人身上。
So again, the premise of intervening in an older person, and I'll just include you and me in older people for the sake of this definition, as much as I'm reticent to do that in general.
再说一次，干预老年人的前提，为了这个定义，我只是将你和我包括在老年人中，尽管我一般不愿意这样做。
I think the premise of light modulation for nearsightedness in older people is probably not so strong.
我觉得调光治疗老年人近视的前提可能没有那么强。
I think there are a lot of other benefits.
我认为还有很多其他好处。
You've talked a lot about circadian rhythm.
您已经谈论了很多有关昼夜节律的内容。
There are so many health benefits to exercise, and if you're getting outdoors, there's a good chance you're going to be walking or bicycling.
锻炼对健康有很多好处，如果您要到户外活动，很有可能会步行或骑自行车。
So exercise value for the health of our eyes and the rest of our body is clearly there.
因此，运动对于我们眼睛和身体其他部位的健康的价值是显而易见的。
But I don't know that there's really a strong premise that you're going to change your glasses prescription in our 40s or 50s or beyond.
但我不知道是否有一个强有力的前提，即您将在 40 多岁、50 多岁或更长的时间改变您的眼镜处方。
Andrew Huberman:
安德鲁·休伯曼：
It's probably worth touching on some of the dos and some of the don'ts for eye health generally.
一般来说，为了眼睛健康，可能值得讨论一些该做和不该做的事情。
And then I promise I'm going to get us back to adult eye exams, because I have a lot of questions about that.
然后我保证我会让我们回到成人眼科检查，因为我对此有很多疑问。
I can imagine that it's probably not a great idea to be exposed to extremely bright light, and this is why people who weld wear eye shields.
我可以想象，暴露在极亮的光线下可能不是一个好主意，这就是焊接人员戴护目镜的原因。
But of course, most people are not welding.
但当然，大多数人都不会焊接。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What other sorts of environmental conditions are detrimental to our vision health across the lifespan, including brightness of light?
还有哪些其他环境条件对我们整个生命周期的视力健康有害，包括光亮度？
We talked a little bit about near, far.
我们谈论了一些近的、远的。
Obviously, we want to keep toxins and acids and solvents and things out of the eye.
显然，我们希望防止毒素、酸、溶剂等物质进入眼睛。
But what do you see, hopefully not commonly, but what are some of the things that you feel might not be discussed enough in terms of eye health?
但是您看到了什么，希望不是常见的，但您认为在眼睛健康方面可能没有充分讨论哪些事情？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
I think at all ages, eye safety is something that we don't talk about enough.
我认为在所有年龄段，眼睛安全都是我们谈论得不够多的事情。
Our eyes are delicate.
我们的眼睛很脆弱。
The front surface of the eye, the cornea, the clear window that lets the light go into your eye, that's a delicate, very sensitive structure.
眼睛的前表面，即角膜，是让光线进入眼睛的透明窗口，是一个精致且非常敏感的结构。
It's thin, maybe a millimeter at the thickest, a half millimeter in the center of our eye.
它很薄，最厚的可能有一毫米，在我们眼睛的中心有半毫米。
The retina, it's neural tissue.
视网膜，它是神经组织。
This is really an outgrowth of the brain.
这确实是大脑的产物。
This is very sensitive.
这是非常敏感的。
It's subject to degenerative disease and injury.
它容易遭受退行性疾病和损伤。
Our eyes, even if they just get hit, can get very inflamed.
我们的眼睛，即使只是被击中，也会发炎。
Our eyes can be more inflammatory than a bruise on our skin on our shoulder might be.
我们的眼睛可能比肩膀上的皮肤瘀伤更容易发炎。
So eye safety is a big one, and people who are working in certain industries, anyone who's doing any metal grinding, people who are even just gardening.
因此，眼睛安全非常重要，对于在某些行业工作的人、任何从事金属研磨的人、甚至只是从事园艺的人来说都是如此。
And if you're doing some significant gardening and cutting and you could fleck a little bit of dirt, and there's a lot of, for example, fungus that lives in the ground, natural stuff that's all very normal in the Earth.
如果你正在进行一些重要的园艺和切割工作，你可能会弄脏一点泥土，并且有很多，例如，生活在地下的真菌，这些天然物质在地球上都是非常正常的。
But our eyes aren't really made to absorb that fungus and have a piece of dirt stick in our eye like that.
但我们的眼睛并不是天生就能吸收真菌的，所以会有一块污垢像这样粘在我们的眼睛里。
And so people are at risk, I think.
所以我认为人们处于危险之中。
And we see too much really unnecessary eye injury, eye trauma, that if people wore either their glasses because they happen to wear prescription glasses or goggles or for more advanced work, safety goggles, of course, if you're sanding, doing wood shop projects, anything like that, sawing, including, again, in the garden, cutting things.
我们看到太多真正不必要的眼部伤害、眼外伤，如果人们戴眼镜是因为他们碰巧戴了处方眼镜或护目镜，或者为了更高级的工作，安全护目镜，当然，如果你在打磨，做木工项目，类似的事情，锯切，再次包括在花园里切割东西。
I think eye safety, eye trauma is a big one.
我认为眼睛安全，眼外伤是一大问题。
And we probably see one or two, what we call open globes a week come into the emergency room.
我们可能每周都会看到一两个我们所谓的开放地球仪进入急诊室。
And those are tough because, again, the eye's delicate and it can do a lot of healing, but not infinite, right?
这些都很难，因为眼睛很脆弱，它可以起到很多治愈作用，但不是无限的，对吧？
And so that's one that I think is really an untapped opportunity, is just a little more education around eye protection, protecting against eye trauma.
因此，我认为这确实是一个尚未开发的机会，只是围绕眼睛保护、防止眼外伤进行更多教育。
Andrew Huberman:
安德鲁·休伯曼：
What about eye cleanliness?
眼睛的清洁度怎么样？
There's some pretty dramatic videos also.
还有一些非常戏剧性的视频。
I've put some of these on my Instagram handle.
我已将其中一些放在我的 Instagram 账号上。
These are MRIs of people rubbing their eyeballs and people really getting a sense of, first of all A restatement of what you said, getting a real sense of just how much the eyes are an outgrowth of the brain because when you see them with the optic nerves and all their beauty and the eyeballs moving around as someone rubs their eyes.
这些是人们揉搓眼球的核磁共振成像，人们真正感受到，首先重述你所说的，真正感受到眼睛是大脑的产物，因为当你看到它们的视神经和它们的美丽，以及当有人揉眼睛时眼球移动时。
I have to imagine that rubbing your eyeballs a little bit isn't bad, but I actually called you, I don't know if you remember.
我不得不想象，揉揉你的眼珠子也不错，但我确实给你打电话了，我不知道你是否记得。
When I was a junior professor, I woke up from a nap one day and I couldn't see out of one eye.
当我还是一名初级教授时，有一天我从午睡中醒来，一只眼睛看不见了。
I was freaking out, so of course, I called you.
我吓坏了，所以我当然给你打电话了。
And I had pressure blinded myself by falling asleep on my hand or something like that, and you assured me that my vision would come back, and indeed it did.
我因压着手睡着或类似的事情而使自己失明，你向我保证我的视力会恢复，事实确实如此。
So you played dual role of ophthalmologist and psychiatrist.
所以你扮演了眼科医生和精神科医生的双重角色。
Thank you.
谢谢。
And indeed, I can see out of both eyes now.
事实上，我现在双眼都能看见东西了。
But rubbing our eyes, getting gunk in our eyes, I think unless somebody has lost their vision temporarily, it's hard to imagine this as like a big deal.
但是揉揉眼睛，让眼睛里有粘稠物，我想除非有人暂时失去视力，否则很难想象这有什么大不了的。
But when it happens, it is truly frightening.
但当它发生时，真的很可怕。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
We're so dependent on vision.
我们非常依赖视觉。
So, what are your recommendations about rubbing or not rubbing eyeballs, about hand washing and cleanliness, and also how do you wash an eye properly?
那么，您对揉或不揉眼球、洗手和清洁以及如何正确洗眼睛有什么建议？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Do you use soap and flush it with water?
您是否使用肥皂并用水冲洗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Or do you just flush it with water, or should you not even do that?
或者你只是用水冲洗它，或者你甚至不应该这样做？
Should you use saline?
你应该使用生理盐水吗？
And I realize these might sound like low level questions, but these are the things that people deal with on an all too frequent basis.
我意识到这些可能听起来像是低级问题，但这些是人们经常处理的事情。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
For most people, most of the time, actually, the eyes are a very good, clean environment.
对于大多数人来说，很多时候，其实眼睛是一个非常好的、干净的环境。
And actually, our tears contain enzymes that help break down bacteria-
事实上，我们的眼泪含有有助于分解细菌的酶——
Andrew Huberman:
安德鲁·休伯曼：
Hmm
嗯
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
and bacterial toxins.
和细菌毒素。
And so for most people, regular eye washing doesn't have to be any part of their standard routine.
因此，对于大多数人来说，定期洗眼不一定是他们标准习惯的一部分。
In terms of the surface of the eye, the part of your eye, the conjunctiva, over the whites of the eyes, underneath the eyelids, anything underneath the eyelids, it's pretty self-cleaning.
就眼睛的表面而言，眼睛的一部分，结膜，眼白上方，眼睑下方，眼睑下方的任何地方，它都具有相当的自清洁能力。
And actually our-
实际上我们的-
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
tear production and blinking is very good at keeping our eyes clean.
眼泪的产生和眨眼非常有助于保持眼睛清洁。
The eyelids, eyelashes can be another story, and especially as we age, our skin is breaking down a little differently than when we were younger.
眼睑、睫毛可能是另一回事，尤其是随着年龄的增长，我们的皮肤与年轻时的情况有所不同。
You can develop what we sort of nickname scurf, which is like little dead skin bits that accumulate around the eyelashes.
您可以开发我们称之为皮屑的东西，它就像睫毛周围积聚的小死皮碎片。
A lot of people develop what we call blepharitis-
很多人都会患上我们所说的睑缘炎——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
which just means inflammation of the eyelashes.
这仅仅意味着睫毛发炎。
Andrew Huberman:
安德鲁·休伯曼：
I've had that.
我有过这样的经历。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And for that, doing some eye scrubs is a good idea.
为此，做一些眼部磨砂是个好主意。
They actually sell little pads that you can buy-
他们实际上出售你可以购买的小垫子-
Andrew Huberman:
安德鲁·休伯曼：
Oh
噢
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
that you rip open, and you can use to lightly clean the eyelashes.
将其撕开，即可用来轻轻清洁睫毛。
But you can also just use like a No More Tears baby shampoo, just pump a little bit into the palm of your hand once or twice a day, dilute it with a little water under the sink, and either with your finger or an edge of a washcloth, just very lightly rub the eyelashes.
但你也可以像No More Tears婴儿洗发水一样使用，每天一次或两次将一点点泵入手掌，在水槽下用少量水稀释，然后用手指或毛巾边缘轻轻擦拭睫毛。
What I like to do-
我喜欢做什么-
Andrew Huberman:
安德鲁·休伯曼：
With the eyes closed
闭着眼睛
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
With the eyes closed.
闭着眼睛。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And don't scrunch them closed too tight because you're actually burying the eyelashes, the roots of the eyelashes when you really scrunch closed.
并且不要将它们拧得太紧，因为当您真正拧紧时，您实际上是在掩埋睫毛，即睫毛根部。
So just gently close your eyes, just real gentle closure and then just lightly scrub.
因此，只需轻轻闭上眼睛，真正轻柔地闭上眼睛，然后轻轻擦洗即可。
It shouldn't be abrasive.
它不应该是磨蚀性的。
You're not trying to exfoliate the eyelids or eyelashes in any way.
您并不是试图以任何方式去除眼睑或睫毛的角质。
Just lightly rub with that kind of dilute No More Tears baby shampoo, and that can really help people with their eye comfort.
只要用那种稀释的No More Tears婴儿洗发水轻轻擦拭，就可以真正帮助人们舒适眼睛。
If you feel like you got something in your eye, your ideal eye wash is actually going to be a sterile saline solution, a saltwater solution that they sell little bottles over the counter, eye wash solutions like that.
如果你觉得眼睛里有东西，你理想的洗眼液实际上是一种无菌盐水溶液，一种盐水溶液，他们在柜台上出售小瓶的盐水溶液，类似的洗眼液。
A lot of people who wear contacts will have that kind of eye wash solution, just a sterile saline eye wash.
很多戴隐形眼镜的人都会有那种洗眼液，就是无菌盐水洗眼液。
Just pure saltwater, doesn't have to have any other chemicals or preservatives in it.
只是纯净的盐水，不需要任何其他化学物质或防腐剂。
You can, of course, use-
当然，您可以使用-
Andrew Huberman:
安德鲁·休伯曼：
Not actual seawater or saltwater.
不是真正的海水或咸水。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Not saltwater.
不是盐水。
Thank you.
谢谢。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Not saltwater out of your salt pool.
不是盐池里的盐水。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Not saltwater out of the ocean.
不是来自海洋的咸水。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
But like a saline saltwater that's available in a sterile.
但就像无菌的盐水一样。
Now you can also just use artificial teardrops, and some of those come in non-preservative, some of those come in preserved versions.
现在您也可以只使用人造泪滴，其中一些是非防腐剂，一些是防腐剂。
Those are all also completely safe to use in the eye.
这些在眼睛中使用也是完全安全的。
And there, you can sort of spritz into your eye, hold a lid open and give it a little spritz.
在那里，你可以喷一点到你的眼睛里，打开盖子，喷一点。
If you feel like you got something in your eye, a piece of dirt or a lash that's not coming out, just to rinse it.
如果您感觉眼睛里有东西、一块污垢或一根睫毛无法脱落，只需冲洗即可。
But having a regular routine, you're not going to hurt anything with the occasional eye rubbing.
但只要有规律的生活习惯，偶尔揉眼睛就不会造成任何伤害。
We all do these things just as a even a nervous habit or just absentmindedly, you might scratch your arm or rub your eyes or things like that.
我们做这些事情只是一种紧张的习惯，或者只是心不在焉，你可能会抓伤手臂或揉眼睛或类似的事情。
That's fine.
没关系。
You're not going to hurt anything.
你不会伤害任何东西。
There are conditions where people sort of develop almost like a psychological habit.
在某些情况下，人们几乎会养成一种心理习惯。
There are certain conditions where people actually do too much eye rubbing.
在某些情况下，人们实际上会过度揉眼。
It can be dangerous if you're in that group.
如果您属于该群体，那可能会很危险。
But for the regular run-of-the-mill, everyday occasional eye rubbing, fine.
但对于平常的情况，每天偶尔揉揉眼睛，没问题。
Certainly if you get a lash in there and you're trying to rub it and blink it and tear it out.
当然，如果你的睫毛插在那里，你试图揉搓它，眨眼它，然后把它撕下来。
And again, in that situation, you can use some artificial tears, wetting drops, saline drops.
同样，在这种情况下，您可以使用一些人工泪液、湿滴剂、生理盐水滴剂。
Those would be the way to do it.
这些就是做到这一点的方法。
Andrew Huberman:
安德鲁·休伯曼：
What an incredible tissue.
多么令人难以置信的组织啊。
The way you describe it, the self-cleaning and yet so delicate, a piece of the brain literally lining the back of each of our eyes like a pie crust.
正如你所描述的那样，它具有自我清洁能力，但又如此精致，就像馅饼皮一样排列在我们每只眼睛的后面。
It's a really remarkable biological system.
这是一个非常了不起的生物系统。
Of course, I don't have to tell you that.
当然，我不必告诉你这一点。
It never ceases to amaze me.
它永远让我感到惊讶。
Let's talk about eye exams in adults.
我们来谈谈成人的眼科检查。
So people are aware presumably that there are optometrists and ophthalmologists.
所以人们大概知道有验光师和眼科医生。
I think it's important that we define their different and also overlapping roles.
我认为重要的是我们定义他们不同且重叠的角色。
And for those that are past high school age, probably not getting eye exams unless they're sensing a problem.
对于那些已经过了高中年龄的人来说，除非感觉到有问题，否则可能不会接受眼科检查。
Perhaps not even with blurry vision or difficulty seeing at a distance, but Sometimes just what feels like fatigue of the eyes or a hard time maintaining alignment of the eyes.
也许甚至没有视力模糊或看远处有困难，但有时只是感觉眼睛疲劳或很难保持眼睛对齐。
So how often do you recommend people get eye exams?
那么您建议人们多久进行一次眼科检查？
What is a true regular eye exam?
什么是真正的定期眼科检查？
And is it important that people go to an ophthalmologist, or will an optometrist suffice?
人们去看眼科医生重要还是验光师就足够了？
Typically, optometrists are a little bit easier for most people to access because there's usually one someplace near an eyeglass store.
通常情况下，大多数人都更容易找到验光师，因为通常在眼镜店附近就有验光师。
So what are their roles?
那么他们的角色是什么？
How often should we get our eyes checked?
我们应该多久检查一次眼睛？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Optometrists and ophthalmologists do have very overlapping roles in being eye care providers.
验光师和眼科医生在眼保健提供者方面确实有着非常重叠的角色。
There are something over 40 or 50,000 optometrists in the United States.
美国大约有超过 40 或 50,000 名验光师。
There's somewhere around 20,000 ophthalmologists in the United States.
美国大约有 20,000 名眼科医生。
Optometrists get an optometry degree.
验光师获得验光学位。
They often have OD after their name.
他们的名字后面经常有 OD。
Ophthalmologists usually went to medical school, so they either have an MD after their name, or they have a DO version of a medical degree.
眼科医生通常毕业于医学院，因此他们的名字后面要么有 MD，要么有 DO 版本的医学学位。
And then optometrists will have done additional clinical training in their area of eye care provision.
然后验光师将在其眼部护理提供领域进行额外的临床培训。
Ophthalmologist, MD, doctor ophthalmologist, eye care providers, in addition to that training, will have done surgical training in ophthalmology.
眼科医生、医学博士、眼科医生、眼科护理人员，除了培训之外，还将接受眼科外科培训。
Now, there's a lot of overlap, and in both scenarios, you can be getting your general exam taken care of, maybe a screening exam.
现在，有很多重叠，在这两种情况下，您都可以进行一般检查，也许是筛选检查。
I think that there's been a traditional differentiation between optometrists and ophthalmologists, with optometrists providing a little more of the primary care, eye screening, maybe managing early disease, common diseases as well, with more advanced disease often upgrading to perhaps specialist ophthalmologists in those areas.
我认为验光师和眼科医生之间存在传统的区别，验光师提供更多的初级护理、眼睛筛查，也许还管理早期疾病、常见疾病，而更晚期的疾病通常会升级到这些领域的专业眼科医生。
But that distinction has been declining over time.
但随着时间的推移，这种区别一直在减弱。
It's still true that in, I think, most if not all states, only the MD ophthalmologists, surgeons can do eye surgeries, but both groups of eye care providers can diagnose, both can prescribe appropriate eye drop treatments, including prescription eye drop treatments for many of our eye diseases.
我认为，在大多数州（如果不是所有州），只有医学博士眼科医生、外科医生可以做眼科手术，但两组眼保健提供者都可以诊断，都可以开出适当的滴眼液治疗处方，包括针对我们许多眼部疾病的处方滴眼液治疗。
And in some states, optometrists have successfully lobbied for expanded rights of providing eye care.
在一些州，验光师成功地游说扩大了提供眼科护理的权利。
And again, access to care for the regular person, wherever they may live, is the most important element.
再说一遍，为普通人提供护理，无论他们住在哪里，都是最重要的因素。
And so being able to access eye care, whether it's with an optometrist in your community or an ophthalmologist that may be in your community or may be at a distance, I think that's the really important thing is to access care.
因此，能够获得眼部护理，无论是您所在社区的验光师还是您所在社区或远处的眼科医生，我认为真正重要的是获得护理。
Now, kind of like we were talking about with kids, if you're in your teens, 20s, maybe even 30s, and not having any problem, you've got no complaints, you can see at distance, you can see at near, so you can read without glasses, you can drive without glasses, you're not having any eye pains, pains around the eyes, redness of the eyes, you may never present to an eye care provider through the first four decades of life.
现在，有点像我们和孩子们谈论的那样，如果你十几岁，20多岁，甚至30多岁，没有任何问题，你没有任何抱怨，你可以看远处，你可以看近处，所以你可以不戴眼镜阅读，你可以不戴眼镜开车，你没有任何眼睛疼痛，眼睛周围疼痛，眼睛发红，你可能永远不会在生命的前四十年向眼科护理人员求助。
And almost all the time, it's going to be okay.
几乎所有时候，一切都会好起来的。
If you're not symptomatic, the chance you've got some terrible lurking disease in there is low.
如果您没有症状，那么您感染某些可怕的潜伏疾病的可能性就很低。
But we do wish that we had a little more screening going on because there are some diseases, glaucoma, for example, my specialty.
但我们确实希望进行更多的筛查，因为有一些疾病，例如青光眼，这是我的专长。
The two main risk factors for glaucoma are increasing age, and it usually presents, in most cases, actually after age 40, but also increasing eye pressure.
青光眼的两个主要危险因素是年龄增长，在大多数情况下，它通常在 40 岁之后出现，而且眼压也会升高。
And if your eye pressure is too high, you can't feel that.
如果你的眼压太高，你就感觉不到。
That won't feel funny to you if it sort of slowly has crept up over the years.
如果这些年来它慢慢地蔓延开来，你就不会觉得好笑了。
And so from a screening perspective, it is good to get some kind of screening exam.
因此，从筛选的角度来看，进行某种筛选考试是件好事。
Could be at a public health fair, could be that you go into the local optometrist, just say, "Hey, I've never been checked.
可能是在公共卫生博览会上，可能是你去当地的验光师那里，只是说，“嘿，我从来没有做过检查。
I'd like to be checked once, make sure everything's good."
我想检查一次，确保一切都好。”
Andrew Huberman:
安德鲁·休伯曼：
Sorry to interrupt, but could somebody say, "I'd like my pressures checked"?
抱歉打扰，但是有人可以说“我想检查一下我的压力”吗？
As I recall, at the optometrist, they're going to do a puff test.
我记得在验光师那里，他们要做一个抽吸测试。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So they're going to blast some air, get a sense of how rigid or soft, again, using non-clinical, non-technical language here, the eyeball happens to be.
所以他们会吹出一些空气，再次使用非临床、非技术性的语言来感受一下眼球的刚性或柔软程度。
Right now, by the way, I'm sure there are several hundreds of thousands of people who are with eyes closed, touching the sides of their eyeballs, and I'm only half-joking.
顺便说一句，现在我确信有几十万人闭着眼睛，摸着眼球的两侧，我只是半开玩笑。
Please don't do this, folks, given the conversation we just had about eye cleanliness and eye rubbing.
伙计们，鉴于我们刚刚讨论过眼睛清洁和揉眼睛的问题，请不要这样做。
But my understanding is that the truly old-fashioned eye pressure exam was you would close your eyes, and the ophthalmologist would gently press to see whether or not your eyes were more rigid than last time.
但我的理解是，真正老式的眼压检查是你闭上眼睛，眼科医生会轻轻按压，看看你的眼睛是否比上次更僵硬。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Is that right?
是这样吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's called blotment, and you can kind of just take one second if you're listening and press on your eyes, just very lightly, and there's a little give.
这就是所谓的吸墨，如果你在听的话，你可以花一秒钟的时间，轻轻地按一下你的眼睛，就会有一点让步。
Of course, the eyelid's part of that give, but it's not rock hard.
当然，眼睑是其中的一部分，但它并不坚硬。
And if we press and it feels under the eyelid like, gosh, something under there is rock hard, then we know something is wrong.
如果我们按压眼睑下方，感觉就像，天哪，下面有东西像岩石一样坚硬，那么我们就知道出了问题。
That is way too high pressure if it's rock hard.
如果它坚硬如石，那压力就太高了。
But I'll tell you, our ability to differentiate the fine points of eye pressure other than rock hard or not rock hard is pretty limited.
但我要告诉你，除了坚如磐石或不坚如磐石之外，我们区分眼压细微差别的能力非常有限。
So yeah.
所以是的。
The optometrist office or the ophthalmologist office, as part of a comprehensive screening exam, they'll check the eye pressure, they'll look at the surface of your eyes, make sure everything's looking healthy there, including the eyelids and lashes, and they'll look inside the eye and be able to screen for these diseases that way, too.
验光师办公室或眼科医生办公室，作为全面筛查检查的一部分，他们会检查眼压，他们会检查你的眼睛表面，确保那里的一切看起来都很健康，包括眼睑和睫毛，他们会检查眼睛内部，也能够通过这种方式筛查这些疾病。
In addition to checking if you're complaining of any blurriness at distance or at near.
除了检查您是否抱怨远处或附近有任何模糊之外。
Now- After age 40 or so, a lot of people will present to an eye care provider because we all get what's called presbyopia.
现在——40岁左右之后，很多人都会去看眼科护理人员，因为我们都会患上所谓的老花眼。
And presbyopia just translates to vision of the aged.
老花眼就是老年人的视力。
So, myopia is our word for nearsighted.
所以，近视就是我们所说的近视眼。
Hyperopia is farsighted.
