#823: Dr. Jeffrey Goldberg — Creating Supranormal Vision, Cutting-Edge Science for Eye Health, Supplements, Red Light Therapy, and The Future of Eyesight Restoration
In this episode of The Tim Ferriss Show, Dr. Jeffrey Goldberg and Ferriss explore vision health and emerging treatments for eye conditions. The discussion covers common age-related vision problems like presbyopia, the role of eye pressure in glaucoma, and treatment options ranging from traditional eye drops to innovative blood-derived solutions. They also examine how athletes can enhance their visual performance through specialized training.
The conversation delves into the biology of vision, explaining how mitochondrial health affects eye diseases and how the immune system influences conditions like glaucoma. Goldberg shares updates on research in vision restoration, including stem cell transplantation and gene therapies, while discussing the broader implications of this work for treating neurodegenerative conditions. The discussion bridges the gap between current vision care practices and potential future treatments for previously irreversible conditions.
This is a preview of the Shortform summary of the Aug 20, 2025 episode of the The Tim Ferriss Show
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1-Page Summary
Preventing and Treating Age-related Vision Decline
Tim Ferriss and Jeffrey Goldberg discuss presbyopia, a common age-related vision condition that typically begins around age 40. Goldberg explains that this condition occurs when the eye's lens becomes less flexible, making it difficult to focus on close objects. While reading glasses are a common solution, Goldberg notes that FDA-approved eye drops that constrict the pupil offer an alternative treatment option.
Enhancing Visual Performance in Professional Athletes
The discussion explores innovative approaches to improving visual performance in athletics. Ferriss shares his experience with training devices that present quick flashes of blurry circles, reporting improvements in his near vision after a month of use. Goldberg adds that combining visual challenges with physical responses leads to enhanced visual-motor skills, particularly beneficial for rehabilitation after concussions and brain injuries.
Addressing Eye Diseases
Goldberg identifies glaucoma as the leading cause of irreversible vision loss worldwide, emphasizing the importance of monitoring eye pressure fluctuations for diagnosis. While cannabis can temporarily lower eye pressure, Goldberg explains that eye drops provide more consistent treatment. For dry eye conditions, he recommends preservative-free artificial tears and discusses innovative treatments using serum-based drops derived from patients' blood.
Biology and Neuroscience in Vision
The conversation delves into the connection between vision and overall nervous system health. Goldberg explains how mitochondrial dysfunction in retinal and optic nerve cells contributes to various eye diseases. He discusses promising research showing that mice raised in germ-free environments don't develop optic nerve degeneration from elevated eye pressure, highlighting the immune system's role in conditions like glaucoma.
Emerging Research and Treatments
Goldberg's lab is advancing vision restoration through various approaches, including stem cell transplantation and gene therapies. He shares optimistic views about the future of treating irreversible vision loss, suggesting that conditions like glaucoma might soon be reversible. These developments, Goldberg notes, may also offer insights into treating broader neurodegenerative conditions, with research extending into areas such as visual stimuli and brain plasticity.
1-Page Summary
Additional Materials
Counterarguments
- While FDA-approved eye drops for presbyopia offer an alternative to reading glasses, their long-term effects on eye health are not as well understood, and they may not be suitable for everyone.
- Training devices that improve vision through quick flashes of blurry circles may not have the same effect on all athletes, and improvements in near vision may not necessarily translate to better performance in all sports.
- The enhancement of visual-motor skills through combined visual and physical challenges may vary significantly between individuals, and the evidence supporting their effectiveness for concussion rehabilitation might not be conclusive.
- While monitoring eye pressure is important for glaucoma diagnosis, it is not the only factor to consider, and other diagnostic methods and risk factors should also be acknowledged.
- Cannabis's role in lowering eye pressure is complex and may not be a viable treatment option for glaucoma due to its temporary effects and potential side effects.
- Serum-based drops for dry eye conditions are innovative but may not be accessible or affordable for all patients, and their efficacy compared to traditional treatments may require further research.
