Functional Blepharitis, Dry Eye, MGD Treatment with Dr. Kambiz Silani
Recently, we interviewed Dr. Kambiz Silani, a second generation eye care professional who grew up in LA and spent his childhood going to eye care trade shows. His family has been in the eye care field for over 50 years. He attended the University of California, Los Angeles (UCLA) as well as Western University of Health Sciences to receive his optometric education, where he also focused his studies on ocular nutrition, innovative ophthalmic technologies, and ocular disease. During his training, he worked alongside world-renowned vision scientists, retinal specialists and refractive surgeons. His passion for the profession is seen in various publications, while he lectures, and over social media.
He proudly runs one of the top optometric practices in Los Angeles and built a premier dry eye center featuring a number of A-list celebrities, corporate executives, and royal family members. In the optometric community, he is an influencer, thought leader, consultant and speaker for a number of well-known eye care companies including Johnson & Johnson, Visionix, Lumenis, Tear Film Innovations, Oculus, and others. In this interview, we get into his typical dry eye protocol, how nutrition plays a role in healing dry eye disease, and we answer your dry eye questions.
I will put some of the great talking points below, but tune in to the whole video.
Treating Dry Eye With Functional Medicine
When you come into Dr. Silani’s office, you’ll first fill out a SPEED or OSDI questionnaire to assess where you are in your symptoms. These are important because they allow us to not only see where you’re starting from, but we also get to watch your progress over time. Tear volume and quality is always evaluated, as well as evaluation of the oil glands within the eyelids. Each patient is also asked about lifestyle factors such as cosmetic use, sleep, diet, hydration, and more. Diving deep into home routine and environment allows the doctor to immediately eliminate some of the things that may be contributing to the issue, and maximize their treatment protocol.
Of course, steroid eye drops and other pharmaceuticals have their place in dry eye treatment, but they don’t necessarily need to be the starting point unless the eyes are acutely red and inflamed.
How Diet Plays a Role
First of all, seek out cleaner products both in cosmetics and in food. Stay away from pesticides and other additives. If you wish to eat meat, go for grass-fed and grass-finished meat - essentially, make sure the meat you’re consuming has been grass-fed its entire life and not just ¾ of the time. For fish, wild caught, smaller fish (sockeye salmon vs. king salmon) is the way to go. And overall, consuming a high fat, low inflammatory, low grain, high vegetable diet with lots of colorful fruits and vegetables ensures that you’re getting the polyphenols your eyes need. Cilantro is a great chelator for toxins, and glutathione (IV or orally) may be helpful as well.
Additionally, consider working with a functional medicine doctor alongside your optometrist or ophthalmologist. They can help to optimize diet and other factors in your life, testing for food sensitivities, taking stool samples as needed, and performing other testing that may not be a part of Western medicine.
A Place for Advanced Treatment
Cleaning of the Lid Margins - BlephEx or Zocular Zest
These remove bacteria, demodex, and biofilm. This is recommended 2-4 times per year.
Heat Modalities - LipiFlow, TearCare, iLux
These clear the stagnant oils out of the glands and may be combined with meibomian gland expression or not.
Light Therapy - IPL
IPL helps to decrease inflammation of the skin and eyes, working well for those with MGD and ocular rosacea. Most patients benefit from four sessions, 2-4 weeks apart. Maintenance is done 2-4 times per year.
27:25 - Tina Capello-Silvestri - What causes your glands to atrophy?
28:55 - Pamela Matousek - I understand the need for low inflammation foods. What do you do when your intestinal track doesn’t tolerate green leafy vegetables but seems to prefer grains (even white) to salads, beans and a lot of the healthy foods?
31:40 - Sue Mancione - Have they ever successfully reversed dry eye disease and how does stress play a role in healing?
33:04 - Louise Budowski Cook - What kind of testing should be done and what should we be looking for as causes and treatments outside of just looking at the eyes?
33:45 - Pam Kirby - Is there a correlation to dry eyes and high cholesterol? What are non statin options to treat high cholesterol?
34:30 - Kim Lehman Johnson - How does gut health correlate to dry eye?
34:57 - Jo Logan - How far away is a cure?
36:05 - Stacey Schofield - 1. Is there a cure for SIBO (small intestinal bacterial overgrowth)? Also can it be caused by taking too many probiotic supplements? Does SIBO affect dry eyes?
37:33 - Tracy Tulloh Galloway - Has he been able to get the meibomian gland oil from a toothpaste/sludge consistency to olive oil? What did it take to get this done? What is the protocol?
38:10 - Tracy Tulloh Galloway - Ocular rosacea...has he been able to put this into remission and if so, how?
39:17 - Cristy Patterson - Is it healthy to do gland expressions every 3 months?
39:53 - Pam Staerker - What is their protocol for aqueous deficient dry eyes?
41:18 - Tracy Tulloh Galloway - What does he recommend for supplements for dry eye/mgd?
41:46 - Tracy Tulloh Galloway - How does one supply nutrients to the cornea with lack of tear production? Special drops?
42:50 - Kim Taylor - Hormones? Estrogen or no estrogen?
43:40 - Yashwanth Chakka Plz - What are some natural/functional ways to regrow shortened glands?
44:29 - Yashwanth Chakka - Is it true that shortened glands produce less oil than larger straight glands?
44:37 - Anne Wagner - What are the most typical reasons for foreign body sensation ?
45:33 - Karen L. Torgerson - How does mold spore toxicity affect the eyes? Just the usual? (inflammation)