远视就是远视。
Actually, emmetropia means normal-sighted, so I can see at distance without any glasses.
事实上，正视眼的意思是正常视力，所以我可以不戴眼镜看远处。
I'm emmetropic.
我是正视眼。
But then we all get presbyopia, and as we age, the lens inside our eye that's helping focus light onto our retina gets stiffer, such that our eye muscles are no longer able to relax and reshape that lens, and we're not as good, as we age, at moving our focus from distance vision.
但随着年龄的增长，我们都会患上老花眼，眼睛内帮助将光线聚焦到视网膜上的晶状体会变得更加僵硬，这样我们的眼部肌肉就不再能够放松和重塑晶状体，而且随着年龄的增长，我们也越来越不擅长将焦点从远距离视觉上移开。
Distance vision, by the way, is basically anything three feet or further away.
顺便说一下，远距离视力基本上是三英尺或更远的东西。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
You're basically viewing light rays coming from infinity once you're past three feet.
一旦你超过三英尺，你基本上就会看到来自无限远的光线。
So three feet or further, being able to focus that into 14 inches or 12 inches, which might be a normal, comfortable reading space for you, we lose that ability to flex our lens, relax our lens, refocus our lens from distance to near.
因此，在三英尺或更远的距离，能够将其聚焦到 14 英寸或 12 英寸（这对您来说可能是一个正常、舒适的阅读空间）时，我们就失去了弯曲镜头、放松镜头、将镜头从远处重新聚焦到近处的能力。
And most people around age 40, could be a couple years before, could be five or 10 years later that you notice it, but sort of around that time you start needing reading glasses.
大多数人在 40 岁左右，可能是几年前，也可能是五年或十年后，你才会注意到这一点，但大约在那个时候你开始需要老花镜。
You need a little extra-- Even if you can see fine at distance and don't need prescription glasses for distance, you need a booster.
您需要一点额外的东西——即使您在远处看得很清楚并且不需要远距离处方眼镜，您也需要一个助推器。
You need reading glasses for near.
您需要戴老花镜才能看近。
I don't know if you're experiencing this yet.
我不知道你是否也经历过这样的情况。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, I'm really intrigued by this, but maybe you could clarify.
是的，我对此很感兴趣，但也许你可以澄清一下。
When you say reading glasses, do you mean just a magnifier?
当您说老花镜时，您指的是放大镜吗？
Because I use a 0.5 or a 0.75 magnifier for reading.
因为我用0.5或0.75的放大镜看书。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yep.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But I try and rely on them as little as possible, and I want to get to this, about using glasses as a crutch and the problems with that.
但我尝试尽可能少地依赖它们，我想解决这个问题，关于使用眼镜作为拐杖以及随之而来的问题。
I have a story about that, too.
我也有一个关于这方面的故事。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Okay.
好的。
Andrew Huberman:
安德鲁·休伯曼：
It's no coincidence I decided to work on vision.
我决定从事视觉研究并非巧合。
After all, I had a bunch of vision issues that fortunately are corrected.
毕竟，我有很多视力问题，幸运的是都得到了纠正。
But I do experience, for instance, when I wake up in the morning, if I look at my phone, which by the way, folks, I try and get outside and see sunlight first before ever looking at the phone.
但我确实经历过，例如，当我早上醒来时，如果我看手机，顺便说一句，伙计们，我会尝试先到外面看看阳光，然后再看手机。
But I'll notice when I first look at my phone in the morning that I can see it very clearly through my right eye, but that if I cover my right eye, my left eye is extremely blurry to the point where I'm like, "Oh, I'm calling Jeff." I'm afraid.
但我会注意到，当我早上第一次看手机时，我可以通过右眼非常清楚地看到它，但如果我遮住右眼，我的左眼就会变得非常模糊，以至于我会想，“哦，我正在给杰夫打电话。”我耽心。
But then over the course of maybe 10, 15 minutes, it resolves.
但过了大概 10、15 分钟后，问题就解决了。
And I don't think it's because something's in my eye.
我不认为这是因为我的眼睛里有东西。
I don't think it's pressure of having slept on that side.
我不认为这是睡在那边的压力。
I don't think it's a lubrication of the eye issue.
我认为这不是眼睛润滑的问题。
But the two eyes seem to come into focus, so to speak, at different rates early in the day.
但可以说，两只眼睛在一天的早些时候似乎以不同的速度聚焦。
And if I pop my readers on, I can see right away.
如果我打开我的读者，我就能立即看到。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
So I will use readers late in the day often-
所以我会经常在一天的晚些时候使用读者-
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Mm-hmm
嗯嗯
Andrew Huberman:
安德鲁·休伯曼：
...
...
if I want to read at night or something like that.
如果我想在晚上读书或类似的事情。
So it feels so much more relaxing.
所以感觉轻松多了。
I feel like I can finally relax, whereas otherwise I realize that I'm straining in order to see.
我觉得我终于可以放松了，但除此之外我意识到我为了看东西而费尽了心思。
Is there any clinical data in what I just described?
我刚才描述的有临床数据吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andy, I'll tell you my story that's like that.
安迪，我会告诉你我的故事就是这样。
And we were living down in San Diego when you and I were both professors at UC San Diego, and we had moved into a house, and I found a pair of glasses, a pair of reading glasses, in a closet.
当你和我都是加州大学圣地亚哥分校的教授时，我们住在圣地亚哥，我们搬进了一所房子，我在壁橱里发现了一副眼镜，一副老花镜。
And we asked around, did any of the grandparents leave some glasses behind?
我们四处询问，祖父母中是否有人留下了一些眼镜？
Nobody seemed to know who they were.
似乎没有人知道他们是谁。
So we finally just decided, "Well, I guess the people who moved out of the house just left a pair of glasses in the back of this closet." And then I tried the glasses on, and I looked at my phone up close and was just like, "Oh my God, wait a second.
所以我们最终决定，“好吧，我猜搬出房子的人只是在壁橱后面留下了一副眼镜。”然后我试戴了眼镜，近距离看着我的手机，心想：“天啊，等一下。
I didn't realize how blurry my near vision was." And this is back I was about 40, 42, something like that.
我没有意识到我的近视有多模糊。”那时我大约 40、42 岁左右。
So I didn't even realize until I put on the readers, and these were 1.25 magnifiers.
所以直到我戴上阅读器时我才意识到，这些是 1.25 放大镜。
Andrew Huberman:
安德鲁·休伯曼：
Not huge, but yeah, fairly mild.
不是很大，但是是的，相当温和。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Mild ones.
温和的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And I'll tell you, I got addicted because who doesn't like good vision?
我告诉你，我上瘾了，因为谁不喜欢良好的视力呢？
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Right?
对吗？
Oh my God, now I can make the type smaller on my phone.
天哪，现在我可以把手机上的字体变小了。
It was wonderful.
太棒了。
Andrew Huberman:
安德鲁·休伯曼：
And you can relax a bit.
你可以放松一下。
The musculature that's responsible for moving the lens and focusing the eye, and then all this extraocular musculature, and we forget-- I'm definitely going crow's feet around my eyes, probably because I squint or something.
负责移动晶状体和聚焦眼睛的肌肉组织，然后是所有这些眼外肌肉组织，我们忘记了——我的眼睛周围肯定有鱼尾纹，可能是因为我眯眼什么的。
But just the ability to relax one's face.
但只是放松脸部的能力。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It just feels like more energy, I feel like, can be devoted to what we're actually looking at.
我觉得，这只是感觉可以将更多的精力投入到我们真正关注的事情上。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I'm not making light of this.
我并不是轻视这一点。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Well, pretty soon I just kept that one pair of glasses with me all the time, and I would just keep them in a pocket and whip them out whenever I was working at near using my phone.
好吧，很快我就一直随身带着一副眼镜，我会把它们放在口袋里，每当我工作时接近使用手机时，我就会把它们拿出来。
At a little greater distance, like a typical computer distance, I could still see the computer fine.
在稍远一点的距离，就像典型的计算机距离一样，我仍然可以很好地看到计算机。
So it really started for that close-up phone.
所以这真的是从那部特写手机开始的。
I could get into here, but not all the way into here.
我可以进入这里，但不能完全进入这里。
And then pretty soon I was just totally addicted, and so then I had to go buy 10 pairs and leave them, one by the bedside table, one in the car, one in the computer bag, one on every desk I work at.
很快我就完全上瘾了，所以我不得不去买 10 双，然后把它们放在床头柜上，一双放在车里，一双放在电脑包里，我工作的每张桌子上都有一双。
Andrew Huberman:
安德鲁·休伯曼：
Because you would forget them?
因为你会忘记他们？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah, because I'd leave them anywhere-
是的，因为我会把它们留在任何地方-
Andrew Huberman:
安德鲁·休伯曼：
Right
右
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
and forget them and that way I could just-
然后忘记它们，这样我就可以-
Andrew Huberman:
安德鲁·休伯曼：
You're a professor after all.
毕竟你是教授。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah, exactly.
是的，完全正确。
Andrew Huberman:
安德鲁·休伯曼：
Former professor.
前教授。
Sure.
当然。
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
So whether using the readers accelerates the progression of dependence on the readers is still ...
那么使用读者是否会加速对读者的依赖的进程仍然是......
that's still up for debate.
这仍有待争论。
Some studies say maybe yes, some studies say maybe no. But certainly, psychologically, we get addicted to good, easy vision.
一些研究说也许是，一些研究说也许不是。但可以肯定的是，从心理上来说，我们会沉迷于良好、轻松的视觉。
And if you don't have to squint, and if you're not straining your muscles, and all of a sudden the text on your phone looks crisper again, boy, that's addictive.
如果你不必眯着眼睛，如果你没有拉伤你的肌肉，突然间你手机上的文字看起来又变得更清晰了，孩子，这会让人上瘾。
You're going to like good vision, and so it feels like you're getting dependent.
你会喜欢良好的视力，所以感觉你越来越依赖。
And how much of that is change in the eye muscles, and how much of that is just the psychology of wanting to have good vision?
其中有多少是眼部肌肉的变化，有多少只是想要拥有良好视力的心理变化？
I think probably the jury's a little bit out on that point.
我认为陪审团在这一点上可能有点偏激。
But point being, either way, your dependence will grow.
但重点是，无论哪种方式，你的依赖都会增加。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And as you continue to age, 40s, 50s, up until about 60, 65, the ability to shape that lens gets weaker and weaker and weaker.
随着年龄的增长，40多岁、50多岁，直到60多岁、65多岁，塑造晶状体的能力会变得越来越弱。
And so you need to move from the .5s to the 1.0s to the 1.5s, and you eventually-
所以你需要从 0.5s 转向 1.0s 再到 1.5s，最终——
Andrew Huberman:
安德鲁·休伯曼：
To the Coke bottle.
到可乐瓶。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Well, thankfully not.
好吧，幸好没有。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
You eventually max out at about plus 2.5 or plus three.
您最终的最大值约为+2.5 或+3。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Because that's the amount of extra refractive power that you need in magnifiers to take the equivalent of your infinity viewing and bring it up to 14 inches to read it near, basically.
因为基本上，这是您在放大镜中需要的额外屈光力，以实现相当于无限远观看并将其放大到 14 英寸以便在附近阅读。
You need a plus three, and then you don't need any lens eye muscle action whatsoever.
你需要一个加三，然后你就不需要任何镜头眼肌动作。
So you kind of max out around 2.5s or threes.
所以你最多可以跑 2.5 秒或 3 秒。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
So because most people will hit this somewhere in their 40s, this sort of like, "Gosh, I'm having trouble on the phone," I think most people actually use that.
因为大多数人在 40 多岁的时候都会遇到这种情况，就像“天哪，我打电话遇到麻烦了”，我想大多数人实际上都会使用这种方式。
That's the first time for a lot of people.
这对很多人来说都是第一次。
They're like, "Well, I guess I should go to the eye office," right?
他们会说，“好吧，我想我应该去眼科，”对吧？
See the optometrist or maybe ophthalmologist.
看验光师或眼科医生。
And when they go in, they should be getting the standard in either of those offices, will be to give you a full screening exam, including maybe it's the puff test or a blue light test or a little pen that can check your eye pressure, and having a look inside and seeing if your retina and optic nerve look healthy.
当他们进去时，他们应该在这两个办公室中获得标准，即为您提供全面的筛查检查，包括可能是吹气测试或蓝光测试或可以检查您的眼压的小笔，并检查内部并查看您的视网膜和视神经是否看起来健康。
Just screening for all the main diseases.
只需筛查所有主要疾病即可。
And they'll tell you at that point, "Hey, you look great.
那时他们会告诉你，“嘿，你看起来很棒。
If you feel like your glasses aren't doing it for you in a year or three years, come back." Or they might say, "Hey, I've detected something.
如果您觉得您的眼镜在一年或三年内无法发挥作用，请回来。”或者他们可能会说：“嘿，我发现了一些东西。
I'm worried about you," and they'll set up a routine for your ongoing eye care.
我很担心你”，他们会为你制定持续的眼部护理程序。
Andrew Huberman:
安德鲁·休伯曼：
Assuming that somebody doesn't have some form of amblyopia or the need for some really robust corrective lenses, and they are already using readers, let's say a plus one or so, plus one, plus or minus .5 reader, would you recommend, based on my experience and based on your experience, that people strive to avoid using them for as long as they can?
假设某人没有某种形式的弱视或不需要一些真正强大的矫正镜片，并且他们已经在使用阅读器，比如说一个加一左右，加一，加或负 0.5 阅读器，根据我的经验和你的经验，你会建议人们尽可能避免使用它们吗？
Because in some sense, if that's the recommendation, then the recommendation is that people deal with the fact that they're seeing a little less well or a lot less well than they possibly could.
因为从某种意义上说，如果这就是建议，那么建议就是人们要面对这样一个事实：他们的视力比他们可能看到的稍微差一点或差很多。
So I'm assuming that people can still drive well, people can still read, but it involves a little bit more effort.
所以我假设人们仍然可以很好地开车，人们仍然可以阅读，但这需要付出更多的努力。
In other words, are we weakening our eyes by using these readers?
换句话说，我们是否因为使用这些阅读器而削弱了我们的眼睛？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I realize you said that the data are a little bit mixed, but as long as one can perform their required daily activities, would we be better off delaying the use of readers?
我知道你说的数据有点混杂，但只要能完成日常所需的活动，我们推迟使用阅读器会不会更好？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
There's two important answers to that question.
这个问题有两个重要的答案。
One is regarding the lens and the eye muscles that control the lens, and it's entirely plausible.
一是关于晶状体和控制晶状体的眼部肌肉，这是完全合理的。
That's what I was saying the data's mixed on.
这就是我所说的数据混合的情况。
But it's plausible that if we would just exercise, work a little harder, not use as strong a reader as we want, or not use that reader as often as we might really enjoy.
但如果我们只是锻炼身体，多努力一点，而不是像我们想要的那样使用强大的阅读器，或者不像我们真正喜欢的那样频繁地使用该阅读器，这是有道理的。
Are we exercising those muscles and exercising the ability to stretch versus relax the lens, and slow the progression from the 1.0 reader to the 1.25 reader to the 1.5 reader, et cetera, right?
我们是否正在锻炼这些肌肉并锻炼拉伸与放松晶状体的能力，并减慢从 1.0 阅读器到 1.25 阅读器再到 1.5 阅读器等的进展，对吧？
And so that's why I was saying the data's mixed, but there's a good premise that maybe if you're exercising.
这就是为什么我说数据好坏参半，但有一个很好的前提，也许如果你正在锻炼的话。
But let me give you the on the other hand.
但让我告诉你另一方面。
It's probably ideal to give your retina and your brain the sharpest visual signals you can.
尽可能为您的视网膜和大脑提供最清晰的视觉信号可能是理想的选择。
So why hamstring your retina and your brain and your vision and your enjoyment and ability to read or do near work by constantly undercutting the reading glasses or leaving them out, or you're not helping the whole back part of your...
那么，为什么要通过不断地削弱老花镜或不戴老花镜来损害你的视网膜、你的大脑、你的视力、你的阅读或近距离工作的乐趣和能力，或者你不能帮助你的整个后部……
Maybe you're helping the lens, but you're definitely not helping your retina and brain by feeding it blurry information all of that time.
也许你对晶状体有帮助，但你一直向视网膜和大脑提供模糊的信息绝对不会帮助你的视网膜和大脑。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
So I actually think just give in.
所以我实际上认为就屈服吧。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Use the readers.
使用读者。
Enjoy your best vision all the time, and if that means wearing glasses...
始终享受最佳视力，如果这意味着戴眼镜......
And by the way, if that means that you're going to have minus two glasses for vision, and you'll eventually need minus 2.50s for distance vision, or if you're going to need readers, 1.5 readers now, and in a few years, 2.0 readers, okay, so you'll get the next reader.
顺便说一句，如果这意味着你要戴负两副眼镜来视力，并且你最终需要负2.50秒的远视力，或者如果你需要阅读器，现在需要1.5个阅读器，几年后需要2.0个阅读器，好吧，所以你会得到下一个阅读器。
It's actually not a big deal.
其实没什么大不了的。
You're not hurting.
你没有受伤。
You're probably helping.
你可能正在帮忙。
And in the meantime, it's an enormous enjoyment to actually have good vision all the time, right?
与此同时，始终拥有良好的视力也是一种巨大的享受，对吧？
So I actually counsel people, just wear the glasses that work best for you.
所以我实际上建议人们，戴上最适合你的眼镜。
You're only minimally changing how your prescription's going to change over time, very minimally.
您只是对处方随时间变化的方式进行最小程度的改变，非常小的改变。
So just enjoy your best vision, even if it's using readers for close or prescription glasses for far.
因此，只需享受您的最佳视力，即使是使用阅读器看近处或使用处方眼镜看远。
Andrew Huberman:
安德鲁·休伯曼：
I appreciate that recommendation.
我很欣赏这个建议。
I do enjoy using the readers at night.
我确实喜欢在晚上使用阅读器。
It really helps for all the reasons I mentioned before.
出于我之前提到的所有原因，它确实很有帮助。
I've noticed that driving at night presents an enormous strain on my visual system, and I've noticed this for a number of years.
我注意到夜间驾驶会给我的视觉系统带来巨大的压力，而且我已经注意到这一点很多年了。
I know there's something called stationary night blindness.
我知道有一种叫做静止性夜盲症的东西。
I don't think I'm stationary night blind.
我不认为我是静止夜盲症。
I think the mutation for stationary night blindness was identified in the Calusa horse or something like that.
我认为静止性夜盲症的突变是在卡卢萨马或类似的东西中发现的。
These were horses that you could walk up to very easily, and they wouldn't even see you until you were right there.
这些马你可以很容易地走近，它们甚至不会看到你，直到你到了那里。
Someone's going to correct me on this.
有人会纠正我这一点。
It's the internet.
这是互联网。
But I think the mutation was identified, et cetera, but I don't think I'm stationary night blind.
但我认为突变已被识别，等等，但我不认为我是静止夜盲症。
But I do find that driving at night, I get very fatigued.
但我确实发现晚上开车我会很疲劳。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Mm.
嗯。
Andrew Huberman:
安德鲁·休伯曼：
And then I'll sometimes even wear my plus-one readers when I drive at night, which removes the fatigue, even though I'm looking more or less at a distance.
有时，我什至会在晚上开车时佩戴我的 plus1 阅读器，这样可以消除疲劳，即使我或多或少地在远处看。
Are there some conditions that make it hard for people to see at night, for which they would want corrective lenses?
是否存在某些情况会导致人们在夜间看东西困难，因此需要佩戴矫正镜片？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And what sorts of biology underlies that, assuming that somebody is not stationary night blind or a Calusa, I think is the name of the breed, horse?
假设某人不是静止的夜盲症或卡鲁萨人，我认为这个品种的名称是马？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah, that's a great question.
是的，这是一个很好的问题。
For the optical defects in our eyes, most or many of which can be corrected with just having the right prescription lenses, we can get away with it without using those corrections in brighter light.
对于我们眼睛的光学缺陷来说，其中大部分或大部分都可以通过正确的处方镜片来矫正，我们可以不用在较亮的光线下进行这些矫正来摆脱它。
And so during the daytime, you could be slightly blurry.
所以在白天，你可能会有点模糊。
If I have a real bright light, and a good high-contrast book, with black letters on the white page, I can get away with reading that without my readers.
如果我有真正明亮的光线和一本高对比度的好书，白页上有黑色字母，我就可以在没有读者的情况下阅读它。
Unlike if I'm in dim light, and that might be kind of what you're describing if you're reading at night, you actually prefer to use the readers a little more even at night.
与我在昏暗的灯光下不同，这可能就是您所描述的晚上阅读的情况，您实际上更喜欢在晚上多使用阅读器。
Because we can make up for a lot of that blur if we just have bright enough signal and contrast coming into our eyes.
因为如果我们的眼睛有足够明亮的信号和对比度，我们就可以弥补很多模糊。
Andrew Huberman:
安德鲁·休伯曼：
Makes sense.
有道理。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
So when you're driving at night and noticing this, this might be revealing a little bit of a need for glasses.
因此，当您在夜间开车并注意到这一点时，这可能表明您需要佩戴眼镜。
Now, I'm not suggesting this is the answer, but far more common than having congenital stationary night blindness would be being what's called a latent hyperope.
现在，我并不是说这就是答案，但比先天性静止性夜盲症更常见的是所谓的潜在远视。
Okay.
好的。
Now, we talked about already how the lens inside our eye goes from focusing at distance to then we squeeze the muscles, the lens actually rounds up, and it allows us to focus at near.
现在，我们已经讨论了我们眼睛内的晶状体如何从远距离聚焦到然后我们挤压肌肉，晶状体实际上变圆，它使我们能够聚焦近处。
Some people's optical system of their eye is actually wired, or designed, or sort of set up in length, not for regular distance, which would be anywhere from about three feet to infinity, but it's actually tuned for being beyond infinity, which doesn't make any actual sense when you talk about it.
有些人眼睛的光学系统实际上是有线的，或者是设计的，或者是按长度设置的，不是针对常规距离的，常规距离可以是从大约三英尺到无穷远的任何地方，但它实际上是为了超越无穷远而调整的，当你谈论它时，这没有任何实际意义。
But just the optics of the eye at their best focus are actually focusing the light behind the retina.
但实际上，只有眼睛的光学器件处于最佳聚焦状态才能将光线聚焦在视网膜后面。
And if you're doing that when you're younger, you're actually using some of your focusing power to use those muscles, strain those muscles, relax that lens, round up that lens, and have your vision focus from beyond infinity to normal distance, like distance vision.
如果你在年轻的时候这样做，你实际上是在利用你的一些聚焦能力来使用这些肌肉，拉紧这些肌肉，放松晶状体，圆润晶状体，让你的视力从无限远聚焦到正常距离，就像远视力一样。
And so if you're a latent hyperope, you are constantly using those muscles.
因此，如果您是潜在的远视者，您就会不断地使用这些肌肉。
And again, if you're tired, it's the end of the day, your muscles are feeling a little fatigued, your latent hyperopia, or by the way, if you've had a drink or two, alcohol can do this, too.
再说一次，如果你累了，一天结束了，你的肌肉感觉有点疲劳，你的潜在远视，或者顺便说一句，如果你喝了一两杯，酒精也会造成这种情况。
Your latent hyperopia can kind of kick in, especially as we're age and we're not as good at refocusing that lens anyway.
你潜在的远视可能会开始出现，尤其是当我们上了年纪，而且我们也不擅长重新聚焦晶状体时。
And now all of a sudden, your vision is kind of reverting to its natural state-
现在突然之间，你的视力有点恢复到自然状态了——
Andrew Huberman:
安德鲁·休伯曼：
Mm
毫米
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
which is slightly out of focus at distance because it's actually focused beyond infinity, if you will.
如果你愿意的话，它在远处会稍微失焦，因为它实际上聚焦在无穷远之外。
And so all of a sudden, you put on that plus one just for a little extra booster kick, and you're like, "Oh, yeah.
所以突然间，你穿上加一只是为了一点额外的助推器，你会说，“哦，是的。
Distance vision is clean and easy now." So I'll have to bring you into the clinic to really be sure, but you could be exhibiting a little bit of that kind of latent hyperopia.
远距离视力现在变得干净、轻松。”所以我必须带你去诊所才能真正确定，但你可能表现出一点潜在的远视。
Andrew Huberman:
安德鲁·休伯曼：
I definitely want the eye exam, and I want it from you.
我确实想要做眼科检查，我也想要你做。
And I've been called a lot of things in life- ...
我在生活中被称为很多东西——...
and we can now add perhaps latent hyperopic to that.
现在我们可以添加潜在的远视。
Another piece here, and again, this discussion is not designed to be an eye exam for me, but I have yet another experience that I think illustrates the key importance of both critical period plasticity and the questions about whether or not to rely on corrective lenses.
这里的另一篇文章，再说一次，这个讨论并不是为了对我进行眼科检查，但我还有另一个经历，我认为它说明了关键期可塑性和是否依赖矫正镜片的问题的关键重要性。
And that is, from the time I was pretty young, I could make my sister laugh by deviating one eye inward, so not crossing my eyes, but moving one eye inward.
