Dr. Jeffrey Goldberg — Creating Supranormal Vision, Cutting-Edge Science for Eye Health, Supplements, Red Light Therapy, and The Future of Eyesight Restoration (#823)

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Dr. Jeffrey Goldberg is chair of the Department of Ophthalmology and director of the Byers Eye Institute at Stanford University. He is a leading scientist in the development and degeneration of the visual system from eye to brain and a professor, practicing ophthalmologist, and surgeon.
Dr. Goldberg is a member of the National Academy of Medicine, and has won a number of prestigious awards, such as Scientist of the Year by the Hope for Vision foundation and the Cogan award from the Association for Research in Vision and Ophthalmology. Dr. Goldberg received his BS magna cum laude from Yale University and his MD and PhD from Stanford University, where he made significant discoveries about the failure of optic nerve regeneration.

Dr. Goldberg’s research is directed at vision restoration, including neuroprotection and regeneration of the retina and optic nerve, a major unmet need in glaucoma and other eye diseases. His laboratory is developing novel molecular, stem-cell, and nanotherapeutics approaches for eye repair, and he is widely recognized for translating advances in the lab into clinical trials for patients.

A number of his innovations have spun out into startups and clinical-stage companies, and he serves as medical and scientific advisor to a number of ophthalmic start-up, pharma and device companies. His goal is to translate scientific discoveries to patient therapies.

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Dr. Jeffrey Goldberg — Creating Supranormal Vision, Cutting-Edge Science for Eye Health, Supplements, Red Light Therapy, and The Future of Eyesight Restoration

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Want to hear another podcast episode with a Stanford neuroscientist who won awards for vision research? Listen to my conversation with Dr. Andrew Huberman, in which we discussed the foundations of physical and mental performance, core supplements, sleep optimization, psychedelics, neural plasticity, and much more.

SELECTED LINKS FROM THE EPISODE

• Connect with Dr. Jeffrey Goldberg:

Faculty Profile | Stanford Ophthalmology | Clinical Trials

Conditions and Key Concepts

• Presbyopia: Age-related decline in near vision due to the stiffening of the lens.
• Myopia: Nearsightedness; an epidemic condition, especially in children, that can be slowed with red or violet light.
• Glaucoma: A neurodegenerative disease and the leading cause of irreversible blindness, characterized by damage to the optic nerve, often associated with high eye pressure.
• Age-Related Macular Degeneration (AMD): An eye disease that can cause blurred or no vision in the center of the visual field.
• Cataracts: A clouding of the lens in the eye that leads to a decrease in vision.
• Dry Eye: A common condition where the eyes don’t produce enough quality tears.
• Neuroplasticity: The brain’s ability to reorganize itself by forming new neural connections, a key concept for vision training and restoration.
• Supranormal Vision: Vision that is better than the “normal” 20/20 standard, such as 20/12.
• Mitochondrial Health: The proper functioning of mitochondria, the “powerhouses” of the cell, which is crucial for the health of neurons in the eye and brain.
• Metabolic Syndrome: A cluster of conditions (high blood pressure, high blood sugar, etc.) that increase the risk of heart disease, stroke, and type 2 diabetes.
• APOE3/4: A genetic variant that increases the risk of developing Alzheimer’s disease.
• Three-Parent Technique: An IVF method that cleverly avoids passing along mitochondrial disease to the offspring by incorporating DNA from three parents.

Anatomy of the Eye

• Cornea: The clear front window of the eye that does most of the light bending.
• Iris: The colored part of the eye (brown, blue, etc.) that controls the size of the pupil.
• Pupil: The opening in the center of the iris that light passes through.
• Lens: The structure behind the iris that performs fine-focusing; it stiffens with age, causing presbyopia.
• Vitreous: The gel-like substance that fills the middle of the eye.
• Retina: The light-sensitive tissue at the back of the eye that contains photoreceptors.
• Rods and Cones: The two types of photoreceptor cells in the retina. Rods are for low-light vision, and cones are for daytime color vision.
• Retinal Ganglion Cells: The neurons that collect visual information from the retina and send it to the brain.
• Optic Nerve: The bundle of nerve fibers (axons) from the retinal ganglion cells that connects the eye to the brain.