- The connection between mitochondrial dysfunction and eye diseases is an area of ongoing research, and while promising, it may not yet provide actionable treatment strategies.
- The findings from studies on mice in germ-free environments may not directly translate to humans due to differences in physiology and environmental factors.
- While stem cell transplantation and gene therapies are promising areas of research for vision restoration, they are still in experimental stages and may not be widely available or successful for all types of vision loss.
- The reversibility of conditions like glaucoma through emerging treatments is an optimistic view, but such outcomes may not be realized in the near future or may only be applicable to a subset of patients.
- Research into visual stimuli and brain plasticity is promising but is still in the early stages, and its applicability to broader neurodegenerative conditions remains to be fully understood and proven.
Actionables
- You can enhance your visual-motor skills by incorporating balance exercises with visual tasks, like catching a ball while standing on one leg, to potentially aid in your own rehabilitation process or simply improve coordination.
- This strategy combines physical activity with visual challenges, similar to the training devices mentioned for athletes. For example, you might try reading small print on a ball or object before catching it, which could help train your eyes and body to work together more effectively.
- If you're experiencing dry eye symptoms, create a comfortable indoor environment by using a humidifier and taking regular screen breaks to blink and rest your eyes.
- This approach addresses eye comfort without relying on products. By maintaining a humidity level of around 40-60% in your living space and practicing the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds), you can naturally support eye moisture and reduce strain.
- To potentially contribute to future vision restoration research, consider participating in clinical trials or studies if you have a relevant condition, as patient involvement is crucial for advancing medical breakthroughs.
- By volunteering for research, you provide valuable data that can help scientists understand how treatments work in real-world scenarios. You can find clinical trials through registries like ClinicalTrials.gov or local research hospitals, ensuring that any study you join is ethical and well-regulated.
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Preventing and Treating Age-related Vision Decline (E.G. Presbyopia)
As individuals age, their vision is likely to decline due to conditions such as presbyopia. This condition, among others, can impact daily tasks significantly. It is essential to understand the changes happening in our eyes and potential treatments or preventions for age-related vision issues.
Presbyopia: Age-related Lens Stiffening Affects Close Focus
Aging Leads To Lens Rigidity, Requiring Reading Glasses
Tim Ferriss brings up the topic by mentioning his own experience with presbyopia, a common age-related visual decline where near vision falters. Typically noticeable around age 40, this decline in near-focus ability is due to the lens inside the eye becoming less flexible and unable to compress or reshape to focus on close objects, leading to the need for reading glasses. As we age, typically after 40, the lens stiffens, making refocusing from far to near difficult and often necessitating the use of reading glasses.
Reading Glasses May Increase Dependence Over Time
Ferriss shares his concern about the common problem of increasing dependence on reading glasses and the potential need for higher magnification over time. Jeffrey Goldberg points out that from age 40 to 60, the lens progressively stiffens, requiring reading glasses with stronger correction as one ages. The progression and increased need for stronger glasses will occur whether one wears reading glasses or not, peaking at around +2.5 to +3.0 diopters, facilitating comfortable reading.
However, Goldberg also addresses a myth regarding reading glasses. He clarifies that perceived dependence on them is not due to further stiffening of the lens but rather psychological dependence. After experiencing heightened clarity with glasses, individuals tend to prefer that improved vision, leading to a sense of reliance on glasses.
Eye Drops As Alternative to Glasses For Near Vision
An alternative to reading glasses, as discussed by Goldberg, includes FDA-approved eye drops that reduce pupil size by causing the iris to constrict. This creates a pinhole effect, ...
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Preventing and Treating Age-related Vision Decline (E.G. Presbyopia)
Additional Materials
Counterarguments
- The efficacy of eye drops as an alternative to reading glasses may vary among individuals, and long-term effects are not fully understood.
- The pinhole effect created by eye drops may reduce the amount of light entering the eye, potentially making vision worse in low-light conditions.
- Supplements like AREDS2 may not have a significant impact on all individuals, and their effectiveness can be influenced by genetic factors and overall diet.