也就是说，从我很小的时候起，我就可以通过将一只眼睛向内倾斜来逗我姐姐笑，所以不是斜视，而是向内移动一只眼睛。
And then what happened was when I was in college and studying a lot, a lot, and getting very fatigued, I noticed that this eye started to just kind of drift in a little bit.
然后发生的事情是，当我上大学时，学习了很多很多，并且变得非常疲劳，我注意到这只眼睛开始有点漂移。
So I went to the campus health center, and they gave me a prescription for a prism lens, which of course redirects the image.
所以我去了校园健康中心，他们给了我一张棱镜镜片的处方，这当然可以改变图像的方向。
But then I noticed that this eyeball moving inward, and I guess for those of you watching on YouTube and not just listening, I can do this by just moving one eye in.
但后来我注意到这只眼球向内移动，我想对于那些在 YouTube 上观看而不只是聆听的人来说，我只需将一只眼睛移入即可做到这一点。
All right.
好吧。
I can move this eye in.
我可以把这只眼睛移进去。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Oh, I see it.
哦，我明白了。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
It's fairly pronounced.
这是相当明显的。
It started to really drift in at a relaxation state, and I started seeing double again.
它开始真正进入放松状态，我又开始看到重影。
So I thought, "Whoa, this one prism lens is a crutch of the sort that I really don't want." Crushed the glasses, broke them, and never went back to them.
所以我想，“哇，这个棱镜透镜是我真的不想要的那种拐杖。”把眼镜打碎，打碎，再也没有放回去。
I have voluntary control over it, but that's one example where the corrective lens can actually create a pretty significant shift in eye position if one relies on it.
我可以自愿控制它，但这就是一个例子，如果人们依赖矫正镜片，它实际上可以使眼睛位置产生相当大的变化。
So this gets back to this issue of When should people force themselves to work with their natural vision, maybe do some more far viewing, and certainly get outside and get into the sunlight, full-spectrum light, as opposed to relying on corrective lenses?
所以这又回到了这个问题：人们什么时候应该强迫自己用自然视力工作，也许做一些更远的观察，当然还要到户外接触阳光、全光谱光，而不是依赖矫正镜片？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
And you've raised a very important distinction here, and that's the distinction between the muscles that are inside our eye that we use to relax and refocus the lens, and the muscles that are on the outside of the eyeball, of course, inside our orbit, but on the outside of the eyeball that turn the eyes, and if everything's working right, keeps our eyes really yoked straight.
你在这里提出了一个非常重要的区别，那就是我们用来放松和重新聚焦晶状体的眼睛内部的肌肉和眼球外部的肌肉之间的区别，当然，在我们的眼眶内，但在眼球外部转动眼睛的肌肉，如果一切正常，我们的眼睛就会真正保持直立。
And we talked about earlier this possibility that you may have been having a little bit of intermittent esotropia or intermittent turning in of the eyes that then culminated on that day at the pool when you really noticed it.
我们之前讨论过这种可能性，即您可能有一点间歇性内斜视或间歇性内翻，然后在那天在游泳池时您真正注意到它时达到了顶峰。
And your ongoing ability to actually turn one eye in could be related to that.
你持续的睁一只眼闭一只眼的能力可能与此有关。
I remember as a kid standing in front of the mirror, and I couldn't get my eyes to cross even though friends could do it.
我记得小时候站在镜子前，我无法让眼睛交叉，尽管朋友可以这样做。
And so I was in the losing group on that end of the spectrum.
所以我属于那一端的失败者。
Andrew Huberman:
安德鲁·休伯曼：
And you became an ophthalmologist.
然后你成为了一名眼科医生。
Perfect.
完美的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And then I became an ophthalmologist.
然后我成为了一名眼科医生。
Andrew Huberman:
安德鲁·休伯曼：
And I must say, it is very reassuring that you have excellent vision.
我必须说，您拥有出色的视力，这非常令人放心。
I always worry when I go to a new dentist, and then I look up at them in one moment, and if they're not wearing a mask that their teeth are not pristine, I think, "Well, what am I doing here?" So, an ophthalmologist with excellent vision brings me great comfort.
当我去看新牙医时，我总是担心，然后我抬头看着他们，如果他们没有戴口罩，他们的牙齿就不干净了，我想，“好吧，我在这里做什么？”所以，视力极佳的眼科医生给我带来了很大的安慰。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
The cobbler's children should have shoes.
鞋匠的孩子应该有鞋子。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Exactly.
确切地。
But yeah, so when to correct, when not to correct with lenses.
但是，是的，所以什么时候用镜片矫正，什么时候不矫正。
And I realize here we haven't talked at all about contacts.
我意识到我们在这里根本没有讨论过联系方式。
We've been talking about eyeglasses.
我们一直在谈论眼镜。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Let's come to contacts in a sec if you want, but yeah, let me return to your question.
如果您愿意的话，让我们稍后联系一下，但是，是的，让我回到您的问题。
The difference between providing corrective lenses that allow you to focus for near or distance in your glasses so that you can go easy on the inside the eye muscle having to work so hard.
提供矫正镜片的区别在于，它可以让您在眼镜中聚焦于近距离或远距离，这样您就可以轻松地缓解眼部肌肉内部的辛苦工作。
A lot of people get eye strain and sort of headaches even from that, from not having adequate correction that they're wearing.
许多人甚至因此而感到眼睛疲劳和头痛，因为他们没有佩戴足够的矫正器。
That's different actually, especially when we're children, or again maybe even into the teens and even young adult years.
实际上这是不同的，尤其是当我们还是孩子的时候，甚至可能进入青少年甚至年轻的成年时期。
From the eye muscles on the outside of the eyes, which are supposed to be yoking our eyes straight, and so that you have them both looking at the same point in space.
来自眼睛外侧的眼部肌肉，这些肌肉应该使我们的眼睛笔直，这样你就可以让它们都看着空间中的同一点。
And there, it's actually quite a common treatment to try to under-correct and ask people to exercise and not just give a prism that says, "Hey, if your eye's in sometime, we'll use a prism so the light sort of looks right to you," but rather under-correct that and sort of really force you to exercise trying to yoke your two eyes straight together.
在那里，实际上一种很常见的治疗方法是试图矫正不足，并要求人们锻炼，而不仅仅是给一个棱镜说，“嘿，如果你的眼睛在某个时候，我们会使用棱镜，这样光线看起来就适合你”，而是矫正不足，实际上迫使你锻炼，试图将你的两只眼睛伸直在一起。
And so that's in contrast, and there are actually, I think, many optometrists who often specialize in what are the right glasses to give in a situation like that.
所以这是相反的，我认为，实际上有很多验光师经常专门研究在这种情况下应该配什么眼镜。
Wherever possible, especially during development as our bodies are developing, as we're sort of growing in our younger years, take the approach of intentionally trying to under-correct, not use a prism or not use a full prism correction to really help.
只要有可能，特别是在我们的身体正在发育的过程中，当我们在年轻时成长时，采取故意尝试不足校正的方法，不使用棱镜或不使用完整的棱镜校正来真正有所帮助。
Sometimes it's also like an accommodative reflex that your eyes are just, you're spending so much time reading at near.
有时候，这也就像你的眼睛的一种调节反射，你花了很多时间在近距离阅读。
When you read at near, your eyes actually naturally turn in a little bit to focus at that near so that they can be looking at the same word on the page.
当你在近处阅读时，你的眼睛实际上会自然地转动一点，聚焦在近处，这样他们就可以看到页面上的同一个单词。
And that can also, if you've got too much muscle drive, you can overshoot that.
如果你的肌肉驱动力太大，你也可能会超过它。
Andrew Huberman:
安德鲁·休伯曼：
Hmm.
嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And so sometimes just using not a prism, but a little bit of a plus lens in kids, just so they don't have to work quite so hard to turn their eyes in and sort of over-exercise those muscles.
所以有时不使用棱镜，而是给孩子使用一点正光镜，这样他们就不必那么努力地转动眼睛并过度锻炼这些肌肉。
These are all great examples where going to an eye care provider, often for these kinds of issues, an optometrist is the right first place to start.
这些都是很好的例子，通常对于此类问题，去眼保健提供者那里，验光师是正确的第一选择。
You'd like to say that every optometrist and every ophthalmologist is always going to give the exact right thing for each kid or young adult or older adult to do, and we wish all medical care providers were always right on target.
你想说的是，每一位验光师和每一位眼科医生总是会为每个孩子、年轻人或老年人提供正确的事情，我们希望所有的医疗保健提供者总是正确地瞄准目标。
And a lot of times it's a perfect science, but a lot of times it's an imperfect science.
很多时候它是一门完美的科学，但很多时候它是一门不完美的科学。
And so it could be that at least with, we're now 20, 25, 30 years later, but it could be that today, that 20-year-old version of yourself would've been given a different approach to having one eye intermittently, occasionally turning in like that.
所以，至少我们现在已经是 20、25、30 年后的事了，但今天，20 岁的你可能会被赋予一种不同的方法，间歇性地拥有一只眼睛，偶尔会像那样转动。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Is there any real value to near-far exercises, so-called pencil pushups or smooth pursuit tracking?
远近练习、所谓的铅笔俯卧撑或平滑追踪追踪有任何真正的价值吗？
I've talked a little bit about it before on the podcast, but that was some time ago.
我之前在播客上谈过一些，但那是很久以前的事了。
So what are your thoughts on that?
那么你对此有何看法？
Is there any value whatsoever?
有任何价值吗？
They require a little bit of work, just like going to the gym, but 25 reps a day of near-far, especially as one is transitioning from age 30 to age 50, is it worthwhile?
他们需要一点点工作，就像去健身房一样，但是每天25次远近，尤其是当一个人从30岁过渡到50岁时，值得吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Is it harmful in any way?
它有什么危害吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Definitely not harmful.
绝对没有害处。
And again, would it slow down your progression to presbyopia or needing those reading glasses?
再说一次，它会减慢您老花眼的进展或需要老花镜吗？
Could be.
可能是。
Some people also develop a real failure to properly turn their eyes in, and so they actually would benefit.
有些人还无法正确地转动眼睛，因此他们实际上会受益。
If you've been diagnosed with that inability, you're having double vision at near but not at distance, so that kind of convergence insufficiency, for example, then pencil pushups often get prescribed as a way to try to exercise those skills in your eye muscles.
如果你被诊断出患有这种无能，你在近距离时有复视，但在远距离时却没有，因此会聚不足，例如，铅笔俯卧撑通常被认为是尝试锻炼眼部肌肉这些技能的一种方法。
Andrew Huberman:
安德鲁·休伯曼：
I should interrupt here and just tell people, for those of you that are listening not watching, the pencil pushup, we can put a link to it in the show note captions, but it's essentially taking a pen or pencil, looking at it at arm's distance, and then slowly moving it toward your nose and deliberately working hard.
我应该在这里打断一下，告诉人们，对于那些正在听而不是在看的人，铅笔俯卧撑，我们可以在节目注释中放置一个链接，但它本质上是拿着一支钢笔或铅笔，在一臂距离处看着它，然后慢慢地将它移向你的鼻子，并刻意努力。
And it is a bit of effort to continue to focus on it at a close distance.
而且近距离持续关注，也是费了点力气的。
At some point, it'll become blurry because I can't cross my eyes any further unless I become a Cyclops, and then moving it back out again and doing that for 10 to 25 repetitions, maybe once or twice a day, a few times a week.
在某些时候，它会变得模糊，因为我无法再斜视，除非我成为独眼巨人，然后再次将其移回原处并重复 10 到 25 次，也许每天一到两次，每周几次。
Those are pencil pushups.
这些是铅笔俯卧撑。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
So you're certainly not going to hurt anything.
所以你肯定不会伤害任何东西。
There are other situations where those really do get prescribed, and there's definitely some good clinical trial data suggesting that they can actually help, for example, recovery from concussion.
在其他情况下，这些药物确实会被处方，并且肯定有一些良好的临床试验数据表明它们实际上可以帮助例如从脑震荡中恢复。
Andrew Huberman:
安德鲁·休伯曼：
Hmm.
嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Actually, one of the really telling ways to diagnose concussion, and this can be concussion from sports or a fall or any source of concussion, your smooth pursuit.
实际上，诊断脑震荡最有效的方法之一是运动、跌倒或任何脑震荡来源引起的脑震荡，您可以顺利进行。
Let's say I've got a dot moving around in a circle on a screen and I'm following that dot with my eyes.
假设屏幕上有一个点在绕圈移动，我用眼睛追随该点。
My eyes should be able to very smoothly follow that circle around, rotating the eyes.
我的眼睛应该能够非常顺利地跟随那个圆圈，旋转眼睛。
Andrew Huberman:
安德鲁·休伯曼：
It's the lit-up hockey puck on one watching a hockey game.
这是观看曲棍球比赛时佩戴的发光冰球。
Is that-
难道是——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Like that.
就这样。
Andrew Huberman:
安德鲁·休伯曼：
You're a hockey fan, right?
你是曲棍球迷，对吧？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Like that.
就这样。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, exactly.
是的，完全正确。
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Just following a ball-
只是跟着一个球-
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
following any movement with smooth pursuits of your eyes.
眼睛平稳地追随任何动作。
And after concussion, actually, those systems in our brain, the sort of reflexive ability to properly follow that, use that visual input to tell your eye muscles exactly where to move, gets disrupted, and so all of a sudden your smooth pursuit starts to look choppy.
事实上，在脑震荡之后，我们大脑中的那些系统，即正确遵循这一点的反射能力，使用视觉输入告诉你的眼部肌肉到底要移动到哪里，会受到干扰，所以突然之间，你平稳的追踪开始变得不稳定。
It's not so smooth anymore.
不再那么顺利了。
And it's actually a way to diagnose and follow recovery from concussion.
这实际上是一种诊断脑震荡并跟踪其恢复情况的方法。
And part of the visual rehab, sort of neuro rehab, one of the approaches being used, and further studied still in recovery from concussion, is actually doing those kinds of exercises, like pencil pushups or basically what you've described is focusing from far away to focusing near, and doing that back and forth, and using that to sort of help regain the tighter control of our eye movements and that eye-brain connection.
视觉康复的一部分，一种神经康复，正在使用的方法之一，仍在从脑震荡中恢复中进一步研究，实际上是做那些类型的练习，比如铅笔俯卧撑，或者基本上你所描述的就是从远方聚焦到近处聚焦，然后来回做，并用它来帮助重新获得对我们的眼球运动和眼脑连接的更严格的控制。
Andrew Huberman:
安德鲁·休伯曼：
So if traumatic brain injury causes deficits in smooth pursuit eye movements, and some of the recovery protocols for traumatic brain injury are to have people do smooth pursuit protocols and pencil pushups, are these also the sorts of things that anyone can just do?
那么，如果创伤性脑损伤导致平滑追踪眼球运动的缺陷，而一些创伤性脑损伤的恢复方案是让人们做平滑追踪方案和铅笔俯卧撑，那么这些也是任何人都可以做的事情吗？
Whenever possible, we like to share tools for various aspects of health on this podcast, but of course, we don't want people cowboying this stuff in a way that could be detrimental to their vision.
只要有可能，我们都喜欢在这个播客上分享有关健康各个方面的工具，但当然，我们不希望人们以可能损害他们视力的方式来欺骗这些东西。
So is it okay to get on YouTube and find a smooth pursuit tool, we can put a link to these, there are several of them, and people spend a few minutes doing this?
那么是否可以上 YouTube 并找到一个流畅的追踪工具，我们可以放一个链接到这些工具，其中有几个，人们花几分钟来做这件事？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
You're definitely not going to hurt anything, so totally fine to do it.
你绝对不会伤害任何东西，所以完全可以这样做。
And some people may notice they feel a little more visually active if they do these kinds of exercises.
有些人可能会注意到，如果进行此类练习，他们会感觉视觉上更加活跃。
I think most people would do them and not notice something in their daily life.
我认为大多数人都会这样做，但在日常生活中却没有注意到一些事情。
We actually have made so much progress in research in thinking about how do we take the diseased or dysfunctioning or aging eye and get it back to healthy and normal.
实际上，我们在研究如何使患病、功能障碍或老化的眼睛恢复健康和正常方面取得了很大进展。
But there's a whole other area of science that we're really just barely touching.
但还有一个我们几乎没有接触过的科学领域。
We've actually just opened a vision performance center to really get at not just how do we rehab the sick eye back to health, but what's the difference between functioning normally and functioning above normally.
实际上，我们刚刚开设了一个视力表现中心，不仅要真正了解如何使患病的眼睛恢复健康，还要了解正常功能和高于正常功能之间的区别。
For example, athletes, when they get studied for vision characteristics, they have faster visual reflexes, higher visual acuity.
例如，运动员在研究其视力特征时发现，他们的视觉反应更快，视力更高。
How much of that was genetic?
其中有多少是遗传因素？
How much of that is trained?
其中有多少是经过培训的？
We don't really understand.
我们真的不明白。
Could we train all of us with normal vision to get up to supra-normal vision?
我们能否训练所有具有正常视力的人达到超正常视力？
These are great important questions that are really relevant to every regular person.
这些都是非常重要的问题，与每个普通人都息息相关。
Of course, people doing esports and the gaming community, and athletes is part of what we're studying in the Vision Performance Center, but these are really, really big opportunities to try to understand how do we move people from normal vision to supra-normal vision.
当然，从事电子竞技和游戏社区的人们以及运动员是我们在视觉表现中心研究的一部分，但这些确实是一个很大的机会，可以尝试了解我们如何将人们从正常视力转变为超正常视力。
And there's evidence that you can do it.
并且有证据表明您可以做到。
So here's a great example.
这是一个很好的例子。
Some athletes train using these special goggles that actually use electrical signals in the glasses part of the goggles to actually black out your vision 1/30 of every second, 2/30 of every second, 3/30 of every second.
一些运动员使用这些特殊的护目镜进行训练，这些护目镜实际上使用护目镜眼镜部分中的电信号来实际遮蔽您的视野每秒 1/30、每秒 2/30、每秒 3/30。
Now imagine you and I are passing a basketball back and forth, except you're wearing goggles, and all of a sudden you're only getting 90% of the data of where's that basketball on its way to my hands.
现在想象一下，你和我正在来回传递一个篮球，除非你戴着护目镜，突然间你只能获得篮球到达我手中的过程中 90% 的数据。
Now you're only getting 80%.
现在你只得到了80%。
Now you're only getting 70% of that visual information, and you are practicing.
现在你只获得了 70% 的视觉信息，而且你正在练习。
You are getting good at catching a basketball when you only have a fraction of the visual information.
当你只有一小部分视觉信息时，你就会越来越擅长接篮球。
And now I put you back on the basketball court without the goggles.
现在我让你不戴护目镜回到篮球场。
You might be really good at passing that basketball around and catching that basketball, right?
你可能真的很擅长传球和接球，对吧？
And so the idea that we could train and understand the biology of training to get the eyes from normal to supra-normal performance, I think it's an amazing area and one that we've really just started to dig into.
因此，我们可以通过训练和理解训练的生物学原理，使眼睛从正常表现变为超正常表现，我认为这是一个令人惊奇的领域，我们才刚刚开始深入研究。
Andrew Huberman:
安德鲁·休伯曼：
Well, that's fantastic.
嗯，那太棒了。
So this is a new program at Stanford through the Department of Ophthalmology?
这是斯坦福大学眼科的一个新项目吗？
Is it linked up at all with the Wu Tsai Performance Institute?
和五仔表演学院有联系吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Actually, there's been a lot of focus over the years, I think, in human performance, and there's actually a new human performance alliance and center.
事实上，我认为多年来人们对人类表现给予了很多关注，而且实际上有一个新的人类表现联盟和中心。
We've long had, really run through the Department of Orthopedics, a human performance laboratory that's really much more about joints and muscles and strength and conditioning and stretching.
我们长期以来一直在骨科部门工作，这是一个人体表现实验室，它更多地涉及关节、肌肉、力量、调节和伸展。
To layer onto that now, a real understanding of how vision is operating.
现在，我们要真正了解视觉是如何运作的。
It's interesting.
这很有趣。
Let's go back to the example of concussion.
让我们回到脑震荡的例子。
We've got, I don't know, about 800 varsity student athletes in all the different sports at Stanford.
我不知道，斯坦福大学有大约 800 名参加各种不同运动项目的校学生运动员。
And you might have a student athlete come in and say, "Something doesn't feel right.
你可能会有一名学生运动员进来并说：“感觉有些不对劲。
I got a little hit on the head.
我的头受到了一点撞击。
I feel like my vision is a little bit messed up.
我感觉我的视力有点混乱。
Maybe I've got a mild concussion." You could imagine doing some of these tests on some of these performance athletes, for example, and saying, "Well, gosh, you look normal." But actually, they used to be operating at a supernormal rate, and this is a noticeable decrement for them.
也许我有轻微脑震荡。”例如，你可以想象对其中一些表现出色的运动员进行一些测试，然后说：“好吧，天哪，你看起来很正常。”但实际上，他们曾经以超常的速度运转，这对他们来说是一个明显的下降。
And so just starting to study and understand what's the difference between normal and supernormal, how do we go back and forth between those two, how do we measure that difference, and maybe ultimately, how do we train into that difference, I think it's going to be exciting.
因此，刚开始研究和理解正常和超常之间有什么区别，我们如何在这两者之间来回切换，我们如何衡量这种差异，也许最终，我们如何训练这种差异，我认为这将是令人兴奋的。
And not just for athletes, for regular people.
不仅对于运动员，对于普通人也是如此。
You talk about driving at night.
你说的是晚上开车。
Is there a solution where we could train our eyes to be better at driving at night, and I don't know, maybe reduce the number of accidents that happen out in the world.
有没有一种解决方案可以训练我们的眼睛更好地在夜间驾驶，我不知道，也许可以减少世界上发生的事故数量。
So-
所以——
Andrew Huberman:
安德鲁·休伯曼：
Well, certainly there's physical training protocols which are redefining what a 60-year-old or a 70-year-old could look like and feel like and be able to perform like.
当然，体能训练方案正在重新定义 60 岁或 70 岁的人的外观、感觉和表现。
Why not do the same for vision?
为什么不对视觉做同样的事情呢？
So I don't think there's anything supernatural or greedy about doing it.
所以我不认为这样做有什么超自然或贪婪的地方。
I think that's the excitement of biology and neuroplasticity, that you can extend it forward as opposed to just trying to wire up correctly during development.
我认为这就是生物学和神经可塑性的令人兴奋的地方，你可以将其向前延伸，而不是仅仅在发育过程中尝试正确连接。
This is a perfect time for me to ask you a question that I'd love a clear answer on, if it's possible.
现在是我问你一个问题的最佳时机，如果可能的话，我希望得到一个明确的答案。
It's not always possible.
这并不总是可能的。
Which is, could you define 20/20 vision- ...
也就是说，你能否定义 20/20 愿景 - ...
and a few of the variants so that any person could understand it?
以及一些变体以便任何人都可以理解它？
So we think of 20/20 as perfect vision.
所以我们认为 20/20 是完美的视力。
What does that mean?
这意味着什么？
What would degraded vision look like, whatever those numbers are?
无论这些数字是多少，视力下降会是什么样子？
And then what would above normal, supernormal vision look like?
那么超出正常、超常的视力会是什么样子呢？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And is it true that fighter pilots have supernormal vision?
战斗机飞行员真的有超常视力吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's another population, like many athletes, of people who may have better than normal vision.
与许多运动员一样，这是另一个视力可能比正常人更好的人群。
20/20, we define almost everything we do based on a average, not sick human being, adult, whatever it is.
20/20，我们所做的几乎所有事情都是基于普通人、非病人、成年人，无论是什么。
Right?
正确的？
And so 20/20 vision means that you can read the smallest letters at 20 feet away that the average healthy person can read at 20 feet away.
因此，20/20 视力意味着您可以在 20 英尺外阅读普通健康人在 20 英尺外可以阅读的最小字母。
So you can read at 20 what they can read at 20.
所以你20岁时可以读到他们20岁时可以读到的内容。
Okay?
好吧？
Now, if you have worse than 20/20 vision, maybe you have 20/25 vision, 20/40 vision, maybe you have 20/200 vision, which on the eye chart at the office is the big E at the very top, is 20/200 vision.
现在，如果你的视力比20/20差，也许你有20/25视力，20/40视力，也许你有20/200视力，在办公室的视力表上最上面的大E，就是20/200视力。
That means you can read at 20 feet what a normal person could read at 200 feet.
这意味着您可以在 20 英尺处阅读正常人在 200 英尺处可以阅读的内容。
Right?
正确的？
So you've got pretty limited lower vision.
所以你的低视力相当有限。
We can measure down to like 20/400, 20/800.
我们可以测量到 20/400、20/800 等。
At that point, we're getting into like, gosh, can you count how many fingers I'm holding up?
那时，我们就陷入了这样的境地，天哪，你能数一下我举起了多少根手指吗？
That kind of thing.
那种事。
And then ultimately, hand motion.
最后是手部动作。
Can you even tell if my hand is moving in this side of your vision or this side of your vision?
你能分辨出我的手是在你视野的这边移动还是在你视野的这边移动吗？
And then ultimately, after that, light perception.
最后，最后是光感。
Can you tell if the room lights are on or off?
你能看出房间的灯是开着还是关着吗？
Right?