Supplements, Treatments, and Technologies

• AREDS 2: An over-the-counter supplement formulation clinically proven to slow vision loss in moderate age-related macular degeneration.
• Vitamin B3 (Nicotinamide): A vitamin supplement being studied for its potential to restore vision in diseases like glaucoma.
• CoQ10 and Ginkgo: Other supplements mentioned as having been studied for vision, with less conclusive evidence.
• Pilocarpine: The active ingredient in some FDA-approved eye drops that constricts the pupil to improve focus and treat presbyopia temporarily.
• Red Light and Violet Light Therapy: The use of specific wavelengths of light for minutes a day, shown to slow myopia progression in children and potentially support mitochondrial health.
• Strobe Goggles: Eyewear that reduces the visual frame rate (e.g., by strobing or flickering) to train an athlete’s reflexes and hand-eye coordination.
• Visual Perception Training: Computer-based exercises that aim to improve vision by training the brain’s processing abilities.
• Cannabis (THC/CBD): Mentioned for its ability to temporarily lower eye pressure in glaucoma patients, though continuous use is impractical.
• Low-Dose Psychedelics: Compounds like LSD mentioned for their potential to increase visual acuity and induce neuroplasticity.
• Stem Cells: Mentioned as a future, but not yet ready, therapy for replacing damaged retinal cells.
• Serum Tears: Custom eye drops made from a patient’s own blood serum, rich in growth factors to treat severe dry eye.
• Preservative-Free Artificial Tears: Recommended for frequent use to treat dry eye, as preservatives in standard drops can be irritating.

Media and Resources

• Andrew Huberman’s Podcast: Where I first heard Dr. Goldberg speak.
• Clinicaltrials.gov: A US government website for finding and learning about clinical trials for various conditions.
• Stanford Ophthalmology Website: Mentioned by Dr. Goldberg as a resource for finding clinical trials related to vision.
• Science is Real: A song by They Might Be Giants.

Institutions, Companies, and Foundations

• Stanford University: The institution where Dr. Goldberg, Dr. Huberman, Dr. Eagleman, and Dr. Williams work or have worked.
• FDA (Food and Drug Administration): The US agency responsible for approving medical treatments, mentioned in relation to eye drops and red light therapy.
• Cognito Therapeutics: A company developing a headset using light and sound to treat Alzheimer’s disease.
• MIT (Massachusetts Institute of Technology): The university where Ed Boyden and Li-Huei Tsai conducted foundational research.
• Harvard University: The institution where researcher Dongfeng Chen works.
• Holobiome: A company mentioned for creating a comprehensive library of gut microbiota.
• Glaucoma Research Foundation: A San Francisco-based non-profit organization.
• The Glaucoma Foundation: A New York City-based non-profit organization.
• DARPA (Defense Advanced Research Projects Agency): Mentioned for using devices to improve language acquisition.

People

• Andrew Huberman: A neuroscientist at Stanford and a mutual friend.
• David Eagleman: A neuroscientist at Stanford mentioned in the context of sensory substitution tools.
• Aaron Rodgers: A professional athlete mentioned in connection with using low-dose psychedelics for performance.
• Nolan Williams: A researcher at Stanford known for work on accelerated TMS for depression.
• Ed Boyden: A neuroscientist at MIT who co-developed the technology behind Cognito Therapeutics.
• Li-Huei Tsai: A neuroscientist at MIT who co-developed the technology behind Cognito Therapeutics.
• Dongfeng Chen: A professor at Harvard whose research linked the immune system and gut bacteria to glaucoma in mice.
• Gul Dolen: A researcher, formerly at Johns Hopkins and now at UC Berkeley, known for work on reopening critical periods of brain plasticity with psychedelics.
• Andreas Tolias: A researcher mentioned for creating a “digital twin” of the brain.
• Matthew McConaughey: American actor, author, and producer.

