124. Change Your Life With Vision Therapy with Dr. Bryce Applebaum, Part 2

Dr. Bryce Applebaum 0:05

Therapy is arranging the conditions to raise the somebody's awareness of what they're doing so they can learn how to self correct and self monitor and make that habits no longer options.

Dr. Stephanie Gray 0:16

Welcome to the your longevity blueprint podcast. I'm your host, Dr. Stephanie gray. My number one goal with the show is to help you discover your personalized plan to build your dream health and live a longer, happier, truly healthier life.

Today, you again, get to hear from Dr. Bryce Applebaum. This is part two of a two part series, I'd encourage you go back and First listen to part one where he shared what vision therapy is why nearsightedness is increasing at an alarming rate, how ATD ADHD and dyslexia are related to vision. And we talked about controversy over AI patching. In today's show, we'll talk about how vision impacts sports performance, discuss concussions, how COVID can impact a vision talk motion sickness and supplements for the eyes. Let's get started.

Let's transition to sports for a minute. So in your bio, obviously, you work with a lot of athletes, which is super just fascinating. So I do want to get to concussion and injuries, sports injuries. But first, let's talk about how vision impacts sports performance.

Dr. Bryce Applebaum 1:19

Absolutely. So if you could think about at an early age, and you're probably doing this with your son, you're saying, Hey, you gotta keep your eye on the ball. And you're always taught that but we're never really taught how to do that. From a sports performance standpoint, you know, the things that matter in sports are obviously seeing the ball and knowing where the ball is, but most importantly, being able to anticipate where the ball will be. So having really good depth perception that's dynamic, understanding your sense of selfless in space accurately, being able to use peripheral vision with central vision at the same time, a lot of athletes always talk about being in the zone, when you're in the zone. That's this kind of locked in the heightened state of visual arousal, where it's almost like you are in this tunnel vision and nothing else around you is going on because you're so locked in, we can actually teach that and teach somebody to be able to slip into that place where they are so heightened peripherally, that they can lock in and localize essentially, really, really well. So I work with a lot of teams and players at the professional level at the high level where it's small, incremental changes and lots of different areas leads to a large cumulative effect in terms of performance. But especially you know, a child or somebody who's a weekend warrior trying to compete with that with other dads or moms or other peers. From a vision standpoint, the small ball sports vision matters that much more. So baseball, softball, basketball, tennis, vision, development and cognitive development, and how will they coincide matters a time. And for somebody to have athletic talent, that's just God given an actual you can't really train that. But to be able to allow somebody to maximize what they do have and utilize it for longer when you can teach somebody how to see the court or the field from other perspectives, or how to learn a playbook more efficiently or have visual memory that supports rapid changes that they can then filter and process like a movie rather than a flipbook. Let's say, first, identifying the areas of opportunity for learning is important. But then knowing how to close those gaps and the clean things up so that take the talent you already have, but elevating it by achieving at the potential based off of using vision as that dominant sensory system that's guiding and leading rather than one that's just kind of there. So you have a screening or assessment that you put your athletes through. And then obviously you find their weaknesses. And yes, my most thorough evaluation is about three hours long. And it's looking at lots of different areas, we have a much shorter one that will do for more as like a screening tool. But we work with the lots of teams, lots of players in unique sports. A lot of people with racecar driving and with archery and Riflery and fencing. I mean sport vision. I'm biased. Of course, Vision matters. And it matters. It matters in all sports, but certain sports, it matters a lot more than another. So there are specialists who do sports vision evaluations, there's few doctors who that's all they do. But especially people in the vision therapy world, at least have an understanding of how to elevate performance. And many, you know, that's a little bit more of a niche than anything else. But even less so than than those who do vision therapy. There's not so many sports vision AI doctors out there.

Dr. Stephanie Gray 4:36

Serious question, can I elevate the sports performance in a three and a half year old by improving his vision?