- Anecdotal evidence of vision improvement with supplements is not a substitute for rigorous scientific research, and placebo effects cannot be ruled out without controlled studies.
- The idea that dependence on reading glasses is psychological may oversimplify the complex interaction between visual acuity, brain adaptation, and the psychological comf ...
Actionables
- You can monitor your vision changes by keeping a vision diary, noting the situations where you struggle with near vision and the lighting conditions. This can help you track the progression of presbyopia and determine if and when you might need to consider alternatives like eye drops or supplements. For example, if you notice difficulty reading menus in dimly lit restaurants, you might benefit from carrying a small flashlight or using a smartphone light to assist your vision.
- Experiment with different lighting scenarios at home or work to find the optimal conditions that reduce your reliance on reading glasses. For instance, you could try installing brighter bulbs in areas where you read or work, or use a directed task lamp to concentrate light exactly where you need it. This could potentially alleviate the need for stronger magnification as your eyes may respond better to well-lit environments.
- Create a personalized eye health supplement plan ...
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Enhancing Visual Performance in Professional Athletes
Experts like Dr. Jeffrey Goldberg and Tim Ferriss delve into how modern technology and training regimens can take the visual capabilities of athletes from good to exceptional, with applications both in competitive enhancement and rehabilitation.
Devices and Training Enhance Visual Acuity and Reflexes
In the field of athletics, where milliseconds and the slightest edge can make the difference between winning and losing, devices and specialized training are being leveraged to heighten visual acuity and reflexes.
Frame Rate-Reducing Goggles May Enhance Visual System Performance
Tim Ferriss discusses his experience with innovative training devices designed to improve visual perception. Ferriss has used a device that presents quick flashes of blurry circles and requires him to determine varying levels of blurriness. The device's adaptive nature modifies its training regimen according to the user's performance over time. Ferriss reports noticeable improvements in his near vision after a month of consistent training—a fact even recognized by his partner. Ferriss is also intrigued by goggles that reduce frame rate, suggesting they might enhance visual performance for athletes.
Additionally, Dr. Goldberg speaks to the use of frame rate-reducing goggles, which challenge athletes' eyes by presenting objects that become smaller, dimmer, or blurrier, potentially enhancing their visual system performance. By practicing with constrained visual data, and then reverting to normal conditions, an athlete might improve performance in visual tasks.
Motor-Based Visual Training Enhances Visual-Motor Skills
The effectiveness of visual training reaches new heights when demanding a motor outcome or action. According to Goldberg, training that combines visual challenges with physical responses—such as pointing out the correct option or taking specific actions—leads to reinforced visual-motor skill ...
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Enhancing Visual Performance in Professional Athletes
Additional Materials
Clarifications
- Plastic remodeling in neural pathways between the eye and the brain refers to the brain's ability to reorganize its connections in response to learning, experience, or injury. This process involves changes in the strength and structure of neural connections, allowing for adaptation and recovery. In the context of visual training after concussions or brain injuries, stimulating plastic remodeling can help restore and improve visual function by rewiring the communication between the eye and the brain. This phenomenon highlights the brain's neuroplasticity, demonstrating its capacity to adapt and optimize neural pathways for better visual outcomes.
- Visual training for athletes involves specialized exercises that challenge and enhance the visual system's capabilities, such as visual acuity and processing speed. By consistently engaging in targeted visual exercises, athletes can improve their neural pathways between the eyes and the ...
Counterarguments
- The effectiveness of frame rate-reducing goggles is not universally accepted; some experts may argue that the evidence is anecdotal or lacks sufficient scientific rigor.
- Improvements in visual perception from training devices may not directly translate to enhanced performance in a competitive environment due to the multifaceted nature of athletic performance.
- Adaptive training regimens may not be suitable for all athletes, as individual differences can lead to varying results, and some athletes may not respond to the training as intended.
- The reported improvements in near vision with consistent training may be subject to placebo effects or confirmation bias, and controlled studies are necessary to validate these claims.