SHOW NOTES

• [00:00:00] Start.
• [00:05:30] How do you solve a problem like presbyopia?
• [00:08:34] The athletic benefits of training supranormal (better than 20/20) vision.
• [00:11:49] Indigenous eye drops and FDA-approved pilocarpine for presbyopia.
• [00:14:05] Understanding basic eye anatomy.
• [00:17:27] Exploring AREDS 2, CoQ10, ginkgo, vitamin B3, and other supplements for vision.
• [00:23:00] Visual training devices and psychedelic-prompted brain plasticity.
• [00:25:12] Thoughts on visual training effectiveness and motor action requirements.
• [00:28:29] Concussion rehabilitation and visual perception exercises.
• [00:32:36] Red light and violet light therapy for myopia and mitochondrial health.
• [00:36:07] Vision loss correlation with cognitive decline and depression.
• [00:39:36] Presbyopia progression and psychological dependence on readers.
• [00:41:15] Cognito Therapeutics headset for Alzheimer’s treatment.
• [00:46:46] Glaucoma basics: neurodegenerative disease and risk factors.
• [00:48:53] Eye pressure variability and diurnal cycles.
• [00:50:02] Cannabis effects on eye pressure and compound isolation.
• [00:51:47] Stem cell research for vision restoration.
• [00:53:09] Anti-inflammatory effects and immune system role in eye diseases.
• [00:55:15] Gut microbiome connection to glaucoma in animal models.
• [00:58:43] Metabolic syndrome and GLP-1 receptor agonists.
• [01:00:50] Microbiome sharing and future therapeutic possibilities.
• [01:03:31] Dry eye treatment: preservative-free tears and serum drops.
• [01:08:43] Vision screening recommendations and UV protection.
• [01:11:22] Full-spectrum light benefits vs. UV exposure.
• [01:13:27] Paradigm shifts: irreversible vision loss becoming reversible.
• [01:17:18] Convergence of neuroscience advances and biotech investment.
• [01:21:58] Miraculous mitochondria: health, transplants, and three-parent babies.
• [01:26:24] My family history concerns and metabolic health screening.
• [01:29:26] Exercise’s biggest gain: going from none to some.
• [01:33:03] Clinical trial participation resources and parting thoughts.

DR. JEFFREY GOLDBERG QUOTES FROM THE INTERVIEW

“I have gone my whole life without needing glasses until I hit around age 40. And when everyone hits around age 40, our lens inside the eye won’t compress and reshape to focus up close.”

— Dr. Jeffrey Goldberg

“Professional athletes get studied. They have better vision. They have better reflex time. They have sharper vision. We talk about 20/20 vision. That means I can see at 20 feet what a ‘normal’ person can see at 20 feet, so I have normal vision. But you can have 20/12 vision, which means you can see at 20 feet what normal people can see at 12 feet.”

— Dr. Jeffrey Goldberg

“Glaucoma is the number one cause of irreversible blindness in the world. That, I think, is going to be the piece that we overturn. We have always said, ‘Hey, we’ve got to prevent you from losing vision. We’ve got to slow down the disease because, once you’ve lost whatever vision you’ve lost, I can’t get that back for you.’ And I think that is about to topple. We are about to get into vision restoration at a level that has been totally unexpected and totally unprecedented, and the science supporting these directions in these diseases is getting really, really juicy.”

— Dr. Jeffrey Goldberg

“Cannabis, whether you smoke it or eat it in the brownie or take the chewy, it lowers your eye pressure if you’re using the version … where you feel a little high from it, you get that good feeling. The problem is that it only really lowers the eye pressure during that time that you’re getting high. So I tell patients, ‘It works, but you’d have to be high 24/7, so maybe you should just use this eye drop instead.”

— Dr. Jeffrey Goldberg

“A small dose of daily red light can slow down progression of myopia in young people. We’re talking about teens and younger, even. So what’s even more shocking to me is that it also works with violet light. So how’s it work with light at the two ends of the visible spectrum? And definitely mitochondria are implicated.”

— Dr. Jeffrey Goldberg

“There’s an important myth to dispel, especially when it comes to presbyopia and wearing reading glasses. Between age 40 and around 60 or so, that lens stiffens and stiffens and stiffens. That’s the refractive, the glasses difference between viewing something at infinity, which from an optics perspective is actually just three feet away or further, and viewing something at 14 inches, comfortable reading distance, right in front of us.”

— Dr. Jeffrey Goldberg

“If we all live to a hundred, we’re all going to need cataract surgery—some people younger, some people older. But if you do cataract surgery and restore vision in an older person who … is suffering with cognitive decline and/or depression, you can reverse a significant amount of that decline in either of those domains. It speaks to the interplay of vision with our mental health, our cognitive health, and this is long-term, important stuff.”

— Dr. Jeffrey Goldberg

“The important thing to remember [about exercise] is that the biggest gain comes from going from none to some.”

— Dr. Jeffrey Goldberg

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