Dr. Bryce Appelbaum | Eye Health and Vision Optimization

September 30, 2026
In this episode of the Health Optimization Medicine Podcast, Dr. Scott Sherr and Dr. Bryce Appelbaum explore:
Why is vision more than 20/20 eyesight, and how does the eye-brain connection influence nervous system regulation, movement, cognition, and performance?
How can prolonged screen time, close-up focus, and reduced peripheral awareness contribute to visual stress, sympathetic activation, brain fog, fatigue, headaches, and reduced productivity?
What is the difference between eyesight and functional vision, and why can problems with focusing, eye coordination, and visual processing affect how the brain interprets and responds to the environment?
Why is myopia increasing so rapidly, and what roles do genetics, time outdoors, natural light, near work, poor lighting, and screen use play in the development and progression of nearsightedness?
How can vision performance training, eye exercises, virtual reality, eye tracking, vestibular work, and sensory integration help retrain the way the brain uses visual information for reading, learning, movement, and performance?
What role do cellular energy and mitochondrial function play in the retina and eye-brain connection, and how do approaches such as creatine, red light, and other metabolic support fit into Dr. Appelbaum’s clinical work?
Why can vision become an important part of healthy aging, including balance, spatial awareness, navigation, fall prevention, and cognitive function, and why should functional vision be considered more than simply an eyesight measurement?
What practical strategies can people use to reduce visual stress from screens, including the 20-20-20 rule, visual breaks, outdoor time, screen distance, appropriate lighting, and targeted vision exercises?
Who is Bryce Appelbaum?

Dr. Bryce Appelbaum is an optometrist specializing in functional vision, vision performance, and the connection between the eyes and the brain. Through his work at My Vision First, he focuses on how the brain processes visual information and how improving the eye-brain connection can support reading, learning, athletic performance, productivity, and nervous system regulation. His approach looks beyond eyesight and 20/20 acuity to address how vision influences the way we interact with and respond to our environment.
Dr. Appelbaum’s work includes vision performance training for children and adults with functional vision challenges, as well as athletes, executives, and individuals recovering from traumatic brain injuries and concussions. His methodology combines elements of vision therapy, orthoptics, sensory integration, vestibular rehabilitation, neurocognitive training, and technologies such as virtual and augmented reality and eye tracking. He also works extensively with the effects of screen use and visual stress on the nervous system and performance.
In addition to his clinical work, Dr. Appelbaum created ScreenFit, an online vision training program designed to help people develop the visual skills needed for modern life. Through My Vision First, ScreenFit, and his educational content, he aims to increase awareness of functional vision as an important component of brain health, performance, and healthy aging.
What did Dr. Bryce and Dr. Scott discuss?

00:00 – How Peripheral Vision Can Shift the Nervous System
00:59 – Vision, Screen Time and Autonomic Regulation
02:11 – Why Screen Time Can Keep You in Fight or Flight
03:19 – Tunnel Vision, Visual Stress and Sympathetic Activation
06:32 – The Effects of Screen Time on Eye and Brain Health
07:15 – Eyesight vs. Vision
09:06 – Functional Vision and Progressive Myopia
10:06 – The Rising Rate of Nearsightedness
11:00 – Outdoor Time, Near Work and Screen Use
12:23 – Orthokeratology for Myopia Control
13:13 – How Overnight Contact Lenses Reshape the Cornea
14:32 – Can Adults Use Orthokeratology?
15:23 – Vision Training, the Brain and Cellular Energy
16:02 – Why the Retina Is a Window Into Brain Health
16:56 – Inflammation, Mitochondria and Visual Performance
18:48 – Methylene Blue Eye Drops and Safety Concerns
21:22 – Supplements Used in Vision Training Intensives
23:14 – High-Dose Creatine, Travel and Concussion Support
25:50 – Nervous System Regulation During Vision Training
26:08 – Shiftwave, Red Light and Recovery
27:10 – Visual, Vestibular and Proprioceptive Integration
28:32 – Using Vision to Calm the Nervous System
30:18 – What Is Vision Performance Training?
32:54 – Vision Training for Athletes, Gamers and Performance
33:42 – Why Longevity Medicine Often Ignores Vision
35:15 – Vision, Balance and Fall Prevention
36:03 – Visual Decline Is Common, but Is It Normal?
37:43 – Is Functional Vision a Vital Sign?
38:07 – The Best Screen Setup for Eye Health
39:09 – The 20-20-20 Rule and Screen Breaks
40:33 – The Best Sport for Functional Vision
41:59 – Eye Push-Ups for Focusing Stamina
Full Transcript:

[00:00:00] Dr. Bryce Appelbaum: Periphery and being able to access periphery, which is something we can all do. And then if you think about the two main visual processing pathways, we have a central focal visual processing pathway, and we have a peripheral ambient visual processing pathway. Those two should be balanced at all times.

[00:00:16] Dr. Bryce Appelbaum: Yet in that stress state, we're overriding central and our periphery becomes collapsed. 

[00:00:21] Dr. Scott Sherr: Hmm. 

[00:00:21] Dr. Bryce Appelbaum: So even just learning how to kind of engage in soft gaze and get panoramic viewing and diverge our eyes literally allows us to find the light switch to pull ourselves out of that state. But then also we can be presented with the same stress and not have the same response when we have the right tools in place to not react to our environment in the same way.

[00:00:43] Dr. Bryce Appelbaum: And I think that's really where the, the beauty is of vision performance training. It can allow- Hmm ... your brain to function at a higher level for longer because vision is a direct reflection of how our brain is functioning.

[00:00:59] Dr. Scott Sherr: [00:01:00] Dr. Bryce Appelbaum, it's good to see you again. How are you, how are you today? 

[00:01:02] Dr. Bryce Appelbaum: I'm doing amazing. Thank you for having me on. Good to see you too, my man. 

[00:01:06] Dr. Scott Sherr: So yeah, it's been a while, and I really wanted to get you back on because I've been thinking about you a lot, and, and, and r- really the respect of multiple different things, but the first thing that I wanted to dig in today is autonomic regulation.

[00:01:18] Dr. Scott Sherr: You know, when we think about the eyes, we think about, you know, how our sympathetic nervous system is truly being sort of overdriven in society these days. And I wanted to get-- give you sort of like an open-ended question here is that how do you see this being manifested in the world of, of, of your world overall?

[00:01:36] Dr. Scott Sherr: And, and then, and what are you kind of digging into now that's new maybe that you weren't digging into a couple years ago related to this? 

[00:01:43] Dr. Bryce Appelbaum: Love that. And I've been thinking about you a lot too, my man, so I, so I appreciate that. Yeah, I mean, it's-- what we preach with training the eye-brain connection to optimize performance and productivity, it's now directly related to nervous system regulation.

[00:01:57] Dr. Bryce Appelbaum: Mm-hmm. And I really look at [00:02:00] everyone having the opportunity to have vision be what drives and regulates their nervous system. And I think the, the elephant in the room for me is, is screen time. Right. And- 

[00:02:10] Dr. Scott Sherr: Right ... 

[00:02:11] Dr. Bryce Appelbaum: everybody all day long is engaging with these 2D devices inches from their face, blasting high-energy light at us for hours on end.

[00:02:18] Dr. Bryce Appelbaum: But screen time is toxicity for the nervous system, and unless we have done the work and trained our eye-brain connection like we train the rest of our body, most of us are not visually ready for screen time, and especially kids. And so when we can recognize that our dominant sensory system of vision can tie together input from all the other senses but also allow us to climb out of a fight or flight response with the right ability to access periphery, which grounds us in space, and with the right functional visual skills and abilities in place, screen time can be a lot less detrimental to our nervous system, and we can actually thrive in this digital world, but it requires work to get there and work that anybody can accomplish.

[00:02:58] Dr. Scott Sherr: So you said [00:03:00] periphery. So I wanna- Yes ... kinda dig into that because- Yes, yes, yes ... let's talk about screen time a little bit here because this kind of digs into the sympathetic activation aspect. So y- you're making a distinction between, you know, visual sort of focus, right, and periphery. So talk a little bit about that- Yeah

[00:03:16] Dr. Scott Sherr: in the context of nervous system regulation. 

[00:03:19] Dr. Bryce Appelbaum: So when we are under stress, when our autonomic nervous system is in a fight or flight response, how that shows up visually is our pupils widen, and we get locked in with this tunnel vision, which is literally as if we're looking through paper towel holders.

[00:03:33] Dr. Scott Sherr: Right. 

[00:03:33] Dr. Bryce Appelbaum: And World War III could be going on around us, and we have no idea. Evolutionarily, that is to protect us for the saber-toothed tiger that's charging and- Right ... blocking out the noise, and is this gonna be dinner or do I need to run? And that is the same maladaptation or the same state that we get into when we're on screens.

[00:03:53] Dr. Bryce Appelbaum: And so what happens is our focusing system, the inside muscles of the eyes, the accommodative system, become locked up. 

[00:03:59] Dr. Scott Sherr: Right. 