正确的？
And that's the edge of being actually fully blind.
这就是实际上完全失明的边缘。
We call legal blindness in the United States typically 20/200 or worse.
在美国，我们通常将法律失明称为 20/200 或更糟。
Andrew Huberman:
安德鲁·休伯曼：
And is it true that there are people who are legally blind that are out there driving as we're having this conversation?
当我们进行这次谈话时，真的有法定盲人在开车吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
I have to imagine that that is unfortunately the case.
我不得不想象，不幸的是情况确实如此。
But it shouldn't be, because those people obviously are really severely impaired, and that's obviously quite dangerous.
但不应该，因为那些人显然已经受到了严重的伤害，而且这显然是相当危险的。
So that's 20/20.
所以这是 20/20。
Now, it gets worse, 20/40, 20/80, 20/100.
现在，情况变得更糟，20/40、20/80、20/100。
Can it get better?
能好起来吗？
Yeah.
是的。
It turns out that people can be on the other end of that curve.
事实证明，人们可能处于曲线的另一端。
And so we could have athletes and fighter pilots or people who have had LASIK surgery who are 20/15, 20/10.
因此我们可以有运动员、战斗机飞行员或接受过 LASIK 手术的人为 20/15、20/10。
If you're 20/10, that means you can see at 20 feet what the average person needs to be only 10 feet away to see.
如果您的视力为 20/10，则意味着您可以在 20 英尺处看到普通人仅需要在 10 英尺外才能看到的内容。
Right?
正确的？
And so you've got better than normal vision.
所以你的视力比正常人要好。
And people do get to that through a variety of ways, and so it is possible to have better than 20/20 vision.
人们确实可以通过多种方式实现这一点，因此有可能拥有比 20/20 更好的视力。
Andrew Huberman:
安德鲁·休伯曼：
Does the degree of visual acuity, because that's really what we're talking about here, differ dramatically between the two eyes?
两只眼睛之间的视敏度是否存在显着差异（因为这正是我们在这里讨论的内容）？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
In most healthy people, no. Remember, we talked about you're born with something like 20/200 vision.
对于大多数健康人来说，不会。请记住，我们讨论过您生来就有 20/200 的视力。
Takes you a couple of years, then it could be a little bit asymmetric.
需要你几年的时间，然后它可能会有点不对称。
Andrew Huberman:
安德鲁·休伯曼：
20/200 vision.
20/200 视力。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
That reminds me, I've seen images of what babies can see.
这让我想起，我见过婴儿能看到的图像。
Parents love looking at their child and thinking that their child is looking right back at them, and indeed, often the child is looking right back at them.
父母喜欢看着他们的孩子，并认为他们的孩子正在回望他们，事实上，孩子经常回望他们。
And your face to your child, sorry to break this to you folks, is incredibly blurry, even at that close distance, for probably the first six to eight months even-
你对你孩子的脸，很抱歉打扰你们，即使在那么近的距离下，也非常模糊，可能在最初的六到八个月里——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
before you come into sharp relief.
在你彻底放松之前。
They're not seeing the fine details of your face.
他们看不到你脸上的细节。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So smile big.
所以笑得大大的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
That's right.
没错。
Smile big.
笑得大大的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Keep those eyebrows dark.
保持眉毛深色。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
And keep cooing at them-
并继续对他们咕咕叫——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
That's right
没错
Andrew Huberman:
安德鲁·休伯曼：
...
...
because they can hear pretty well early on.
因为他们很早就能听到很好的声音。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
That's right.
没错。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
The optics of newborn babies are just dreadfully bad.
新生婴儿的视力非常糟糕。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But they need visual stimulation.
但他们需要视觉刺激。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Now, other species, hawks ...
现在，其他物种，鹰......
raptors, owls that hunt, they can naturally have 20/10, 20/8 vision, right?
猛禽、狩猎的猫头鹰，它们自然可以有20/10、20/8的视力，对吗？
So much better vision, and that's just their normal vision as best as has been measured.
视力好得多，这只是他们测量到的最佳正常视力。
So there's definitely the potential for us to have better than 20/20 vision.
所以我们绝对有可能拥有比 20/20 更好的视力。
Now, all of this we call visual acuity, and just to be clear for everyone, that's the vision in the very center of your vision, like when you're reading or looking.
现在，所有这些我们称之为视敏度，为了让每个人都清楚，这是您视野中心的视力，就像您在阅读或看东西时一样。
That's the very center of your vision.
那是你视野的中心。
Our vision is actually described variably as a hill of vision.
我们的愿景实际上被不同地描述为“愿景山”。
The peak is in the center.
峰位于中心。
That's, let's say, 20/20 in most people, right?
比方说，大多数人的比例是 20/20，对吗？
But it's normal to have that slope off.
但倾斜度下降是正常的。
At our visual acuity, your ability to read the eye chart on the edges of your vision, if you can read the big E, that's pretty normal.
以我们的视力，即你阅读视力表边缘的能力，如果你能阅读大E，那是很正常的。
You would be 20/200 out on the edges of your vision, and we would feel like, yep, that's pretty normal.
你的视野边缘会有 20/200 的偏差，我们会觉得，是的，这很正常。
So our highest acuity vision's in the center, and that's a big part of why we spend a lot of time using those eye muscles to look around, right?
因此，我们的视力最高敏锐度位于中心，这就是为什么我们花费大量时间使用这些眼部肌肉环顾四周的重要原因，对吗？
We got to get a little bit of a high acuity view of what's around us, fill in the gaps of what our brain is interpreting our peripheral world to look like.
我们必须对我们周围的事物有一个高度敏锐的认识，填补我们的大脑解释我们的外围世界的空白。
Andrew Huberman:
安德鲁·休伯曼：
It's almost like we have two visual systems.
这几乎就像我们有两个视觉系统。
We have a high acuity, high pixel density camera in the middle, and then surrounding that is a pretty low resolution, but very fast detector camera.
我们在中间有一个高敏锐度、高像素密度的相机，然后周围是一个分辨率相当低但速度非常快的探测器相机。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yes.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned LASIK, but I want to make sure that before we talk about LASIK, that we talk a little bit about contact lenses.
您提到了 LASIK，但我想确保在我们谈论 LASIK 之前，我们先谈谈隐形眼镜。
Is there any detriment to having a piece of glass or a piece of plastic on the front of your eye all the time?
一直在眼睛前面放一块玻璃或一块塑料有什么坏处吗？
And the reason I ask is not because I think we should live necessarily exactly like our ancestors, but it's a pretty bizarre adaptation to put a lens directly onto the front of the eye.
我问这个问题的原因并不是因为我认为我们必须像我们的祖先一样生活，而是因为将晶状体直接放在眼睛的前面是一种非常奇怪的适应。
You have to imagine that the cells and tissues there are accustomed to getting a certain amount of oxygen, they're accustomed to getting a certain amount of interaction with the environment, and you also are now adding another surface.
你必须想象那里的细胞和组织习惯于获得一定量的氧气，它们习惯于与环境进行一定量的相互作用，并且你现在还添加了另一个表面。
The way that the tears are going to interact with the cornea of the eye are probably changed.
眼泪与眼睛角膜相互作用的方式可能会改变。
And who knows, maybe it doesn't make any negative difference at all.
谁知道呢，也许它根本不会产生任何负面影响。
But putting a contact lens on the front of the eye is about as close to putting a device on your brain as I can think of, except for maybe the cochlear implant.
但是，在我能想到的情况下，将隐形眼镜戴在眼睛前面就像在大脑上戴上一个装置一样，除了人工耳蜗之外。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's a great question.
这是一个很好的问题。
Now, first of all, I want to distinguish, there are a few really medical uses for different kinds of contact lenses, like scleral contact lenses.
现在，首先，我想区分一下，不同类型的隐形眼镜有一些真正的医疗用途，例如巩膜隐形眼镜。
For people who have certain diseases, there are other kinds.
对于患有某些疾病的人来说，还有其他类型的疾病。
But I think what we really want to talk about right now is just the run-of-the-mill, "I want to get my prescription taken care of, but instead of wearing glasses, I'm going to wear contacts." Contacts, even the newest generation contacts, yes, they sort of change the tear dynamics on the surface of your eye.
但我认为我们现在真正想谈论的只是普通的，“我想得到我的处方，但我不戴眼镜，而是戴隐形眼镜。”隐形眼镜，即使是最新一代的隐形眼镜，是的，它们会改变眼睛表面的泪液动态。
They decrease the oxygen diffusion that's just sort of out in the air onto the surface of our eye, onto the cells that are on the surface of our eye.
它们减少了氧气在空气中扩散到我们眼睛表面、眼睛表面细胞上的扩散。
But most of us, especially as we're younger, have enough tear film reserve, enough oxygen reserve, that we can easily tolerate these polymer gel soft contact lenses, and wear them happily.
但我们大多数人，尤其是年轻人，有足够的泪膜储备，足够的氧气储备，我们可以轻松忍受这些聚合物凝胶软性隐形眼镜，并愉快地佩戴它们。
The advantage of contact lenses over glasses, purely from the perspective of correcting your vision, is that there's different elements of the shape of your eye that need to be corrected if you need corrective lenses.
纯粹从矫正视力的角度来看，隐形眼镜相对于框架眼镜的优势在于，如果您需要矫正镜片，则需要矫正眼睛形状的不同元素。
And so, for example, if the basketball shape of your eye is a little too steep or a little too shallow, that's what the standard glasses correct.
因此，例如，如果您的眼睛的篮球形状有点太陡或太浅，那么标准眼镜就会纠正这种情况。
You may have been told that you have something called astigmatism.
您可能被告知您患有散光。
That's where instead of having a basketball-shaped eye, you have a slightly football-shaped eye.
这就是你的眼睛不是篮球形状的，而是略呈足球形状的。
It's not round in the same dimensions on both axes.
它在两个轴上的尺寸都不是圆形的。
And again, glasses can correct that.
再说一次，眼镜可以纠正这个问题。
But then there's higher order aberrations in our corneas, in the clear window in the front of our eyes, or to some degree in the lens inside the eye that are focusing the light, that the glasses prescription can't correct.
但是，我们的角膜、眼前的透明窗口或眼睛内聚焦光线的晶状体在某种程度上都存在高阶像差，而眼镜处方无法纠正这些像差。
But if you have a nice smooth contact lens on the front, it can correct.
但如果您的正面有一个光滑的隐形眼镜，它就可以矫正。
So a lot of people who wear glasses and contacts will report that they have a much higher quality of vision with their contact lens correction than with their glasses correction.
因此，许多戴眼镜和隐形眼镜的人都会报告说，他们矫正隐形眼镜后的视力质量比戴眼镜矫正后的视力质量要高得多。
And again, in service of enjoying the best vision that you can enjoy in your daily life, that's an upside to seeing if contacts could work for you.
再说一次，为了让您在日常生活中享受到最好的视力，看看隐形眼镜是否适合您是一个好处。
Now, there's another element, though, and that's like, gosh, is there a risk of contact lenses?
现在，还有另一个因素，那就是，天哪，隐形眼镜有风险吗？
And especially as we age, we have less tear film reserve, so contacts may become less tolerable as we age.
尤其是随着年龄的增长，我们的泪膜储备会减少，因此随着年龄的增长，隐形眼镜的耐受性可能会变得越来越差。
And the other thing is being really good about the cleaning, because the contacts can trap bacteria or fungus, and if you get a corneal infection from a contact lens, it actually can be quite devastating to your cornea.
另一件事是要做好清洁工作，因为隐形眼镜会滞留细菌或真菌，如果您因隐形眼镜而感染角膜，实际上会对您的角膜造成相当大的破坏。
Even if you successfully treat the infection, you can be left with some corneal scarring.
即使您成功治疗感染，您也可能会留下一些角膜疤痕。
Thankfully, this happens very rarely, but when it does happen, it can be quite difficult on the person thereafter to sort of suffer through having maybe a scar from that infection on the surface of their cornea that leads to some blurring vision, for example.
值得庆幸的是，这种情况很少发生，但当它确实发生时，此后的人可能会很难忍受角膜表面感染留下的疤痕，例如导致视力模糊。
So we always recommend that if you're going to wear contacts, that you be really attentive to whether you're tolerating them well And then also to be really attentive to the recommended use and cleaning of the contact lenses.
因此，我们始终建议，如果您要佩戴隐形眼镜，请务必注意您是否能够很好地耐受它们，然后还要真正注意隐形眼镜的建议使用和清洁。
I actually recommend that even though they're a little more expensive to afford, that people should almost always be just using the daily contact lenses that they don't have to clean or use for two weeks or a four-week period.
实际上，我建议，尽管它们的价格稍贵一些，但人们几乎应该始终使用日常隐形眼镜，因为他们不必清洁或使用两周或四个星期。
Andrew Huberman:
安德鲁·休伯曼：
So these are disposable contact lenses.
所以这些是一次性隐形眼镜。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Daily disposable.
日用一次性。
And I hate to think of, I don't know, filling our oceans or what have you with more polymer plastic.
我讨厌想到，我不知道，用更多的聚合物塑料填充我们的海洋或其他什么。
But at least the contact lenses are small, and it's much safer for your eye to use a daily disposable than to use a two-week or a four-week and be responsible for the cleaning.
但至少隐形眼镜很小，而且使用日抛型镜片比使用两周或四周并负责清洁对您的眼睛安全得多。
The other thing to be really responsible about is sleeping in them overnight.
另一件真正需要负责的事情是晚上睡觉时穿着它们。
Because overnight when your eyelids are closed, of course, now you're getting even less oxygen to the surface of your eye.
当然，因为一夜之间，当你的眼睑闭合时，眼睛表面获得的氧气会更少。
And actually, most bacteria, especially many of the infectious bacteria to our bodies and to the surface of our eye, are actually bacteria that don't really like oxygen.
事实上，大多数细菌，尤其是我们身体和眼睛表面的许多传染性细菌，实际上都是不喜欢氧气的细菌。
And so we've got a low risk of getting bacterial infections on the surface of our eye.
因此，我们眼睛表面受到细菌感染的风险很低。
But if we use contacts too much, don't clean them, or sleep in them overnight when our eyelids are closed, and now there's even less oxygen kind of helping keep the surface more clean, if you will.
但是，如果我们过多地使用隐形眼镜，就不要清洁它们，或者在我们的眼睑闭合时戴上隐形眼镜睡觉过夜，而现在，如果您愿意的话，有助于保持表面更清洁的氧气甚至更少。
That increases the risk a lot.
这大大增加了风险。
So being really good with the recommended use and cleaning of the contacts is critical.
因此，真正遵守推荐的使用方法和清洁触点至关重要。
Considering daily use contacts, you don't have to.
考虑到日常使用接触，您不必这样做。
And look, most contacts are going to be the two-week or four-week kind where you put them in the cleaning solution overnight each time, give them a good rinse, and put them back in the next day.
看，大多数隐形眼镜都会持续两周或四个星期，每次将它们放入清洁溶液中过夜，好好冲洗，然后在第二天放回原处。
And again, most people, 99.99 some percent of people are going to do just fine with that, follow the instructions, and never get into trouble.
再说一次，大多数人，99.99％的人都会做得很好，遵循指示，永远不会遇到麻烦。
As we age, they're going to become less tolerable.
随着年龄的增长，它们会变得越来越难以忍受。
People are going to say, "I used to wear my contacts for 12 hours.
人们会说，“我曾经戴隐形眼镜 12 个小时。
Now my eyes feel really dry after 6 or 8 or 10 hours." Maybe some years after that, they say, "Gosh, I can barely use it for four hours.
现在，6、8 或 10 小时后，我的眼睛感觉非常干燥。”也许几年后，他们会说，“天哪，我几乎无法使用它四个小时。
I only use them when I go out on a Saturday night." And that's okay.
我只在周六晚上外出时使用它们。”没关系。
You can back off as you need to back off.
当你需要后退时，你可以后退。
But in the meantime, if it helps you, especially in the younger decades, if it helps you really enjoy your best vision, great.
但与此同时，如果它能帮助你，尤其是在年轻的几十年里，如果它能帮助你真正享受你最好的视力，那就太好了。
Andrew Huberman:
安德鲁·休伯曼：
What about UV protection in eyeglass lenses and/or contacts?
眼镜镜片和/或隐形眼镜的紫外线防护怎么样？
I've dealt with many questions about blue light.
我已经处理过许多有关蓝光的问题。
I am not somebody who believes that all blue light is terrible.
我不认为所有蓝光都是可怕的。
I think it's important to avoid bright lights of any wavelength late at night if you want your melatonin production to be normal and you want to sleep well.
我认为，如果您希望褪黑激素的分泌正常并且想要睡个好觉，那么在深夜避免任何波长的强光非常重要。
It doesn't matter if you're wearing blue blockers or not.
无论您是否穿着蓝色防护服，都没有关系。
If you're just under blazingly bright lights, it's going to suppress your melatonin.
如果您处于明亮的灯光下，它会抑制您的褪黑激素。
And yet some people enjoy blue blockers for that reason.
然而，由于这个原因，有些人喜欢蓝色阻滞剂。
Nowadays, a lot of people wear blue blocker glasses or blue-blocking lenses or contacts throughout the entire day, thinking that blue light is bad for our eyes during the day.
如今，很多人整天戴着防蓝光眼镜或防蓝光镜片或隐形眼镜，认为白天蓝光对我们的眼睛不好。
I happen to subscribe to the idea that we want as much bright light as we safely can tolerate during the day, ideally from sunlight, in order to set our circadian rhythm.
我碰巧同意这样的观点：我们需要白天能够安全承受的尽可能多的明亮光线，最好是阳光，以设定我们的昼夜节律。
And yet, a lot of eyeglasses and a lot of contact lenses out there have UVA and/or UVB blocking features to them.
然而，许多眼镜和隐形眼镜都具有 UVA 和/或 UVB 阻挡功能。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So what are your thoughts on this?
那么您对此有何看法？
And I'm perfectly happy to be wrong and revise my stance on this.
我很高兴自己犯了错误并修正了我的立场。
What do you think about this UV A/B blocking?
您对这种 UV A/B 阻挡有何看法？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
It's really important to distinguish that UV light on the light spectrum is right next to blue light.
区分光谱上的紫外线与蓝光紧邻非常重要。
Red light's on the other end, and of course, infrared is beyond that.
红光在另一端，当然，红外线还不止于此。
And our eyes, other animals can see these, but our eyes can't see infrared.
而我们的眼睛，其他动物可以看到这些，但我们的眼睛看不到红外线。
That's why we call it beyond red, and we can't see ultraviolet, hence we call it beyond violet.
这就是为什么我们将其称为“超越红色”，而我们看不到紫外线，因此我们将其称为“超越紫罗兰色”。
UV light is right next to blue light.
紫外线紧邻蓝光。
UV light is known to have a lot of adverse effects.
众所周知，紫外线会产生很多不利影响。
It's not really good for our skin, and therefore, we really want to avoid sunburn and UV exposure and damage on our skin.
它对我们的皮肤不太好，因此，我们真的想避免晒伤和紫外线照射以及对我们皮肤的伤害。
Similarly, it's not really good on our eyes, and it affects both the ocular surface a little bit in terms of how dry or irritable your eyes might feel for some people.
同样，它对我们的眼睛也不好，而且它会对眼表产生一点影响，让某些人感觉眼睛干燥或发炎。
And certainly over the long term, UV light will accelerate the formation of cataract, which is an oxidative blurring of the lens inside the eye.
当然，从长远来看，紫外线会加速白内障的形成，白内障是眼睛内晶状体的氧化模糊。
Profound UV light can be damaging to the retina if you're getting way too much on the inside.
如果您的视网膜内部接触过多的强紫外线，可能会损害视网膜。
So blocking UV light, I believe, is just absolutely standard in every pair of eyeglasses, and I don't know actually how much, to what degree the different kinds of contact lenses also filter at least UV light.
因此，我相信，阻挡紫外线是每副眼镜的绝对标准，而且我不知道不同种类的隐形眼镜实际上至少能过滤多少、达到何种程度。
Now, blue blockers, blue-blocking glasses is totally different.
现在，蓝光阻挡器、蓝光阻挡眼镜完全不同了。
And as I say, I think almost all glasses because the plastics-- Almost all glasses are not made of glass anymore, they're made of plastics.
正如我所说，我认为几乎所有眼镜都是因为塑料——几乎所有眼镜都不再由玻璃制成，而是由塑料制成。
But I think almost all of them now filter the UV light, which again is probably the safe move for our eyes and periocular environment, around the eye environment.
但我认为几乎所有的现在都过滤紫外线，这对于我们的眼睛和眼周环境，眼睛周围的环境来说可能又是安全的举动。
So, blue blockers, that's been a huge fad.
所以，蓝色阻滞剂，这是一种巨大的时尚。
And I'll tell you, the last three years through the pandemic, everybody getting on their computer, hours in front of Zoom meetings where we used to walk from building to building for a meeting, things like that.
我会告诉你，在过去三年的大流行中，每个人都坐在电脑前，在 Zoom 会议前几个小时，我们过去常常从一栋楼走到另一栋楼去开会，诸如此类的事情。
I remember the sort of big uptick in these kinds of questions, and I'm not sure that there's any data that blocking blue is helpful in any way.
我记得这类问题的数量大幅增加，而且我不确定是否有任何数据表明阻挡蓝色有任何帮助。
And as you say, it may actually play into a sort of circadian entrainment of our natural daily rhythm.
正如你所说，它实际上可能会影响我们自然的日常节奏。
So I think blocking UV is a good idea, and I think it's pretty standard.
所以我认为阻挡紫外线是个好主意，而且我认为这是相当标准的。
They make glasses, by the way, that actually react to UV light.
顺便说一句，他们制造的眼镜实际上对紫外线有反应。
They're called Transitions.
它们被称为过渡。
There may be a few different brands, I don't know.
可能有几个不同的品牌，我不知道。
But these are the sunglasses that are clear, except then they turn dark if you're out in the sunlight.
但这些太阳镜是透明的，但如果你在阳光下，它们就会变暗。
And it's not just any sunlight, it's actually the UV- Wavelengths that cause the chemical reaction in the glasses to turn from clear see-through to sunglass blocked glasses.
不仅仅是阳光，实际上是紫外线波长导致眼镜中的化学反应从清晰的透明眼镜转变为遮挡太阳镜的眼镜。
And you may notice, if any of you out there are using these kinds of glasses, that they don't work in the car.
您可能会注意到，如果你们中有人使用此类眼镜，它们在车内不起作用。
You'll wear them in the car, and they won't go to sunglasses even though it's sunny out.
你会在车里戴上它们，即使外面阳光明媚，它们也不会戴上太阳镜。
And again, that's because all standard car glass also filters UV.
再说一遍，这是因为所有标准汽车玻璃也能过滤紫外线。
That's why if you're riding around in the car and it's sunny out, and you've got your hand up next to the window wearing a T-shirt, you never get a sunburn through the car window anymore because all our car glass is also filtering UV light for us.
这就是为什么如果你在车里骑行，外面阳光明媚，你穿着 T 恤把手放在车窗旁边，你就不会再透过车窗被晒伤，因为我们所有的汽车玻璃也会为我们过滤紫外线。
Andrew Huberman:
安德鲁·休伯曼：
So that's a very informative answer.
这是一个非常有用的答案。
And before we started recording, you and I were discussing this practice of morning sunlight viewing, which again, I highly recommend over and over.
在我们开始录制之前，你和我正在讨论这种早晨阳光观看的做法，我再次强烈推荐这一做法。
And you pointed out that low solar angle sunlight, so sunlight low in the sky, viewed for maybe 10 minutes a morning, and again, not forcing oneself to look at it and stare, but blinking as needed, is not going to cause extensive UV damage to the eyes.
您指出，低太阳角阳光，即天空中较低的阳光，每天早上观看大约 10 分钟，并且不要强迫自己看它并凝视它，而是根据需要眨眼，不会对眼睛造成广泛的紫外线伤害。
It's really when the sun is directly overhead that we're getting a lot of UV.
事实上，当太阳直射头顶时，我们就会受到大量紫外线的照射。
Which raises this other question, which is for people that don't wear corrective lenses and therefore are not blocking UV light to the eyes, what should they do?
这就提出了另一个问题，对于那些不戴矫正镜片并因此不阻挡紫外线进入眼睛的人来说，他们应该做什么？
Are they in trouble?
他们遇到麻烦了吗？
Should they be wearing a brimmed hat?
他们应该戴有檐帽子吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Brimmed hat's a great idea.
带檐帽子是个好主意。
That'll get rid of a lot of the direct light into the eye.
这样可以消除大量直接进入眼睛的光线。
Of course, you still have reflected light off of surfaces, and that can include UV light, of course.
当然，表面仍然会反射光，其中当然可以包括紫外线。
Wearing sunglasses outside, even if you don't have corrective lenses, it may also be more comfortable to wear sunglasses outside.
在户外佩戴太阳镜，即使您没有矫正镜片，在户外佩戴太阳镜也可能会更舒服。
So these are all fine.
所以这些都很好。
At the end of the day, it's probably not making a huge difference in the health of your eye whether you've spent the last 50 years wearing sunglasses really dogmatically for your outdoor time or not.