Dr. Bryce Applebaum 4:42

Knowing that vision is on a continuum? And you know, there's certain skills that are considered normal for three and a half year old. I mean, there's we have a lot of young kids on home programs where we are literally advancing vision development so that you know because there's a problem but also. Just to help it become that much more efficient so depends on what sport you're trying to teach baseball, absolutely. Baseball but no.

Dr. Stephanie Gray 5:09

If you talk to my husband Yeah,

Dr. Bryce Applebaum 5:10

Playing catch being a different distances, different size balls, I mean that you drill that hard early on. Not that I'm suggesting we do that because then you can, you can burn them out. But I mean, that's something that there's a reason why repetition and practice really does. Absolutely, absolutely. You got me thinking you when you see the little even like the two and a half year olds who try to hit the ball off the tee, and they're obviously not always hitting the ball reading the tape. And yes, that could be a coordination thing. But is it just their vision is still you think about how hard it is like with your body rotating to be able to hold fixation on something as your all your gross motor muscles are moving or as you're trying to rotate or turn. I mean, when you see a two and a half three year old who's like hitting a golf ball or hitting off the tee. And there's a reason these go viral. It's not more credible.

Dr. Stephanie Gray 5:59

Fun, fun. Okay, let's talk more I don't want to say doom and gloom because there's something we can do about this. But let's talk about sports related related injuries. So what is that concussion? And how is vision impacted with concussions?

Dr. Bryce Applebaum 6:09

Great question. So this is becoming a huge, huge topic and my specialty and actually my private practice now is over 50% concussion and brain injury rehab, and it's only increasing every year. So a concussion is any type of kind of insult or trauma to the brain. A lot of people think it has to be from this massive blow or hit. But we now know that even the most southern little a celebration or deceleration of the brainstem like a whiplash can be considered a concussion because the damage that occurs neuronal ly to the brain is at such a small micro cellular level that it impacts function, and structure. In many cases as well. Vision is represented in every lobe of the brain. There's more areas of the brain dedicated to processing vision than every other sense combined. So it's almost impossible to have a head injury in my opinion, not have vision be impacted. It's just a matter of at what level is it and the most common symptoms with head injury very often are related to vision, fatigue, eyestrain, headache, brain fog, dizziness. First of all, anybody who you know, is suspected to have a head injury or experiences any of these symptoms after any type of head injury, car accident, anything like that. I mean, they should consult a sports medicine physician and be evaluated to determine what's going on. I will say in doing that, make sure especially as a parent, you recognize that most of the testing after a suspected head injury is going to come back normal. Meaning MRIs, CAT Scans, CT scans, we run those to make sure there's nothing terrible and catastrophic happening. And sometimes there is and then, without doing those tests, you're not going to look you're not going to see them. But you know, usually those all show everything is fine. And then it's kind of like alright, your brain is bruised, go rest and go, we'll take it easy. That was the old school philosophy is rest and sit in a dark room. And don't be around anything sensory wise. And now, I think we're almost we were at the other end of the spectrum, now we're a little bit more in the middle, a lot of head injuries do resolve on their own in terms of the symptoms and then do improve with time. And a larger percentage of older adolescents do return to like a pre injury level, let's say before head injury and a lot of adults do but for many, it can take a lot longer. And I think there's an interesting study that came out fairly recently that said, after a year after a concussion or a year after a concussion, a third of kids still have symptoms or headache or irritability that can affect school performance. And very often you just the child feels if it's a child, you can't articulate or communicate how they're feeling or what's going on. It's just behaviors, different frustrations are different. You know, the symptoms that happen from a concussion very often don't go away without active work or active learning to take place. And that can really complicate the recovery getting back to previous level of functioning and can make it so you know, life is very different. And going to a mall and grocery store with all this sensory input is this is overload or seeing a pattern on the shirt is dizzying or nauseating. Or you're getting motion sick and things like that. And I think that's something that is getting a lot more awareness now is we are all learning about head injuries and getting research coming out and having athletes who are now speaking up, but our brains are the only brains we got and I know this is your bread and butter and then what you are the expert in but we got to take care of our brains and be able to get to a place where we can prevent the the avoidable head injuries that happen down the road because we know with one head injury more likely to have another and another unless we're able to rehabilitate especially the visual brain and get back to a place where we know where we're located in space and where the things are in relation to us.