[00:03:59] Dr. Bryce Appelbaum: [00:04:00] Then the outside muscles, the eye coordination system, starts to kind of like a seesaw try and take over for what the inside muscles aren't doing, and we have faulty synergy between these two main eye coordination, eye focusing systems, and that allows us to perform very differently, and our brain gets in overdrive and starts becoming overwhelmed with all the sensory input.

[00:04:19] Dr. Bryce Appelbaum: And then as you know, you know, our ability to, to think outside the box shifts. Our fatigue becomes more pronounced. Our ability to divergently think becomes not even accessible. And then all of a sudden we're in this stressed state all day long when we're- Mm-hmm ... on screens all day long, which means people who are in desk jobs or anyone who's on screens, you're making critical decisions for work, for your family, for your livelihood in a stressed state.

[00:04:42] Dr. Scott Sherr: Hmm. 

[00:04:42] Dr. Bryce Appelbaum: Nobody wants that. 

[00:04:43] Dr. Scott Sherr: When it comes to Basically what you're saying here is that being on screen time, being on screens is sympathetic activation, is just, it's just the way it is, right? 

[00:04:53] Dr. Bryce Appelbaum: 100%. 

[00:04:54] Dr. Scott Sherr: And would you say that there's gonna be a spectrum here, of course, right? And I always talk about this. It's not like it's an on/off [00:05:00] button, you know, with your sympathetic nervous system.

[00:05:01] Dr. Scott Sherr: There's, there's like, it's like a dimmer switch and, uh, you know, the o- opposite of a dimming, you know, going up. Is that how you describe it to people? Because, I mean, it- looking at a screen like you and I are right now, there's gonna be some element of sympathetic activation, but there can also be more significant.

[00:05:14] Dr. Scott Sherr: How do we, how do you sort of measure that or how do you think about that, you know, from a quantitative perspective? Like, in the sense of like, or and how, and how can you sort of see that reflected in how, how people are kind of presenting to you? 

[00:05:25] Dr. Bryce Appelbaum: So we can absolutely measure it in a testing protocol, you know, with a really thorough functional vision evaluation, but most people don't have access to that or don't even know what that is.

[00:05:33] Dr. Bryce Appelbaum: So, and I think what that shows up as is often the symptoms like brain fog and fatigue and decreased productivity throughout the workday and avoidance of reading and avoidance of even interpersonal communication or not wanting to read before bed 'cause you're too exhausting or reading actually helping you fall asleep faster because it's pushing you over the limit, and really that's when our eyes are not working well together as a team and when the brain is [00:06:00] not able to filter, process, and interpret everything coming in through the eyes, try to make sense of it, derive meaning, and then direct whatever action is needed.

[00:06:07] Dr. Bryce Appelbaum: You know, it's performance, right? I mean, we train- Right ... athletes train performance, speakers train performance. There's so many areas where we can up-level our game, but when most people don't even know that this is possible, it just means that they kind of accept status quo, and then they go down the path of struggling unnecessarily with reading, with learning, with driving, with navigating through space, even with social interaction.

[00:06:32] Dr. Bryce Appelbaum: And so love that we're having this conversation because the toxicity that is screen time to our nervous system, the screens aren't going away, right? And yet we're now seeing the data of how this is impacting myopia progression, nearsightedness. 

[00:06:48] Dr. Scott Sherr: Yep, 

[00:06:48] Dr. Bryce Appelbaum: yep. How it's causing headaches, dry eyes, and tired eyes, how it's causing oxidative stress within our retinas that's now impacting the rest of our body, and, you know, it's, it's the type of thing that there's so much more that can [00:07:00] be done other than just avoiding it or relying on filters, right?

[00:07:04] Dr. Bryce Appelbaum: It, it's how do we use the eyes to rewire the brain to change how we're using the software- 

[00:07:10] Dr. Scott Sherr: Right ... 

[00:07:10] Dr. Bryce Appelbaum: and then having the right hardware and software to support performance moving forward. 

[00:07:15] Dr. Scott Sherr: Yeah, I love that. And I think one of the sort of more basic questions that I know that you get often asked, but I think it's important from a definition perspective, is the difference between eyesight and vision.

[00:07:25] Dr. Scott Sherr: Because this is kind of what you're kind of driving at, right? Oh, yeah. Which is there's a much different permutation here when we think about how we want to retrain. It's not retraining the eyes as much as the brain, right? And so talk about maybe the difference between those. 

[00:07:37] Dr. Bryce Appelbaum: Eyesight is our ability to focus light clearly.

[00:07:40] Dr. Bryce Appelbaum: Eyesight is a symptom. That's what glasses are for, what contacts- Right ... are for. 

[00:07:44] Dr. Scott Sherr: Mm-hmm. 

[00:07:44] Dr. Bryce Appelbaum: But vision is so much more complex, and there's so much more to vision than just 20/20, 20 whatever eyesight. Vision is how our brain is gathering information through the eyes, interpreting it, making sense of it, and then [00:08:00] facilitating what's needed moving forward.

[00:08:02] Dr. Bryce Appelbaum: And very often, eyesight is a reflection of vision. Right. So what that, what that means is- Right ... you know, when far away gets blurry, especially as we age, it's almost always related to a near problem, our focusing system not having the flexibility or stamina to withstand the demand. And so then the system becomes sluggish, our focusing muscles become w- more rigid, less flexible, like they're stuck in the mud, and then far away gets blurry, and then everyone listening knows the drill.

[00:08:32] Dr. Bryce Appelbaum: You go to the eye doctor, "Yep, I can't see stuff as well." "Great, here's stronger lenses." We're adapting to the lenses we're in to need something stronger to maintain that same clarity. 

[00:08:41] Dr. Scott Sherr: Yep. 

[00:08:41] Dr. Bryce Appelbaum: We go down this vicious cycle. 

[00:08:43] Dr. Scott Sherr: Yep. 

[00:08:43] Dr. Bryce Appelbaum: And the glasses aren't making things worse. It's our adaptation to life through the glasses, and the f- the brain that's attached to the eyes not having the bandwidth yet to be able to with- to maintain that.

[00:08:56] Dr. Bryce Appelbaum: So any adult who has their distance prescription [00:09:00] changing as they get older, red flags, neon lights around it, that is a functional vision problem. 

[00:09:05] Dr. Scott Sherr: Wow, 

[00:09:06] Dr. Bryce Appelbaum: yeah. And any child who's noticing that far away is getting blurrier, and, and myopia, which is increasing at an alarming rate now, and we can go over stats if we'd like, there's always a, a functional component to that.

[00:09:18] Dr. Bryce Appelbaum: And now the doctors who are specialized in myopia, even the structural doctors intervening when there's eye disease and looking only at structure, not even function, are recognizing that, wow, we need... We can actually predict this progression- 

[00:09:31] Dr. Scott Sherr: Hmm ... 

[00:09:32] Dr. Bryce Appelbaum: slow it down and stop it in many cases, and in some cases even reverse it, but it requires the right work, right motivation, and of course, the right compliance to do that type of work.

[00:09:40] Dr. Scott Sherr: And so maybe just some statistics on what you're describing, especially in children, if you have them- Yeah ... top of mind would be helpful, just because I'm seeing this in my own family, right? We do our best with screen time, like many families do, and but I have a 15, 14, 11, and nine-year-old, right? And so the three older ones have [00:10:00] phones.

[00:10:00] Dr. Scott Sherr: They're in, in school, and I know these statistics are kind of crazy, so- 

[00:10:03] Dr. Bryce Appelbaum: All right. It's- 

[00:10:03] Dr. Scott Sherr: Please ... 

[00:10:04] Dr. Bryce Appelbaum: it's, they're, they're nuts here. So- 

[00:10:06] Dr. Scott Sherr: Yeah ... 

[00:10:06] Dr. Bryce Appelbaum: when we landed on the moon in 1969, about a fourth of America was nearsighted. Right now, that number is at about 44% and climbing. And so to give a little bit more of a global perspective, 30% of the world right now is nearsighted or is myopic, and it's estimated that by 2050 50% of the world will be nearsighted, and that's including countries that don't have access to technology and education like we do.

[00:10:30] Dr. Bryce Appelbaum: And we now have the research and the literature to support what we've known in my specialty for a long time, that genetics and environment play a big role. 

[00:10:39] Dr. Scott Sherr: Mm-hmm. 

[00:10:39] Dr. Bryce Appelbaum: So if we were to talk about genetics, you can't control who the parents are, but even just if two individuals right now were to have a child and both individuals are nearsighted, that child would have a one in two chance of being nearsighted.

[00:10:50] Dr. Scott Sherr: Sure. 

[00:10:51] Dr. Bryce Appelbaum: If only one parent is, one in three chance, and if neither parent is, a one in four chance, and that's because of environment and lifestyle. And we know the three [00:11:00] biggest risk factors for the development and progression of nearsightedness are, number one, not enough time outdoors, and it's proven that two hours a day is actually protective- Hmm

[00:11:09] Dr. Bryce Appelbaum: for the progression development of nearsightedness. And that's not just you're outside getting away from screens, although that's helpful, but it's the natural sunlight and UV light that actually is helpful that, in that scenario. It's the engaging with three-dimensional space. It's the having vision guide movement, which it's intended for.