归根结底，无论您在过去 50 年是否在户外活动时一直教条地佩戴太阳镜，都可能不会对您的眼睛健康产生巨大影响。
If you are going to develop, let's just say, age-related cataracts inside your eyes, which if we all live to 120, we all get cataracts.
如果您的眼睛内会出现与年龄相关的白内障，如果我们都活到 120 岁，我们都会患上白内障。
It's going to happen.
这将会发生。
Some people younger, some people older.
有的人年纪小，有的人年纪大。
Maybe if you were really dogmatic about wearing your UV blocking sunglasses, maybe you'd get your cataracts at 75 years old instead of 72 years old.
如果您真的坚持佩戴防紫外线太阳镜，也许您会在 75 岁而不是 72 岁时患上白内障。
It may not be a huge difference in that regard.
在这方面，可能差别并不大。
So again, not something to be super stressed.
再说一次，这不是一个压力太大的事情。
I think it's more a question of just what are you comfortable in.
我认为这更多的是一个你对什么感到舒服的问题。
And then certainly I will say the other advantage of a wide brimmed hat is it's keeping sun off of your face, especially the upturned portions of your face, like the cheeks and the nose.
当然，我会说宽边帽子的另一个优点是它可以防止阳光照射到你的脸上，尤其是脸颊和鼻子等上翘的部分。
These are some of the most common places to get some of the skin cancers that you can get over a lifetime of sunlight exposure.
这些是一些最容易患上皮肤癌的地方，这些皮肤癌是您一生中暴露在阳光下可能患上的。
So the wide brimmed hat, it's helping you for that as well.
因此，宽边帽也能帮助你做到这一点。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Can't help but ask about comfort at varying levels of brightness.
忍不住要问不同亮度下的舒适度。
I'm the person that when sitting in a cafe or something and on a bright day, I can be directly across from somebody like you, who seems to be perfectly fine without sunglasses and maybe even more shaded under an umbrella or something of that sort, and I'm squinting like crazy.
我是那种在阳光明媚的日子坐在咖啡馆或其他地方时，我可以直接面对像你这样的人，他不戴墨镜看起来很好，也许在雨伞之类的东西下更阴凉，而我疯狂地眯着眼睛。
Is it normal for there to be a pretty wide variation in sensitivity to light, and does this have anything to do with the lightness or darkness of the eyes?
对光的敏感度存在很大差异是否正常，这与眼睛的明暗有关吗？
You have brown eyes, I have green eyes, but is there any real correlation there?
你有棕色的眼睛，我有绿色的眼睛，但这两者之间有什么真正的相关性吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
It's a good question.
这是一个好问题。
I don't know if it's been formally studied, but I will tell you I have the same impression you do, which is that if you have blue eyes or light colored eyes, that you're more likely to have more sensitivity.
我不知道是否已经被正式研究过，但我会告诉你，我有和你一样的印象，那就是如果你有蓝眼睛或浅色眼睛，你更有可能有更高的敏感性。
We know that there's differences in the iris muscles that constrict and dilate in response to light.
我们知道，虹膜肌肉对光线的收缩和扩张存在差异。
For example, when you go into your eye care provider and they're going to do a dilated exam, and they put the eye drops in your eye that dilate the eyes, they sort of change the nerve impulses onto the iris muscle so the iris dilates and you get those big open eyes.
例如，当您去看眼科护理人员时，他们要进行散瞳检查，他们将眼药水滴入您的眼睛中以散瞳，他们会改变虹膜肌肉上的神经冲动，因此虹膜扩张，您就会睁大眼睛。
People with blue eyes, we absolutely know blue or hazel or light colored eyes, you put that eye drop to dilate their eyes, it's going to last four, six, eight hours.
蓝眼睛的人，我们绝对知道蓝色或淡褐色或浅色的眼睛，你滴点眼药水来扩大他们的眼睛，它会持续四、六、八个小时。
Whereas in a brown-eyed person, often the dilation only lasts one to four hours.
而对于棕色眼睛的人来说，扩张通常只持续一到四个小时。
So there's clearly biological differences between the irises and their muscles and maybe the nerves that feed those muscles between light-eyed people and darker-eyed people.
因此，浅色眼睛的人和深色眼睛的人的虹膜和肌肉之间存在明显的生物学差异，也许还有为这些肌肉提供营养的神经。
And that may also therefore relate to this differential sensitivity that some people have.
因此，这也可能与某些人的这种不同的敏感性有关。
If you're not able to constrict your eyes in the bright light as effectively, you're going to find that bright light more frustrating, more annoying, even painful.
如果你不能在强光下有效地收缩你的眼睛，你会发现强光更令人沮丧、更烦人，甚至痛苦。
People will feel like their eyes are cramping almost as they try to get those eye muscles to activate to bring down the pupil and block some of that excess light from getting in.
当人们试图激活眼部肌肉以降低瞳孔并阻止一些多余的光线进入时，他们会感觉眼睛几乎在痉挛。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Let's go back to LASIK.
让我们回到LASIK。
What is LASIK, and should I get LASIK eye surgery?
什么是 LASIK？我应该接受 LASIK 眼科手术吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Does everyone need LASIK?
每个人都需要LASIK吗？
Can it make us super physiological?
它能让我们超生理吗？
Can it make me a 20/10?
它能让我获得 20/10 吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Often it can.
通常可以。
I'll just say that right up front.
我就在前面说一下。
It is amazing.
太神奇了。
People will come out of LASIK surgery better than 20/20.
接受 LASIK 手术的患者术后康复效果优于 20/20。
But the cornea we talked about before, that's the clear window on the front of your eye.
但我们之前谈到的角膜，就是眼睛前面的透明窗口。
All the light has to get through there.
所有的光都必须从那里穿过。
And we talked about before already, if your cornea is misshapen, if the basketball shape of it is too shallow or too steep, then you're going to need glasses to see at distance and also at near.
我们之前已经讨论过，如果你的角膜畸形，如果它的篮球形状太浅或太陡，那么你将需要眼镜来看远处和看近处。
If it's too football instead of basketball, then it's going to be what we call astigmatism, and then you need a correction for that.
如果它太像足球而不是篮球，那么这将是我们所说的散光，然后你需要对此进行矫正。
Instead of correcting with glasses that sort of help shape the light so it can go through your slightly off shape cornea, instead of wearing contact lenses, which also shape the light just as it's entering your cornea right on the surface of the eye, you can just reshape the cornea And the way LASIK does that, there's a few different versions of LASIK, but basically the way the LASIK does that is it actually ablates or gets rid of a little ring or rim of that corneal tissue.
不用戴眼镜来矫正，这种眼镜可以帮助塑造光线，这样光线就可以穿过稍微变形的角膜，而不是戴隐形眼镜，隐形眼镜也会在光线进入眼睛表面的角膜时塑造光线，你可以重塑角膜。LASIK 的方式有几种不同的版本，但基本上 LASIK 的方式是，它实际上消融或去除了角膜组织的一个小环或边缘。
So that, for example, if you were a little shallow and you got rid of a little bit of that tissue around the edge with the laser, LASIK starts with the word laser.
因此，例如，如果您有点浅，并且用激光去除了边缘周围的一点组织，那么 LASIK 就会从“激光”一词开始。
If you got rid of that edge tissue, then you're sort of making it a little more basketball shaped, right?
如果你去掉了边缘组织，那么你就可以让它更像篮球形状，对吗？
Or if you were too steep on your cornea and you used the laser to kind of shave off a little bit of the tip of that basketball, right, then you're flattening it out, flattening out the cornea.
或者，如果你的角膜太陡，你用激光剃掉了篮球尖端的一点点，对吧，然后你就把它弄平了，弄平了角膜。
So it's that kind of reshaping.
所以这就是一种重塑。
And the technology has come so far that the LASIK procedures can actually correct not just the regular aberrations that we talked about, but also some of these higher order aberrations, and there are different monikers for this kind of LASIK.
技术已经发展到今天，LASIK 手术实际上不仅可以矫正我们谈到的常规像差，还可以矫正一些高阶像差，并且这种 LASIK 有不同的名称。
It's all, I think, become fairly standard, but wave front-guided where it's actually using light waves to measure with a very exact localization exactly how much and where to laser for each individual eye to make that cornea pass the light as ideally as possible.
我认为，这一切都变得相当标准，但是波前引导，它实际上使用光波以非常精确的定位来测量每只眼睛的激光照射量和位置，以使角膜尽可能理想地通过光线。
Now, one or a few percent of patients will actually have a dry eye problem after LASIK because it does interfere a little bit with those corneal nerves, for example.
现在，百分之一或百分之几的患者在接受 LASIK 手术后实际上会出现干眼问题，因为它确实会稍微干扰角膜神经。
And I do think that if you're a person who already has dry eye, hopefully if you're asking your eye surgeon about LASIK, hopefully you're being counseled that if you have dry eye, this might not be a good idea for you, just like contacts might not be a good idea for you if you already have a lot of dry eye.
我确实认为，如果您是一个已经患有干眼症的人，希望您向眼科医生询问有关 LASIK 的问题，希望您得到的建议是，如果您患有干眼症，这对您来说可能不是一个好主意，就像如果您已经患有严重干眼症，隐形眼镜对您来说可能不是一个好主意一样。
But for a lot of people, especially a lot of younger people, it's quite common.
但对于很多人，尤其是很多年轻人来说，这是很常见的。
I think the statistics suggest maybe 15 or 20% of people who would benefit from LASIK, who would otherwise be wearing glasses may get LASIK at some point in their life.
我认为统计数据表明，可能有 15% 或 20% 的人会从 LASIK 中受益，而本来会戴眼镜的人可能会在一生中的某个时刻接受 LASIK。
And I used to joke LASIK, it costs more money than a pair of glasses, but it doesn't cost more money than 10 pairs of prescription glasses over the course of a decade or two.
我曾经开玩笑说LASIK，它比一副眼镜要贵，但在十年或两年内不会比10副处方眼镜贵。
And so I used to joke that, gosh, if everyone had to have laser eye surgery for their best vision, and someone came along and said, "Hey, I've got an invention.
所以我常常开玩笑说，天哪，如果每个人都必须接受激光眼科手术才能获得最佳视力，然后有人走过来说：“嘿，我有一项发明。
You don't have to have laser eye surgery anymore.
您不再需要进行激光眼科手术。
It rests on the ears and the bridge of your nose.
它位于耳朵和鼻梁上。
I call them glasses." Could they have sold those for $1,000, $2,000 a pair?
我称它们为眼镜。”他们能以 1,000 美元、2,000 美元一对的价格出售吗？
I don't know.
我不知道。
Maybe.
或许。
But there's kind of a cultural element of saying, "I don't want to wear glasses.
但有一种文化元素是这样说的：“我不想戴眼镜。
I'd love to be able to walk around without relying on glasses or contacts." Of course, people who are very athletic or spending a lot of their time doing athletics, they may be quite irritated to have to deal with glasses or contacts.
我希望能够在不依赖眼镜或隐形眼镜的情况下四处走动。”当然，对于运动能力很强或花大量时间进行运动的人来说，他们可能会对戴眼镜或隐形眼镜感到非常恼火。
People who have very severe prescriptions.
有非常严格处方的人。
If you wake up and you can't even really-- You're fumbling for your glasses on the bedside table because you have such a strong prescription you can't even see what it says on the alarm clock next to the bed.
如果你醒来了，但你甚至不能——你会在床头柜上摸索你的眼镜，因为你有一个很强的处方，你甚至看不到床边闹钟上的内容。
These are all groups of patients who really change their daily lives by getting out of glasses or contacts and taking advantage of LASIK.
这些患者通过摘除眼镜或隐形眼镜并利用 LASIK 手术，真正改变了他们的日常生活。
And in, I don't know, 99% of the time, it's going to be a safe, comfortable outcome for the patient.
我不知道，99% 的情况下，这对患者来说都是安全、舒适的结果。
Andrew Huberman:
安德鲁·休伯曼：
Do they do LASIK on kids?
他们给孩子做 LASIK 手术吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
There are certain conditions, unusual corneal conditions where procedures like LASIK get used, but I believe it's ideal to not do it on children, or even young teenagers.
在某些情况下，不寻常的角膜状况，需要使用像 LASIK 这样的手术，但我认为最好不要对儿童甚至青少年进行这种手术。
And the reason goes back to what we were talking about before.
原因又回到了我们之前讨论的内容。
You are much more likely to change the shape of your eye, and therefore the prescription you need, and therefore what exactly the LASIK would laser while you're still in those growing years.
您更有可能改变眼睛的形状，从而改变您需要的处方，以及当您仍处于生长发育阶段时，LASIK 到底会激光什么。
And you really want to be able to say, "Hey, my eyeglasses prescription has not changed in the last two or three or five years." Because if you do LASIK and then your eye keeps changing shape, then by the next year, all of a sudden, the LASIK's not doing-- You're back in glasses again, right?
你真的希望能够说：“嘿，我的眼镜处方在过去两三年或五年里没有改变。”因为如果你做了 LASIK，然后你的眼睛形状不断改变，那么到了明年，突然间，LASIK 就不起作用了——你又重新戴上了眼镜，对吗？
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
You can do a touch-up LASIK, do a little bit more, but it's generally you're going to be a happier person if you've reached that point in your life, and maybe that's your late teens.
你可以做一次激光近视矫正手术，或者多做一点，但如果你达到了人生的那个阶段，通常你会成为一个更快乐的人，也许那是你十几岁的时候。
More commonly, it's into the 20s, where your eye has stopped changing its prescription every year.
更常见的是，到了 20 多岁，您的眼睛就不再每年更换处方了。
You've been steady and stable for some years, and now you do the LASIK, and it could easily last you a decade.
你已经稳定稳定地生活了好几年了，现在你做了 LASIK，它很容易就能让你持续十年。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned dry eye.
你提到了干眼症。
Get a lot of questions about dry eye, and a few years ago, I think you and I were at a meeting, and someone who is very woven in with the companies that build and test drugs for different aspects of vision health said, "You know what the field really needs is a treatment that works for dry eye." And I thought, "Dry eye?
收到很多关于干眼症的问题，几年前，我想你和我参加了一次会议，一位与为视力健康不同方面生产和测试药物的公司关系密切的人说，“你知道这个领域真正需要的是一种适用于干眼症的治疗方法。”我想，“干眼症？
Like of all things, why dry eye?" And then the more I learned about it, I realized that there are millions and millions of people that really suffer from dry eye, and for whom standard drops are just not working.
就像所有的事情一样，为什么会干眼呢？”随着我了解得越多，我意识到有数以百万计的人确实患有干眼症，而标准滴眼液对他们来说根本不起作用。
So what underlies dry eye?
那么干眼症的根源是什么？
Is it some deficiency in the lacrimal glands that produce tears for the eye?
是不是泪腺缺乏导致眼睛流泪？
And I think of tears as just kind of salty water, and I wonder if they are more than that.
我认为眼泪只是一种咸水，我想知道它们是否还不止于此。
Is there an oil in there?
里面有油吗？
And if we know what's in tears, why can't somebody just manufacture something that works as well as tears?
如果我们知道眼泪里有什么，为什么不能制造出像眼泪一样有效的东西呢？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
It turns out we've got a lot of other eye diseases, but by far, the most common eye disease, and I've been told by far the most common eye treatment purchased by anyone, now granted, it's almost always over-the-counter things like artificial tears, is for dry eye.
事实证明，我们还有很多其他眼部疾病，但到目前为止，最常见的眼部疾病，我听说迄今为止任何人购买的最常见的眼部治疗方法，现在理所当然，它几乎总是非处方药，如人工泪液，是治疗干眼症。
And in part that's because as we age, our tear quantity goes down and our tear quality goes down.
部分原因是随着年龄的增长，我们的泪液量和泪液质量都会下降。
And so what do those two mean?
那么这两个是什么意思呢？
We have two different major elements to tears, and as you alluded to, one is the saltwater part of the tears, and those are made primarily by the lacrimal gland, and there's a steady drip of those tears onto the ocular surface, as well as reflexive tearing, right?
眼泪有两种不同的主要成分，正如你提到的，一种是眼泪的盐水部分，它们主要由泪腺产生，这些眼泪会稳定地滴到眼表面，这就是反射性流泪，对吗？
If you get an eyelash in your eye or you cry, your lacrimal gland will actually squeeze out extra saltwater tears onto the surface of the eye.
如果睫毛进入眼睛或哭泣，泪腺实际上会将多余的盐水挤出到眼睛表面。
And so, that's where most of the wet part is coming from.
所以，这就是大部分潮湿部分的来源。
But there's also essential oils, critical oils.
但也有精油、临界油。
These come from other types of glands, including glands in our eyelids called meibomian glands.
它们来自其他类型的腺体，包括我们眼睑中称为睑板腺的腺体。
And the oils form a surface over the saltwater part of the tear film, and also intermix into the tears.
油脂在泪膜的盐水部分上形成表面，并与眼泪混合。
And as we age, we go down in the quantity of both saltwater part of our tears and oil part of our tears, but also the quality, and in particular, the oil parts can often be seen to be going down more quickly.
随着年龄的增长，眼泪中的盐水部分和眼泪中的油部分的数量都会下降，而且眼泪的质量也会下降，特别是油部分通常会下降得更快。
The eye drop industry has pretty much solved for replacing the saltwater part of your tears, right?
滴眼液行业已经基本解决了替换眼泪中的盐水部分的问题，对吗？
You can get either bottles of preservative-containing, you could use that bottle all month or for a month or two, or you can buy these strips of preservative-free artificial tears, which are really basically like the saltwater component.
您可以购买含有防腐剂的瓶子，您可以使用该瓶子整个月或一两个月，或者您可以购买这些不含防腐剂的人工泪液条，它们基本上就像盐水成分一样。
And you can use those preservative-free ones.
您可以使用那些不含防腐剂的。
We have patients using them every hour if they need to, right?
如果患者需要的话，我们每小时都会使用它们，对吧？
You're not going to hurt anything with preservative-free artificial tears.
使用不含防腐剂的人工泪液不会伤害任何东西。
Andrew Huberman:
安德鲁·休伯曼：
You just drop them in.
你只需要把它们放进去。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Just drop them in, yeah.
只要把它们放进去，是的。
Either eye as often as you want or need, when you feel it.
当你感觉到的时候，只要你愿意或需要，就可以经常看。
It's exacerbated in the world we live in, especially these days now with more time on computer.
在我们生活的世界中，这种情况更加严重，尤其是现在人们使用电脑的时间越来越多。
It turns out that when you read, including when we maybe used to read more books than we do now, but also read on the computer or stare at the computer screen or work on the computer, or actually just even watch the TV.
事实证明，当你读书的时候，包括我们以前可能读的书比现在多，但也会在电脑上看书或者盯着电脑屏幕或者在电脑上工作，或者实际上只是看电视。
I've done very careful studies.
我做了非常仔细的研究。
You blink less when you're doing any of those activities.
当您进行这些活动时，眨眼次数会减少。
And when you blink less, you're redistributing the tears less effectively, and you're squeezing out less of the tears, including less of the oils, as effectively as you could be when you're blinking.
当你眨眼次数减少时，你重新分配眼泪的效率就会降低，你挤出的眼泪（包括油脂）就会减少，而你眨眼时的效率就会降低。
And so between aging, tear quality, tear quantity, a lot of our activities, we're kind of in this losing proposition.
因此，在衰老、眼泪质量、眼泪数量以及我们的许多活动之间，我们有点处于这种失败的状态。
Now, I mentioned that we're pretty good at replacing the wet, salty part of our tears, but actually as an industry, we haven't really figured out, A, how to really effectively replace the oily part.
现在，我提到我们非常擅长替换眼泪中湿的、咸的部分，但实际上作为一个行业，我们还没有真正弄清楚如何真正有效地替换油性部分。
And the oils do a few things, including when you have a layer of oil on top of a layer of water, the water's less likely to evaporate.
这些油有很多作用，包括当一层水上面有一层油时，水就不太可能蒸发。
And so the oils help hold the tears on the surface of your eye.
因此，油有助于将泪水保留在眼睛表面。
And so if we're not making as many or as good oils as part of our tear film, that's also at kind of working against the saltwater part of our tears.
因此，如果我们没有制造出尽可能多或优质的油作为泪膜的一部分，这也会对我们眼泪中的盐水部分产生作用。
So yeah, as an industry, as a community, we haven't really figured out how to get the oil part solved for, either by effectively replacing the oils or treating our eyelids in a way, kind of rejuvenating those oil glands, getting them to go back to their youthful state again.
所以，是的，作为一个行业，作为一个社区，我们还没有真正弄清楚如何解决油脂问题，要么通过有效地更换油脂，要么以某种方式治疗我们的眼睑，使这些油腺恢复活力，让它们再次回到年轻状态。
So the eyes, including the eyelids and the oil glands, unfortunately, they're aging just like the rest of our body.
因此，不幸的是，眼睛，包括眼睑和油腺，它们就像我们身体的其他部分一样正在老化。
So this is one of the major features is dry eye, and it's tough on patients because you feel it.
因此，干眼症是主要特征之一，这对患者来说很困难，因为你能感觉到。
It's really tough because you feel it.
这真的很难，因为你感觉到了。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
I have yet another experience to report where when I had the blepharitis, which fortunately was transient, I also experienced it every time I would blink, I could feel the blink.
我还有另一次经历要报告，当我患有睑缘炎时，幸运的是这是暂时的，每次我眨眼时我也会经历它，我能感觉到眨眼。
And boy, I'll tell you, most of us take for granted what a pleasure it is to not observe the blinking of our eyes.
天哪，我告诉你，我们大多数人都认为不观察自己的眨眼是多么愉快的事情。
Because for those, I think it lasted about two weeks, every time I blink, I'd feel an almost sandpaper-like experience.
因为对于那些，我认为它持续了大约两周，每次我眨眼，我都会感觉到一种几乎像砂纸一样的体验。
It wasn't particularly painful, but it was very uncomfortable because you're suddenly conscious of every blink, and it's very distracting.
这并不是特别痛苦，但非常不舒服，因为你突然意识到每次眨眼，这非常分散注意力。
Now, that resolved when the blepharitis resolved, but I can't even imagine what it would be like to deal with that all day long every day.
现在，当睑缘炎解决后，这个问题就解决了，但我什至无法想象每天整天处理这个问题会是什么样子。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It'd be really dreadful.
那就真的太可怕了。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yes, it really is.
是的，确实如此。
And so you're absolutely right.
所以你是绝对正确的。
It's one of our really big unmet needs and although for most people with dry eye, it can be managed with just the regular over-the-counter artificial tear drops you can buy at the grocery store or over the counter at the pharmacy.
这是我们真正未满足的巨大需求之一，尽管对于大多数干眼症患者来说，只需在杂货店或药房柜台购买的常规非处方人工泪滴剂即可解决。
For a subset of people who have really much more severe symptoms with the dry eye, it's hard.
对于一部分干眼症状确实严重得多的人来说，这很难。
It's a really hard thing to have to live with all the time.
必须一直忍受这确实是一件很难的事情。
And we counsel on the use of tears, we counsel on the use of eyelid cleaning like we talked about before, where you take either these eyelid scrubs or a little dilute baby shampoo to keep those eyelashes really clean.
我们建议使用眼泪，我们建议使用眼睑清洁剂，就像我们之前讨论过的那样，你可以使用这些眼睑磨砂膏或一点稀释的婴儿洗发水来保持睫毛真正清洁。
That keeps those oil glands functioning at their top capacity for you, so that you're maximizing high-quality tear production.
这可以让这些油腺保持最佳状态，从而最大限度地产生高质量的泪液。
Reducing inflammation is also important, whether that's inflammation from allergy, and of course, a lot of people's dry eye gets much worse in the spring with seasonal allergies, when pollen is around, if you have dust allergies in your home, that worsens your symptomatic dry eye, or other forms of inflammation.
减少炎症也很重要，无论是过敏引起的炎症，当然，很多人的干眼症在春季因季节性过敏而变得更严重，当花粉在周围时，如果您家里有灰尘过敏，这会加重症状性干眼症或其他形式的炎症。
There's an element of dry eye that we actually think is a ...
我们实际上认为干眼症的一个因素是......
inflammation kind of working against our tear glands.
炎症会损害我们的泪腺。
And in fact, some of the prescription drops now to help combat more severe dry eye are anti-inflammatory or even low-dose steroid types of eye drops.
事实上，现在一些有助于对抗更严重干眼症的处方滴眼液是抗炎滴眼液，甚至是低剂量类固醇滴眼液。
So I think these are all sort of next generation treatments.
所以我认为这些都是下一代治疗方法。
I think at the really leading edge of next generation treatment is trying to better understand the nerves on the cornea and ocular surface, and if there are ways that we could better treat them and help regenerate and rejuvenate how the nerves and the tissue cells are interacting underneath that tear film.
我认为下一代治疗的真正前沿是试图更好地了解角膜和眼表面的神经，以及是否有方法可以更好地治疗它们并帮助再生和恢复神经和组织细胞在泪膜下相互作用的方式。
And that's where for some patients, we can actually use either, for example, blood serum.
对于某些患者来说，我们实际上可以使用其中的一种，例如血清。
Your blood serum is actually very rich in growth factors, and many of those growth factors, it turns out empirically are really helpful for people with dry eye.