Dr. Stephanie Gray 9:50

Would you say a lot of you call them like the sports medicine physicians who kind of treat the concussion do they seek out someone like you for vision therapy? I mean is that the ones who know what they're doing

Dr. Bryce Applebaum 10:00

They should, that's what you're saying they should. Yeah, good. You know, I think a lot of PT has adopted vision work and vestibular work to help with concussion recovery just because the need is so great. And PT adapted this, which I think is fantastic. But a lot of times it does leave people kind of up a creek without a paddle where they're doing some vision work where it's like, it jumps from one place to another vestibular work, which is kind of that internal orientation system that lets us know which way is up and down and left and right. And with most head injuries, there's some level of disconnect between vision and vestibular input, where we're not able to integrate central and peripheral processing at the same time. And so PT does some work there. I think all the big, at least by us, all the hospitals that are really progressive and developing programs for head injury, they have a vestibular PT on staff they have in house stuff, but then you know, at least for the ones in the area, by me, I usually only get sent the ones who are just not getting better at the speed or rate that they should. And it's crazy to think that almost any head injury and when I say almost the vast majority, you can get back to previous level of functioning with the right work and the right motivation. I'm not really trained in acute care medicine, but quickly for our listeners, what should someone do if they get a concussion? I mean, obviously, you go to the ER, but like, if it's minor, or are there any just basic tips like should they take anti inflammatories like so I think definitely, you know, don't go to sleep right away. You know, that's the type of thing that I think a lot of doctors are pretty consistent with is, you know, when that happens, you know, try and obviously remove yourself from play. That's a big issue if it's from sports, but most head injuries are not from sports now. And I think for the first couple weeks omega threes are hugely important. There's a neurologist I work with who prescribes for anyone who's had a head injury, whether it was a recent one or years ago, I loading dose of nine grams for the first two weeks, and then six grams thereafter. I think that's a lot. But omega threes help facilitate healing and our brain is made out of, you know those substances, so, but I think changing nutrition and increasing protein and increasing hydration and electrolytes, and there's lots of supplements that are important as well. But I think definitely getting it checked out anti inflammatories can help obviously remediate the symptoms and the headaches that are occurring. But kind of try and avoid environments with lots of bright light emulation. Yeah. And noise. And you know, that heightened sense of arousal is what really allows that autonomic nervous system to turn into a fight or flight response. And then you just want to retreat and do nothing. Couple other questions. This is great. I'm thinking Where should I go next? So you did mention COVID a few times like when we kind of opened the episode talking about how Yeah, parents probably were letting their kids FaceTime, see grandparents or you know, whatnot. How else has COVID impacted our eyes. So two main areas, the first we have seen, we've stopped counting, it's been so high patients who've come in with symptoms and, and findings in presentation completely consistent with a concussion or head injury, but who haven't had a head injury. And doing a lot of research or a lot of digging in terms of the history in many of these cases, it was either after getting COVID after receiving a vaccine or booster and I don't think we should go down that route of talking about all that. But if there's low level inflammation, and then there's some sort of event that allows for that inflammatory cascade to then increase, it can create these symptoms that are like a head injury. So the dizziness, the blurriness, the headaches, the fatigue all that more consistently across the board. And I say across the board, like almost everybody I'm seeing, if we go back to we talked about about visual stress and stress from our environment, if we don't have the tools in place to meet the demands of the stress, we adapt or we avoid. We are not meant to be staring at screens all day. And especially with virtual learning for kids who don't have the visual development and systems in place, or telework. For adults were staring at a screen for sometimes 1012 even longer hours of the day without even getting up or looking away. And I think there's there's so much we can do to set up Visual ergonomics to take breaks to be able to force our brain to disengage until we get outside and to balance the distance with the near demands. But I would say from COVID The incidence of nearsightedness has dramatically increased the amount of kids with visual developmental delays impacting learning and reading has definitely increased and the amount of headaches and eyestrain from what I'm seeing has increased. One great solution for this is there's certain glasses that can be helpful for a lot of people. Everyone's kind of heard about Blue blocking filters and and that's, that's helpful, but I think blue blocking filters with the right performance lenses in them. So in many cases it's a low plus magnification that relaxes the focus or sometimes prism that helps disengaged so you don't have to converge the eyes as much. There's support systems in the setup of of a lens or spectacle lens that can really help make it so that there's less visual stress. And then your internal response to that is different from the blue light standpoint, blue light is is not bad blue light is actually good for us and in certain quantities and in certain scenarios, but blue light blocking glasses, blocks a certain wavelength of light. And that's that high contrast, high energy bright light from the screens as artificial, artificial lights different than natural light. But with that artificial light, a higher quality blue light blocking lens is going to block a larger wavelength. So a larger range, so it's more protective, versus the $5 ones that you see on Amazon, for most people doesn't really have too much of a protective benefit. And I found out those have like 10%, you know, blue light blocking ability, it's not like they're blocking 100%. If you really want to block blue light, you got to wear the nerdy, you know, Amber like glasses, those are the ones that block the blue light. So if they're really fashionable like that, you know, $10, off Amazon, they're probably only slightly blocking the blue light. To my understanding. Yeah, I mean, ask them when they when they go to their eye doctor, that's almost always an add on that she can get on glasses, but asked about different tiers. I know my practice, we have three different tiers of blue light blocking filters, and almost never do we even allow somebody to get the lowest tier, so just go get it online, that's cheaper, and you're gonna make more sense. But the higher tier, you're blocking a larger range. And just like you said, the ones that actually have tints in them, because they're blocking that much light aren't always needed, but are life changing. I have many patients who that's they wear those all day long, because that's the only way you can get out of bed.