- Motor-based visual training might not be more effective than traditional training methods, and the benefits could be due to the increased overall training intensity rather than the specific visual-motor integration.
- The role of visual training in rehabilitating concussions and brain injuries, while promising, is still an emerging field, a ...
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Addressing Eye Diseases (Glaucoma, Macular Degeneration, Dry Eye)
Dr. Jeffrey Goldberg's research focuses on vision restoration, including neuroprotection and regeneration of the retina and optic nerve. He recognizes vision loss as a significant risk factor for cognitive decline and underscores the importance of regular eye exams to prevent diseases like glaucoma and age-related degeneration.
Glaucoma Is a Leading Cause of Irreversible Vision Loss, Often From High Pressure Damaging the Optic Nerve
Glaucoma, the number one cause of irreversible vision loss worldwide, is a neurodegenerative disease affecting the optic nerve and retinal ganglion cells. Timothy Ferriss highlights that eye pressure fluctuations are crucial for glaucoma diagnosis, as pressure might appear normal during the day but can spike during night-time.
Timing Matters: Eye Pressure Fluctuations Key for Diagnosis
About 2% of the aging population will develop glaucoma, with a family history increasing risk up to about 20%. Despite earlier data suggesting diabetes might be slightly protective against glaucoma, subsequent studies indicated it could actually be harmful, with metabolic syndrome showing no significant effect. Despite this, Goldberg insists on the importance of eye exams, especially for those with a family history of eye disease.
Cannabis Briefly Lowers Eye Pressure; Other Treatments Preferred
Ferriss points out that while cannabis temporarily lowers eye pressure, its short-lived effect makes eye drops a more consistent treatment for glaucoma. Goldberg discusses the exploration of THC and non-psychoactive components of cannabis for pressure-lowering effects in glaucoma, with companies developing non-intoxicating eye drops to make treatment safer and more compatible with daily activities.
Aging Reduces Tear Production and Quality, Increasing Dry Eye
With aging comes decreased tear production and quality.
Preservative-Free Artificial Tears and Serum-Based Drops Alleviate Dry Eye Symptoms
For those with dry eyes, over-the-counter artificial teardrops are a simple solution. However, frequent users of ...
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Addressing Eye Diseases (Glaucoma, Macular Degeneration, Dry Eye)
Additional Materials
Actionables
- You can set reminders on your phone or calendar for regular eye exams to catch diseases like glaucoma early. By scheduling these reminders for every six months or annually, depending on your risk factors and age, you ensure that you're proactive in monitoring your eye health. For example, if you have a family history of glaucoma, you might set more frequent reminders.
- Incorporate foods rich in antioxidants and vitamins into your diet to support eye health and potentially slow down age-related degeneration. Foods like leafy greens, berries, and fish that are high in omega-3 fatty acids can be beneficial. Try creating a weekly meal plan that includes these eye-friendly foods to make it easier to incorporate them into your diet.
- Use a UV-blocking film on your home and car windo ...
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Biology and Neuroscience in Vision: Mitochondria and Inflammation
The nexus of biology and neuroscience is a critical area of study in understanding vision, particularly focusing on how mitochondrial health and inflammation within the visual system may impact eye diseases and overall nervous system health.
Retina and Optic Nerve: Brain Extensions Linking Vision To Nervous System Health
The retina, hit by light passing through to reach photoreceptors called rods and cones, transforms light into electrical signals. These signals propagate through retinal ganglion cells and via the optic nerve to the brain. According to Jeffrey Goldberg, this connection between the eye and brain underscores the interrelation of visual systems to nervous system health.
Mitochondrial Dysfunction in Retinal and Optic Nerve Cells Implicated In Neurodegenerative Eye Diseases
Goldberg discusses how mitochondrial dysfunction in the retina and optic nerve cells is implicated in the progression of myopia and neurodegenerative diseases of the eye and the brain. Mitochondria are essential for converting sugar into energy for cellular processes, and dysfunction is a common thread across various neurodegenerative diseases. Goldberg elaborates on the unique characteristics of mitochondria, including their ability to fuse and separate, their trafficking within neurons, and their role as scaffolds for cellular signaling, all contributing to conditions such as neurodegenerative diseases.