您的血清实际上富含生长因子，并且根据经验证明，其中许多生长因子对干眼症患者确实有帮助。
So if you're one of those people who's been really struggling with dry eye, you might ask your eye care provider, "Hey, I heard about serum tears.
因此，如果您是那些一直在与干眼症作斗争的人之一，您可能会问您的眼科护理人员，“嘿，我听说过血清泪液。
Is that something that could help me?"
这有什么可以帮助我的吗？”
Andrew Huberman:
安德鲁·休伯曼：
Serum tears.
血清泪。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Serum.
血清。
Andrew Huberman:
安德鲁·休伯曼：
So is this PRP?
那么这是 PRP 吗？
Is this platelet-rich plasma?
这是富含血小板的血浆吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Related, but not the platelet-rich portion, at least not yet.
相关，但不是富含血小板的部分，至少目前还不是。
They can draw your blood, spin out all the cells.
他们可以抽取你的血液，旋转出所有的细胞。
You're left with the kind of liquid part of your blood, that's the serum, and then they can dilute that with some salt water, maybe with some preservatives in some cases.
你只剩下血液中的液体部分，那就是血清，然后他们可以用一些盐水稀释它，在某些情况下可能还用一些防腐剂。
You could keep it in your freezer, thaw out the bottle when you're ready to use it, each few weeks, and then use it just like an eyedropper bottle.
您可以将其放在冰箱中，每隔几周在准备使用时将瓶子解冻，然后像滴管瓶一样使用它。
And those serum tears actually can be very helpful for people with much more advanced or severe, hard to control dry eye symptoms.
这些血清泪液实际上对于患有更严重或严重、难以控制干眼症状的人非常有帮助。
Companies are really trying to figure out, "Hey, what are the most important parts of the serum?
公司确实想弄清楚，“嘿，血清中最重要的部分是什么？
Can we just identify and package just the growth factor and turn that into a product for dry eye patients?" And so there's a lot of research on the ocular surface and dry eye going into that space right now.
我们能否仅识别并包装生长因子，然后将其转化为针对干眼患者的产品？”因此，现在有很多关于眼表和干眼症的研究进入这个领域。
I'll tell you the one other recommendation that I always give patients.
我会告诉你我总是给病人的另一项建议。
There's a fair amount of evidence that if you're getting too much of some of these preservative chemicals, which of course if you're going to use an eye drop bottle for a month, it should have a preservative in it, right?
有相当多的证据表明，如果您摄入了过多的某些防腐剂化学物质，当然，如果您要使用一个月的滴眼液瓶，那么里面应该含有防腐剂，对吧？
So that you don't open the bottle and then it grows bacteria a couple of weeks later and now you're using contaminated eye drops.
这样你就不会打开瓶子，几周后它就会滋生细菌，而现在你正在使用受污染的眼药水。
So for bottles, it's typical to have preservatives, but I really recommend for patients, if they're using anything more than a couple drops here and there for their dry eye control, to actually go for one of the preservative-free artificial tears.
因此，对于瓶子来说，通常含有防腐剂，但我真的建议患者，如果他们为了控制干眼而使用的不仅仅是几滴，实际上应该选择一种不含防腐剂的人工泪液。
They come in lots of brands.
它们有很多品牌。
I'm sure the house brands at any of the pharmacies use them too, make them too.
我确信任何药店的自有品牌也使用它们，也制造它们。
And these are the ones that come in strips, plastic strips, and you break one off, you break off the little cap.
这些是条状的，塑料条状的，你折断其中一条，你就折断小盖子。
You could use as much as you want all day.
您可以一整天想用多少就用多少。
You have to throw that one out if you have anything left over.
如果你还有剩下的东西，你就必须把那个扔掉。
You have to throw it out at the end of the night, and the next day break off a new one because there's no preservatives, and once you open it, you don't want bacteria to grow in that salt water, right?
你必须在晚上把它扔掉，第二天再拆一个新的，因为没有防腐剂，一旦你打开它，你不想让细菌在盐水中生长，对吗？
But it's really good because the preservatives can be very irritating or even inflammatory to the ocular surface, to the surface of our eyes.
但这确实很好，因为防腐剂会对眼表、我们眼睛的表面产生很大的刺激甚至炎症。
So we really do want to, if we're using more than a drop or two, upgrade.
因此，如果我们使用的数量超过一两滴，我们确实希望升级。
They cost a little bit more money.
他们花了更多的钱。
They're still over the counter.
他们还在柜台上。
Upgrade yourself to the preservative-free artificial tears.
升级为不含防腐剂的人工泪液。
Andrew Huberman:
安德鲁·休伯曼：
Those are great recommendations.
这些都是很好的建议。
I'm also really interested in this serum thing, because were this discussion taking place 10 years ago and I raise PRP, platelet-rich plasma, there would probably be a lot of eye rolls, no pun intended, because I think myself and a lot of other people in the, let's call it the standard scientific and medical community, looked at platelet-rich plasma right alongside stem cell therapies because they were cheek to jowl back then, as you recall, before the FDA regulations about stem cell claims, which we will get to.
我对血清的事情也很感兴趣，因为如果这个讨论发生在 10 年前，我提出 PRP（富含血小板血浆），可能会有很多白眼，没有双关语，因为我认为我自己和标准科学和医学界的许多其他人都将富含血小板血浆与干细胞疗法一起研究，因为你还记得，当时它们是贴身的，在 FDA 对干细胞声明的规定之前，我们将谈到这一点。
Of course, PRP was suggested as a source of stem cells.
当然，PRP 被建议作为干细胞的来源。
It turns out there are very few, if any, true stem cells in PRP.
事实证明，PRP 中真正的干细胞即使有也很少。
And yet now, as I understand it, PRP is an FDA-approved protocol for injection into the uterus, injection into pretty much every tissue and organ system of the body in order to, quote-unquote, rejuvenate it.
然而现在，据我了解，PRP 是 FDA 批准的一种注射方案，用于注射到子宫中，注射到身体的几乎每个组织和器官系统中，以便使之恢复活力。
And here I'm not promoting PRP, and yet it is a very common practice now in more standard medical clinics, but it started off kind of niche, even gray market, kind of underground.
在这里，我并不是在推广 PRP，但它现在在更标准的医疗诊所中是一种非常常见的做法，但它始于某种利基市场，甚至是灰色市场，某种地下市场。
It's diverged from stem cell therapies, and we're going to talk about major modes of vision loss in a moment, and this horrible situation that happened down in Florida of a clinic injecting stem cells into patients' eyes to recover vision, and it actually blinded them.
它与干细胞疗法不同，我们稍后将讨论视力丧失的主要模式，以及佛罗里达州一家诊所向患者的眼睛注射干细胞以恢复视力的可怕情况，结果实际上使他们失明。
So we'll talk about stem cell therapies.
所以我们将讨论干细胞疗法。
But for the record, is PRP something that's now standard in major ophthalmic clinics, excuse me, including your department at Stanford?
但郑重声明一下，请问，PRP 现在是主要眼科诊所（包括您在斯坦福大学的部门）的标准配置吗？
Are you drawing out blood, spinning it down, taking plasma, taking serum, and reinjecting it or reapplying it to patients' eyes?
您是否会抽出血液，将其离心，提取血浆，提取血清，然后重新注射或重新涂抹到患者的眼睛上？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Not yet in ophthalmology, in eye clinics.
眼科、眼科诊所还没有。
I would say we're sort of right now on the edge of groups are starting to study that.
我想说，我们现在正处于开始研究这一点的边缘。
Is it safe?
安全吗？
Is it valuable?
有价值吗？
Is it any better for certain conditions, like on the ocular surface, than serum tears, for example, this sort of diluting a patient's own blood serum?
对于某些情况，例如在眼表面，它是否比血清泪液更好，例如稀释患者自身的血清？
So it's being studied.
所以正在研究它。
It's a very active area.
这是一个非常活跃的领域。
Now it turns out that this PRP plasma has again, a high concentration of growth factors.
现在事实证明，这种 PRP 血浆再次含有高浓度的生长因子。
That's probably what's responsible for a lot of the kind of, quote, tissue rejuvenation effects, be they as they may.
这可能就是造成许多组织再生效应的原因，无论它们可能如何。
But it's being studied, but it's definitely not a standard of care yet, at least in ophthalmology space.
但它正在研究中，但它绝对还不是护理标准，至少在眼科领域是这样。
And I think Whenever there's something really new, it really deserves to be properly studied.
我认为只要有真正新的东西，它就确实值得好好研究。
We talked before about at first you're going to do trials where you just test it carefully in a few people, maybe a few of the most severely affected patients.
我们之前谈到过，首先你要进行试验，在少数人身上仔细测试，也许是一些受影响最严重的患者。
Be really thoughtful about the ethics of trying out for safety.
认真考虑尝试安全的道德规范。
Then, as you develop a little understanding of the safety, you really want to eventually get to properly controlled, randomized, what people in the community often call double-blind trials, but we in ophthalmology like to call double-masked trials.
然后，当您对安全性有了一点了解时，您确实希望最终能够进行适当控制的随机试验，社区中的人们通常称之为双盲试验，但我们在眼科领域喜欢称之为双盲试验。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Blind is a bad word in an ophthalmology-
盲在眼科里是个坏词——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
That's right.
没错。
We don't want any blind trials
我们不想要任何盲目的试验
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
So you really want properly controlled trials testing, is it really working?
那么您确实想要进行适当的对照试验测试，它真的有效吗？
Does it really deserve the claims that people are making?
它真的值得人们所说的吗？
And that has not yet really come to fruition at that level for ophthalmology or eye care yet.
对于眼科或眼科护理来说，这一点还没有真正实现。
Andrew Huberman:
安德鲁·休伯曼：
So we've been talking a lot about normal visual development, eye checks, and some of the more typical challenges that people have with their vision, but we haven't yet touched on some of the really debilitating stuff.
因此，我们一直在谈论正常的视觉发育、眼睛检查以及人们在视力方面遇到的一些更典型的挑战，但我们还没有触及一些真正使人衰弱的东西。
Things like glaucoma, things like retinitis pigmentosa, macular degeneration, the things that if we could, we would all avoid, and yet are out there in the world at pretty high rates.
像青光眼、色素性视网膜炎、黄斑变性这样的疾病，如果可以的话，我们都会避免，但在世界上它们的发病率相当高。
I'm sure you'll share with us what those rates are.
我相信您会与我们分享这些费率是多少。
And as bad as these things are, there are ways to detect and offset their progression so that people don't necessarily lose their vision.
尽管这些事情很糟糕，但还是有办法检测和抵消它们的进展，这样人们就不一定会失去视力。
So if you could, can you share with us what are the major forms of vision loss in childhood and in adulthood, and what can each and all of us do in order to find out if we have one of these conditions, and therefore treat it effectively?
那么，如果可以的话，您能否与我们分享一下儿童期和成年期视力丧失的主要形式是什么？我们每个人都可以做些什么来找出我们是否患有其中一种病症，从而有效地治疗它？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's great.
那太棒了。
Let's start by just reminding ourselves what are the major causes of vision loss.
让我们首先提醒自己视力丧失的主要原因是什么。
And these are going to differ where you are in the world, but the number one cause of low vision is actually refractive error.
这些都会因你在世界各地而有所不同，但低视力的首要原因实际上是屈光不正。
People who need glasses, and especially in other countries, affordability, access, can't even get glasses, okay?
需要眼镜的人，尤其是在其他国家，有能力、有机会的人，甚至都买不到眼镜，好吗？
So that's just refractive error, but that's fundamentally correctable.
所以这只是屈光不正，但基本上是可以矫正的。
The next most common cause of vision loss is cataract.
视力丧失的第二个最常见原因是白内障。
Cataract is the blurring, the aging of the lens inside the eye, behind the cornea.
白内障是指角膜后面的眼睛内部晶状体模糊、老化。
We talked about how that is responsible for focusing light onto the back of the eye.
我们讨论了它如何将光线聚焦到眼睛后部。
It also has to be clear enough that the light gets through the lens.
它还必须足够清晰，以便光线能够穿过镜头。
And a cataract is a normal aging process.
白内障是正常的衰老过程。
As I said, if we all live to 100 or 110 years old, we'll all get cataracts, we'll all need cataract surgery.
正如我所说，如果我们都活到 100 岁或 110 岁，我们都会患白内障，我们都需要进行白内障手术。
We actually, in the eye clinic, we see cataracts years or even decades before they're affecting your vision in a meaningful way.
实际上，在眼科诊所中，我们在白内障以有意义的方式影响您的视力之前几年甚至几十年就看到了白内障。
So the cataracts are forming, and that's okay, but at some point they get bad enough that it's time to take them out.
白内障正在形成，这没关系，但到了某个时候，它们会变得很严重，需要将其摘除。
We've actually solved for cataract surgery pretty efficiently.
事实上，我们已经非常有效地解决了白内障手术的问题。
We can do a four-to-eight-minute surgery.
我们可以进行四到八分钟的手术。
Maybe if we're taking our time, it's 10 or 12 minutes of surgical time.
如果我们慢慢来的话，手术时间可能是 10 或 12 分钟。
Take out a cataract, it works beautifully 99-point-something percent of the time.
除去白内障，它在 99% 左右的时间里效果都很好。
We put a clear plastic lens inside the eye, exactly where your lens used to be, and there's even lenses that can flex or focus light from far and near.
我们在眼睛内放置了一个透明的塑料镜片，就在您的镜片原来所在的位置，甚至还有可以弯曲或聚焦远近光线的镜片。
So cataract, there's still room for improvement, but it's fundamentally a solved problem.
所以说白内障，还有改进的空间，但是从根本上已经解决了。
The problem is that worldwide, there aren't enough cataract surgeons, there's not access to care, the machinery or the lenses cost too much money in developing countries to get out to the number of people who would need them.
问题是，在世界范围内，没有足够的白内障外科医生，无法获得护理，在发展中国家，机器或镜片的成本太高，无法满足需要它们的人数的需求。
So it's actually just, again, an access to care.
所以这实际上只是再次获得护理。
Cataract is a reversible, treatable, easily treatable problem, but it's number two on the list of causes of vision loss in the world because we don't have enough access to care.
白内障是一种可逆、可治疗、容易治疗的问题，但由于我们没有足够的护理机会，它在世界视力丧失原因中排名第二。
We need a lot more programming around global ophthalmology, global eye care to solve for cataract, just to bring that solution to countries around the world.
我们需要围绕全球眼科、全球眼保健开展更多规划来解决白内障问题，只是为了将该解决方案带给世界各国。
Then after that, you start hitting the eye diseases that lead to what are currently irreversible, non-reversible causes of vision loss.
然后，您开始患上眼部疾病，这些疾病会导致目前不可逆转的视力丧失。
The number one cause of irreversible vision loss in the world is glaucoma.
世界上导致不可逆视力丧失的第一大原因是青光眼。
So what is glaucoma?
那么什么是青光眼呢？
Glaucoma is actually probably a little cluster or constellation of diseases that we lump together.
青光眼实际上可能是我们混为一谈的一小群或一组疾病。
It's a degenerative disease, like a neurodegeneration.
这是一种退行性疾病，就像神经退行性疾病一样。
We talk about neurodegenerations in the brain, like Alzheimer's and Parkinson's.
我们谈论大脑中的神经退行性疾病，例如阿尔茨海默氏症和帕金森氏症。
Glaucoma is a neurodegenerative disease.
青光眼是一种神经退行性疾病。
Instead of affecting one or a different area in your brain, it happens to affect the optic nerve that connects the eye to the brain.
它不会影响大脑中的一个或不同区域，而是会影响连接眼睛和大脑的视神经。
And we need our optic nerves to carry all the visual information from the eye to the brain.
我们需要视神经将所有视觉信息从眼睛传递到大脑。
And so if your optic nerve is degenerating in glaucoma, and I should add, there are other optic neuropathies, so-called diseases of optic nerve degeneration.
因此，如果您的青光眼导致视神经退化，我应该补充一点，还有其他视神经病变，即所谓的视神经退化疾病。
For example, you can get a stroke of the optic nerve.
例如，您可能会出现视神经中风。
You can have an inflammatory disease like multiple sclerosis called optic neuritis that affects the optic nerve.
您可能患有一种炎症性疾病，如多发性硬化症（称为视神经炎），会影响视神经。
So you can get other optic nerve diseases.
所以你可能会患上其他视神经疾病。
But glaucoma is by far the most common optic neuropathy.
但青光眼是迄今为止最常见的视神经病变。
And the problem is just like spinal cord injury, which is also part of the central nervous system, right?
问题就像脊髓损伤一样，它也是中枢神经系统的一部分，对吧？
The brain, the spinal cord, the retina, and the optic nerve.
大脑、脊髓、视网膜和视神经。
That's the central nervous system.
那是中枢神经系统。
And there's no regeneration, and that's why spinal cord injury leads to permanent paralysis.
并且没有再生能力，这就是脊髓损伤导致永久性瘫痪的原因。
Well, optic nerve injury or optic nerve degeneration unfortunately leads to permanent vision loss.
不幸的是，视神经损伤或视神经变性会导致永久性视力丧失。
So in the case of glaucoma, how do we get ahead of that Glaucoma has two major risk factors.
因此，就青光眼而言，我们如何预防青光眼有两个主要危险因素。
One is increasing age.
一是年龄增长。
There are actually infantile and pediatric glaucomas, unfortunately, and those can be much more aggressive, much more damaging when they present so early in kids, in babies, and in children.
不幸的是，实际上存在婴儿和小儿青光眼，当这些青光眼在儿童、婴儿和儿童中如此早期出现时，它们的侵袭性和破坏性会更大。
Most of the kind of run-of-the-mill glaucoma usually presents in adulthood, and even in the aging adult.
大多数普通青光眼通常出现在成年期，甚至老年期。
So much more common after 50, or 60, or 70 years old, increasing.
50 岁、60 岁或 70 岁以后更常见，而且还在增加。
The other main risk factor for glaucoma is increasing eye pressure.
青光眼的另一个主要危险因素是眼压升高。
The eye actually stays inflated.
眼睛实际上保持充气状态。
It's a balloon.
这是一个气球。
It has to stay inflated.
它必须保持充气状态。
We need some amount of eye pressure to keep our eye as an inflated balloon.
我们需要一定的眼压才能让我们的眼睛像充气的气球一样。
But if the eye pressure goes too high, and we talked about this before, you won't even feel it if it slowly gets too high.
但如果眼压太高，我们之前谈到过，慢慢太高你甚至感觉不到。
If the eye pressure goes too high, that causes glaucoma.
如果眼压过高，就会导致青光眼。
And that's one of the things that we talked about.
这就是我们讨论的事情之一。
You really include in a comprehensive eye exam, when you're just getting a screening checkup at your eye care provider, at your optometrist or ophthalmologist office, they're going to check your pressure and just as a screening tool, check to make sure it's not too high.
您确实将其纳入全面的眼科检查中，当您刚刚在眼科护理人员、验光师或眼科医生办公室进行筛查检查时，他们会检查您的眼压，并作为筛查工具，检查以确保压力不会太高。
We can treat glaucoma today by trying to reduce the impact of that high pressure, by lowering the eye pressure.
今天，我们可以通过降低眼压来减少高压的影响来治疗青光眼。
So we have treatments for glaucoma that target the eye pressure.
因此，我们有针对眼压的青光眼治疗方法。
We have medications like eye drops.
我们有眼药水之类的药物。
We have lasers that can be used inside the eye that can also lower the eye pressure.
我们有可以在眼内使用的激光，也可以降低眼压。
And ultimately, if we need them, we also have surgeries that can also provide an outflow that lets the fluid out of the eye in a controlled way, so that the eye pressure can be brought back down into normal ranges.
最终，如果我们需要的话，我们还可以进行手术，以可控的方式让液体流出眼睛，从而使眼压恢复到正常范围。
Again, the reason that glaucoma ends up being the number one cause of irreversible blindness in the world is number one, we can't get those therapies everywhere in the world.
再说一遍，青光眼最终成为世界上不可逆失明的第一大原因，原因是我们无法在世界各地获得这些治疗方法。
The affordability of eye drops, the access to lasers or surgical procedures around the world isn't equal to what it is here.
世界各地眼药水的承受能力、激光或外科手术的可及性与这里不同。
And even within our country, people may not be accessing healthcare effectively to get screened for glaucoma or to get treated for glaucoma.
即使在我们国家，人们也可能无法有效地获得医疗保健来进行青光眼筛查或青光眼治疗。
The other big problem with glaucoma is that it affects our peripheral vision first, and only very late in the disease does it pinch in and finally pinch off the center of our vision in typical glaucomas.
青光眼的另一个大问题是，它首先影响我们的周边视力，只有在疾病的晚期，它才会挤压并最终挤压典型青光眼中我们的视力中心。
And that's a real problem because we don't notice if our peripheral vision is down.
这是一个真正的问题，因为我们没有注意到我们的周边视力是否下降。
Our peripheral vision isn't that good to begin with, and if you're driving and you can see a pedestrian step off the sidewalk, you think your peripheral vision is fine, but actually, your peripheral vision could already start being damaged by glaucoma, and you won't notice it in regular daily life.
我们的周边视力本来就不太好，如果你在开车时看到人行道上有一个行人走下来，你会认为自己的周边视力很好，但实际上，你的周边视力可能已经开始受到青光眼的损害，而你在日常生活中不会注意到这一点。
And that's where the importance of screening and early detection really comes in for glaucoma.
这就是青光眼筛查和早期检测的重要性所在。
What we don't have for glaucoma, we can come back to what's the cutting edge of the future in these eye diseases.
对于青光眼我们没有什么，我们可以回到这些眼病的未来前沿。
What we don't have are treatments that really target the optic nerve degenerative process, and we can come back and talk about that.
我们没有真正针对视神经退行性过程的治疗方法，我们可以回来讨论这个问题。
So that's glaucoma and optic neuropathies.
这就是青光眼和视神经病变。
Then the next two major causes of currently largely irreversible vision loss are age-related macular degeneration, and then diabetic retinopathy.
目前造成不可逆转视力丧失的下两个主要原因是年龄相关性黄斑变性，然后是糖尿病性视网膜病变。
Now, age-related macular degeneration is just like it sounds.
现在，年龄相关性黄斑变性就像听起来一样。
Major risk factor is age.
主要危险因素是年龄。
It's very common.
这很常见。
And actually, in the developed world, countries that are more developed, also countries that have a larger Caucasian white population, it's more common in certain populations than in others.
事实上，在发达国家，更发达的国家，还有白人人口较多的国家，这种情况在某些人群中比在其他人群中更常见。
It actually is definitely a leading cause of vision loss in the elderly population, for example, in the United States.
事实上，它绝对是老年人口视力丧失的主要原因，例如在美国。
And there's two forms of macular degeneration, but they both end up targeting the same part of the retina.
黄斑变性有两种形式，但它们最终都针对视网膜的同一部分。
And that part of the retina is really the rods and the cones that we talked about before.
视网膜的那部分实际上就是我们之前讨论过的视杆细胞和视锥细胞。
The rods do your low-light vision at nighttime, primarily your cones do color vision and bright light, sort of normal lighting that we experience through most of our awake day.
视杆细胞在夜间负责弱光视觉，视锥细胞主要负责色觉和强光，这是我们在白天大部分时间所经历的正常照明。
And in that back of the retina, you can have what's called dry macular degeneration, which is a slow, thankfully slow, but slow, insidious disease that causes the degeneration of the rods and cones, and also the support cells that help feed the rods and cones and take care of the rods and cones.
在视网膜的后部，你可能会患上所谓的干性黄斑变性，这是一种缓慢的、值得庆幸的是缓慢的疾病，但缓慢、阴险，会导致视杆细胞和视锥细胞以及帮助喂养视杆细胞和视锥细胞并照顾视杆细胞和视锥细胞的支持细胞退化。
They're called RPE cells, retinal pigment epithelium.
它们被称为 RPE 细胞，即视网膜色素上皮细胞。
It's not really critical, of course, the names of every different cell type.
当然，每种不同细胞类型的名称并不重要。
But these are the light-collecting cells in our eyes in the retina, and they degenerate in macular degeneration.
但这些是我们眼睛视网膜中的光收集细胞，它们会在黄斑变性中退化。
And in the dry form, there's this slow degeneration, but some percent of people with the dry form of macular degeneration will actually convert to what's called the wet form.
在干性黄斑变性中，会发生缓慢的变性，但有一定比例的干性黄斑变性患者实际上会转变为所谓的湿性黄斑变性。
It's called wet because new blood vessels actually grow inappropriately under and even into the retina.
之所以称为湿，是因为新血管实际上在视网膜下方甚至进入视网膜中不适当地生长。
And new blood vessels, unlike our mature blood vessels, tend to be leaky, and so the fluid leaks out of those blood vessels, gets into the retina, interferes with vision, and that can lead to a much more acute loss of vision.
与我们成熟的血管不同，新血管往往会渗漏，因此液体从这些血管中渗漏出来，进入视网膜，干扰视力，这可能会导致更严重的视力丧失。
Now, we have some treatments for wet macular degeneration.
现在，我们有一些治疗湿性黄斑变性的方法。
We have injections that can go into the eye that actually fight against the molecules that are causing those new blood vessels to grow.