[00:11:26] Dr. Bryce Appelbaum: The second, too much near work and poor lighting, and then the third, too much screen time. And so, you know, for your children, your children born when we were kids very likely would have less myopia in place, maybe not even any at all, and there's a lot we can control. There's also a lot we can't control.

[00:11:42] Dr. Bryce Appelbaum: So I have three children. I've got twins who are 12. I have a, a eight-year-old as well. My twins are, who were showing signs of myopia early on, as early as five, and of course they're my kids. They don't have any other option. We're f- we're addressing this. Right. At 12 now we've rerouted things and [00:12:00] they're solid.

[00:12:01] Dr. Bryce Appelbaum: Nice. But my eight-year-old actually has mild to moderate myopia, even though I've been on top of it. And the big difference for her, she's a competitive dancer, so she's away from screens a lot, but she's indoors. 

[00:12:13] Dr. Scott Sherr: Right. 

[00:12:14] Dr. Bryce Appelbaum: And most of her life is indoors, and we know what natural light and UV light and engaging with three-dimensional space does for that progression.

[00:12:23] Dr. Bryce Appelbaum: And so she's actually now in something so cool called orthokeratology, which are contact lenses that she sleeps in at night, kind of like a retainer for her eyes instead of her teeth. 

[00:12:32] Dr. Scott Sherr: Interesting. 

[00:12:33] Dr. Bryce Appelbaum: It reshapes the cornea, kind of like a reversible LASIK would do. She takes them off in the morning. She sees crystal clear all day long.

[00:12:40] Dr. Bryce Appelbaum: She puts them back in at night. It is the number one way to slow down the progression of nearsightedness in our clinical experience. Wow. And one of three or four that has been FDA approved to actually address this in terms of the slowing down. But for her, we've not only slowed it down, we've drawn a line in the sand, and she's actually reversed some.

[00:12:58] Dr. Bryce Appelbaum: And so from that standpoint, you [00:13:00] know, she's, she was in these as early as seven, but she knows if she doesn't wear the contacts at night, she doesn't see the next day. And so it's one of 

[00:13:09] Dr. Scott Sherr: these things- Interesting. So it's a very, very direct relationship between... So these contacts, what are they doing exactly, and how are they working?

[00:13:13] Dr. Bryce Appelbaum: So if you think of the cornea, the front surface of the eye as this mound of sand, we're flattening the cornea, so the ce- central cells are migrating into the periphery. Okay. And with LASIK, we're shaving off the cornea- 

[00:13:25] Dr. Scott Sherr: Right ... 

[00:13:25] Dr. Bryce Appelbaum: to allow the image to be focused on the back of the eye more easily. This is creating the same effect, but We're targeting the right type of zones within that cornea.

[00:13:36] Dr. Bryce Appelbaum: So it's almost like a bullseye where the center of the cornea is the flattest, and then it gets progressively less flat as we go out. And we take topographical maps of her cornea at certain intervals so we can really tweak it to get to the perfect level. But it's a very similar parallel to, like, a retainer- Yeah

[00:13:51] Dr. Bryce Appelbaum: for your teeth, right? Right. Sure. If you stop wearing the retainer, you go backwards. 

[00:13:53] Dr. Scott Sherr: Right. 

[00:13:54] Dr. Bryce Appelbaum: But if you wear it, then your teeth are straight, and you get to a point where things do level out and flatten. 

[00:13:59] Dr. Scott Sherr: Okay. That was gonna be my [00:14:00] question. Yeah, yeah. 

[00:14:00] Dr. Bryce Appelbaum: But this is, I mean, the num- we have so many professional athletes in these as well who are like, "I don't want my performance impacted because of a quick eye movement, and the lens doesn't follow or dryness or whatever."

[00:14:10] Dr. Bryce Appelbaum: So not only is this super cool and convenient, it's clinically the most effective treatment that we find, and it's rare to have a patient go into these and have their prescription increase because you're essentially strong-arming, you know, the, what is changing- Yeah ... and allowing the brain to then not have to adapt as quickly, and then the eyeball doesn't elongate like it used to, and then- Sure

[00:14:32] Dr. Bryce Appelbaum: you have a better scenario. 

[00:14:32] Dr. Scott Sherr: So this would, would be really something, would be ineffective for somebody that was having sort of progressive myopia, right? Somebody that, like, like a child, for example. But when somebody has more of, like, stable myopia as an adult, is there a role for them to use something like this there as well or how does that- 

[00:14:45] Dr. Bryce Appelbaum: Absolutely, and, and, you know, I think the, the talk about Ortho-K is more about for children because it slows down the progression.

[00:14:51] Dr. Bryce Appelbaum: Yeah, yeah. But you could take an adult or any eye that has myopia, and up to a certain level- Sure ... I mean, there's certain diagnostic criteria that have to be met, but- 

[00:14:59] Dr. Scott Sherr: [00:15:00] Right ... 

[00:15:00] Dr. Bryce Appelbaum: yeah, adults can wear these, take them off, and then they see clear all day long. We have a lot of adults who say, you know, "I wanna be 20 happy in the distance, but then I wanna make it so I'm not gonna need reading glasses."

[00:15:09] Dr. Bryce Appelbaum: Yes. So we can kind of find whatever middle ground is needed, have that be what the Ortho-K's set for, and then we're relying on other glasses if we need to for specific scenarios. 

[00:15:19] Dr. Scott Sherr: Gotcha, gotcha. Yeah. 

[00:15:19] Dr. Bryce Appelbaum: But these benefit any two eyeballs or one eyeball that's attached to a brain. 

[00:15:23] Dr. Scott Sherr: At least one. You're gonna have to have at least one eyeball, you know?

[00:15:25] Dr. Scott Sherr: Two- At least one ... two's a bonus. I get it. What, what this kind of brings up as you were speaking, though, Bryce, is what you've des- described earlier, the sense that vision is not just about the eyes. It's about retraining the brain and sort of the metabolic capacity of the brain. So how does that interact in the sense that, you know, one of the things that I think about a lot these days is cellular energy.

[00:15:45] Dr. Scott Sherr: Yeah. I talk about this all the time. I, I do think that, unfortunately, what we often try to do is try to, like, down-regulate somebody's nervous system before they have enough energy to be able to do it. And, and I, I would imagine there's a significant reflection in this in, in vision training and the stuff that you're doing with the brain.

[00:15:59] Dr. Scott Sherr: [00:16:00] How does, how does that sort of reflect on, on the work that you do? 

[00:16:02] Dr. Bryce Appelbaum: Yeah. So, you know, the retina is some of, if not the most metabolically active tissue within our body. 

[00:16:09] Dr. Scott Sherr: And there- Yeah, I wonder what the number is. I wonder what the ranking is. I was wondering about the retina because I, I, I always talk about the brain, you know, being number two- Yeah

[00:16:15] Dr. Scott Sherr: outside of the reproductive organs, having the most mitochondria per cell, but I know the retina's up there, too, so. 

[00:16:20] Dr. Bryce Appelbaum: So I've been looking for numbers, and I hear- Yeah ... I- rankings are easy to find, and it's like- 

[00:16:24] Dr. Scott Sherr: Yeah ... 

[00:16:24] Dr. Bryce Appelbaum: per d- per density or per square, you know, area of the eye, but retina- Sure ... is brain tissue.

[00:16:31] Dr. Scott Sherr: True. 

[00:16:31] Dr. Bryce Appelbaum: Yeah. And it, retina emerges from the brain in utero in the first trimester- Very true. Yeah ... and it is the only part of the brain you can see without things getting messy. 

[00:16:40] Dr. Scott Sherr: Yeah. 

[00:16:40] Dr. Bryce Appelbaum: And so, you know, I think that, you know, what you do with, with cellular health and, and how you are the absolute leader in mitochondrial function and how we can optimize the, the hardware, you know, that just sets up work on the software for success.

[00:16:56] Dr. Bryce Appelbaum: And, you know, when there's systemic inflammation, it almost always [00:17:00] shows up in the eyes as well. And oftentimes we can see structural changes within the eye that give a window into the rest of the body before it even manifests in, in the rest of the body. Mm-hmm. So I think from that standpoint, you know, powering up mitochondria, whether it's with methylene blue, red light, or whatever we're, we're tapping into, it allows the, the synapses and the signals to be sent more quickly, more accurately, more efficiently so that the brain can then actually utilize that more efficiently.

[00:17:31] Dr. Bryce Appelbaum: And if we're working on somebody's depth perception or reaction time or peripheral awareness or eye movement control, having the input and the connection be as robust as possible only allows for better outcomes, and that's why I know we- we've spoken, I have all of our intensives take methylene blue and take Troscriptions methylene blue because it's only gonna help the work we're doing.