Anti-Inflammatory Interventions, Like Supplements and Drugs, May Protect Vision By Supporting Mitochondria
With advances such as FDA-approved red light therapy for macular degeneration and vitamin B3 treatments affecting metabolic signaling associated with mitochondria, the possibility exists for these interventions to also be protective in other eye diseases. Tim Ferriss explores the potential link between mitochondrial health and Alzheimer's disease, implicating mitochondrial dysfunction in neurodegenerative diseases. He and Goldberg consider anti-inflammatory effects, such as those from GLP-1 receptor agonists and other anti-inflammatories, that could support vision by fostering mitochondrial function.
Immune System's Role in Eye Diseases Lik ...
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Biology and Neuroscience in Vision: Mitochondria and Inflammation
Additional Materials
Clarifications
- Mitochondria play a crucial role in generating energy for cells, including those in the visual system and nervous system. Dysfunction in mitochondria can lead to various neurodegenerative diseases affecting both the eyes and the brain. Inflammation, when uncontrolled, can contribute to mitochondrial damage, exacerbating conditions like glaucoma and macular degeneration. Strategies that target inflammation and support mitochondrial function may offer potential therapeutic avenues for preserving vision and overall nervous system health.
- Mitochondria play a crucial role in neurodegenerative diseases by providing energy for cellular processes. Dysfunction in mitochondria is a common factor in various neurodegenerative conditions. Their unique characteristics, such as fusion, trafficking within neurons, and involvement in cellular signaling, contribute to the progression of diseases like Alzheimer's and Parkinson's. Maintaining mitochondrial health through interventions like anti-inflammatory treatments can potentially help protect against neurodegenerative diseases.
- Anti-inflammatory interventions can help protect vision by supporting mitochondrial function. Mitochondria play a crucial role in providing energy for cellular processes, and dysfunction can contribute to various eye and brain diseases. By reducing inflammation, these interventions can potentially improve mitochondrial health, which is essential for the proper functioning of cells in the visual system. This approach may offer new avenues for treating and preventing conditions like macular degeneration and other neurodegenerative eye diseases.
- The immune system plays a crucial role in neurodegenerative eye diseases like glaucoma and macular degeneration by influencing the inflammatory response in the eye. In conditions such as glaucoma, immune responses can contribute to optic nerve damage and vision loss. Modulating the immune response through innovative drug therapies can potentially help preserve vision by targeting spe ...
Counterarguments
- While mitochondrial dysfunction is implicated in neurodegenerative diseases, it is not the only factor, and focusing solely on mitochondria may overlook other critical aspects such as genetic factors, environmental influences, and lifestyle choices that also play significant roles.
- The essential role of mitochondria in energy conversion is well-established, but it is also important to consider that disruptions in other cellular organelles and systems can contribute to disease processes.
- The commonality of mitochondrial dysfunction across neurodegenerative diseases suggests a shared mechanism, but it is also possible that each disease has unique mitochondrial dysfunctions that require specific interventions.
- The unique characteristics of mitochondria are indeed significant, but the complexity of these processes means that interventions targeting one aspect of mitochondrial function may have unintended consequences on others.
- Anti-inflammatory interventions show promise, but their long-term efficacy and safety profiles are not fully understood, and they may not be universally beneficial for all patients with eye diseases.
- The exploration of the link between mitochondrial health and Alzheimer's disease by Tim Ferriss and others is valuable, but it is important to note that this is a developing field and conclusions should be drawn cautiously.
- The potential for anti-inflammatory drugs to support vision is intriguing, but these treatments may not address the underlying causes of mitochondrial dysfunction and could potentially mask symptoms rather than provide a cure.
- The role of the immune system in eye diseases is complex, and while modulating the immune response is a promising approach, it is also challenging to achieve without affect ...