我们有可以进入眼睛的注射剂，实际上可以对抗导致新血管生长的分子。
And these are antibodies that can be injected into the eye, and they can be very effective controlling patients' wet macular degeneration.
这些抗体可以注射到眼睛中，可以非常有效地控制患者的湿性黄斑变性。
It's been a much bigger uphill battle, even over the last decade as advances are being made, to really try to knock back or slow down even the dry form of macular degeneration.
即使在过去的十年里，随着技术的不断进步，要真正尝试击退或减缓甚至是干性黄斑变性，这也是一场更大的艰苦战斗。
There was just some exciting news, even just in the last few months.
即使是在过去的几个月里，也有一些令人兴奋的消息。
The first successful trials of a treatment for the dry form have just shown success in properly randomized controlled human clinical trials, phase three clinical trials.
干型治疗的首次成功试验刚刚在适当的随机对照人体临床试验（三期临床试验）中取得了成功。
So it's an exciting time.
所以这是一个令人兴奋的时刻。
Those new treatments are not going to be a panacea.
这些新疗法不会成为灵丹妙药。
They slow the progression, like an anatomic progression of the disease, maybe by 20 or 25%.
它们可以减缓疾病的进展，就像疾病的解剖学进展一样，可能减缓 20% 或 25%。
So patients are still going to get worse even with those treatments, so there's still a lot more to be done to really knock back macular degeneration.
因此，即使接受这些治疗，患者的病情仍然会变得更糟，所以要真正击退黄斑变性，还有很多工作要做。
I want to mention, you mentioned retinitis pigmentosa.
我想提一下，你提到了色素性视网膜炎。
That's like an inherited form of a type of macular degeneration.
这就像一种黄斑变性的遗传形式。
It's also affecting the rods and cones and also the support cells, the RPE cells in the back of the eye.
它还影响视杆细胞和视锥细胞以及支持细胞，即眼睛后部的视网膜色素上皮细胞。
Retinitis pigmentosa is an inherited form.
色素性视网膜炎是一种遗传形式。
There are actually many different genes you could have that could leave to retinitis pigmentosa.
实际上，您可能拥有许多不同的基因，这些基因可能会导致色素性视网膜炎。
In aggregate, if you add up all the people with all those different genes, and it can be very devastating because it can really affect the vision, knock out your vision very early in life, including in children and even versions of that in babies.
总的来说，如果你把所有拥有这些不同基因的人加起来，这可能是非常具有破坏性的，因为它确实会影响视力，在生命的早期就破坏你的视力，包括儿童甚至婴儿的视力。
But you add that all up, it's still much less common in aggregate than macular degeneration, but in a way, it's quite a bit more severe because it does affect people much earlier in life.
但总的来说，它仍然比黄斑变性少见得多，但在某种程度上，它要严重得多，因为它确实会影响人们更早的生命。
So I sort of clump those together, macular degeneration, retinitis pigmentosa, degeneration of the rods and cones and the support cells, the RPE support cells.
所以我把这些归结在一起，黄斑变性、色素性视网膜炎、视杆细胞和视锥细胞以及支持细胞、RPE支持细胞的变性。
And then you can't have this part of the discussion about what are the devastating eye diseases without bringing up diabetic retinopathy, especially because diabetes, unfortunately, really continues to grow in, especially, let's say, in the United States, certainly in the developed world, especially type 2 diabetes, with eating habits, exercise habits contributing to a proliferation of some of the risk factors for type 2 diabetes, metabolic syndrome, obesity.
然后，在讨论什么是毁灭性眼病时，你就不能不提到糖尿病视网膜病变，特别是因为不幸的是，糖尿病确实在继续增长，尤其是在美国，当然是在发达国家，尤其是 2 型糖尿病，饮食习惯、运动习惯导致 2 型糖尿病、代谢综合征、肥胖的一些危险因素的扩散。
We're unfortunately seeing a proliferation, a growth in the number of people with diabetes.
不幸的是，我们看到糖尿病患者数量激增。
And with the growth in diabetes, unfortunately, comes a growth of the complications of diabetes.
不幸的是，随着糖尿病发病率的增加，糖尿病并发症也随之增加。
And one of the major complications of diabetes is damage to the retina inside the eye, and we call that diabetic retinopathy.
糖尿病的主要并发症之一是眼内视网膜的损伤，我们称之为糖尿病性视网膜病变。
And there again, some of the same damage that occurs, especially when in diabetes, again, some new blood vessels are growing or blood vessels are leaky.
再次出现一些相同的损害，特别是在糖尿病中，再次，一些新血管正在生长或血管渗漏。
Some of that can be treated with, it used to be lasers, and now more commonly is often being treated with some of the same injectable drugs that are treating macular degeneration.
其中一些可以用激光治疗，现在更常见的是用一些与治疗黄斑变性相同的注射药物进行治疗。
But there's still a lot of vision loss with diabetes and diabetic retinopathy.
但糖尿病和糖尿病性视网膜病变仍然导致大量视力丧失。
I think that's an area where, again, early screening, making sure if you have diabetes, that's an indication where you definitely have to be going in and getting your at least annual exam with an eye care provider or having someone take a photograph of the inside of your eye and rate that photograph to say if you have any diabetic retinopathy or not.
我认为，在这个领域，再次进行早期筛查，确保您是否患有糖尿病，这表明您肯定必须去眼科护理人员那里进行至少一年一次的检查，或者让某人给您的眼睛内部拍一张照片，并对照片进行评分，以确定您是否患有糖尿病视网膜病变。
Andrew Huberman:
安德鲁·休伯曼：
In terms of interventions, can we talk about diabetic retinopathy first?
在干预方面，我们可以先谈谈糖尿病视网膜病变吗？
Because, of course, type 1 diabetes is a failure to produce insulin, relatively rare compared to type 2 diabetes, which as you mentioned, is proliferating in developing countries, right?
当然，因为 1 型糖尿病是无法产生胰岛素，与 2 型糖尿病相比相对罕见，正如您提到的，2 型糖尿病在发展中国家正在激增，对吗？
This is probably unprecedented in the sense that developing countries have better medical care typically than non-developed countries, more opportunities for food nourishment, and yet it's clearly a problem of over-nourishment, insulin insensitivity, obesity, et cetera.
这可能是前所未有的，因为发展中国家通常比非发达国家拥有更好的医疗保健，有更多的食物营养机会，但显然存在营养过度、胰岛素不敏感、肥胖等问题。
Is the type of diabetic retinopathy that one observes the same for type 1 diabetics versus type 2 diabetics?
1 型糖尿病患者与 2 型糖尿病患者观察到的糖尿病视网膜病变类型是否相同？
Because my understanding is that type 2 diabetes, this insulin insensitivity, is a bit of a continuum, right?
因为我的理解是，2 型糖尿病，这种胰岛素不敏感，有点连续，对吧？
Type 1 diabetes, as far as I know, is all or none.
据我所知，1 型糖尿病要么全有，要么全无。
You either make insulin or you don't.
你要么制造胰岛素，要么不制造。
But type 2 diabetes, someone could be mildly insulin insensitive or severely insulin insensitive.
但对于 2 型糖尿病，某人可能会出现轻度胰岛素不敏感或严重胰岛素不敏感。
And sometimes I'm told people are not necessarily obese and can have type 2 diabetes as well.
有时我被告知人们不一定是肥胖的，也可能患有 2 型糖尿病。
Certainly things like smoking and alcohol intake can contribute to that.
当然，吸烟和饮酒等因素也会导致这种情况。
So how equivalent are type 1 and type 2 diabetes when framed under the umbrella of diabetic retinopathy?
那么，如果将 1 型糖尿病和 2 型糖尿病归入糖尿病视网膜病变的范畴，它们的等效性如何呢？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
The time to presentation can be different.
演示的时间可能会有所不同。
A type 1 diabetic usually presents with sort of a cataclysmic sudden loss, sudden sort of final loss of their ability to make insulin.
1 型糖尿病患者通常会出现某种灾难性的突然丧失，突然最终丧失制造胰岛素的能力。
It usually presents in childhood or teenage years, but can present, you can have late onset type 1 diabetes.
它通常出现在儿童期或青少年时期，但也可能出现迟发型 1 型糖尿病。
Because it's kind of a sudden presentation, it can take some years after that to show any diabetic retinopathy.
因为这是一种突然的表现，所以可能需要几年的时间才能表现出任何糖尿病视网膜病变。
Whereas just like you said, type 2 diabetes can be on a continuum.
正如您所说，2 型糖尿病可能是一个连续体。
People can have a mild type 2 diabetes, but be getting along, going through life, maybe not even realizing at first.
人们可能患有轻度 2 型糖尿病，但在相处、度过一生时，可能一开始甚至没有意识到。
And so when you're diagnosed with type 2 diabetes, you've probably had some insulin resistance for the years prior to your diagnosis.
因此，当您被诊断患有 2 型糖尿病时，在诊断之前的几年里，您可能已经存在一定的胰岛素抵抗。
And so in that case, you're at higher risk for presenting sooner with the complications of diabetes, like diabetic retinopathy.
因此，在这种情况下，您较早出现糖尿病并发症（如糖尿病视网膜病变）的风险更高。
Now, given that the actual retinopathy ...
现在，考虑到实际的视网膜病变......
is very similar, maybe the same, between type 1 diabetes and type 2 diabetes.
1 型糖尿病和 2 型糖尿病之间非常相似，甚至可能相同。
And again, it involves things like leaky blood vessels, new blood vessel growth.
再说一次，它涉及血管渗漏、新血管生长等问题。
There's some amount of neurodegenerative dysfunction that just simply occurs.
有些神经退行性功能障碍只是自然发生的。
So you can have little hemorrhages or bleeding spots in the retina, tiny little strokes or microvascular events in the retina.
因此，视网膜上可能会出现少量出血或出血点、视网膜中出现微小的中风或微血管事件。
So that can happen in either type 1 or type 2 diabetes.
因此，这种情况可能发生在 1 型或 2 型糖尿病中。
Once you start having the retinopathy, it does look pretty similar.
一旦你开始患有视网膜病变，它看起来确实非常相似。
Andrew Huberman:
安德鲁·休伯曼：
So what can people do to prevent or treat diabetic retinopathy?
那么人们可以做些什么来预防或治疗糖尿病视网膜病变呢？
Obviously, the type 1 diabetic needs to take insulin in order to survive, really.
显然，1 型糖尿病患者确实需要服用胰岛素才能生存。
Type 2 diabetics need to get their obesity under control, if they are in fact obese, and get their blood sugar levels under control, regardless.
无论如何，2 型糖尿病患者需要控制肥胖（如果他们确实肥胖的话），并控制血糖水平。
That's my understanding.
这是我的理解。
And by extension, are you seeing any reductions in diabetic retinopathy with people that are taking these glucagon-like peptide mimics, like Ozempic, which is used to treat type 2 diabetes?
推而广之，您是否发现服用这些胰高血糖素样肽模拟物（例如用于治疗 2 型糖尿病的 Ozempic）的人的糖尿病视网膜病变有所减少？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
It's been a very exciting development for the diabetes field, this new class of anti-diabetic drugs.
对于糖尿病领域来说，这种新型抗糖尿病药物是一个非常令人兴奋的发展。
And so you've touched on a couple of them.
所以你已经谈到了其中的几个。
There are a few key things for reducing the risk of diabetes, or the impact of diabetes on your retina, risk of diabetic retinopathy, or impact of diabetes on your retina.
有一些关键因素可以降低患糖尿病的风险或糖尿病对视网膜的影响、糖尿病性视网膜病变的风险或糖尿病对视网膜的影响。
One is, as I mentioned, get regular eye exams, be screened.
正如我提到的，其中之一是定期进行眼科检查和筛查。
Any diabetic should be screened at least once a year with a good comprehensive retinal exam looking for any of these items.
任何糖尿病患者都应该每年至少进行一次全面的视网膜检查，以寻找这些项目。
The number one most important element to prevent diabetic retinopathy is to control your diabetes, and having a real good blood sugar control, keeping your hemoglobin A1C, which is one of the blood tests that gets used to measure how your long-term diabetes management is going.
预防糖尿病视网膜病变的第一个最重要的因素是控制您的糖尿病，并进行真正良好的血糖控制，保持糖化血红蛋白，这是用于衡量您的长期糖尿病管理进展情况的血液测试之一。
That's really, first and foremost, the most important, and that's been shown in large clinical trials.
这确实是最重要的，并且已经在大型临床试验中得到了证明。
They actually randomized patients to, "Hey, take care of your diabetes, or do a real good job taking care of your diabetes." And the patients who did a real good job taking care of their diabetes have much less diabetic retinopathy.
他们实际上将患者随机分组，“嘿，照顾好你的糖尿病，或者好好照顾你的糖尿病。”那些在糖尿病治疗方面做得非常好的患者，其糖尿病性视网膜病变的发生率要低得多。
So that's number one.
所以这是第一。
It turns out that if you have high blood pressure and diabetes, that blood pressure is also really damaging to your retina, also, by the way, the kidneys, and probably all the other organs that are suffering from the diabetic insult.
事实证明，如果您患有高血压和糖尿病，那么血压也会真正损害您的视网膜，顺便说一句，还会损害肾脏，可能还损害所有其他遭受糖尿病损害的器官。
So in addition to controlling blood sugar, really important to have blood pressure under great control.
所以除了控制血糖之外，控制好血压也很重要。
Now, both blood sugar and blood pressure in type 2 diabetics, especially if you're catching them early, can be improved with some of these so-called lifestyle changes.
现在，2 型糖尿病患者的血糖和血压，特别是如果您发现得早，可以通过一些所谓的生活方式改变来改善。
Like improving eating, watching what your food intake is, getting good exercise, trying to lose weight.
比如改善饮食、注意食物摄入量、进行良好的锻炼、尝试减肥。
So, these are definitely on that list of how do you get to good blood sugar and blood pressure control.
因此，这些肯定都在如何实现良好血糖和血压控制的清单上。
But suffice it to say, blood sugar and blood pressure control, right at the top, and then also including the regular, at least annual exams.
但我只想说，血糖和血压控制是最重要的，然后还包括定期的、至少每年一次的检查。
And then if diabetic retinopathy is detected, and blood sugar and blood pressure control are not going to be enough for that patient, we do have treatments.
然后，如果检测到糖尿病视网膜病变，并且血糖和血压控制对该患者来说还不够，我们确实有治疗方法。
As I mentioned before, there are drugs that can be injected if your retina is getting leaky blood vessels from diabetes.
正如我之前提到的，如果您的视网膜因糖尿病而出现血管渗漏，可以注射一些药物。
There are treatments that we can give the eye specifically to try to counter the diabetic retinopathy.
我们可以采取一些专门针对眼睛的治疗方法来对抗糖尿病视网膜病变。
Andrew Huberman:
安德鲁·休伯曼：
Terrific.
太棒了。
In terms of glaucoma, as you mentioned, glaucoma is related to pressure, although there is pressure-normal glaucoma.
就青光眼而言，正如您提到的，青光眼与压力有关，尽管有压力正常的青光眼。
Glaucoma is a death of the retinal ganglion cells, the neurons that connect the eye to the brain, and once they are gone, at least at this point in human history, they can't be replaced.
青光眼是视网膜神经节细胞的死亡，视网膜神经节细胞是连接眼睛和大脑的神经元，一旦它们消失，至少在人类历史的这个阶段，它们就无法替代。
Although hopefully, because of work that you've done and that other laboratories are doing, at some point, that statement I just made will not be true, and the RGCs can be replaced.
尽管希望，由于你们所做的工作以及其他实验室正在做的工作，在某些时候，我刚才所做的陈述将不会是真实的，并且 RGC 可以被取代。
Meanwhile, what can and should people do to find out if they have glaucoma, and to treat glaucoma?
与此同时，人们可以而且应该做什么来查明自己是否患有青光眼并治疗青光眼？
And is it true that even if somebody has normal pressure, that lowering their eye pressure further protects them against glaucoma?
即使某人的眼压正常，降低眼压是否可以进一步保护他们免受青光眼的侵害？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
That's absolutely right.
这是绝对正确的。
So most important is to get screened with a formal exam at your optometrist or ophthalmologist, because you won't notice, you won't have any symptoms.
因此，最重要的是在验光师或眼科医生处进行正式检查，因为您不会注意到，也不会出现任何症状。
If your eye pressure is too high, you're not likely to notice until very late in the disease if your peripheral vision is being damaged through the course of glaucoma.
如果您的眼压过高，那么直到疾病晚期您才可能注意到您的周边视力在青光眼病程中受到损害。
So most important is to have a screening exam.
所以最重要的是进行筛选检查。
A good comprehensive screening exam will always include checking the eye pressures and also looking in the back of your eye.
良好的全面筛查检查始终包括检查眼压并检查眼睛后部。
The head of the optic nerve, where all the fibers leave the eye and carry the optic nerve information back to the brain, we can see that when we look inside your eye.
视神经头是所有纤维离开眼睛并将视神经信息带回大脑的地方，当我们观察眼睛内部时，我们可以看到这一点。
And glaucoma has a fairly characteristic look to it in the optic nerve head.
青光眼在视神经乳头中具有相当特征性的外观。
So looking at the optic nerve head, we have imaging and peripheral vision testing that can also be included in those screening exams.
因此，针对视神经乳头，我们进行成像和周边视力测试，这些测试也可以包含在这些筛查检查中。
So if you really get a comprehensive screening exam, you can very reliably detect if you have glaucoma to worry about or you're in the clear.
因此，如果您真的进行了全面的筛查检查，您就可以非常可靠地检测出您是否患有青光眼，或者您是否患有青光眼。
If you have glaucoma to worry about, we have treatments, and you're absolutely right.
如果您担心青光眼，我们有治疗方法，您是完全正确的。
Whether you start with an abnormally high pressure, or you start with a pressure that's on the face of it in the normal range In either case, lowering the pressure has been shown in large, properly controlled clinical trials to slow the progression of optic nerve damage and vision loss.
无论您是从异常高压开始，还是从表面压力在正常范围内开始，无论哪种情况，大型、适当对照的临床试验都表明，降低压力可以减缓视神经损伤和视力丧失的进展。
So absolutely, in either case, starting with high pressure or starting with normal pressure, in either case, you've got to lower the pressure further.
所以绝对，无论哪种情况，从高压开始还是从常压开始，无论哪种情况，你都必须进一步降低压力。
And as I mentioned, we have eye drops.
正如我提到的，我们有眼药水。
Those are usually the first line.
这些通常是第一行。
There's very good data that there's a very benign, non-invasive laser.
有非常好的数据表明存在一种非常良性的、非侵入性的激光。
It's not the same kind of laser that gets used for LASIK, but there's a benign, very safe type of laser called selective laser trabeculoplasty, SLT we call it, and that's also very effective as a first line.
它与用于 LASIK 的激光不同，但有一种良性、非常安全的激光，称为选择性激光小梁成形术，我们称之为 SLT，作为一线治疗也非常有效。
Actually, in the largest clinical trial, from which the data have been coming out just even over the last few years, it's called the LIGHT trial.
事实上，在最大规模的临床试验中，数据是在过去几年才出来的，它被称为 LIGHT 试验。
In the LIGHT trial, patients with glaucoma were randomly assigned to either get the laser or the sort of most common, first strongest eye drop that gets used clinically.
在 LIGHT 试验中，青光眼患者被随机分配接受激光治疗或临床上使用的最常见、最强效的眼药水。
And actually, on many features, they both worked at least as well.
事实上，在许多功能上，它们至少都工作得很好。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
But when looking out over the long term, actually, the laser had some advantages over the eye drop, not in the least of which, by the way, it's very nice for patients to not have to remember to use the eye drop every night.
但从长远来看，实际上，激光比滴眼剂有一些优势，其中最重要的是，顺便说一句，患者不必记住每晚使用滴眼剂，这是非常好的。
And so that's quite helpful, I think, to keep in mind as a treatment option early in the course of the disease.
因此，我认为，在病程早期牢记这一点作为治疗选择是非常有帮助的。
Of course, if the eye drops and/or lasers are not enough early in the disease, we also have surgical approaches to lower the eye pressure further.
当然，如果在疾病早期滴眼剂和/或激光还不够，我们还可以通过手术方法进一步降低眼压。
Even with all of our treatments, all of these treatments, stepping patients through all of this, about 10, 15, even 20% of patients will lose very meaningful functional vision, and maybe five, 10, 15% of patients, especially depending where you are in the world, will go blind from glaucoma, including in, quote unquote, "developed countries." There's still a very significant cohort of patients that go blind, legally blind, and then absolute blindness, like can't even tell if the lights are on in the room.
即使采用我们所有的治疗方法，所有这些治疗方法，让患者经历所有这些，大约 10%、15%、甚至 20% 的患者将失去非常有意义的功能性视力，并且可能有 5%、10%、15% 的患者，特别是取决于您在世界上的哪个地方，将因青光眼而失明，包括在“发达国家”。仍有相当多的患者失明、法定失明，甚至完全失明，甚至无法分辨房间里的灯是否亮着。
Andrew Huberman:
安德鲁·休伯曼：
Mm.
嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
So it's devastating, it's insidious, it's hard to detect early, and so glaucoma is still a tough one, even with all of the treatments that we have.
因此，它是毁灭性的、阴险的，很难及早发现，所以即使我们采取了所有的治疗方法，青光眼仍然是一种棘手的疾病。
Andrew Huberman:
安德鲁·休伯曼：
Okay, so get your pressures checked, folks, and if you are prescribed drops, take your drops.
好的，朋友们，检查一下你的压力，如果给你开药水，就服用药水。
I hear about patients not taking their drops, which to me just seems baffling, but I guess having to do something day in and day out can be troublesome enough that unless people are losing their vision very quickly or they are very afraid of losing their vision, sometimes they just neglect to take them.
我听说患者不服用眼药水，这对我来说似乎令人困惑，但我想日复一日地做某事可能会很麻烦，除非人们很快失去视力或者他们非常害怕失去视力，有时他们只是忽略服用它们。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
It's hard.
这很难。
It's hard for glaucoma eye drops.
青光眼滴眼药水很难。
It's hard for taking your blood pressure medication.
服用降压药很困难。
It's hard for a lot of medicines.
很多药都很难。
If you're taking a medicine where you don't feel better-- If you have a headache and you take an aspirin or a Tylenol or an ibuprofen, you feel better.
如果您服用的药物感觉不舒服——如果您头痛，服用阿司匹林、泰诺或布洛芬，您会感觉好一些。
You feel reinforced.
你感觉自己被强化了。
Gosh, taking that pill made sense, right?
天哪，服用那颗药是有道理的，对吧？
But if you're using an eye drop that like, hey, this is going to protect you for the next 20 years from losing your vision, but you don't notice every day that anything's better.
但如果你使用的眼药水是这样的，嘿，这将保护你在接下来的 20 年里不失去视力，但你不会每天都注意到情况有所好转。
And by the way, the eye drops could be a little irritating.
顺便说一句，眼药水可能有点刺激。
Maybe it stings a little for a minute or two when you put it in your eye.
当您将其放入眼睛时，可能会有点刺痛一两分钟。
Some people are even less tolerant of the eye drops.
有些人对眼药水的耐受性更差。
It's hard to feel motivated every day, and we know that.
每天都感到充满动力是很困难的，我们知道这一点。
We call that compliance.
我们称之为合规性。
We know that it's very hard for patients to stay compliant with prescribed medications where they don't feel or notice a difference in a daily way.
我们知道，如果患者在日常生活中感觉不到或没有注意到差异，就很难坚持服用处方药物。
Andrew Huberman:
安德鲁·休伯曼：
I realize that we can't stop aging yet.
我意识到我们还无法阻止衰老。
But right now, you can't stop aging, and age is a risk factor for glaucoma.
但现在，你无法阻止衰老，而年龄是青光眼的危险因素。
My understanding is, so is smoking or vaping nicotine, and so is alcohol, and by that reasoning, should people strive to drink less and smoke less, including vaping nicotine less, if they are concerned about glaucoma?
我的理解是，吸烟或吸尼古丁也是如此，酒精也是如此，因此，如果人们担心青光眼，是否应该努力少喝酒、少抽烟，包括少吸尼古丁？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
And not just glaucoma, macular degeneration.
不仅仅是青光眼，还有黄斑变性。
Actually, macular degeneration has a couple major risk factors.
事实上，黄斑变性有几个主要的危险因素。
Macular degeneration, aging, just like with glaucoma, major risk factor.
黄斑变性、衰老，就像青光眼一样，是主要的危险因素。
Smoking, including exposure to secondhand smoke, major risk factor for macular degeneration and for the progression and vision loss potentially associated with macular degeneration.
吸烟，包括接触二手烟，是黄斑变性以及黄斑变性进展和视力丧失的主要危险因素。
In the case of macular degeneration, there's also a couple of genes that we've sequenced, the human genome, and there's a couple of genes associated with macular degeneration, too.
就黄斑变性而言，我们还对一些基因（人类基因组）进行了测序，并且还有一些与黄斑变性相关的基因。
That's less true for your typical run-of-the-mill adult glaucoma.
对于典型的普通成人青光眼来说，情况并非如此。
There are genes for the pediatric and infantile forms of glaucoma.