Yeah, yep. I want go to motion sickness, next. This is something I've struggled with. So how is vision related to car sickness?

In my opinion, this is one of the biggest kept secrets in eye care, or at least in the vision therapy world. So for most people who are motion sick, it's usually way worse when you're in the backseat. If you're reading, if you're on a tablet, if you're on a train, and you're trying to read and everything's going sideways motion sickness, from a lot of perspectives is thought about inner ear, and certain things like manures disease and things like that, which that's not my wheelhouse, that's not amendable to this type of treatment and what I specialize in, but I would say that probably about 80 to 85% of motion sickness has a visual component that's treatable. So I don't want to get into the weeds with neurology, but to really simplify it, we have two different types of visual processing pathways in our brain that are wired together, one that responds to central vocal visual input, and one that responds to peripheral ambient visual input. And when those are providing the same feedback on where something is in space, what's in motion, what's not, we're then functioning in a healthy way, we're not experiencing motion sickness, what happens when we're in a car. And in those scenarios, we're in the backseat or reading on a tablet, we're overriding that vocal input that's letting telling our brain that we are static, and we are not in motion, yet, the vestibular system and the peripheral processing system activates this, this receptors that allow us to know we're in motion. And our brain is in this disconnect, where it's kind of almost like a seesaw going back and forth between using those two systems to process information. And that push and pull or that tug of war makes it so that we don't know which way is up or down or left or right and where we are, which is why when we're sitting in the front seat, or when we're driving, we can override central focal processing and plan ahead and plan our body ahead for the turns that are common even unconsciously. It's rare to not have motion sickness improve with neuro optometric vision therapy, and in many cases completely eliminated given back this not motion sickness or other things like that can give your listeners a procedure to do at home to help with motion sickness, please, please, yeah, for this will help some it may help a ton. It's called the Infinity walk. So if you can picture an infinity signs, kind of like the number eight turns, start off by putting like, two stools in a room or two objects. And you're basically going to be walking in infinities path around the stools, whether your eyes are physically physically walking, but trying to keep he put like a sticker on the wall or look at something on the wall so that as you're turning, you're never looking away from the sticker or never looking away from the wall. So you're walking in this infinity pattern, but you're making all these body and neck and head rotations while never losing fixation. And that creates an a wonderful cross cerebral cross brain connection, that doing that enough with the right kind of building can help a lot of people and if you even Google infinity walk you'll see a lot of different procedures out there that build off of that you can then add eye movements to it you can add changes in position you can move away that the different targets the stools that you're walking around and you can visualize where they are you can make the pattern large. Sure you can make it smaller in terms of the path you're on. You can change directions, you can turn on a metronome and every time, every X amount of beats, you're changing direction there, because then you're integrating multiple sensory input. I mean, there's a lot that can be done to start broad, and then fine tune that moving forward.