[00:17:54] Dr. Bryce Appelbaum: And a lot have noticed significant improvements in terms of how much they can push while they're [00:18:00] here- Right. Right ... and then the recovery piece as well. 

[00:18:01] Dr. Scott Sherr: Right, because, you know, methylene blue has this amazing capacity to just make the mitochondria more efficient, and it does it very, very quickly within a couple days of finding the right dose.

[00:18:10] Dr. Scott Sherr: That's what I love about it, is it really does have that systemic capacity to support mitochondrial function. The Health Optimization Medicine Conference is happening. Two days of events, October 2nd and 3rd, Chicago, Illinois, at the Drake Hotel. CMEs available to practitioners who need them. Just 150 people with amazing speakers on the cutting edge of health and wellness.

[00:18:30] Dr. Scott Sherr: This is a community. It's not your average conference. If you're interested, go to homehope.org and save 25% on your ticket by using conference25 at checkout. I hope to see you there. O- other than methylene blue, what is it, what other supplements are, are usually within your stack of, uh, of supplements you require for more of an intensive?

[00:18:48] Dr. Bryce Appelbaum: Uh, well, actually, can I ask you a quick question first? 

[00:18:50] Dr. Scott Sherr: Of course, yeah. 

[00:18:51] Dr. Bryce Appelbaum: Methylene blue eye drops 

[00:18:53] Dr. Scott Sherr: Yes. Th- there is a th- this is a thing. Um- 

[00:18:55] Dr. Bryce Appelbaum: This 

[00:18:55] Dr. Scott Sherr: is a 

[00:18:55] Dr. Bryce Appelbaum: thing ... 

[00:18:56] Dr. Scott Sherr: but I, I don't know how to dose them exactly. [00:19:00] I don't know what the, the dilution should be. I don't think it's gonna make people's eyes blue. I know that would be one concern.

[00:19:06] Dr. Scott Sherr: We have a couple companies that have methylene blue containing skin creams, and it's, like, mildly blue, but it doesn't look blue- Yeah ... when it goes on you. So I think the, I, I don't think the concentration needs to be as high because it's gonna be in a drop going directly on the eye. Have you played around with these yet or, or no?

[00:19:21] Dr. Bryce Appelbaum: Well, so I've not played around with it, but I'm- Yeah ... I know I'm biased, and I've got- Yeah ... a very busy two-location clinic, but we see so many people who have ocular complications and toxicities from whatever methylene blue drop they're using off of Amazon. 

[00:19:37] Dr. Scott Sherr: Aye. Yes. Yeah, yeah. 

[00:19:39] Dr. Bryce Appelbaum: And- Very, 

[00:19:39] Dr. Scott Sherr: yeah ... 

[00:19:40] Dr. Bryce Appelbaum: of course, quality with everything matters big time, but- 

[00:19:43] Dr. Scott Sherr: Yes

[00:19:44] Dr. Bryce Appelbaum: I, you don't even know what's in there. You don't even know- Yeah ... how it's formulated. So I'm seeing the people who have, like, conjunctivitis and- 

[00:19:52] Dr. Scott Sherr: Yeah ... 

[00:19:53] Dr. Bryce Appelbaum: scary stuff, and oftentimes they hide that it was methylene blue, but when I- Interesting. Yeah ... you know, when you do, when you ask enough, it's like, "Oh, [00:20:00] yeah, I was doing this 'cause some influencer online told me this- Yeah

[00:20:02] Dr. Bryce Appelbaum: was what I need to do," and- 

[00:20:04] Dr. Scott Sherr: Yeah, 

[00:20:04] Dr. Bryce Appelbaum: you gotta be so careful ... so that's good to know. Yeah. 

[00:20:05] Dr. Scott Sherr: You gotta be so careful with methylene blue because contamination of heavy, heavy metals and, uh, lead, mercury, cadmium, and arsenic are not gonna be good for any part of your body, including your eye. Right. And then dilution is an is- an issue because I don't know exactly how much the eye should get of actual methylene blue, and there's also metabolites of methylene blue that can, might be more dangerous to the eye if it's been o- if it's old methylene blue.

[00:20:25] Dr. Scott Sherr: So that's why we, you know, we care as much as we do about quality. Maybe you and I can convince my team to make eye drops. I can see what- Well- ... I can see. 

[00:20:32] Dr. Bryce Appelbaum: Well, we'll try it out. I, I trust anything coming from your team and from Troscriptions, so I'm, I'm down- Yeah ... if you are. And- I appreciate you ... you know, the, the absorption in the eye is, is incredible.

[00:20:41] Dr. Bryce Appelbaum: I know- Of course ... when I was in school and worked at a, uh, clinic in Chicago that was all disease- Yep ... and some scary things, we would see people who have, you know, temporary or sometimes permanent blindness from putting certain drugs actually in their eyes for quicker [00:21:00] absorption. Yep. And I mean, the, I, I've seen corneas, like, entirely ripped off essentially to the point where- Yeah

[00:21:07] Dr. Bryce Appelbaum: although the cornea's some of the fastest healing tissue- Bad news when you're in that scenario, so, um- 

[00:21:13] Dr. Scott Sherr: Yeah, yeah, for sure. You gotta be really careful of what, where you're putting anything in your body, of course, but- 

[00:21:18] Dr. Bryce Appelbaum: Totally ... 

[00:21:18] Dr. Scott Sherr: your eyes are kind of a big deal, so. Yeah, so but- So 

[00:21:20] Dr. Bryce Appelbaum: other supplements. 

[00:21:21] Dr. Scott Sherr: Yeah, yeah, go ahead.

[00:21:21] Dr. Scott Sherr: Yeah, please. 

[00:21:22] Dr. Bryce Appelbaum: So I, I would say we have a stack, uh, for our intensives. In our intensives, you know, we see people every week from all around the world who come in for treatment, and they do this boot camp, and we only have five days in office, so we want to maximize every second. So methylene blue is part of this in Troscriptions.

[00:21:36] Dr. Bryce Appelbaum: We, we do exogenous ketones as well, which, you know, really allow- Yeah, 

[00:21:41] Dr. Scott Sherr: which type? Which ones are you using? 

[00:21:42] Dr. Bryce Appelbaum: So I, I love right now Kinetica. 

[00:21:45] Dr. Scott Sherr: Okay. Yep. 

[00:21:46] Dr. Bryce Appelbaum: And they have a, a medical-grade concentration. Yep. I know. And they've actually-- They're an incredible company, and they helped create our own protocol, especially for traumatic brain injury.

[00:21:56] Dr. Scott Sherr: Nice. 

[00:21:56] Dr. Bryce Appelbaum: And that's been amazing, so that's a big pillar for what, [00:22:00] for what we use for supplements. Glutathione, specifically Glu- Glutaryl, the spray form from Ora Wellness. That is incredible in terms of just From a detox standpoint and, and really allowing the recycling trucks to go through and clean up the body.

[00:22:14] Dr. Bryce Appelbaum: Mm-hmm. And then a lot of the, the ones that you're probably familiar with that are kind of standard for a lot of different disciplines, but omega-3s, we do a lot of minerals. We do creatine for brain health, and I know creatine's getting a lot of attention these days. It 

[00:22:28] Dr. Scott Sherr: is. It has, yes. Yeah. We c- I combine a lot of my protocols now, of course, with methylene blue and creatine together because they're very, very synergistic, those two.

[00:22:36] Dr. Scott Sherr: Yeah. A- 

[00:22:36] Dr. Bryce Appelbaum: and, uh, the HCL form, there's a, a company called Cheatine that h- comes in HCL. So- 

[00:22:43] Dr. Scott Sherr: Hmm ... 

[00:22:43] Dr. Bryce Appelbaum: the monohydrate, especially for women, can be r- can really disrupt digestion and cause bloating for women. We have found that when you can load up creatine in the HCL format, I mean, it's, it's so much better tolerated.

[00:22:55] Dr. Scott Sherr: Have you played around with the dosing at all, like in the sense of can you... Because I mean, we talk about creatine, for example, [00:23:00] and there, the research on sleep deprivation and, and using very high doses. Have you played around- Yeah ... with super high doses before training to see if it has any effect comparatively?

[00:23:08] Dr. Bryce Appelbaum: Absolutely. A- and I always experiment with myself first- 

[00:23:11] Dr. Scott Sherr: I know 

[00:23:11] Dr. Bryce Appelbaum: you do. ... before I, I offer it to patients. But, uh- 

[00:23:13] Dr. Scott Sherr: Yeah ... 

[00:23:14] Dr. Bryce Appelbaum: usually it, it's about 3 to 4X the recommended dose. So for monohydrate- Right ... you know, it's upwards of, like, 15 to 20. Creatine actually is incredible for jet lag once your circadian rhythm disruption is in place.

[00:23:27] Dr. Bryce Appelbaum: And so I, I load up two days before I travel and then throughout until I'm, I'm regulated there. With the HCL format, it's, you know, a different dose because it's more readily digestible and absorbable. Okay. Mm-hmm. But I think the three, the 3 to 4X of whatever the, the standard dose is, has -- we found is, is kind of being the sweet spot.