存在儿童和婴儿青光眼的基因。
So yeah, smoking 100%, including vaping, it's a no-no for your eyes, just like it's a no-no for the rest of your body.
所以，是的，100% 吸烟，包括电子烟，这对您的眼睛来说是禁忌，就像对您身体的其他部位来说也是禁忌一样。
And it's tough as the eye doctor to have these conversations with patients because you kind of feel like, well, they must know it already, and I'm trying to be the good guy in the room with the patient, convince them to use their other medications.
作为眼科医生，与患者进行这些对话是很困难的，因为你会觉得，好吧，他们一定已经知道了，而我正在努力成为患者房间里的好人，说服他们使用其他药物。
But it's important for us also as eye care providers to reinforce the message with our patients.
但对于我们作为眼保健提供者来说，向患者强化这一信息也很重要。
Hey, smoking, terrible idea for macular degeneration, also for glaucoma.
嘿，吸烟对于黄斑变性和青光眼来说是个糟糕的主意。
Glaucoma's interesting because the optic nerve, where it degenerates, kind of right at the head of the optic nerve, where it exits the eye, it's what we call a watershed zone.
青光眼很有趣，因为视神经退化，就在视神经的头部，它离开眼睛的地方，这就是我们所说的分水岭区域。
It's kind of the edge of two blood vessel supplies, and if either of those blood vessel supplies are a little bit short on blood or oxygen supply to that optic nerve head, your glaucoma is going to get worse.
它是两个血管供应的边缘，如果其中任何一个血管供应的视神经乳头的血液或氧气供应有点短缺，你的青光眼就会变得更糟。
Your optic nerve's going to be underfed, and that's going to worsen this degenerative process just by not having all the right nutrients and oxygen.
你的视神经将会营养不足，而如果没有足够的营养和氧气，就会加剧这种退化过程。
So the other thing is that, especially for glaucoma, everything that we talk about for being heart healthy For the rest of our body is almost certainly true for glaucoma.
所以另一件事是，特别是对于青光眼，我们所说的关于心脏健康的一切对于我们身体的其他部位来说几乎肯定适用于青光眼。
And so I also always counsel glaucoma patients, it's not just no smoking, but eat healthy, have a multivitamin, get some exercise.
所以我也经常建议青光眼患者，不仅仅是不要吸烟，还要健康饮食，服用多种维生素，进行锻炼。
All those things that are good for your cardiovascular system are going to be good for your eyes in general, and in particular, if you have glaucoma, or are at high risk for glaucoma.
所有这些对心血管系统有益的东西一般都会对您的眼睛有益，特别是如果您患有青光眼或青光眼的高风险人群。
Andrew Huberman:
安德鲁·休伯曼：
I realize that smoking or vaping are problematic for glaucoma and for macular degeneration, but we can't have a conversation about glaucoma without at least mentioning cannabis.
我意识到吸烟或吸电子烟会导致青光眼和黄斑变性，但我们不能在谈论青光眼时至少提到大麻。
I did an entire episode about cannabis, which touched on some of the real dangers of very high THC concentration cannabis.
我做了一整集关于大麻的节目，其中涉及了高 THC 浓度大麻的一些真正危险。
This lost me a few followers, I'm sure.
我确信这让我失去了一些追随者。
No problem, because what was important was to convey the fact that the cannabis that's out there nowadays comes in a variety of different strains and ratios of THC to CBD.
没问题，因为重要的是要传达这样一个事实：现在市面上的大麻有各种不同的品种以及 THC 与 CBD 的比例。
There's some severe risks of high THC, especially in young males, although not always.
高 THC 存在一些严重的风险，尤其是年轻男性，但并非总是如此。
The point being that there are, and I want to be very clear about this, because for whatever reason, cannabis gets people really up in arms.
重点是，大麻确实存在，而且我想非常清楚地说明这一点，因为无论出于何种原因，大麻都会让人们真正勃然大怒。
They always say it's not as bad as alcohol, but guess what?
他们总是说它不像酒精那么糟糕，但你猜怎么着？
We did an entire episode about alcohol, and there the message is very clear, zero is better than any, and two a week is probably the limit.
我们做了一整集关于酒精的节目，其中的信息非常明确，零比任何都好，每周两次可能是极限。
And if you're an alcoholic, zero is the rule.
如果你是个酒鬼，零就是规则。
So with cannabis, it's clear by my read of the data that it can lower eye pressure, which may undermine the progression of glaucoma somewhat.
因此，通过我阅读的数据，大麻可以清楚地表明它可以降低眼压，这可能会在一定程度上抑制青光眼的进展。
But if people are smoking that cannabis, is it therefore going to offset any gain that one would get from that cannabis?
但是，如果人们吸食大麻，是否会抵消人们从大麻中获得的任何收益？
And then how does one account for the potentially problematic aspects of very high THC cannabis?
那么如何解释高 THC 大麻的潜在问题呢？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
It's a great question.
这是一个很好的问题。
And the truth is that in most patients, cannabis will lower the eye pressure.
事实上，对于大多数患者来说，大麻会降低眼压。
The problem is, is it really only lowers that eye pressure during the period that you're high from the cannabis.
问题是，它真的只会在你因大麻而兴奋期间降低眼压吗？
And the second problem is that smoking version of getting that cannabis into your system, the smoking is bad for your lungs.
第二个问题是吸烟版的大麻进入你的系统，吸烟对你的肺部有害。
By the way, the smoke from cannabis or from cigarettes is also terrible for your dry eyes.
顺便说一下，大麻或香烟产生的烟雾对眼睛干涩也很糟糕。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
It causes inflammation, it dries out your eyes, so it's also very bad from that perspective.
它会引起炎症，使眼睛干燥，所以从这个角度来看，这也是非常糟糕的。
Now, so the problem with cannabis is not that it doesn't work to lower the pressure.
现在，大麻的问题并不是它不能降低压力。
We want to lower the pressure, that's great.
我们想减轻压力，这很好。
The problem with cannabis is that it's not realistic for most of our patients to prescribe, could you go out and be high from cannabis 24 hours a day, seven days a week for the next 20 years?
大麻的问题在于，对于我们的大多数患者来说，开处方是不现实的，你能在接下来的 20 年里每周 7 天、每天 24 小时出去吸食大麻吗？
Andrew Huberman:
安德鲁·休伯曼：
I'm sure some people have tried and succeeded.
我相信有些人已经尝试过并且成功了。
But right, that's not practical-
但是，这不切实际——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
for most people, and certainly for young people it could be really especially problematic-
对于大多数人来说，当然对于年轻人来说，这可能确实是特别有问题的——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yes
是的
Andrew Huberman:
安德鲁·休伯曼：
...
...
I should say.
我应该说。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Absolutely.
绝对的。
So, I recommend not taking that approach.
因此，我建议不要采取这种方法。
But that said, I'm definitely not a decrier of it, and now that there are edible forms, I certainly have patients who are using it in a responsible way, especially edible forms.
但话虽如此，我绝对不是谴责它，现在有了可食用的形式，我当然有以负责任的方式使用它的患者，尤其是可食用的形式。
And in select cases, like that could make the difference for them helping to keep the pressure down.
在某些情况下，这样的做法可能会给他们带来帮助，帮助他们减轻压力。
And I'll say, for example, it turns out you've talked a lot over the last couple of years about diurnal curves and circadian rhythms.
例如，我会说，事实证明您在过去几年中谈论了很多有关昼夜曲线和昼夜节律的内容。
It turns out that our eye pressure also undergoes a circadian rhythm, and it's actually highest at night while we're sleeping, kind of peaks in those early morning hours, then hits a low throughout the early day, and then kind of rises again throughout the afternoon into the evening.
事实证明，我们的眼压也经历昼夜节律，实际上在我们睡觉时的晚上最高，在清晨达到峰值，然后在整个清晨达到低点，然后在整个下午到晚上再次上升。
And we have a lot of patients who they come into their clinic visit, their eye pressure looks normal, but it's actually quite a bit higher when they're at home.
我们有很多来诊所就诊的患者，他们的眼压看起来很正常，但实际上当他们在家时，眼压要高一些。
And that could explain some fraction of what we call normal pressure glaucoma.
这可以解释我们所说的正常眼压青光眼的一部分。
It just looks normal during the day.
白天看起来很正常。
It's actually high at night.
晚上其实温度很高。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
And so in particular, I certainly have some patients who are using these products, like let's say before bed, and if it's controlling their eye pressure at night while they're asleep when the eye pressure would've been the highest, it may confer some protective advantage over time.
因此，特别是，我当然有一些患者正在使用这些产品，比如在睡觉前，如果在晚上睡觉时眼压最高时控制他们的眼压，随着时间的推移，它可能会带来一些保护优势。
But that said, again, like for most patients, it's not going to be the primary approach.
但话虽如此，就像大多数患者一样，这不会成为主要方法。
I'm most excited about the idea of laboratories or companies figuring out which the compounds within these cannabinoids they're called, within these products, are actually responsible for lowering the eye pressure, and could we get like a more potent eye specific long-acting drug that's basically derived from the concept of cannabis, but works better and is more compatible with not bringing along all the other adverse elements that can come with cannabis use.
我最兴奋的是实验室或公司弄清楚这些大麻素中的哪些化合物，在这些产品中，实际上负责降低眼压，我们是否可以得到一种更有效的眼睛特异性长效药物，它基本上源自大麻的概念，但效果更好，并且更兼容，不会带来大麻使用可能带来的所有其他不利因素。
Andrew Huberman:
安德鲁·休伯曼：
You mentioned the circadian rhythm and eye pressure, and the fact that eye pressure is higher at night.
您提到了昼夜节律和眼压，以及夜间眼压较高的事实。
Is there any advantage to sleeping in a particular position?
以特定的姿势睡觉有什么好处吗？
I know this might sound a little detailed, but I seem to recall an abstract or a paper a few years ago at a meeting that you and I both attended where that said that if people slept with their head below their feet, eye pressures were higher than if their head was slightly elevated above their feet.
我知道这听起来可能有点详细，但我似乎记得几年前你和我都参加的一次会议上的一篇摘要或论文，其中说，如果人们睡觉时头低于脚，眼压会高于头稍微高于脚的情况。
And for somebody who has glaucoma, this could make pretty substantial difference in terms of their eye pressures at precisely the hours of the night, we should say, in which they could be doing the most damage to the ganglion cells.
对于患有青光眼的人来说，这可能会对他们在夜间的眼压产生相当大的影响，我们应该说，他们可能对神经节细胞造成最大的损害。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Absolutely.
绝对地。
And we will sometimes counsel patients with severe glaucoma, especially if they're poorly responsive to standard therapies or poorly able to tolerate standard therapies.
我们有时会为患有严重青光眼的患者提供咨询，特别是如果他们对标准疗法反应不佳或无法耐受标准疗法。
We'll counsel them if they're able to sleep up on a couple pillows, get kind of a 30-degree sleep angle going.
如果他们能够睡在几个枕头上，或者保持 30 度的睡眠角度，我们会建议他们。
What I don't want to do is interfere with a person's sleep because I fundamentally feel for the total health of the whole human being, getting a good night's sleep is maybe more important than that 30 degrees.
我不想做的是干扰一个人的睡眠，因为我从根本上认为，为了整个人类的整体健康，睡个好觉可能比那 30 度更重要。
And if trying to sleep up on pillows at 30 degrees is going to lead to kind of restless, difficult sleep night, I'd rather the patient get a good night's sleep.
如果尝试在 30 度的枕头上睡觉会导致夜间不安、睡眠困难，我宁愿患者睡个好觉。
But if they can tolerate it, and especially if they have a sort of a tough version of glaucoma, then we'll let them try, see if they can sleep up.
但如果他们能够忍受，特别是如果他们患有某种严重的青光眼，那么我们会让他们尝试，看看他们是否可以入睡。
The other really interesting question that arises is, does which side you sleep on affect which eye might have worse glaucoma.
另一个真正有趣的问题是，你睡哪一侧会影响哪只眼睛的青光眼情况可能更严重。
Glaucoma is almost always, with a few rare exceptions, almost always a disease of two eyes.
除了少数罕见的例外，青光眼几乎总是两只眼睛的疾病。
But it can present very asymmetrically.
但它可能表现得非常不对称。
In fact, it's quite common to have one eye have worse damage than the other.
事实上，一只眼睛的损伤比另一只眼睛严重的情况很常见。
And we don't know fundamentally why that is, but one hypothesis was, gosh, maybe if you sleep on the right eye, then your right eye will have worse glaucoma because the pressure's a little higher down below, or maybe it's pressing on the pillow in a way or something like that.
我们根本不知道这是为什么，但一个假设是，天哪，也许如果你用右眼睡觉，那么你的右眼青光眼会更严重，因为下面的压力有点高，或者它可能以某种方式或类似的方式压在枕头上。
There have been a couple studies really looking at that question.
有几项研究确实在研究这个问题。
A couple studies have said the lower eye will have worse glaucoma.
几项研究表明，下眼的青光眼会更严重。
A couple studies have said the higher eye will have worse glaucoma.
一些研究表明，眼睛位置越高，青光眼的情况就越严重。
So the upshot is it probably doesn't matter which side you sleep on.
所以结果是，你睡哪一边可能并不重要。
We also know when you video people in their normal sleep pattern, even if you feel you always fall asleep on the left side of your face, people toss and turn all night.
我们还知道，当你拍摄人们正常睡眠模式时，即使你觉得自己总是用左脸睡着，人们也会整夜翻来覆去。
Probably over the course of the night, you're spending a similar amount of time on each eye.
可能在整个晚上，您在每只眼睛上花费的时间都差不多。
Andrew Huberman:
安德鲁·休伯曼：
I'm glad you brought up that point.
我很高兴你提出了这一点。
In terms of macular degeneration, I'm curious about the things that people can do as opposed to the don'ts in order to perhaps offset macular degeneration.
就黄斑变性而言，我很好奇人们可以做哪些事情，而不是不可以做哪些事情，以抵消黄斑变性的影响。
One of the things that I'm intrigued by are the results of Glenn Jeffrey's laboratory over at University College London.
我感兴趣的事情之一是伦敦大学学院格伦·杰弗里实验室的结果。
I'd known Jeff for probably a decade or more, and he had typically worked on animal models, but then a few years ago started publishing studies, and I believe there are now two published studies showing how red light exposure and near-infrared light exposure done early in the day to the eye at a distance of about two feet for just a couple of minutes a few times a week could offset some of the vision loss associated with age-related macular degeneration in people older than 40.
我认识杰夫大概有十年或更长时间了，他通常从事动物模型研究，但几年前开始发表研究，我相信现在有两项已发表的研究表明，每天早些时候在距离约两英尺的地方对眼睛进行红光照射和近红外光照射，每周几次，每次几分钟，可以抵消 40 岁以上人群与年龄相关性黄斑变性相关的部分视力丧失。
That's my understanding of these studies.
这就是我对这些研究的理解。
And there's a theory there about enhancing function of mitochondria and photoreceptors by reducing reactive oxygen species.
有一种理论是通过减少活性氧来增强线粒体和光感受器的功能。
There's a whole mechanistic hypothesis.
有一个完整的机制假设。
But my question is, is that the sort of protocol that produces significant enough offset of macular degeneration, like we should all be looking at red lights in the morning?
但我的问题是，这种方案是否能够产生足够显着的黄斑变性抵消效果，就像我们都应该在早上看红灯一样？
Or is it still too early days in order to really conclude that?
或者现在下结论还为时过早吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
I think the data is very compelling.
我认为数据非常有说服力。
The data are very compelling that this kind of red or near-infrared light therapy can be, at some level, neuroprotective.
数据非常令人信服，这种红色或近红外光疗法在某种程度上可以起到神经保护作用。
And yes, the data suggest that ramping up high-functioning mitochondria is a part of that, activating neuroprotective pathways in the retina.
是的，数据表明，增强高功能线粒体是其中的一部分，激活视网膜中的神经保护通路。
It's actually been demonstrated in animal models and a little human data here and there, but both for macular degeneration kind of degenerative disease, but also for optic neuropathies-
事实上，它已经在动物模型和一些人类数据中得到了证明，但既适用于黄斑变性这种退行性疾病，也适用于视神经病变——
Andrew Huberman:
安德鲁·休伯曼：
Mm
毫米
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
like glaucoma and retinal ganglion cells, the cells that carry all that visual information from the eye to the brain.
就像青光眼和视网膜神经节细胞一样，这些细胞将所有视觉信息从眼睛传递到大脑。
They're chock-full of mitochondria, too.
它们也充满了线粒体。
And so the idea that this could be a therapeutic approach, I think is very compelling.
因此，我认为这可能是一种治疗方法的想法非常引人注目。
There are a number of studies, actually, I think still ongoing today, really trying to figure out what's the right dose, how much brightness do you need?
实际上，我认为今天仍在进行许多研究，真正试图弄清楚什么是正确的剂量，您需要多少亮度？
Is there an optimal wavelength?
有最佳波长吗？
How many minutes?
多少分钟？
Does it matter when during the day you provide that light, or how many minutes or hours?
白天何时提供照明，或者提供多少分钟或小时，这很重要吗？
These are still very much open questions.
这些仍然是非常悬而未决的问题。
What's the dose?
剂量是多少？
What's the delivery?
交货是什么？
But it's very promising looking, and there's biological premise, and I'm excited to see where that goes because again, that's a very accessible sort of therapeutic approach that could be brought to a very broad swath of people.
但它看起来非常有前途，并且有生物学前提，我很高兴看到它的发展方向，因为这又是一种非常容易获得的治疗方法，可以带给很多人。
So-
所以——
Andrew Huberman:
安德鲁·休伯曼：
Yeah, and completely-
是的，而且完全——
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
I'm excited about that.
我对此感到很兴奋。
Andrew Huberman:
安德鲁·休伯曼：
Sorry, I didn't mean to interrupt.
抱歉，我不是有意打扰的。
And completely non-invasive.
并且完全非侵入性。
I should probably mention a warning, which is if people are going to decide that they're going to jump on this result and do red light exposure in the early part of the day, no matter what color a light is, if it's too bright, you can damage your eye.
我可能应该提一个警告，那就是如果人们决定要接受这个结果并在一天的早些时候进行红光照射，无论光是什么颜色，如果太亮，就会损害你的眼睛。
So I think this is why you're pointing to the fact that we need established protocols before people really start blasting their eyes with red light.
所以我认为这就是为什么你指出这样一个事实：在人们真正开始用红光照射眼睛之前，我们需要制定协议。
And if they are going to expose themselves to red light, it shouldn't be uncomfortably bright.
如果他们要将自己暴露在红光下，那么红光的亮度不应太亮。
Do I have that correct?
我说的对吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah, that's absolutely right.
是的，完全正确。
Actually, light effect, we talked about this a little bit earlier.
其实光效这个我们之前就讲过。
There's actually now data also that red light, and actually interestingly, studies using light at the other end of the visible spectrum, violet light, either of those in small daily doses can also be used to prevent progression of nearsightedness in children-
实际上现在还有数据表明，红光，实际上有趣的是，使用可见光谱另一端的光、紫光的研究，无论是每日小剂量的光，也可以用于预防儿童近视的进展——
Andrew Huberman:
安德鲁·休伯曼：
Mm
毫米
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
...
...
in school-aged children.
在学龄儿童中。
And so, I think we're really just on the cusp of really understanding the biology of how these different light therapies might be leveraged maximally to maximize our eye health, both during development and at the other end of the spectrum as we age.
因此，我认为我们确实正处于真正了解如何最大限度地利用这些不同的光疗法来最大限度地提高我们的眼睛健康的生物学方面，无论是在发育过程中还是随着年龄的增长。
So it's an exciting area, and I think this kind of phototherapy is a very hot topic for research right now.
所以这是一个令人兴奋的领域，我认为这种光疗是目前研究的一个非常热门的话题。
Very hot topic.
非常热门的话题。
Andrew Huberman:
安德鲁·休伯曼：
One has to wonder whether or not these light therapies, the fact that infrared works and maybe ultraviolet works, are really just capturing some of what sunlight is naturally doing when, as you mentioned before, a child or perhaps an adult also spends a certain number of hours outdoors.
人们必须想知道，这些光疗法（红外线起作用，也许紫外线起作用这一事实）是否真的只是捕捉到阳光自然产生的一些作用，正如您之前提到的，当儿童或成年人也在户外度过一定时间时。
Maybe we're just filling in the blanks that are neglected nowadays because we're spending so much time indoors under artificial lights and in front of screens.
也许我们只是填补了当今被忽视的空白，因为我们在室内人造光下和屏幕前花费了太多时间。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Perhaps.
也许吧。
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Very thoughtful possibility, yeah.
非常深思熟虑的可能性，是的。
Andrew Huberman:
安德鲁·休伯曼：
I have a couple of, we don't have to call them quick questions, but common questions that perhaps have brief explanations of, for instance, I put out a request for questions in anticipation of this episode, and I got a lot of people asking, what are floaters?
我有几个，我们不必称之为快速问题，但可能有简短解释的常见问题，例如，我在预期这一集时提出了提问请求，很多人问我，什么是飞蚊症？
in the eye, and is there anything that people can do to get rid of floaters?
人们可以采取什么措施来消除飞蚊症吗？
Dr. Jeffrey Goldberg:
杰弗里·戈德堡博士：
Yeah.
是的。
Our eye, when we're born, is actually filled in the middle of it with a jelly.
当我们出生时，我们的眼睛的中间实际上充满了一种果冻。
It's not just fluid.
它不仅仅是液体。
It's kind of a jelly.
它有点像果冻。
There's collagen fibers, and thankfully, the whole jelly is largely invisible, so the light can get through our eye back to the retina without being impeded.
有胶原纤维，值得庆幸的是，整个果冻基本上是不可见的，因此光线可以不受阻碍地穿过我们的眼睛回到视网膜。
As we age, those different fibers and gels shrink and contract, and they peel off of the back of the retina, so there's just in the middle.
随着年龄的增长，这些不同的纤维和凝胶会收缩，它们会从视网膜背面剥落，所以就在中间。
Now, your eyeball doesn't shrink because it fills in with fluid, with saltwater, basically.
现在，你的眼球不会收缩，因为它基本上充满了液体，即盐水。
But the gel part shrinks, and as it shrinks and also peels off the retina, it can pull off little tiny retinal bits, not important to your vision bits, but just little tissue bits.
但凝胶部分会收缩，当它收缩并从视网膜上剥离时，它会脱落一些微小的视网膜碎片，这对你的视力并不重要，而只是一些组织碎片。
And also, as it congeals, it kind of can get little concretions in the jelly, and we perceive those as floaters.
而且，当它凝结时，它会在果冻中产生一些小结核，我们将它们视为漂浮物。
Little, almost semi-translucent or in some cases grayish, blackish.
很小，几乎半透明，或者在某些情况下呈灰色、黑色。
Sometimes you get a big one if it peels off the edge of the optic nerve in the back of the eye, as happens.
有时，如果它从眼睛后部的视神经边缘剥落，你就会得到一个很大的东西，就像发生的那样。
We call that a posterior vitreous detachment.
我们称之为玻璃体后脱离。
You can actually see a moon or a half-moon floater in your vision.
您实际上可以在视野中看到月亮或半月漂浮物。
These are very frustrating to a lot of people.
这些让很多人非常沮丧。
And the good news is, in almost all cases, they will just go away by themselves.
好消息是，几乎在所有情况下，它们都会自行消失。
In theory, it's been played with.
理论上来说，已经被玩过了。
Gosh, we could do a big surgery to chew up all that jelly, replace it all with saltwater, try to get rid of your floaters.
天哪，我们可以做一次大手术，把所有的果冻嚼碎，用盐水代替，试着去掉你的飞蚊症。
There's risk associated with that surgery.
该手术存在风险。
We use it very effectively in retinal detachments or other diseases, bad diabetic retinopathy, bleeding inside the eye.
我们在视网膜脱离或其他疾病、严重的糖尿病视网膜病变、眼内出血等方面非常有效地使用它。
We can take out the jelly from the eye, replace it with saltwater.
我们可以把眼睛里的果冻取出来，用盐水代替。
But that's not putting patients through the risk of that surgery just to get rid of a couple of floaters or a few floaters that probably are going to go away over the next few months.
但这并不意味着让患者冒着手术的风险，只是为了去除一些飞蚊症或一些可能会在未来几个月内消失的飞蚊症。
I actually like to tell patients it's nothing to worry about, just ignore them.
我实际上喜欢告诉病人没什么可担心的，不用理会他们。
And actually, if you stop focusing on them, your brain will actually start filtering them out.
事实上，如果你停止关注它们，你的大脑实际上会开始过滤掉它们。
You'll stop noticing them if you can kind of not worry about them, be a little intentional about ignoring them in the beginning.
如果你能不担心它们，一开始就故意忽略它们，你就会不再注意到它们。
And then they do actually go away.
然后他们就真的消失了。
And look, some will go away.
看，有些人会消失。
These three will go away.
这三个人将会消失。
These two will appear.
这两个就会出现。
Eventually, you'll stop having floaters.
最终，您将不再有飞蚊症。
Most patients will stop having floaters.
大多数患者将不再有飞蚊症。
So we really don't like to put a patient at risk by intervening
所以我们真的不喜欢通过干预将患者置于危险之中