Dr. Stephanie Gray 20:17

So is that like, what vision therapy is like these sorts of exercises that kind of teach? I mean, is that...

Dr. Bryce Applebaum 20:22

I would say, yes, vision therapy is more like that on steroids. Reason therapy relies a lot on lenses and prism, and filters and take for a lot more than sure. But take, for instance, that affinity walk there. But instead of as we're building that maybe we have then a target on the wall, where it's a picture of a clown and the hat, and the clown is seen by the right eye and the hat seen by the left eye and you're wearing red green glasses or Polaroid filters that controls what each eye sees and how we check filters. So that when the eyes disengage, or become unstable, you'll see that shift. And then maybe we'll use a lens or prison to artificially change where the hats located, move it on top of the clown, and then teach the patient that what it feels like what it looks like, and the depth or the 3d awareness that occurs when the eyes are working together. And then we ask them to reproduce that setup, whether it's with movement or on an overhead or projected out a window and then using lenses or prison to support what they can't do on their own, but then eventually substituting their visual skills or abilities for what that was doing. So that the hats on top of the cloud without the help of any other filter lenses or prison because your eyes are pointing in the same place and your brains turning on and respond to that information appropriately. That makes sense a little?

Dr. Stephanie Gray 21:33

Yes. I mean, it's it's somewhat over my head and I'm sure the listeners but it sounds amazing. And it takes a smart person they figure that out.

Dr. Bryce Applebaum 21:40

Vision therapy is arranging the conditions to raise the somebody's awareness of what they're doing so they can learn how to self correct and self monitor and make bad habits no longer options.

Dr. Stephanie Gray 21:50

Love it. We could end the episode right there. But I have to ask one more question and we'll wrap up.

Dr. Bryce Applebaum 21:55

Absolutely.

Dr. Stephanie Gray 21:56

So I do want to ask about supplements to promote the longevity of the eyes because you mentioned fish oil briefly. Do you want to just mention a couple others if you have some top favorites?

Dr. Bryce Applebaum 22:04

Yes, well first with with fish. I think coldwater fish which you probably can speak to way better than anybody else. green leafy vegetables are fantastic. kale, collard greens, spinach, all of that. And the the lutein and Xanthine that's in there is great for the macula, which is the sweet spot of your eye for the line of sight. Eggs are great. They have lutein they have lots of choline. Absolutely. I think vitamins AC and E, and citrus fruits and fruits with it and dark, dark foods with antioxidants great for preventing macular degeneration cataracts. And I know you're big on nutrition as well. You know, there's a lot of information coming out now about how macular degeneration can almost be viewed as as like type three diabetes, and it's in response to inflammation and insulin resistance. We have a lot of patients who we put on a strict elimination diet are on a keto diet where they can shift how their brain and body is functioning as what it's using as a fuel source, going away from sugar going into ketones, and especially if there's inflammation already, or concussion that speeds up the recovery dramatically. Coenzyme Q is great carrots, broccoli, this is how she we should be eating for hormones, as well as nurse and not just for our eyes or just in general. This is how we should be eating weight. And you probably see with a lot of a lot of your clients and patients that when hormones are all out of whack. Some of the symptoms are visual. Mm hmm. You know that brain fog comes from a lot of different areas. But hormonally that should be the first thing we're addressing. And back to concussion. I know progesterone is neuroprotective. Testosterone is great for blood flow, optimizing hormones can even help with recovery from injury and concussion and whatnot too. So a little plug in for hormones there.