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Emerging Research and Treatments For Vision Restoration
Dr. Jeffrey Goldberg's lab is at the forefront of translating advances in eye repair research into potential clinical trials, exploring stem cells, nanotherapeutics, and novel molecular approaches for treating vision loss.
Rapid Advances In Inducing Neuroplasticity and Regeneration In the Visual System
Goldberg's work considers the active and intricate visual processing that may be enhanced by inducing neuroplasticity and regeneration.
Stem Cell, Gene Therapies, and Neural Devices May Restore Lost Vision
Goldberg talks about the successful transplantation of mitochondria to prevent inherited diseases, suggesting a possibility for therapeutics to delay or prevent conditions like glaucoma. His lab's work includes generating retinal ganglion cells from human stem cells, which have shown promise in animal models for potential vision restoration. He warns against premature clinical application but maintains that irreversible vision loss from glaucoma could soon be a thing of the past, with science on the brink of enabling restoration in unprecedented ways.
Applying Restorative Techniques To the Nervous System
Reversing Vision Loss May Lead To Breakthroughs In Treating Neurodegenerative Brain Conditions
Advances in vision restoration technologies may also offer insights into treating neurodegenerative brain conditions. Goldberg discusses molecular pathways and cell therapies for inducing plasticity in the brain, allowing integration of new cells into the adult retina. He notes that these advances are swiftly moving into human clinical trials and may soon restore cognitive functions in diseases like Alzheimer's, highlighting the broad potential of these neuroplasticity techniques.
Tim Ferriss delves into non-surgical approaches, asking about methods that could bypass traditional treatments. Goldberg mentions visual stimuli as a means to enhance or protect neuronal function, implying that devices aimed at vision restoration could be on the horizon. He also touches on the importance of the visual system in maintaining brainwave activity, essential for preventing cognitive decline.
Exploratory research in drugs like [restricted term] and microdosing LSD, as well as investigations into the gut ...
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Emerging Research and Treatments For Vision Restoration
Additional Materials
Counterarguments
- While stem cell and gene therapies show promise, there are ethical and regulatory concerns that need to be addressed before widespread clinical application.
- The complexity of the visual system and individual variability in disease pathology can make it challenging to create one-size-fits-all treatments.
- The success of treatments in animal models does not always translate to human success due to differences in physiology and complexity of the diseases.
- The idea that vision restoration techniques could help treat neurodegenerative brain conditions is speculative and requires more evidence to establish a direct causal relationship.
- The safety and long-term effects of using devices to restore vision or cognitive functions are not yet fully understood.
- The impact of factors like [restricted term], microdosing LSD, and the gut microbiome on vision health is still under investigation, and their therapeutic potential is not yet confirmed.
- The use of psychedelic substances like LSD, even in microdosing, is controversial and may face regulatory and social hurdles.
- The effectiveness of non-surgical approaches, such as visual stimuli, in enhancing or protecting neuronal function needs more robust clinical evidence.
- The assumption that preventing cognitive decline is direc ...
Actionables
- You can participate in citizen science projects focused on vision health to contribute to research and gain insights into your own visual system. Many research institutions and organizations run citizen science projects where non-experts can help with data collection or analysis. For example, you might engage in a project that asks you to track certain aspects of your vision over time or to play games designed to test visual processing. Your participation could provide valuable data for researchers and give you a better understanding of your own visual health.
- Start a visual health journal to monitor changes in your vision and potential influences. By keeping a daily log of your visual experiences, diet, and any supplements or medications you take, you can identify patterns or changes in your visual health. This could be particularly useful if you're experimenting with lifestyle changes that might impact your vision, such as adjusting your sleep patterns, trying a new diet that affects the gut microbiome, or incorporating visual exercises into your routine.
- Engage with onlin ...
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1-Page Summary- Preventing and Treating Age-related Vision Decline (E.G. Presbyopia)
- Enhancing Visual Performance in Professional Athletes
- Addressing Eye Diseases (Glaucoma, Macular Degeneration, Dry Eye)
- Biology and Neuroscience in Vision: Mitochondria and Inflammation
- Emerging Research and Treatments For Vision Restoration
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