[00:23:45] Dr. Bryce Appelbaum: Okay. And typically over that you're not really absorbing it and a little bit different. And I think especially from traumatic brain injury and concussion standpoint, creatine is huge, and we've been recommending that for years. Right. But it's great to see it get all this attention now beyond just getting buff in the [00:24:00] gym.

[00:24:00] Dr. Scott Sherr: I know. I mean, when I was back in medical school, I was taking a whole bunch, and I gained like 20 pounds of water weight, uh, basically, and then I stopped it, and then it all went away. So it does cause hydration of the muscles. We know it. We do know this, but we also know that the brain, as, as, as you know, has very little energetic reserve.

[00:24:16] Dr. Scott Sherr: It doesn't keep anything in reserve, so it has to continue to recycle to get more ATP. It's not like it's got glycogen around to hang out, you know? And that's why it seems that creatine is as effective. A- and for these kinds of protocols for TBI, for your intensive, are you using this high dose on a daily basis typically or does it depend on the patient?

[00:24:34] Dr. Scott Sherr: How do you typically do 

[00:24:35] Dr. Bryce Appelbaum: it? So, so it depends if they've been taking it or not. Okay. If they have been taking it, we go high dose immediately. Okay. And if they have not, we start low and then that's more of a exit into life strategy. I mean, you bring up an interesting point here, though. I remember when I was in high school and college and lifting and same thing.

[00:24:51] Dr. Bryce Appelbaum: Like, I -- you get swole and your muscles, you know- 

[00:24:53] Dr. Scott Sherr: Yeah ... 

[00:24:54] Dr. Bryce Appelbaum: water pulls in. It feels like that doesn't happen now as we're old guys. W- w- is there -- is that just- 

[00:24:58] Dr. Scott Sherr: I haven't, I haven't tried to s- I haven't [00:25:00] been taking that much Consistently. I took it like six months for, like 20 grams a day for six months or something like that.

[00:25:05] Dr. Scott Sherr: So I'm sure you did at least something like that too. 

[00:25:07] Dr. Bryce Appelbaum: Yeah. Um, yeah. Well, I'm interested. I, I wonder now, 'cause I don't I don't hear that from anybody now 

[00:25:13] Dr. Scott Sherr: I, I think if you did take that high of a dose for that long- Yeah. You would, yeah ... you would get the same effect. But it, it is a, it's a hydration effect though.

[00:25:19] Dr. Scott Sherr: So things look bigger because you have more hydration in the muscles. But I think, I mean, maybe we can dig into this a little bit because I don't know how much people know that, you know, about sort of energetic store, right? In the sense that there are certain places in the body where we can store energy, where so we have it as sort of rapid need.

[00:25:34] Dr. Scott Sherr: But the brain is not one of them, and I'm sure this is one of the reasons why we're seeing such depletion, right? People are always in sympathetic activation. They're always having their eye muscles turned on as a result, and this is probably one of the main reasons why that they're getting so fatigued, right?

[00:25:47] Dr. Scott Sherr: Is that they're just getting, like, energetically depleted. 

[00:25:50] Dr. Bryce Appelbaum: Absolutely. And, and that then pulls on the rest of the systems. And, you know, it's funny, for our intensives we do a lot of the other-- We do magnesium L-threonate, we do [00:26:00] ashwagandha, we do different minerals, we do a couple nootropics, but we also do a lot for nervous system regulation.

[00:26:07] Dr. Bryce Appelbaum: So we- 

[00:26:07] Dr. Scott Sherr: Yeah, I was gonna ask you. Yeah. Yeah. 

[00:26:08] Dr. Bryce Appelbaum: Are you familiar with the Shiftwave chair? 

[00:26:10] Dr. Scott Sherr: Yeah. I've heard of it. Yeah. 

[00:26:11] Dr. Bryce Appelbaum: So we have one of those, and it is, it is incredible. We, we have a protocol where we have patients use that at the end of their treatment during their intensives, and it's almost just this, like, calming reboot.

[00:26:21] Dr. Bryce Appelbaum: But I know they, they have a lot of, uh, different professional sports teams that use it. Yep. And I-- from what I hear, like, Special Forces and some Navy SEALs use this as, like, a return from a mission protocol. 

[00:26:31] Dr. Scott Sherr: Mm-hmm. 

[00:26:32] Dr. Bryce Appelbaum: So that's been awesome. Um, we do a lot of red light as well. 

[00:26:34] Dr. Scott Sherr: Do you use that too? Do you use the Shiftwave at the office?

[00:26:35] Dr. Scott Sherr: And that's what I'm jealous of- Well- ... is have- not having one, not having a, having an office so I can have one of those chairs, 

[00:26:40] Dr. Bryce Appelbaum: so You know, I, I don't use it enough knowing it's right next door in my, in my office here. I know. Yeah. But it's funny, my docs like, you know, end of the day, oftentimes I'm like, "Oh, they're staying late.

[00:26:49] Dr. Bryce Appelbaum: This is awesome," and they're just on the Shiftwave hanging out. But- 

[00:26:52] Dr. Scott Sherr: It's great. How long, how long is the protocol on the, on the, on the chair typically? 

[00:26:55] Dr. Bryce Appelbaum: So they have- Different ones ... many different protocols. The one we do is, is [00:27:00] 12 minutes- Okay ... but they have some that are an hour long for sleep, and they have certain ones for, you know, getting to a meditative state, and they have certain ones for...

[00:27:07] Dr. Bryce Appelbaum: We, we wanna create one to help support motion sensitivity. Hmm. 

[00:27:10] Dr. Scott Sherr: Okay. 

[00:27:10] Dr. Bryce Appelbaum: Yeah. And to have certain vision exercises while you're doing that because I think for the vestibular system, visual system, and proprioceptive systems to be speaking the same language, that can eliminate or reduce motion sickness for the vast majority of the population.

[00:27:26] Dr. Scott Sherr: Hmm. 

[00:27:26] Dr. Bryce Appelbaum: And I think that's one way that could make this almost be this sped up protocol rather than having to go through all the treatment if it is more of an isolated symptom. 

[00:27:34] Dr. Scott Sherr: Yeah. Have you ever thought about using it before treatment as well as a way to kind of, kind of- Prime the system ... break people?

[00:27:40] Dr. Scott Sherr: Yeah, prime the system, yeah. 

[00:27:41] Dr. Bryce Appelbaum: Yeah. I, I think in a perfect world, we use that first for activation, and then we use it after for kind of a- Sure ... calming effect. We, we do have, for some of our very symptomatic TBI patients, that's what we do. 

[00:27:55] Dr. Scott Sherr: Hmm. 

[00:27:55] Dr. Bryce Appelbaum: Mm-hmm. But time is, is limited, you know, in terms of we only have a certain amount of time [00:28:00] while they are here.

[00:28:00] Dr. Bryce Appelbaum: But we do have a lot of our intensives who will just hang out in the chair after their treatment's done, and- 

[00:28:04] Dr. Scott Sherr: Yeah ... 

[00:28:05] Dr. Bryce Appelbaum: it's great 

[00:28:05] Dr. Scott Sherr: Yeah. One of the-- It just kind of comes to mind, right? Because you have somebody that's already sort of sympathetically dominant that's coming into your clinic to do brain training.

[00:28:14] Dr. Scott Sherr: Like, that could be hard, right? Like, so what are some of the other tools you use? I mean, you probably-- I mean, like we talked about, you can use vision both ways. You can use it to calm down the system. You can use it to activate the system. So if somebody's coming in sympathetically activated to the office, like, what's your, what's your, what's your program here?

[00:28:30] Dr. Scott Sherr: What do you tell them to do? Yeah. 

[00:28:32] Dr. Bryce Appelbaum: Well, and the most of the people we work with are visually overloaded- Yeah, exactly. Yeah ... and their brain is, is putting in, is on overdrive just trying to align, point, and focus the eyes, that the ability- Yeah ... to process and use it is not even accessible. I, I honestly think vision performance training is what can calm the nervous system.

[00:28:46] Dr. Bryce Appelbaum: Okay. And it's not like physical therapy where you wanna kind of have the no pain, no gain mentality. I mean, w-we kind of position this as it's using your eyes as, like, joysticks to tap into the brain to allow for new connectivity. Does anybody know 

[00:28:59] Dr. Scott Sherr: what a [00:29:00] joystick is anymore? I don't know if, you know- 

[00:29:01] Dr. Bryce Appelbaum: I know.

[00:29:01] Dr. Bryce Appelbaum: I- I guess there's still that on Xbox controllers that they use like 

[00:29:04] Dr. Scott Sherr: that, but- Oh, okay. I don't even know. All right 

[00:29:05] Dr. Bryce Appelbaum: I, I don't either, but, 

[00:29:06] Dr. Scott Sherr: uh- I think about, like, the old Atari or, like, the arcade things, you know, but anyway. 

[00:29:09] Dr. Bryce Appelbaum: But our eyes can rewire the software of our brain to change how we're using vision, but to allow for much-- uh, to allow the airplanes in our brain to take off and land more ef-effectively.