Dr. Stephanie Gray 23:51

Well, this has been amazing. So tell us where listeners can find you. So you do you work with clients virtually? If someone's listening and they they want to work with you. Do you work virtually? Or do you have any sort of online programs kind of tell us about your business?

Dr. Bryce Applebaum 24:04

My practice is in is in Maryland outside DC but as of this year, I've set up a way to work with people virtually as Dr. Bryce applebaum.com There's a lot of different things that we ways to work with mirror ways to offer help. We have a couple of different programs, we have one called Screen fit, which is absolutely awesome and fantastic. And it's a wellness program designed to help people engage with screens for longer by doing vision exercises daily, almost like go into the gym for your eyes so that screens are less terrible, and that you can develop the systems to support those demands, even though we should be avoiding screens as much as we can. So screen fit.com is where you can find that and we'd love to offer a discount to all of your listeners here. We'll put the discount code if you can put it in the show notes maybe but we can give give a discount to to join that. And then I'm on Instagram to brace Applebaum Practice website Applebaum. vision.com. But I hope that everyone learned a ton and learn that they can we all know better so we can do better. And we should be challenging doctors and people where things don't make sense. And unfortunately, it's a problem with the eye care world more than anything else. But vision matters way more than eyesight. Think of those as different things.

Dr. Stephanie Gray 25:23

Love it, I would ask your top longevity tip, but I feel like that last sentence was a great longevity tip, what's your top longevity tip.

Dr. Bryce Applebaum 25:29

So everyone's heard of 2020 eyesight. Everyone should be doing a 2020 20 rule. Which means with screen time with needlework with anything up close, never more than 20 minutes without taking a break for 20 seconds and look at something 20 feet away. Speaking of longevity, most people around their 40th birthday we were all of a sudden arms aren't long enough, we have to hold things farther away. We can train our bodies we can train our muscles, but for some reason people think we can't train our eye muscles. We can't train our eyes, you can prolong the need for reading glasses, you can decrease the power that's needed for reading glasses by exercising the visual system and by developing better control over focus, stamina and focus flexibility. And there are lots of exercises that can be done at home as almost like a daily ritual, kind of like meditation or going to the gym. I have a lot of my patients it's here's the top two top three top five things I want you to do every day and it can definitely slow down the anatomical changes that occur and in many cases dramatically.

Dr. Stephanie Gray 26:31

I love it - mic drop thank you so much. Thank you for coming on the show today and sharing so much I know I and the listeners didn't know about their vision and how it's different from eyesight right so I know this will be helpful to many thank you so much.

Dr. Bryce Applebaum 26:43

This was awesome. appreciate having having me on here and thank you so much for offering this to your listeners

Dr. Stephanie Gray 26:51

Wow, that was awesome. Again, so insightful. As he said vision matters more than eyesight. Think of those as different things and remember his 2020 20 rule with screens never use them for more than 20 minutes without taking a break for 20 seconds and looking at something 20 feet away. Dr. Applebaum said vision therapy can change your life and I believe it if you'd like to connect with Dr. Applebaum use code Dr. Gray 10 knots Dr. Gra y 10 to receive 10% off his recently released screen Fit program their premier Doctor create an online vision training program designed to transform your tired strained and blurry computer eyes into HD clear vision. I look forward to trying that out myself. Link will be posted in the show notes.

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