Natural Blepharitis and Dry Eye Treatment with Dr. Rudrani Banik
We just had an inspiring interview with Dr. Rudrani Banik, a functional medicine doctor and neuro-ophthalmologist. She offers a unique approach to managing conditions such as dry eye, macular degeneration, blepharitis, migraine, multiple sclerosis, myasthenia gravis, thyroid eye disease, uveitis, and other autoimmune conditions. In this interview, we get into how you can heal your body naturally, and we touch on simple things you can do to ensure a lifetime of great health for both you and your children.
I will put some of the great talking points below, but tune in to the whole video below.
Treating Dry Eye Disease with Functional Medicine
While some patients suffer from aqueous deficient dry eye and do not produce enough tears, it is well known that the majority of patients have evaporative dry eye, meaning that the surface layer of their tear film is unstable. When first examining someone, Dr. Rani stresses the importance of examining the tear film and glands of the eyelids. Using meibography (such as LipiScan) is a great way to paint a picture of those glands and find out what you’re truly dealing with. After that, it’s important to dive into what may be causing this condition in the first place. What is going on systemically? Are there other medical conditions? Often, patients will have other underlying conditions that could be contributors (such as Lupus, Sjogren’s, inflammatory bowel disease, rheumatoid arthritis, and others). Supporting these conditions can help decrease the symptoms and signs that come along with dry eye disease.
Essential oils can be a great adjunct to any treatment plan, keeping in mind that these
oils cannot be applied directly to the eyes. Tea tree essential oil and lavender oil can be effective remedies for stabilizing the tear film when used in a diffuser. If there is evidence of stagnant oil in the meibomian glands, or MGD, Dr. Rani will recommend warm compresses, lid massage, and LipiFlow.
The Importance of Nutrition
From various studies, we know that omega-3 fatty acids are wonderful for the eyes. Because our bodies don’t make omega-3s, these are often more readily discussed. However, it’s important to ensure that you’re getting the proper ratio of omega 3, 6, and 9 in order to properly heal. For example, omega-6 fatty acids are pro-inflammatory and can lead down a path of disease and even autoimmunity. In the US, the vast majority of people have a very high omega-6:omega-3 ratio, meaning they’re just not getting enough anti-inflammatory omega-3. Obviously, eating fish is the best way to up your ratio - wild caught salmon, mackerel, anchovies, and sardines can be a great addition to your diet. If you’re not into fish, there are plant based sources of omega-3s as well, which include algae oil, chia seeds, and flaxseeds.
Oils in your kitchen can be problematic as well. Common pro-inflammatory oils such as canola, vegetable, and soybean oil should be replaced by organic avocado, olive, almond or coconut oil.
If there is autoimmunity present, probiotics would be recommended to support the gut. If you can, it’s best to get probiotics from food sources vs. taking a supplement. Fermented foods such as kimchi, sauerkraut, and low-sugar kombucha can be great sources. And make sure to mix it up! Don’t eat the same thing every single day so your gut gets exposed to different strains of probiotics.
The Cornerstone of Health
Intaking an adequate amount of healthy food is really the cornerstone of total body health. Oxidative damage is responsible for most of the age-related changes in our bodies, including in our eyes. Oxidative damage has been linked to cataracts, glaucoma, macular degeneration, and potentially dry eye disease. Dr. Rani recommends a plant rich diet which includes tons of antioxidant foods each day. One does not necessarily need to be vegan or vegetarian to do this and get the proper amount of antioxidants, but it is important to make sure you’re getting lots of different colors of fruits and vegetables each day.
Like with probiotics, if you mix it up and eat different antioxidant-rich foods each day, you’ll cover your bases more thoroughly. Our eyes need vitamin A, vitamin C, glutathione, lutein, zeaxanthin, and astaxanthin, among other vitamins and antioxidants, and the best way to get these is to vary what you’re eating. Eating a variety of shades of green (spinach, chard, kale, avocado, broccoli), orange (peppers, carrots), yellow (peppers), red (strawberries, goji berries), blue, purple, and black (blueberries, blackberries) each day is key to a healthy life.
An easy way to think about this is that we generally eat 21 meals per week, so try to eat a different color with each of these meals. Simple as that!
Astaxanthin - The Most Important Antioxidant?
Astaxanthin comes from a marine source of algae which live in very harsh conditions, so the plant must create astaxanthin in order to protect themselves from the harsh climate they live in. This antioxidant has a red pigment, and certain types of salmon, trout, and shrimp will exhibit this natural coloring as well due to ingesting this antioxidant. Astaxanthin is known to help maintain the health of the retina and the eyes in general, and it’s important we get this antioxidant on a daily basis.
Supplementation for Eye Health
Although Dr. Rani doesn’t recommend supplements very often, she does recommend compounded eye drops. A few of the drops she prescribes regularly are acetylcysteine eye drops and vitamin A eye drops. These can be very effective! In addition to this, methylprogesterone drops may be beneficial for balancing the ocular surface.