[00:29:19] Dr. Scott Sherr: Sure. 

[00:29:20] Dr. Bryce Appelbaum: And especially when there's sensory overload in busy, crowded environments like the mall or grocery store, where there's light sensitivity, when there's strained, tired, blurry eyes on screens, that is always related to that eye-brain connection being inefficient and oftentimes how our body's sending a signal to disengage from the task because it's not safe.

[00:29:38] Dr. Bryce Appelbaum: Yeah. And so finding safety, as you know with nervous system regulation, that's like the, the destination. And- 

[00:29:44] Dr. Scott Sherr: Mm-hmm ... 

[00:29:45] Dr. Bryce Appelbaum: you know, we-- I had an interesting conversation this morning with one of our patients who's had double-digit concussions, and she's miserable throughout the day symptom-wise, but she says only when she's in treatment with us and when she leaves her weekly sessions does she feel good, and then [00:30:00] things kind of regress, and it's just now with enough reps in and enough work, and the more opportunity the brain has for learning with the least amount of time between the learning, the faster learning takes place.

[00:30:09] Dr. Bryce Appelbaum: And so now she's at the point where, you know, she doesn't have to come in as often, and she's getting to kind of a sweet spot for allowing just that to be her new equilibrium and her normal. Mm. 

[00:30:18] Dr. Scott Sherr: I love that. I mean, I think it'd be a good time then to d- kind of dig, dig in a little bit into vision performance training.

[00:30:24] Dr. Scott Sherr: Like- Yeah ... we were talking about how this can really throw you into more of a parasympathetic mode and be able to help you actually process visual information much more optimally. Tell me a little bit about what that is for you, Bryce. I know this has- Yeah ... evolved over the years, and I know it probably started off with lots of different things, and you've kind of like whittled it down to the main things that truly help people.

[00:30:44] Dr. Scott Sherr: So maybe if you could just go through some of those main things that you're using and, uh, because it seems like what you're doing really is sort of retraining via joysticks and all this other kind of things to like actually have that parasympathetic activation even in the context of having a lot of screen time for all of us.

[00:30:58] Dr. Scott Sherr: Yeah. 

[00:30:58] Dr. Bryce Appelbaum: For sure. And, and so it... [00:31:00] This started off with kind of old school vision therapy- 

[00:31:03] Dr. Scott Sherr: Right ... 

[00:31:04] Dr. Bryce Appelbaum: which is kind of like physical therapy for the eyes, but really for the brain through the eyes, and with the right arrangement of conditions, raising to somebody's awareness how their eyes are pointing and focusing, and what it feels like and what it looks like when both eyes are working together, and the brain's turning onto that information, and we're perceiving depth, and then being able to reproduce that as we're adding movement and balance and cognition and vestibular input.

[00:31:25] Dr. Bryce Appelbaum: And then over time, and especially over COVID when we saw all these new profiles emerge from too much screen time and what that's doing to the functional visual skills and abilities, we've now created vision performance training more as a methodology in that it takes the best of vision therapy, vision training, orthoptics, sensory integration-based occupational therapy, even vestibular-based physical therapy, and some neurocognitive work, and kind of creates this hybrid model because vision doesn't operate in isolation of all these other systems.

[00:31:54] Dr. Bryce Appelbaum: Right. So we rely on, heavily on technology like Virtual reality, augmented [00:32:00] reality, eye tracking computers, also with very, very low tech things. But one of the coolest things with virtual reality, you know, we can have somebody wear a, a headset and adjust the oculars so their eyes have to converge a specific amount, or diverge a specific amount.

[00:32:14] Dr. Bryce Appelbaum: Mm-hmm, mm-hmm. Or they can oscillate, or we can adjust the brightness, glare, or contrast of one eye, or of both eyes, and then have somebody go through whatever game it is, chopping fruit, popping balloons, whatever it may be, get the data on the back end, adjust the settings so that next time they go in, it's at a higher level of demand.

[00:32:28] Dr. Bryce Appelbaum: Yeah. And we actually now have every single patient that we work with in office go into our customized VR platform at home. Okay. And so I'm buying way too many VR headsets e- every month. But it allows for almost a cross-training approach where learning can take place in a virtual world at home to support the three-dimensional work, two-dimensional work, and free space fusion work that's done in office to kind of allow this to integrate and become a part of that person faster.

[00:32:53] Dr. Scott Sherr: Mm-hmm. 

[00:32:54] Dr. Bryce Appelbaum: And typically what we're working with is, is people with significant functional vision problems. So eye turns, strabismus, [00:33:00] amblyopia, lazy eyes, visual developmental delays impacting reading, learning, and academics, headaches, eye strain, all those symptoms. But now we're working with so many people just for performance, and professional athletes in every sport imaginable, professional gamers, F1 drivers, Olympic athletes, and I really think we are getting to a point where training how our brain uses vision for performance is becoming the new sexy thing and something that we're gonna look back on this time now and recognize, wow, we didn't realize how powerful this was, but also this has been become a need now because of screen time and, and all the toxicity from the junk light, the screens, and just our environments that as humans we're not really equipped to handle yet without the right type of work.

[00:33:42] Dr. Scott Sherr: Yeah. Well beautifully said. I, what kind of came to mind as you were speaking is that all these longevity clinics are popping up all over the world now, but vision is not a part of these so far, right? Right. We're talking about optimizing your body, you know, your heart, your lungs, you know, your kidneys, et cetera, but not really talking about the eyes so [00:34:00] much, Bryce.

[00:34:00] Dr. Scott Sherr: I guess that's why you're in this world and starting to change that conversation. 

[00:34:03] Dr. Bryce Appelbaum: 100%. And we can help- athletes, executives, kids, not just look beyond biomarkers, but to then recognize when their eye-brain connection is of inefficient, it's creating this invisible limiter in terms of performance and ability to achieve at their potential.

[00:34:21] Dr. Bryce Appelbaum: Mm-hmm. And longevity, I mean, if we're ignoring vision and we're living to 150 or, or beyond, gotta be able to see shit to be able to still live happily and consciously. So tha- that's- Yeah ... uh, a big piece of the puzzle. 

[00:34:35] Dr. Scott Sherr: No, I, I love that because we all get so myopic on some level, and a dif- a way of different using or obtuse or whatever.

[00:34:42] Dr. Scott Sherr: Like, I'm looking at various things, like longevity as a word too kinda drives me crazy because it's like you wanna live long, but if you can't do X, Y, Z, then why do it, right? The idea is really health span, and health span includes, I guess, eye span or eye vision span or whatever- Yeah ... you wanna call it.

[00:34:58] Dr. Scott Sherr: Something like that. You have to find a word that [00:35:00] works there, but it's, it's close. Well- Eye span maybe? I, I 

[00:35:02] Dr. Bryce Appelbaum: would- ... uh, we, we, we talk about visual intelligence. We talk about- Okay ... you know, just having an eye-brain connection that is optimized. Yeah. And if the eyes aren't functioning properly, the rest of the system works so much harder to compensate.

[00:35:13] Dr. Bryce Appelbaum: Yeah. And- 

[00:35:14] Dr. Scott Sherr: I got it, yeah ... 

[00:35:15] Dr. Bryce Appelbaum: you know, beyond labs and biomarkers, how your brain receives and then responds to your environment, vision is the gateway for that, and that is longevity, right? Yeah. Like- Yeah ... avoiding falls because you can trust what you see. 

[00:35:26] Dr. Scott Sherr: Right. Right. Yeah. Right? Like- You, you were talking about the, the vision...

[00:35:29] Dr. Scott Sherr: Uh, you're talking about the motion sensitivity and vestibular things. I see that a lot in older people, right? Their vestibular system is just not as optimal, optimized because they're not going on, you know, going on the, the playground and not swinging on something and, and things. Uh, that must be a big piece of integration, I would imagine, is, is the vestibular system.

[00:35:47] Dr. Bryce Appelbaum: 100%. And then also not seeing the change in elevation with a t- a tree root coming over or a curb that you have to step down. Yeah, yeah. 

[00:35:55] Dr. Scott Sherr: And, 

[00:35:55] Dr. Bryce Appelbaum: you know, we get to a point where we often, vision often declines as we age, cognitive [00:36:00] ca- capacity drops as we age. Those are common. That's not normal though, right?

[00:36:03] Dr. Bryce Appelbaum: Right, right. And so to be able to get to a point where your visual midline and your body midline are coincident with each other, and- 

[00:36:11] Dr. Scott Sherr: Hmm ... 

[00:36:11] Dr. Bryce Appelbaum: your internal GPS system and the roadmap of life is allowing you to engage and navigate confidently, I mean, that avoids a lot of bad stuff from happening, but also helps different areas of our brain communicate- Where we now see changes with dementia and Alzheimer's that is directly related to how we, how we perceive the world.

[00:36:33] Dr. Bryce Appelbaum: Mm-hmm. And our spatial relationship, and that's measurable, and it's treatable. And very often, I mean, uh, there's a lot coming out about with hearing issues, how that can- 

[00:36:42] Dr. Scott Sherr: Yeah. No, those are big. Yeah ... you 

[00:36:43] Dr. Bryce Appelbaum: know, contribute to cognitive decline. Same with vision, and I would actually say it's even more profound with vision, and that's not just- 

[00:36:48] Dr. Scott Sherr: Do you think there...

[00:36:49] Dr. Scott Sherr: You know, has that been studied? Is, has vision been associated or d- declines in vision associated with dementia and Alzheimer's as well? 

[00:36:55] Dr. Bryce Appelbaum: Ab- absolutely. Okay. Yeah. And especially knowing that, you know, navigating space is one [00:37:00] of the earliest signs of, of Alzheimer's. Like, we now know that there's certain changes that happen in the retina and in the lens that are very consistent with changes that show up in imaging with people that have advanced stage disease.

[00:37:11] Dr. Bryce Appelbaum: Mm-hmm. And that spatial reasoning, that navigating the surroundings, and, you know, somebody who's in the parking lot, and they're like, "Oh my God, where did I park my car?" You know, that's just not you're getting older. That is, you know, you're not having meaningful experiences, and you're not connecting the dots in terms of movement and cognition and vision and the task that you're going to the store or whatever to, to help try and accomplish.

[00:37:33] Dr. Scott Sherr: Well, cool, man. I'm gonna ask you some rapid-fire questions. Are you ready? 

[00:37:35] Dr. Bryce Appelbaum: Hit me. Let's 

[00:37:36] Dr. Scott Sherr: do it. I'm gonna do a couple of these at the end here. So this is a good one, I think. The first question, and you can keep these relatively short, but if you wanna elaborate a little bit, you can, of course. 

[00:37:43] Dr. Bryce Appelbaum: I can rant if I want to?

[00:37:44] Dr. Scott Sherr: You can rant, of course. So- I'll try not to The first one, functional vision, vital sign or performance metric? 

[00:37:50] Dr. Bryce Appelbaum: Both. But for sure, performance metric. 

[00:37:52] Dr. Scott Sherr: So do you think it should be one of our vital signs that we use, like, for, you know, recognition? 

[00:37:55] Dr. Bryce Appelbaum: 1000%. Every practitioner, if you're not [00:38:00] looking at or even considering vision, you're me- you're leaving a massive piece of health, longevity, happiness still on the table.

[00:38:07] Dr. Scott Sherr: So this is a screen time question. So one large monitor or multiple monitors? Does it matter? 

[00:38:11] Dr. Bryce Appelbaum: Bigger the screen, the farther away the better. 

[00:38:13] Dr. Scott Sherr: Okay. 

[00:38:13] Dr. Bryce Appelbaum: And so what I would say is for most people it's not the screen, it's, it's the habits associated with the screens. 

[00:38:20] Dr. Scott Sherr: Okay. 

[00:38:20] Dr. Bryce Appelbaum: Taking vision breaks, as simple as that sounds, letting the visual system disengage even for a few seconds, looking off at the 

[00:38:26] Dr. Scott Sherr: dis- Yeah, you should just, like, look, look, just look in the distance for, like, five or 10 seconds off your screen, right?

[00:38:30] Dr. Scott Sherr: Just go... Right? Yeah. 

[00:38:31] Dr. Bryce Appelbaum: A- and ideally a movement break, ideally getting up. Of course. But, you know, I, I would say in general, you know, the bigger the screen, the farther away the better, and then if you need to have multiple screens, great, but then have your work set up where you've got the right performance lenses in place if needed, and you've got the right contrast and brightness and glare set up, and you've got the fingerprints wiped off, and you're remembering- Yeah

[00:38:54] Dr. Bryce Appelbaum: to blink as you're doing. I mean, all the things that are simple, but when they add up, have a cumulative effect. 

[00:38:58] Dr. Scott Sherr: I love, I love that. Okay. And so th- [00:39:00] then that's sort of my n- my next question is what do you recommend from a break? So you've talked about maybe 20/20/20 before. Others, what do you think is the best way to break from screens in general?

[00:39:09] Dr. Bryce Appelbaum: So I think for an adult who's on screens all day long, and the average American adult is seven hours and four minutes a day on a screen- 

[00:39:16] Dr. Scott Sherr: I'm under that amount probably. 

[00:39:16] Dr. Bryce Appelbaum: And that's, the number's way higher than that. Yeah. But that's at least what's reported. 

[00:39:20] Dr. Scott Sherr: Yeah. 

[00:39:20] Dr. Bryce Appelbaum: So I would say 20/20/20 is the absolute maximum.

[00:39:24] Dr. Bryce Appelbaum: So at least every 20 minutes, taking a break for at least 20 seconds, looking at something at least 20 feet away. And honestly, just setting an alarm on your phone. Yeah. Or having some annoying, like, sticky note on your screen. Every time you look at it, you remember, "Okay, I gotta get up and look away." 

[00:39:35] Dr. Scott Sherr: Yeah, yeah, yeah.

[00:39:36] Dr. Bryce Appelbaum: I, I think that is, that is huge. But having balance, right? I mean, it... Having conversations in real space and recognizing that engagement with somebody on a screen is very different than engaging in the real world. I just gave a training last week on how to visually enhance your Zoom setup. Okay. And even, like, minimizing the screen sometimes or making a black screen, and I, I know how to [00:40:00] soften my gaze, I know how to relax my focus, I know how to diverge my eyes, so I can have a screen in front of me but not really be engaging with it.

[00:40:07] Dr. Bryce Appelbaum: Okay. And so from that standpoint, if I'm doing Zooms all day long, like it's not impacting me. But then having the blue light filters, having the right type of therapeutic lenses that change how your brain engages with visual stress, I mean, that's something we prescribe for everybody. And it's different for some people, rather than this kind of consistent weakest lens that gives the most improvement.

[00:40:27] Dr. Bryce Appelbaum: But- Yeah ... there's a lot that can be done with lenses and prism to help support brain performance over time through vision. 

[00:40:33] Dr. Scott Sherr: What is the... Okay, Mike's next question here is, um, best sport for developing functional vision? 

[00:40:38] Dr. Bryce Appelbaum: Any type of racket sport. Okay. Tennis, paddle, ping pong. And, and there are studies about, you know, I think it's tennis is the number one sport for longevity because you're getting the cross-cerebral communication.

[00:40:50] Dr. Bryce Appelbaum: Sure, sure. You're having vision guide movement, you're applying vision to fast-moving space, you're making interpretations not just on where the ball is, but where it's going to be, and you're active and moving. So any type of [00:41:00] racket sport I think is definitely number one. 

[00:41:01] Dr. Scott Sherr: The most overrated vision biohack?

[00:41:03] Dr. Bryce Appelbaum: The silly stuff you see on the internet about sunning and palming, and do those and you'll never need glasses. 

[00:41:10] Dr. Scott Sherr: Palming. Believe- What is palming? Is like putting your eyes like... What is that? What does 

[00:41:12] Dr. Bryce Appelbaum: it do? So palming is actually like a good technique to help relax your, your nervous system through vision.

[00:41:18] Dr. Bryce Appelbaum: And so it's- Okay ... rubbing your hands together, creating some heat, putting your elbows on the table, blocking out all light. 

[00:41:23] Dr. Scott Sherr: Okay. 

[00:41:24] Dr. Bryce Appelbaum: And then kind of doing some deep breathing and, and- Okay ... kind of looking at... So you're, you are- Okay, 

[00:41:28] Dr. Scott Sherr: that's palming. Okay ... 

[00:41:29] Dr. Bryce Appelbaum: there's a lot that can be done for that. But there's very well-known doctors that we know together who will talk about, "Oh, I just, I start looking at the sun and I do my palming every day, and I don't need my glasses anymore."

[00:41:41] Dr. Bryce Appelbaum: And I would just say, if it's that simple, everybody would do it and none of us would be wearing glasses. And I'm not anti-glasses, but doing specific vision exercises based off of science and with the right expectations in place, that is really what we need to be doing. 

[00:41:54] Dr. Scott Sherr: Okay, cool. Okay, and then what is the strangest vision exercise that actually works?

[00:41:59] Dr. Scott Sherr: What are the stranger ones that you [00:42:00] do? Ooh, 

[00:42:00] Dr. Bryce Appelbaum: we do some strange things. Um- 

[00:42:01] Dr. Scott Sherr: I know. I figured you did, yeah. 

[00:42:03] Dr. Bryce Appelbaum: I, I, honestly, what we've been talking about the most is, is eye push-ups. Okay. And most people hear this and they're like, "What are you talking about here?" Yeah. I can confidently say if you do eye push-ups every day and you do them right- As an adult, you will not need stronger reading glasses, period.

[00:42:20] Dr. Scott Sherr: Okay. 