If someone is interested in supplementing, Dr. Rani recommends supplements rich in alpha lipoic acid (ALA) and reduced glutathione. However, most nutrients and antioxidants can be easily ingested through food in a plant rich diet, and our bodies respond better to this.
Multivitamins should supplement an already healthy diet, so using one every single day just isn’t needed. If you’d like to use a greens powder in your smoothie, this can be a great addition and is fine to use daily.
Blue Light - The Controversy
Blue light is the most controversial subject in the eye care space lately, and for good reason. Blue light blocking technology is everywhere, including in your eye doctor’s office, yet do you really need to be worried about it? Truly, there is no scientific evidence at this time to show that blue light will damage your retina.
There are different wavelengths of blue light (between 400-500nm), and the majority of blue light comes from the sun. Very little blue light is emitted from our digital devices, but being on them all day will contribute to eye fatigue, dry eye, and eyestrain. For digital eye strain, use the 20-20-20 Rule, meaning every 20 minutes, take a break, close your eyes, or look 20 feet away from your computer for 20 seconds.
However, blue light does have the ability to disrupt the circadian rhythm, meaning that it can disrupt your sleep. If you’re being exposed to a ton of blue light later in the day, it will be hard for you to fall asleep. Try blue light blocking glasses, screen filters (both for computer and smartphone), or stay off your phone two hours before bed. Additional tips for better sleep include using black out curtains and red night lights (if you use them).
Vision in Children
With this being the digital device era, children are spending more and more time in front of screens. There’s really no avoiding it these days. We know that there is an increased risk of myopia (nearsightedness) when children aren’t spending enough time outdoors. This is becoming an epidemic in Asian countries, and it can possibly be avoided.
Make sure that you’re encouraging your children to be outside, ground their feet, play in the dirt, and take in that sunshine. Also, your kids watch what you eat and do. If you teach them to eat properly right now, they will take those lessons with them into adulthood.
Hydration is key as well, so make sure your children are drinking pure water on a daily basis. Get them used to drinking it and asking for it!
Transcription of the Video
2:25 - Dr. Rani introduces herself and explains how personal experiences propelled her from the traditional ophthalmological world into the world of functional medicine, allowing her to heal her own body as well as that of her patients.
6:43 - How Dr. Rani naturally treats dry eye disease, what her typical treatment plan looks like...after determining which form of dry eye disease the patient has, Dr. Rani may recommend essential oils, warm compresses and lid massage, and LipiFlow. In addition to this, nutrition can be incredibly important.
9:25 - How does nutrition affect the eyes? We discuss how important it is to have the proper omega 3-6-9 ratio, how to increase your intake of omega-3 fatty acids through diet, and which oils you should replace in your kitchen.
12:00 - Probiotics for autoimmunity - importance of getting probiotics through foods vs taking a supplement. Sources of probiotics are discussed, as well as how to mix it up.
14:00 - The number 1 step people should take for health in general, from Dr. Rani
17:00 - Why Astaxanthin may be the most important antioxidant for eye health.
19:00 - Which specific foods to eat so that you’re “eating the rainbow” - why being flexitarian and plant-rich is best. How is this attainable? What do you need to focus on?
26:55 - Supplements that Dr. Rani recommends
29:40 - Dr. Zigler and Dr. Rani discuss blue light - is it good for you or bad? And what you can do about it…
37:00 - Dr. Rani gives tips on how to protect the vision of your children, starting today. Eating well, grounding, outside play, and hydration are all so important.
41:20 - How you can connect with Dr. Rudrani Banik!
Who is Dr. Rudrani Banik?
Rudrani Banik, M.D. has specialized training in Functional Medicine. She applies principles of complementary and alternative medicine in conjunction with traditional medical approaches to treat chronic diseases affecting the visual system. She offers a unique approach to managing conditions such as dry eye, macular degeneration, blepharitis, migraine, multiple sclerosis, myasthenia gravis, thyroid eye disease, uveitis, and other autoimmune conditions.
She is the founder of Envision Health NYC, a private practice based in New York City. She is an award-winning Associate Professor of Ophthalmology at Mount Sinai Icahn School of Medicine and also serves as principal investigator for 5 multi-centered clinical trials in neuro-ophthalmology. Dr. Banik is a member of the American Academy of Ophthalmology’s Exam Development Committee and helps to set the standards for board certification in her field. She is sought out as an expert in the media and has been featured in The New York Times, Good Morning America, CBS Evening News, ABC 7 Eyewitness News, CBS NY with Dr Max Gomez, Fox 5 News with Ernie Anastos, NY Magazine’s Best Doctors 2017, 2018, and 2019, The Washington Post, New Tang Dynasty TV, and Real Simple Magazine. She was voted Castle Connolly Top Doctor 2017, 2018, and 2019 by her peers.