[00:42:20] Dr. Bryce Appelbaum: Yet- 

[00:42:20] Dr. Scott Sherr: Describe- 

[00:42:21] Dr. Bryce Appelbaum: Most- 

[00:42:21] Dr. Scott Sherr: Describe what these push-ups are. So, 

[00:42:23] Dr. Bryce Appelbaum: so eye push-ups. So cover up an eye with a hand. 

[00:42:25] Dr. Scott Sherr: Yes. 

[00:42:25] Dr. Bryce Appelbaum: And stick a thumb up like you're giving somebody a thumbs up. Yeah. Look at your nail. Slowly bring that nail towards you, as close as you can until it gets a little blurry. Then when it gets a little blurry, stop.

[00:42:33] Dr. Bryce Appelbaum: Okay. Make it clear. Think about looking hard, locking in your focusing system. Uh. Visualize your pupil getting really tiny. Hold it for five seconds, then look out into the distance for five seconds. And then back at your thumb for five seconds. 

[00:42:44] Dr. Scott Sherr: Like if I'm ... That's without ... If you're not the same looking at your thumb when you're looking in the distance, you- 

[00:42:47] Dr. Bryce Appelbaum: So you're

[00:42:47] Dr. Bryce Appelbaum: It's a gross stimulation, relaxation. Stimulation, 

[00:42:51] Dr. Scott Sherr: relaxation. Right, so you're trying to find ... And then, then you're going further than ... How often, how, so how long are you, you doing the actual- So 

[00:42:55] Dr. Bryce Appelbaum: you wanna do it the same amount of time right eye as you do left eye. 

[00:42:58] Dr. Scott Sherr: Sure. 

[00:42:58] Dr. Bryce Appelbaum: And most people notice one [00:43:00] of their eyes can hold the thumb a little closer than the other- Yeah, yeah, I can definitely

[00:43:02] Dr. Bryce Appelbaum: which means you're focusing your eyes at different planes. But think about this. You do this every day. Let's say you can get that thumb a millimeter closer after a week. 

[00:43:09] Dr. Scott Sherr: Yeah, yeah. 

[00:43:09] Dr. Bryce Appelbaum: Millimeters add up to centimeters. Centimeters add up to inches. Inches add up to more. And the people who discount vision exercises in general, or these even, they're the same people that say normal exercise doesn't work.

[00:43:20] Dr. Bryce Appelbaum: Yeah. Right? Like- Okay ... it works. You gotta do the right stuff for the right reason. So saying, "I'm gonna do 100 jumping jacks to lose 100 pounds," probably not gonna happen. 

[00:43:28] Dr. Scott Sherr: Sure. 

[00:43:28] Dr. Bryce Appelbaum: But eye push-ups in general for our focusing system, they move the needle. They're not that sexy- Okay ... and they're a little weird, but you do it.

[00:43:36] Dr. Bryce Appelbaum: You'll s- Try doing it for a minute each eye. Give yourself a week, and I can promise something's gonna be different, and for some people, massively different. 

[00:43:45] Dr. Scott Sherr: Yeah, then add a, a little bit of red light, add a little methylene blue. Doing all these other things, of course, right? And then all of a sudden you're gonna be- Yeah.

[00:43:50] Dr. Scott Sherr: And 

[00:43:50] Dr. Bryce Appelbaum: maybe ScreenFit and some other things- Maybe ... where you can actually- 

[00:43:53] Dr. Scott Sherr: Yes, exactly ... take a 

[00:43:53] Dr. Bryce Appelbaum: larger lunge forward. 

[00:43:55] Dr. Scott Sherr: Yeah, exactly. And that's ... That, that was gonna be my sort of wrap-up. I know you have a lot of things going on, Bryce, and [00:44:00] not everybody can get to your office. I know you have, like, an online program as well, and I think that's what ScreenFit is.

[00:44:04] Dr. Scott Sherr: Is that right? 

[00:44:04] Dr. Bryce Appelbaum: Yeah, ScreenFit is a online vision training program designed to teach the specific visual skills and abilities needed for life. So it's kind of like doing body weight work instead of going to the gym. Not everybody has access to a gym, so you can do stuff at home. Sure. ScreenFit has turned into an animal.

[00:44:18] Dr. Bryce Appelbaum: We've had thousands of people go through it, as young as five, as old as 89, with 100% of people who have finished the first course seeing a reduction in symptoms. 

[00:44:26] Dr. Scott Sherr: Hm. That's amazing to 

[00:44:27] Dr. Bryce Appelbaum: hear. And it's one of these things where, you know, it sounds a little too good to be true in many cases, and so it's probably not gonna straighten an eye turn if you have one.

[00:44:34] Dr. Bryce Appelbaum: But if you're noticing- Sure ... just tired, strained, blurry eyes after- a workday or after a certain amount of time, this develops broad foundational tools that help support stamina and productivity over time through vision. 

[00:44:48] Dr. Scott Sherr: You're not talking about hours and hours a day of doing training either, right? Te- 

[00:44:51] Dr. Bryce Appelbaum: 10 minutes a day.

[00:44:52] Dr. Bryce Appelbaum: Yeah. It's one new lesson a day. It's not more screen time to treat screen time. It's a video of me describing an exercise. You put it down, and then you [00:45:00] do it, and it's actually being turned into an app right now, and the- Oh, good ... the one piece that we're trying to navigate intentionally is we don't want this to be more screen time.

[00:45:09] Dr. Scott Sherr: Right. No, that's what I was about to say. It's kind of a challenge there, you know, if you 

[00:45:12] Dr. Bryce Appelbaum: don't- So w- 

[00:45:12] Dr. Scott Sherr: Yeah ... 

[00:45:13] Dr. Bryce Appelbaum: we haven't figured that out, the, in terms of the exact positioning, but it's, it's just more robust with more work. That can only help. 

[00:45:19] Dr. Scott Sherr: Cool. Well, of course, we just scratched the surface, as we usually do, Bryce, with these kinds of conversations.

[00:45:24] Dr. Scott Sherr: But it's always good to see you and, and hear what you're up to. If you could just give a rundown of everywhere people can learn about your work and what you're doing. I know you're in Maryland and have some clinics there, but, um, obviously you have the virtual stuff too, so- Yeah ... run it all down. Give it all.

[00:45:38] Dr. Bryce Appelbaum: Appreciate that. So My Vision First is, is the, the clinic, and we, a, a lot of what we do is housed under that, so just myvisionfirst.com. Screenfit.com is our online vision training program, and absolutely want to give your audience a massive discount there, so let's include that. 

[00:45:52] Dr. Scott Sherr: We will. 

[00:45:53] Dr. Bryce Appelbaum: And then social media also is, is a big avenue for us, especially Instagram.

[00:45:57] Dr. Bryce Appelbaum: We're constantly just putting out content, sharing different [00:46:00] exercises for certain types of conditions, and that's Dr. Bryce Appelbaum. But my ancestors made life really hard for us, and, and Appelbaum is not spelled like the fruit. It's A-P-P-E-L, not L-E, just 'cause they wanted to keep us on our toes. But other than that- Yeah

[00:46:13] Dr. Bryce Appelbaum: you, you'll find us on there. And so appreciate this opportunity to educate and empower your community, and love the tidal wave you're creating with not just mitochondrial health and methylene blue, but also now nervous system regulation. I mean, there's such synergy a- and love to see you just casting a wider net for the, the amount of people you can support and help.

[00:46:34] Dr. Scott Sherr: Thank you, sir. Yes, uh, my name used to be long and Russian before I came over to the United States. That's what we found out many years ago. So- What, what was 

[00:46:41] Dr. Bryce Appelbaum: it before, sure? 

[00:46:42] Dr. Scott Sherr: It was, I think it was Usarenko. It was with a U, uh, something like, something like that at least. Yeah. I'm not exactly sure. But it, it's all good.

[00:46:49] Dr. Scott Sherr: And look, I really appreciate all the work you're doing, Bryce. I know you are doing a lot to get the word out there about vision and what we can do about it. Um, you're not, you know, it, it's not a, not a sentence to need reading glasses, which is a big thing you told me a [00:47:00] while ago. I just have to start doing the exercises.

[00:47:01] Dr. Scott Sherr: Maybe I'll start doing them now because I'm starting to realize, you know, and now- Your 

[00:47:05] Dr. Bryce Appelbaum: arms aren't long enough? 

[00:47:05] Dr. Scott Sherr: What? Yeah. No, my, no, my arms are long enough still. Let's keep going. But no, not quite. But, um, look, and un- until we see each other again, thank you, uh, for being here. I just wanna thank everybody for listening to the Health Optimization Medicine podcast.

[00:47:16] Dr. Scott Sherr: If you liked this episode, don't forget to like and subscribe, share with your friends and family, and we'll see you next time.
Find more from Dr. Bryce Appelbaum:

Website: https://myvisionfirst.com/
ScreenFit™: https://screenfit.com/
Instagram: https://www.instagram.com/drbryceappelbaum/
Get $200 off ScreenFit™ using code SNH at https://screenfit.com/enroll
Get 10% off Digital Performance Lenses using code SNH at https://shop.myvisionfirst.com/